Following a letter from a very worried reader whose baby was in a breech position close to due date, we asked the Doctor & Daughter team about the practice of turning a baby through the tummy – does it hurt, is it dangerous and can it cause the onset of early labour?
First of all, it’s a good thing that the midwives and doctors have spotted that your baby is in a breech position. Surprisingly, about 1 in 4 breech babies are not diagnosed until labour, which often results in an emergency caesarean Section, just when you were hoping for a natural birth.
About 1 in 30 babies present bottom first in the last few weeks of pregnancy, and if they stay in this position, are most safely delivered by Caesarean section.
Sometimes, there is a reason for the baby remaining bottom first , and the midwives and doctors will do a careful assessment before advising on the best management. Occasionally, there may be something blocking the birth canal, like a low lying placenta, or a fibroid, an ovarian cyst , or even another baby! Or maybe the womb is an unusual shape or the baby just simply prefers life upside down!
Providing there is no other complication, it is normal practice to recommend turning the baby , through your tummy (external cephalic version ECV)
This is normally performed after 36 weeks, in the hospital , and is designed to reduce the chances of your baby remaining as a breech , and therefore reduce the chances of a planned Caesarean Section.
It is successful in about 50% of the time, with success rates higher in second pregnancies, and also if drugs are used to relax the uterus.
It has a very low risk of complications (less than 1 in 200), but is safest performed in hospital , just in case.
Very occasionally, it may provoke bleeding, or labour or disturb the placenta, and emergency treatment may be needed. However, all the studies show, that there is no extra risk of losing a baby, or of brain damage. It is clear that the benefits appear to outweigh the possible risks and ECV is now considered part of normal practice.
But, as ever, it is always your choice, so do listen carefully to your doctor and midwife.
The procedure is usually a little uncomfortable and occasionally has to be abandoned if it’s painful or distressing. The baby is always monitored carefully afterwards.
It is not recommended if there are other complications, such as bleeding, preeclampsia, twins, reduced amniotic fluid, or if a Caesarean is planned for another reason.
Your midwife may suggest some exercises to encourage the baby to turn , or suggest burning Moxibustion at the tip of your fifth toe. But there is very little scientific evidence to support either practice.
Interestingly, even if ECV is successful, about 1 in 20 turn back by themselves, so you may still need some extra care in labour.
So the answer, probably YES, but do ask all the right questions.
The Doctor and Daughter’s Guide to Pregnancy