External and Internal Cephalic Version: How to Turn a Breech Baby

Version is the process of manually turning a breech baby so that they are head-down during childbirth. It is done externally, internally, or in a bipolar way.

If you’re pregnant and have a baby who is in a breech position (feet or bottom first), there are two ways to turn a breech baby – externally and internally. Some women choose to try turning the baby themselves at home, while others opt for medical intervention. This blog post will discuss the pros and cons of both methods, as well as how to turn a breech baby using each one.

What is the version?

Version is the process of manually turning a breech baby so that they are head-down in preparation for childbirth. A version can be done externally, internally, or in a bipolar way.

Types of version

When the cephalic pole is brought down to the lower pole of the uterus, it is called the cephalic version, and when the podalic pole is brought down, it is called podalic version. The types of versions are:

External version

An external version is done by a doctor, midwife, or another healthcare provider. They will place their hands on the outside of your abdomen and attempt to move the baby into a head-down position. This is usually done at 37 weeks gestation or later.

Internal version

A midwife or another healthcare professional performs an internal version. They will insert their hand into your vagina and try to turn the baby’s head down.

Bipolar version

It is a combination of external and internal cephalic versions. An external cephalic version is performed first to turn the baby’s head down, and then an internal cephalic version is performed to push the baby’s bottom down and out of the birth canal.

The success rate of a bipolar version is slightly higher than that of a regular internal cephalic version, but the risks are also higher.

If you are scheduled for a bipolar version, you will be given a sedative to help you relax. You will also be given an IV so that you can receive pain medication during the procedure. You may feel some pressure and discomfort during the procedure, but the pain should be manageable with the medication.

After the procedure, you will be monitored for a short time to make sure that you and your baby are doing well. You should be able to go home the same day. If your baby is still in the breech position after a bipolar version, you may be scheduled for a Cesarean section.

What to expect during the procedure?

The procedure generally takes about 20 minutes. You will lie on your back on an exam table, with your feet in stirrups. Your abdomen will be cleansed with an antiseptic solution. A monitor will be placed on your abdomen to track the baby’s heart rate during the procedure.

Your doctor will place his or her hands on your abdomen and apply pressure to the baby, attempting to rotate the baby into a head-down position. You may feel pressure and some discomfort during the procedure.

Success rates for the external version are about 50 to 60 percent and about 75 to 80 percent for the internal version.

If the version fails, the pregnancy is to be continued with a usual checkup. Two methods of delivery can be planned:

  • Elective cesarean section
  • To allow spontaneous labor to start and vaginal breech delivery to occur

After the procedure

After the procedure, you will be monitored for about 30 minutes to make sure that the baby’s heart rate is stable. You will then be able to go home. It is important to rest for the remainder of the day. Drink plenty of fluids and avoid strenuous activity. You should be able to return to your normal activities the next day.

Benefits of the version

The version may help you avoid cesarean delivery. Cesarean delivery is a major surgery that carries risks, such as infection, blood loss, and problems with the baby’s breathing.

Risks of the version

The risks of the version include:

  • Premature labor
  • Decreased blood flow to the placenta
  • Rupture of the membranes surrounding the baby (amniotic sac)
  • Placental abruption (placenta separating from the uterine wall)
  • Fetal distress
  • Umbilical cord prolapse (umbilical cord coming out of the vagina before the baby)

You should not have the procedure if you have any of the following conditions:

  • Placenta previa (low-lying placenta)
  • Vasa previa (vessels in the baby’s umbilical cord are low in the uterus and could be torn during the procedure)
  • Uterine scar from a previous cesarean delivery or other surgery
  • Twins or other multiples
  • Certain types of heart disease
  • Bleeding disorders
  • You should also not have the procedure if you are less than 36 weeks pregnant or more than 40 weeks pregnant.

If you are interested in having a cephalic version, talk to your doctor about the risks and benefits. The procedure is usually only done if there is a medical reason for it, such as a breech presentation. You should also be sure that you are comfortable with the risks before having the procedure.

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