Turning a Breech Baby: What Happened During My External Cephalic Version (ECV)

Surprise — Your Baby is Still Breech

When I found out my baby boy was still breech at 37 weeks, and FRANK BREECH at that, I was nervous. I knew this meant a likely cesarean section.

I’ve had abdominal surgery before, an emergency unilateral salpingo-oophorectomy (a fancy way of saying they removed a fallopian tube and an ovary) back in 2018 for a torsion. I wanted to avoid another surgery if at all possible. Yet, I didn’t see a way to deliver vaginally if he wouldn’t flip on his own.

Then my OB offered me an alternative I’d only given fleeting attention to in my What to Expect When You’re Expecting book — an external cephalic version (ECV, or, as they called it in the hospital, simply an external version).

By any name, here’s what it means — they manually flip the baby around. Feeling my baby’s head right under my ribs, and not reading any amazingly reassuring odds, suddenly I found it even harder to breathe.

But my gut told me to do it, and my doctor was also very reassuring. So the next day (and a couple of YouTube videos of success stories later to get my head in the game) I checked into the hospital for the procedure.

Getting Prepared for the Procedure

Checking into the Labor & Delivery unit, every single person I encountered was kind. From the nurses to the anesthesiologist. The more needles and tests that came out, from IVs to catheters to a COVID test (yes it really does sting as badly as everyone has said and for the record it was negative), the more supportive and compassionate they all were. Along with my husband, they were coaching me to breathe, encouraging me to stay strong.

And that’s when I fully realized that how well this went was definitely going to be a mental game as much as physical.

Fortunately, I’d done some prep work in this area. My husband and I had talked about this the night before, that what you focus on grows. And that needing this to go perfectly wasn’t the strategy here, especially since I needed to be fully prepared that our baby may have to be delivered via emergency cesarean if he didn’t tolerate being moved well.

Releasing the need for the ‘desired’ outcome was actually a huge weight off my shoulders. I was able to focus on what mattered moment to moment — my son’s heartbeat, holding my husband’s hand, and just being present. By the time they wheeled me to the operating room where the external version would take place, I was feeling calm.

I was even prepared for how FRIGID the operating room was and how much movement there was by so many people in there prepping for things, thanks to a vulnerable and wonderful Holding Space Podcast episode by Dr. Cassidy Freitas, LMFT that shared her birth stories. Check out that specific episode here, it’s all about the empowerment of having less rigid expectations and a more loving mindset toward yourself and the process!

The External Version Procedure Itself

Immediately after being wheeled in, the actual medication for my epidural was administered, and that’s when it got interesting. Within minutes, my legs got heavy and I couldn’t move them at all.

My OB, a couple of residents, the nurse, and the anesthesiologist were all very focused yet supportive of me when they saw I was a bit nervous (my eyes are pretty expressive, even with a mask on).

My OB asked if I was ready and I said yes, but with one question. Without even having to hear it, she said “Oh yes, can we call in Megan’s husband?”

With Mike holding my hand, I was ready. I have to say, he looked pretty good in scrubs. But it was time to focus. 🙂 I braced myself for up to four attempts. It had been explained that if the baby wouldn’t move in four attempts, we’d quit. And that if he had too much stress, we’d operate and deliver him. So I took deep breaths in and out, planning to alternate between looking over at Mike and closing my eyes.

But before I had much of a chance to do anything, I felt a lot of pressure on my uterus and then, BOOM, the doctor said, “I think he flipped! Can we double-check?” And the ultrasound showed he had turned head down, first try, in a matter of seconds! Joy, pure joy.

Then I heard his heart rate had dropped. My own heart stopped, metaphorically of course, but it felt real. They asked me to turn on my side to see if that helped things while I started crying and just kept asking over and over, “Is he okay? Is he is okay?”.

Both my OB and Mike were so amazing throughout this. Mike softly told me that Finnley was okay and I was okay and guided me through breathing in and out while the OB was compassionately reminding me to keep on breathing. I shook pretty uncontrollably, suddenly realizing just how cold the room was. Yet, I was able to keep my mind reasonably calm.

Finnley stabilized enough to take me back to a triage room, but he still needed monitoring. The OB set me up for monitoring for the next few hours and let me know we’d go from there.

Waiting for Baby Boy’s Recovery

The next few hours are a bit of a blur. Finnley seemed sleepy, I was told. He wasn’t having a bad enough reaction to act immediately, but his heart rate wasn’t showing the variability they needed to clear him either. Things continued that way for awhile.

During this time, the epidural wore off. While I had my legs back, my heart was focused on that monitor. Mike continued to keep me in the moment, cracking jokes and just generally being an amazing husband and partner in things. He’s going to be an amazing dad to Finnley, no doubt.

Mushiness aside, a tough decision had to be made. It was time to induce me, the OB said, and I was admitted into the hospital and taken to a delivery room. Mike and I rolled with the punches. We were ready to meet our baby and had me focused on a YouTube video practicing some last-minute Lamaze breaths.

They put Finnley back on the monitor and waited for the doctor. When she came in, a seeming miracle had happened — Finnley’s vitals were looking better, a LOT better. He was no longer in a range they worried about, and there was a lot of relieved laughter/sighing between us all.

It really did remind me of taking a car to the mechanic only to have it suddenly behave. Except this time it meant our son got to come into this world on his own accord, not because he was stressed, and my heart was full of relief.

Mike and I did find we were so mentally prepared to have him that staying overnight to be monitored and being released the next morning with me still pregnant was, while very happy, a bit odd! We were so ready.

The Final Results & Was It Worth It?

I’m sitting here writing this almost a week later at 38 weeks, 1 day, just very grateful to have him healthy and happy. Plus, his being head down has led to a much more comfortable late pregnancy and everything from my sleeping to my breathing has improved.

While the day or two immediately following was a bit bumpy, including a hospital trip because I mistook an irritable uterus and the occasional contraction for consistent contractions, all of that has leveled out. Other than some unrelated soreness from an IV, there’s no discomfort at all from the procedure.

Now I await the labor and very likely vaginal delivery of our son! Worth it? 1,000%. I would do an external version 500 more times if needed. I’m just very glad it’s not. 🙂 And if things end in a cesarean section after all, I still don’t regret this decision because it felt right and it gave Finnley and I a shot at things, which is really all you can ever hope for.

More soon on the birth story, I can’t wait! This week I really got my own dose of ‘you are perfection, mama! As is!’ And I feel it.

With Love, Megan