Breech Presentation and ECV
What it means when the baby is not head-down and how the care team may try to turn them
What Breech Means
Breech means the baby's buttocks or feet are positioned to come out first instead of the head. Near the due date, about 3 to 4 percent of babies are breech. The most common type is frank breech, where the baby's buttocks are down and the legs are straight up with feet near the head. Complete breech means the baby is sitting cross-legged. Footling breech means one or both feet are below the buttocks.
External Cephalic Version (ECV)
ECV is a procedure where the care provider attempts to turn the baby from breech to head-down by applying firm pressure to your partner's abdomen. It is usually done around 36 to 37 weeks in a hospital setting where emergency monitoring and cesarean are immediately available if needed. The success rate is about 50 to 60 percent and is higher for people who have given birth before. The procedure can be uncomfortable but is usually brief.
What to Expect During ECV
If ECV Does Not Work or Is Not an Option
Not everyone is a candidate for ECV. It may not be recommended if there is low amniotic fluid, if the placenta is in the way, if the baby's heart rate is not reassuring, or if labor has already started. If ECV is not successful or not possible, the options are a planned cesarean or, in some cases, a planned vaginal breech birth. Vaginal breech birth requires an experienced provider and specific conditions. Discuss the risks and benefits of each option with your care team.
Your Role
Your partner may feel anxious about the baby's position or about ECV. Offer reassurance that breech is common and that the care team has clear protocols. Be present during ECV if your partner wants you there. Hold their hand, help them stay relaxed during the procedure, and ask questions if you do not understand what is happening. If a cesarean becomes necessary, support your partner through that decision without framing it as a failure.