Breeched Baby: Trying an ECV
Updated: Aug 2, 2018
Our baby had been breeched at every single scan we went to, including our private 4D scans so it wasn’t a huge surprise when at 36 weeks we were told baby still hadn’t moved to that head-down position. Whilst pleased to hear that everything was okay in terms of growth, we knew that baby being breeched this late on would require some further discussions. We were ushered into a ‘counselling room’ to meet with a midwife who told us that ‘unfortunately’ baby was still in a breech position. She handed us 2 leaflets: one for a caesarean birth, and one for the ECV procedure to try and turn the baby.
Check out this video of an ECV below:
At our consultant appointment later that afternoon, we were asked what we wanted to do. Having spent the afternoon reading the 2 leaflets and Googling, we said that we were interested in trying the ECV provided the consultant did not see any good reason not to. My scan showed that I had enough fluid and that baby wasn’t too big to hinder the process if we wanted to try it. The hospital had recently started offering a spinal analgesia if it was too uncomfortable without one. She explained that the baby is monitored the entire time and if there is any distress they would abandon the procedure and we would just have an elective c-section booked in.
2 days later (36+1), we were back at the hospital. From the leaflets we knew there was a 1/200 chance that the ECV could cause enough distress to the baby that we would have an emergency c-section that same day. Although these odds sounded promising, we still ensured we went to the hospital fully prepared for that outcome. It all seemed to be happening so quickly!
The actual ECV could have been a quick procedure like in the video above. I had an injection to relax my muscles and signed the consent forms. The doctor said to me the most likely reason for failure would be that I wouldn’t cope with the pain; it is an uncomfortable procedure. The doctor had to push his hands into my stomach to try and lift the baby’s bottom out of my pelvis before he could try and push the head round. It takes your breath away at times, almost like you’re being winded. For me, I found it bearable: I knew what was happening and that it wouldn’t last long. But you can’t help but tense up even if you’re not asking them to stop.
After 5 minutes or so of prodding and pushing, the doctor stopped and recommended a spinal analgesia. He explained that although I could cope, my muscles were perhaps too tense and this was hindering the process. The doctor had never failed once a patient had the analgesia, a fairly new option available to patients as before it was simply 50/50 odds according to the information booklet. Despite being very anti-epidural when I imagined a vaginal birth (I hated the thought of not feeling my legs), we felt like we had come too far to give up at this stage and so we agreed to try the procedure with a spinal analgesia.
At this point, it all became a little more complicated! Some people may be successful on that first try, in which case baby would be monitored for a while and you go home and just inform them if you have any concerns about baby’s movement or bleeding. And you hope they don’t turn back!
For my journey, it involved a wait before we went into theatre. Everything seemed a bit more serious when suddenly I was nil-by-mouth, signing consent forms about the spinal analgesia after discussing the side effects, and wearing DVT stockings. I walked down to theatre in my hospital gown and my husband had to prep for theatre too in his gown and welly boots. Once on the bed, I had a cannula put in my hand for a fluid drip and then the surgeon marked up my back for the spinal analgesia. You then slouch forward with your chin on your chest and probably feel slight panic. Although it’s a weird thing to think about, it was honestly absolutely fine and probably the least painful couple of needles I’d ever had (the one earlier in my arm had hurt more!). Your legs start to feel heavy and tingly but it’s not a horrible sensation as such.
The surgeon then did his best to try and move the baby. It was definitely more intense than it had been earlier. He scanned continually to check the progress and baby’s heart rate was always being watched too. My lower stomach was numb but you can still feel pressure so I was aware that the surgeon was trying to wrangle baby out of my pelvis. This part was successful and my husband could pretty much see the baby’s bottom sitting in the doctor’s hands. He had to go very deep through my stomach to do this and apparently you couldn’t really see his fingers at that point, so no wonder they recommend the analgesia when it’s a stubborn baby!
From there the surgeon moved on to try and rotate the baby by pushing its head round. Again, this felt a little bit like being winded but also made me want to belch! This was the most uncomfortable part of the entire procedure. It was clear that baby just would not budge. Whether it was my muscles still being tense up by my ribs or whether my uterus is just a bit of a funny shape, baby was clearly having none of it. It was clear that everyone felt disappointment at this stage, and despite fully considering a c-section beforehand, it was still something we had to come to terms with in that moment.
I went through to post op where I just waited for the feeling to come back in my legs and bottom. I was very conscious about needing a wee but I was glad they hadn’t opted for the catheter as that just would have been one more thing to ‘sort’ before I could leave that evening. As my BP was fine, and baby’s heart rate and movements were too, I was allowed home as soon as the feeling was back.
I am glad we tried the ECV. I don’t feel a caesarean is a decision to be taken lightly (check out the Ordinary Mothers page on what is involved) and so I am glad that we tried everything we could to avoid that outcome. Having been to all these ante-natal classes, you expect to go through labour and you spend months preparing for the idea. You may have invested in a TENS machine, written your birth plan, and dreamed of a calm water birth. I can imagine some people feel disappointed as they book their elective caesarean date, or even scared at the prospect. However, the main thing is that you feel informed about all the different avenues and that you are happy with the choices you make, even if these have to be made on the spot.
I am not scared of the c-section, especially having conquered that fear of an epidural and having been in the same theatre that will eventually be our delivery room. Now that I know this is our only option, I focus on feeling positive about why this is the best route for us. I would have no hesitation recommending that someone tries the ECV if your doctors recommend it. The worst outcome is an emergency caesarean, something you will have to do electively a few weeks later anyway if it’s unsuccessful. Now I just can't wait to meet my stubborn breeched baby!
Please like the post if you found the content useful, and comment if you have tried an ECV - were you successful or not?