Your healthcare provider is a hugely valuable resource for you as you head into the home stretch of pregnancy – get your questions ready!
As per usual, your OB provider will generally measure your weight and blood pressure, and have you leave a urine sample that will be tested for elevated levels of protein and sugar. If you’re having any urinary symptoms like burning or pain, be sure to let your medical team know. Although you leave a urine sample every time, it’s not routinely tested for infection unless you flag symptoms for them. Your OB provider will also measure your uterus to get a good sense of how Baby is growing, and listen to their heart rate with a fetal doppler. They will also ask about Baby‘s movements, and if their frequency or intensity has changed since your last visit. Last but not least, there should be discussion of your mental health and any hurdles you’re facing to getting the care and preparation you need for Baby.
If Baby is still in a breech position, your OB provider may offer an External Cephalic Version (ECV) to maximize your chances of a vaginal birth.
An ECV or “version” is when your OB provider attempts to turn your baby to the head-down position from the outside. Because any procedure involves risks and benefits, your healthcare provider will take many precautions before performing this procedure. These may include:
- Fetal ultrasound: Your healthcare provider needs to know exactly where Baby and the placenta are in your belly, and they must be able to determine the amount of amniotic fluid.
- Fetal heart rate: This is usually done for about 20 minutes prior to and after the procedure to make sure Baby is looking well.
- Terbutaline: A drug that is normally dispensed to stop preterm labor by relaxing the uterus, terbutaline is sometimes given to people who are undergoing an ECV.
- Epidural: Although uncommon, some providers want parents to have an epidural prior to an ECV attempt. This lessens any discomfort from the procedure, and is also available for anesthesia if the procedure leads to an emergency cesarean birth.
ECV’s are a totally optional procedure as there are risks and no guarantees of success. But many parents are glad they “tried everything” even if their baby remains breech. Weighing the pros and cons for your unique situation can go a long way towards feeling like you’ve made the right call.
Reviewed by the Ovia Health Clinical Team
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Sources
- Committee on Obstetric Practice. “Analgesia and Cesarean Delivery Rates: Committee Opinion Number 339.” ACOG. American College of Obstetricians and Gynecologists, 6/6/2015. Web.
- Hofmeyr GJ, Kulier R. “External cephalic version for breech presentation at term.” Cochrane Database Syst Rev. 10:CD000083. doi: 10.1002/14651858.CD000083.pub2. Web. 10/17/2012.
- Andrew S. Coco, M.D., M.S., Stephanie Silverman, M.D. “External Cephalic Version.” American Family Physician. 58(3):731-738. Web. 9/1/1998.
- Mayo Clinic Staff. “Third trimester pregnancy: What to expect.” Mayo Clinic. Mayo Clinic, 5/5/2014. Web.
