External Repositioning of the Baby during Pregnancy

What is external repositioning of the baby?

External repositioning of the baby is a procedure for changing a baby's position in the uterus before the baby is born. Usually it is done to turn a breech baby to a better position for delivery. In a breech position, the baby's bottom or feet will come out before the head when the baby is delivered. This is risky. The baby's head could get trapped in the mother's cervix (the opening of the uterus). Moving the baby to a position where the baby’s head will come out first may let you have a normal vaginal delivery.

The medical term for this procedure is external cephalic version.

When is it used?

If your baby is in a breech position, your healthcare provider may try to turn the baby to a head-first position after about 36 weeks of pregnancy. Your healthcare provider may determine the baby’s position by feeling your belly and finding the baby's head and bottom. You will usually have an ultrasound to check the baby's position.

What happens during the procedure?

This procedure may be done at a place where an emergency cesarean section (C-section) may be done if it becomes necessary.

Just before the procedure an ultrasound is done to confirm the position of the baby and placenta. A nonstress test is done to make sure the baby's heart rate is normal. You may be given medicine to relax your uterus. Sometimes the lower half of your body may be numbed with an epidural anesthetic.

You lie on your back. Your healthcare provider will put his or her hands on your belly and find the baby's head. Your provider will then gently press on your belly to push the baby into a headfirst position.

What happens after the procedure?

After the procedure you will have another nonstress test to check the baby. If the procedure was successful, you may be able to have a normal vaginal delivery.

If your healthcare provider is not able to turn the baby, he or she will talk to you about your choices for delivery. You will discuss the risks and benefits of delivering a breech baby vaginally compared with the risks and benefits of a C-section.

What are the risks associated with this procedure?

The baby could go back to the breech position before you go into labor.

Some of the potential complications of this procedure include:

• going into labor early
• early breaking of the bag of water
• damage to the placenta, which could cause part or all of it to tear away from the uterus before delivery
• the need for an emergency C-section if there is a concern that the baby may not be getting enough oxygen, usually because of a pinched or twisted umbilical cord

The likelihood of these complications is small. However, any of these problems can be very serious. For this reason, many healthcare providers prefer not to do external cephalic version.

When should I call my healthcare provider?

Call your provider right away if:

• You are leaking fluid from the vagina.
• You do not feel the baby moving.
• You have vaginal bleeding.
• You begin to have strong contractions.
• You have pain in your abdomen.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.