“What Is An External Version During Pregnancy?”

What Is An External Version During Pregnancy?

An external cephalic version is a procedure your doctor may use to help turn a fetus if they are in breech or transverse position during pregnancy.

Normally as you approach your final weeks of pregnancy your baby will turn into a vertex or head down position. This is essential for ensuring a successful vaginal birth. Some babies however, will present in a breech or bottom down, or side lying (transverse) position.

While most babies often change positions throughout pregnancy, as you approach your 37th week of pregnancy and beyond if your baby is lying in an abnormal position they have less room to move, thus your doctor may have to help your baby turn into a more normal position.

What Does The External Version Procedure Involve?
The external version procedure is closely monitored to ensure no harm comes to your baby. Generally this procedure is associated with a few risks. It is important you weigh these risks and understand them before deciding whether a version is a good choice for you. Some risks include the risk of premature rupture of the membranes or starting labor. This is why most practitioners wait until you are 37 weeks to perform the procedure.

There is also a small risk of fetal distress during the procedure. If this happens you may need an emergency cesarean section. Still, some women prefer to try a version because if their baby is lying transverse when labor begins, they will need a cesarean section anyway.

Other risks include a small risk of placental abruption. It is important you consult with your healthcare provider to determine whether you are a good candidate for this procedure.

During the procedure, the following takes place:

•  You doctor will perform an ultrasound to confirm your baby’s position.
• Your doctor will monitor your baby’s heart rate to make sure your baby is not in distress.  This will occur before, during and after the procedure.
•  Your doctor will inject a tocolytic medication to help relax your uterus and prevent contractions during the procedure. More commonly terbutaline is used.
•  Your doctor will place both their hands on your abdomen and attempt to turn your baby to a head down or vertex position. Your doctor will stop the procedure if there are any signs of fetal distress.
•  Once the baby is turned your doctor will monitor you and the baby for some time to make sure everything is ok. Many times you will go home after this.

Is A Version Right For Me?
I recently had the external version performed because my baby was lying transverse for most of my pregnancy. I was very nervous as many women I know reported feeling some extreme pain during this procedure.

Fortunately for me, I experienced no pain. My doctor was able to turn my baby in less than a minute, and labor contractions actually started almost immediately. We decided to induce labor at that point to prevent the baby from turning again as I had a very high level of amniotic fluid that was contributing to his ability to move.

My case is unique. My doctor did inform me that many times an external version is not performed successfully. There are many factors that can influence how well a version turns out. In my case my uterus was pretty relaxed after having three children back to back. If this is your first pregnancy, your uterus may not be as relaxed and your doctor may have more difficulty moving your baby.

Again, deciding on an external version is an individual decision. For some, the risks associated with a cesarean section may seem less than those associated with an external version. Be sure you talk about your situation with your doctor before you decide whether the version is a procedure you would like to try. Keep in mind too that some babies do still turn into a vertex position even at the last moments during labor!