What should you know about external cephalic version complications?

During ECV, a clinician uses pressure on the abdomen to encourage a breech baby to turn head-down. Brief discomfort, tightening, or nausea can happen. The team checks the baby’s heart rate before and after the attempt, and may monitor during it. Less common concerns include vaginal bleeding, contractions, rupture of the membranes, or a sustained change in the baby’s heart rate. Because ECV is performed where assessment and obstetric care are available, the team can stop the attempt and decide whether further treatment is needed.

Tell the maternity team about bleeding, fluid leakage, contractions, reduced fetal movement, previous uterine surgery, or any pregnancy complication. Follow instructions about eating, drinking, medicines, and observation after the procedure. If the baby remains breech, discuss planned birth options, including Caesarean Section. Do not arrange to travel far from maternity care immediately after ECV unless your team says it is appropriate.

Contact your maternity unit urgently after ECV for vaginal bleeding, watery fluid leaking, regular painful contractions, severe or persistent abdominal pain, or noticeably reduced fetal movement. Seek emergency help if you feel very unwell or have heavy bleeding. A change in the baby’s movements should be assessed promptly even if the ECV seemed uncomplicated.

Ask where monitoring will take place, what symptoms require immediate contact, how long observation usually lasts, and what happens if the baby’s heart rate changes. Ask how a failed or reversed turn would affect your birth plan and when Caesarean Section would be discussed.