I’ve written about my c-section experience, which was overall very positive. But it took me time to come to terms with my baby being breech. And strangely one of the things that helped me was having an ECV. There isn’t a great deal out there on what an ECV is really like so I thought I would share my experience.
I was devastated when I found out my baby was breech at 36 weeks. It came as a real shock as up until that point my pregnancy had been very easy. I was classed as low risk. Every time I’d visited the midwife she had confirmed that the baby was in a head down position. So finding out that my pregnancy was suddenly not straightforward was a blow.
I felt utterly deflated. I’d spent much of my pregnancy reading about hypnobirthing, practicing breathing techniques for labour, dreaming about how I would create a calm environment for my baby to enter the world. I was actually becoming excited about labour – something I hadn’t really felt possible. So feeling like that had all been taken away from me made me feel like there wasn’t any point carrying on with hypnobirthing.
The registrar who had performed the scan to confirm the baby’s position gave me some options – to schedule a c-section, to have a vaginal breech delivery or to attempt to manually turn the baby. I knew I wanted to have a normal birth if possible so I asked to be scheduled in for an ECV.
So what is an ECV? A external cephalic version is a procedure offered when the baby isn’t yet head down at 36 weeks. The consultant performing the ECV will attempt to manually turn the baby by pressing and massaging the mother’s abdomen. I’d heard various reports of the procedure being painful. It also carries a risk of an emergency c-section being required if the baby becomes distressed. The c-section rate is around 0.5% which is actually pretty high – 1 in 200 women will have a c-section as a result of an ECV. The Royal College of Obstetrics and Gynaecology have a really helpful Leaflet on ECVs and breech births which I encourage you to read if you haven’t already.
It was this possibility of a c-section that really focused my mind. My appointment was on the first Monday of my maternity leave and so I spent the weekend before buying everything I still needed for my birth bag. I decided to prepare for the possibility of having a c-section that day. N took the day off work and we headed to hospital early for my 9am appointment.
When we arrived I was greeted by a midwife who palpated my abdomen to feel the position of the baby. I was convinced that the baby had turned (having spent every day that week performing inversions and putting ice on my tummy to try and encourage movement). The midwife said it felt like the baby was head down, but she needed a scan to be sure so we headed to the ultrasound room.
Unfortunately the baby’s head was still nestled under my ribs so we decided to continue with the ECV. I went back to the maternity assessment ward where I was hooked up to a monitor to get a baseline reading of the baby’s movements. I was also given an injection into my tummy to relax the muscles in order to make it easier for the consultant to try to turn the baby.
Once the relaxant had taken effect we returned to the ultrasound room for the consultant to perform the ECV. The consultant was very honest with me, the chances of success were very low – it was my first pregnancy, I was 37 weeks and the baby was in a frank breech position. All of these factors made it less likely that the baby would turn.
But we gave it a go. I was tilted back on the bed and the consultant got to work, pushing and massaging me really hard while using the ultrasound to watch the position of the baby. It hurt. A lot. I can only describe it as akin to having a really hard sports massage on my stomach. I closed my eyes and concentrated on my up-breathing that I’d learnt in hypnobirthing. I stayed calm and tried to relax – telling myself that the more relaxed I was the more likely the baby would turn.
We gave it several attempts. The consultant was amazed by how calm I was and how long I was willing to put up with the pain for. And it really did hurt but I found the up-breathing really did help. The baby moved half way but for some reason wouldn’t turn all the way. The consultant suggested that it may be that something was stopping the baby, potentially a short umbilical cord (after my c-section the doctor confirmed that there was no obvious reason why R wouldn’t turn, she was clearly just being stubborn).
After the ECV I went back to the assessment ward to be monitored again. I sat for about an hour being monitored, during which time I had a chat with the consultant about my options. We agreed that I would have an unscheduled c-section, ie we would wait for labour to start rather than book a set date. As there is a slightly higher chance of vaginal breech delivery the consultant asked me to come back in for a scan the following week to measure the baby and my pelvis (R arrived two days before this appointment).
After waiting for what felt like forever the midwife came back in to tell me that they still weren’t happy with the baby’s movements following the ECV. She suggested that I go for a break get some lunch and then come back. I hadn’t eaten at all that morning as I wasn’t allowed to eat before the ECV so my energy levels were pretty low and I was glad to get away from the ward as I was starting to worry. Luckily after a sandwich and a drink the baby’s movements picked up and they were happy for me to go home.
I remember after the ECV being upset that it hadn’t been successful, but also feeling quite resolute. This was just the way things would be. I still had hope that the baby would turn before I went into labour but I was more accepting of the possibility that I wouldn’t have a normal vaginal birth. At my next midwife appointment the student midwife who was observing said to me that perhaps this was just how my story was meant to be. I really liked that – one of the most important take aways from hypnobirthing is my body, my birth, my baby, my choice. The experience of having an ECV gave me back my choice.
By preparing for a c-section when I went for the ECV I was able to come to terms with the possibility that my baby might need to be delivered by c-section. I still wasn’t feeling hugely positive but I’d reached acceptance.
Even though the ECV was painful and caused a fair bit of worry about whether the baby was OK afterwards I would do it again if I was in the same situation. And if you are having an ECV I highly recommend using hypnobirthing breathing to shift your focus from the pain and help you to relax.