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Manual Version (ECV)

If nature and natural methods do not help your baby settle into a proper pre-birth position, you have a medical option at 37 weeks. The Manual Version or External Cephalic Version (ECV) is a medical procedure (we do not do them here!) used to guide your baby from breech or other non-headfirst presentation to headfirst (vertex). The medical doctor pushes on your baby through your abdomen, either creating a forward roll like a somersault or a back flip. Whether or not to do an ECV is a personal decision that you should make with your partner and your doctor. To help you make an informed decision, we offer a brief description of the procedure below. All information should be confirmed with your medical doctor.

Since all transverse babies and most breech babies are born by cesarean, moving the baby to cephalic presentation increases the chance of having a vaginal birth. Research has shown that offering ECV to all mothers with breech babies at 37 weeks gestation decreases the cesarean rate for that group of women. The success rate for rotating a baby to headfirst position appears to be about 65%. Many factors affect your individual chances of success including how close you are to your due date, how much fluid is around the baby, how many pregnancies you've had, how much your baby weighs, how the placenta is positioned and how your baby is positioned. For example, the procedure is more successful in women who have had other children, since the baby can move around more easily, than it is for a first-time mom whose baby sits low in her pelvis. We suggest the Webster technique immediately prior to an ECV so that we can try to relax your pelvic bones and muscles to create more room for the maneuver.

Like all procedures (including natural ones) the ECV is associated with possible negative side effects. Often the baby's heart rate will slow during or immediately after the version, especially when it is successful. The heart rate usually comes back to normal within a few moments, and there is no evidence that these short-lived heart-rate changes harm the baby in any way. In very rare situations, the heart rate stays slow long enough that practitioners will start the initial preparations for a possible emergency cesarean section. Although preparation is sometimes necessary, emergency C-sections are extremely rare under these circumstances.

While it's rare to have a serious complication of ECV, it may be uncomfortable or even moderately painful. You always have the right to stop the procedure for any reason. (Remember, it's your body!) If you can keep your abdominal muscles relaxed, you might be more comfortable and the procedure may be more likely to succeed. You may feel sore for a few days. Ideally, you will want a support person with you during the version, and you'll need someone to drive you home afterward.

The procedure usually is not done earlier than 37 weeks, since there is a remote possibility that the baby will need an emergency delivery as a result of the procedure--and you don't want to risk the baby being born that early if possible. Certain factors, such as premature rupture of the membranes, contraindicate the use of an ECV. Your doctor will tell you if you are a candidate for the procedure. Although the risk of complications is small, some doctors prefer not to try an external cephalic version.

Much of the information contained herein comes from familydoctor.org and drspock.com.


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  • "could barely walk at 9 months pregnant she worked a miracle! My 5 year old is so much better also. Plus when I noticed that the new baby always held her head to one side and had a problem breastfeeding on one side we went in. They were able to fix it and it became so much easier to breastfeed and the baby is so much happier."
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  • "I will shout it from the rooftop! This place has changed my life. I didn't even realize how much pain I was living with until Dr. D and Dr. J started my treatment. I'm so much more aware of my body and am nearly pain free. I'm stronger. I'm happier. I'm not self medicating anymore. They are miracle workers here! My heart is filled with gratitude."
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  • "I came to Dr. Dee with such back pain that I couldn't stand up straight and it was hard to walk and stand. I am a hair stylist and a single mother of six kids, I needed to be able to work and function. My doctor prescribed pain killers instead of trying to address the real cause of the problem. Chiropractic has given me my life back!! I couldn't live without Dr. Dee!"
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  • "I began care with Dr. Dee on May 30, 2015, after a car accident that left me with upper and lower back pain and neck pain. I was unable to lift my one year old grand-daughter and missed walking, hikes and taking exercise classes. I tried to control the pain with OTC medications and alternating heat and ice, but it just didn't get better. Chiropractic adjustments have given me back my mobility, reduced and eventually eliminated my pain and I'm able to do my normal activities!"
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  • "I was in a car accident in 2011 that left me with constant pain in my upper back and neck and it would become very severe at times. I lived day to day not knowing what I would be able to lift or accomplish at work. I did take physical therapy over the years and was prescribed muscle relaxants by my physician, but was open to another form of treatment, as it seemed these other things weren't working. Dr. Dee had restored most of my mobility and the pain is mostly gone!"
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