To help resolve a compound presentation or twist, it is up to the mother if she wants to do the balancing work.
An external cephalic version is a technique by a doctor or midwife to turn the baby head down manually by pushing the baby via the abdomen. ECV has a set of risks of its own, including a difficult birth afterwards. ECV works about 50% of the time, with a few midwives and doctors having better rates. No technique is without risk, no life is without risk.
Baby’s heart beat should be listened to carefully before and during and after the ECV. Pausing when baby’s heart rate drops, stopping if the baby doesnt respond well to the next attempt to turn the baby more, and doing an emergency cesarean if the heart rate doesn’t come right back up are 3 ways to protect baby and reduce the small but present chance of death. Please don’t push the baby around at the Chiropractor, massage therapist’s office or your girl friend’s house. It can be done gently, but baby needs to be listened to.
Want to find other ways to flip a baby? https://spinningbabies.com/baby-positions/breech-bottoms-up/what-to-do-about-breech These are gentle, mother-led, baby-responded to techniques that have good results and can be tried before the ECV to work or to make the ECV work more easily without force. NO technique is without risk. Check with your midwife or doctor before setting out on a series of activities to flip your baby. Bring information with you as they may not understand why you would get upside down in pregnancy. Its all about the ligaments!
After the ECV, women can do things to make the upcoming head down birth easier. Actually, if the ECV doesn’t work and the mother goes for a vaginal birth (with a skilled breech care provider, I hope!) these will help the mother’s muscles be more balanced for birthing.
Some women will begin with a gentle but persistent rebozo with her on hands and knees, not knee chest and not vigorous! – just gentle for as long as the helper can do it, 3-6 minutes? 10 minutes?. Rebozo the tummy then buns.
She may benefit by doing 5 forward leaning inversions in one day for only 30 seconds each. These may be key. Not with high blood pressure or risk of stroke. Avoid doing with heart burn.
When labor begins in earnest, she may benefit from 10 abdominal lift and tucks (posterior pelvic tilt) during the contractions.
Here’s a sample issues that SOMETIMEs occurs,
ECV worked! They decided to stay and get induced. Baby tanked during version and I think they were nervous and wanted to be in hospital…[Baby recovered well and induction was attempted.]
Now it’s 3 days later and many doses of cervidil and cytotec later her cervix still thick and closed. Baby is high [above pelvis] and not engaged. I sent her the page from Spinning Babies about ways to engage baby but so far she hasn’t had much change… I wonder if there is something else going on??
Her and baby both healthy, baby doing well, waters intact etc. I don’t know if she just needs to have more time until she’s ready or if baby is trying to tell us something…
What baby is trying to say, is head down is not enough. We must resolve the twist that may be there and that had caused the breech position in this case. Balance first. Check out The 3 Principles of Spinning Babies to see more on Balance.