External Cephalic Version at 37 Weeks Pregnant – my Experience with Flipping a Breech Baby and Why I wouldn’t Do it Again
It was a Tuesday morning, 9 am when we walked into the hospital for my external cephalic version. I was 37 weeks 3 days pregnant, I hadn’t eaten since dinner the night before. And I was so nervous of what the day would bring.
We went through the same procedure the day before, only to wait for 4 hours and to then be sent home.
For an external cephalic version, there needs to be a c-section room ready to use, in case something happens. And the day before, apparently one emergency c-section after another came in. That made it impossible for them to attend to my problem.
But when we walked into the hospital that Tuesday morning, they attended to me right away, assured me my procedure will take place, and put me in the doctor’s examination room to get started.
Reason for my External Cephalic Version
My daughter has been in the breech position since I was 27 weeks pregnant. Did she move until then? Possibly. But at every ultrasound, she was in the same position, head up, once again.
I could feel her little head like a hard ball underneath my left ribcage. My belly was super lopsided, which was very noticeable during all the Braxton-Hicks contractions.
My doctor told me that, especially since this was my first pregnancy and I had never given birth before, a normal vaginal delivery would not be possible in most hospitals.
Apparently, this is due to increased complications with a vaginal delivery of a breech baby, and a c-section is safer for mother and baby.
He told me about one hospital in the city that does allow it, but also advised me that there are things I can try to flip the baby.
Trying to Flip a Breech Baby without External Cephalic Version
When you look into ways to flip a breech baby without external cephalic version, you find all sorts of fun things to try.
Someone suggested using a flashlight or music to lure the baby’s head into a downward position.
Another person said to do certain exercises on an exercise ball.
I tried these a few times, but felt absolutely zero.
Something I enjoyed doing, especially after being on moderate bed rest until week 35 of my pregnancy, was Yoga and specific exercises in bridge position to flip the baby.
I followed this YouTube Yoga workout and this YouTube video on exercises to flip a breech baby religiously once or twice a day.
I even used a cold pack when lying in bridge position for 10-20 minutes afterwards, and pressed it against baby’s head. All that it did was her moving her head from the left side of my rib cage to the right side. But it eventually went right back.
There are a handful of other options that I found that I didn’t end up trying.
One, called moxibustion, involved lighting a certain moxi stick by your toes, near an acupuncture point.
Similarly, another one suggested the use of a candle by your ear.
Or I could’ve gone to get acupuncture done.
Deciding on an External Cephalic Version
In the end I did not want to spend endless money on gimmicks that may or may not help. I could not get an acupuncture appointment in time, otherwise I would have tried that.
I figured if my baby is not moving easily on her own with all the exercises, there might be something else keeping her from it. And I thought maybe an external cephalic version might be my best bet to get her flipped if nothing done at home helps.
My doctor believed I was a good candidate for the procedure.
I had sufficient amniotic fluid, but also not too much.
My doctor said it usually works best on women who had been pregnant before, just due to the fact that the belly has already been stretched out before, and there is space for the baby to turn.
This was not the case for me. The opposite was the case, my belly actually felt quite tight. But he still believed it could work for me.
So I agreed to do the procedure, hoping for a favorable outcome.
Preparation at Home
The external cephalic version is usually scheduled when you reach 37 weeks of pregnancy. This is according to my doctor to ensure that in case something goes wrong and a c-section needs to be performed, the baby will be at full-term. Mine was scheduled for 37+2, at the start of a new week.
In preparation for the procedure, I had a few doctor checkups scheduled in the 1-2 weeks prior to the procedure date.
I also had to go over anesthesia protocols in case I would need an emergency c-section.
The only instructions I received to prepare for the procedure at home was to not eat or drink anything post midnight the day of the procedure. Once again, this was to ensure that my body was prepared for the potential of an emergency c-section.
In addition, they told me to pack a bag for a one-night hospital stay.
I was advised to spend the day and night after the procedure in the hospital. This was just to ensure their monitoring of the baby. In case I felt okay after the procedure, I also had the option to go home and come back for a checkup in the evening and then again the next morning.
I packed and brought a bag nevertheless, as the outcome was unpredictable.
The Procedure
Preparation for the Procedure at the Hospital
The day of the external cephalic version, I was first examined by the doctor. They checked via ultrasound if the baby was still in breech position, and ran a CTG scan to ensure everything was looking good.
Once I was cleared for the procedure, they brought me to an actual labor and delivery room. There, I got undressed and put on a hospital gown and compression socks. I also got connected to a machine that continuously measured my vitals.
In addition, they also started me on an intravenous medication to prevent contractions, a process called tocolysis. This took about 30 minutes.
