I recently went on an outing to a science museum in my area and browsed through an exhibit about pregnancy and birth. They had created life-sized see-through models of pregnant women and the babies growing within them. I was fascinated by the incredible journey these tiny creatures go on, especially in the first few months when the babies go from cells to distinctly human-looking little beings in a matter of weeks. What really struck me, however, was how early the babies seemed to flip upside down. They began either upright or lying down and then they were suddenly head-down, ready for the great slide of birth. This seemed like a really great plan for these babies, as it ensures they are ready to be born well in advance and don’t have to worry about trying to wriggle around when they have just about outgrown their temporary residences. What happens, though, when babies just don’t turn around? What if they turn around and then change their minds and turn back? I know breech births exist, but what do they really mean and can they be avoided?

When pregnant women get within a few months of their delivery date, one of the main aspects of their prenatal appointments will be checking to ensure the baby’s head is down and he is presenting for birth. It is generally not a concern if the baby is still facing up or is at an angle when the mother is still several weeks out from birth, but when it gets closer, a practitioner may start to be concerned that a baby has not gotten into the appropriate position for birth. Breech births, while they do happen, can be extremely dangerous for both mother and child. Instance of perinatal and postnatal death increase dramatically in the instance of a breech birth, and many women who attempt such a birth will undergo many hours of complicated, painful labor only to be forced into an emergency C-section anyway. Most practitioners strongly recommend a woman whose baby simply has not cooperated in getting into the correct position plan a C-section ahead of time to protect both her health and that of her baby. If she is resistant to this idea, the practitioner may recommend a version.

External fetal version is the process by which a team of practitioners try to physically turn the baby around by means of carefully-applied pressure and strokes on the mother’s belly. While the success rate for such a procedure is not particularly high, many mothers who undergo it are able to proceed with a normal vaginal birth rather than risking a breech birth or undergoing a planned C-section.

Source: Flock, F. External fetal version from breech presentation to cephalic presentation: modifying factors, reliability and risks, Zentralbl Gynakol, Volume 120, Issue 2, 1998, pp 60-65.