External cephalic version (ECV)

An external cephalic version (ECV) is a procedure to shift your baby from a breech position into a head-down position on the outside of your abdomen. At De Geboortezaak a number of midwives have been trained and registered as version experts. You can contact us for this external cephalic version, even if you are not a client of De Geboortezaak.

Why an external cephalic version?

25% of the babies are in breech position at around 30 weeks of pregnancy. A large part of these breech babies shift into a head-down position by themselves. About 3% of the babies are still in breech position at 36 weeks. If this applies to your child, then an external cephalic version (ECV) might be an option for you. The chance of the baby shifting by itself after 36 weeks is small.

A breech position during childbirth increases the risk of complications, such as a lack of progress in the delivery, a caesarean section, and children having to be admitted to the incubator ward more often after birth. A caesarean section is a major abdominal surgery and brings about more risks for the mother and her child. With an external cephalic version, you increase the chance for a head-down position, which means there are fewer risks during childbirth.

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The external cephalic version

Before the external cephalic version, an ultrasound is performed to check the exact position of your baby, the amount of amniotic fluid, the location of the placenta and any other details. The heart sounds are examined as well. During the external cephalic version, attempts will be made to shift your baby by the version experts applying external pressure with their hands. Your child should shift by itself, the version expert will not force anything.

An external cephalic version may sometimes feel uncomfortable due to the pressure on the abdomen. If it is too sensitive, the version expert will stop the external cephalic version. Sometimes it takes several attempts to shift the baby during one consult. After the external cephalic version an ultrasound is performed again to confirm the position of the baby and to examine the heart sounds. If you have a Rhesus D negative blood group, you will be given Ant D. On average the success rate is 50%, 30% if this is your first baby and 70% if this is your second baby.

Complications of an external cephalic version

An external cephalic version is a safe procedure. Complications after an external cephalic version are rare. The heart rate of the baby sometimes slows down, but that is usually restored to a normal rhythm within 10 minutes. The abdomen may temporarily feel a bit sensitive and bruised. If you are losing blood or amniotic fluid, you have to contact your midwife immediately. If the external cephalic version failed, your midwife will refer you to a gynaecologist.


The expenses of the external cephalic version are fully reimbursed and will be claimed by us from your healthcare insurer.

Practical tips

  • Wear comfortable clothes. Preferably in layers so that you can easily take something off.
  • Your bladder should be partially filled
  • You can of course take someone with you for support
  • For more information see this page