Once the tocolysis medication was in my system, they escorted me one last time to the bathroom. And then it was time to get started. By then it was about 12-1pm.
I felt incredibly weak, I could barely walk at this point. I’m not sure if this was caused by the medication, the lack of food or water during the day, or just nervousness.
The team lowered the bed so I would lay on my flat back, even slightly tilted with my head below the level of my legs.
The team consisted of 3 doctors/nurses. One jumped on the bed on my right side, the other one stood on the left side, and the third one kept an eye on the monitor with my vitals, with a device in hand ready to check on the baby’s vitals.
They told me they’ll try a total of three times, depending on how it goes. And then they started.
The Actual Procedure
My baby had its head under my left ribcage and the butt in my lower right abdomen, she was already sitting quite low.
The doctor sitting on the bed with me started pushing the butt upwards, while the doctor on the left side on my bed put pressure on baby’s head pushing downwards. Basically, they wanted the baby to do half a forward roll.
The pain of this procedure is really hard to describe.
When the doctor started pushing the baby’s butt upwards, it felt like something I’d compare to super uncomfortable period cramps, but worse. My whole lower abdomen felt like it was pulling and cramping. And all I did was let out one “ouch ouch ouch” after another.
I can’t really recall timing of the procedure, but after about 60-90 seconds, they stopped. They only managed to get the baby slightly moved. But as soon as they let go, she went right back to her original position.
Once they stopped pushing, the third doctor or nurse immediately started looking for baby’s heartbeat. And we couldn’t hear anything. This was probably the scariest moment of the whole procedure.
After a little while, they eventually detected the heartbeat. And looking at my doctor’s face, it wasn’t looking good.
She gave it a couple minutes and then explained to me that the baby was in distress, that the heartbeat sunk quite a bit but was starting to recover.
They told me they would not advise a second or third try. It was too stressful for the baby, and since it hadn’t even worked slightly on the first try, they were positive she wouldn’t flip over on the second or third try either.
I was so scared for my baby’s health that I was just happy for the process to be over. Of course, I was a little sad that after everything, it didn’t even work. But for my baby’s health and safety, I was just grateful they stopped right away.
Next Steps after a Failed External Cephalic Version
After the procedure, they advised me to stay in the hospital overnight for observation purposes.
They explained that especially due to the distress the baby experienced, it would be the smartest decision. And since the experience left me incredibly scared, I happily agreed to stay. And I was glad I packed an overnight bag.
They offered me some lunch since I hadn’t eaten since the night before, and brought in their scheduler to schedule my c-section. Some hospitals still allow a vaginal delivery of a breech baby, but mine didn’t and preferred a scheduled c-section instead. At this point, I figured it might be the safest delivery option for my baby.
The c-section was scheduled for one week later, and I was nervous but excited to soon meet my baby girl.
Observation after a Failed Version
The observation of my and my baby’s vitals started right after the procedure.
Once the baby’s heart rate had caught up to a regular heart rate, they transferred me to my room where I would spend the night.
Nurses kept checking in on my vitals every now and then but other than that only one more checkup was scheduled for later in the evening.
Around 7pm, I was scheduled for another CTG to monitor the baby’s heart rate and check for any signs of contractions or labor.
Everything looked good, so I went back to my room, to spend the night. I just had to come back for a final CTG and checkup the next morning. But I never made it to that checkup.
Giving Birth at 37 Weeks Pregnant
That night at the hospital, at 2:30am, my water broke and my contractions started shortly after.
As my baby was still in breech position, I was not really allowed to get up and move around. I had to wait laying down in my hospital bed until 8:30am when they were finally ready to fit me in for a c-section. Apparently one emergency c-section after another came in before they could fit me in.
My daughter was delivered at 37+4 weeks pregnant, and luckily she was a healthy and happy baby and we did not need any extended stay or observation in the hospital.
To this day, I don’t know whether the attempted external cephalic version caused me to go into labor this early. Or if it would have happened on its own this early anyways.
The last CTG showed no signs of contractions or anything going on. Therefore, everyone was a little surprised that my water broke out of nowhere while I was asleep.
Conclusion
An external cephalic version is not as easy of a procedure as I expected it to be. I watched a few YouTube videos beforehand, that showed how people just went in, got it done, and left.
So I originally thought it would be an easy process.
It turned out much more complex, long, and painful for me. And I would never do it again.
I believe there was a reason my daughter did not want to flip around. Maybe the umbilical cord was too short or in the way. Maybe my uterus is shaped oddly and there was no space for her to fit in differently.
Whatever the reason might have been, I won’t be attempting this procedure again should my next baby be in breech position as well. It’s too painful, and if none of the at home exercises work, then there is probably a valid reason for baby to stay in breech position and not wanting to flip around.