A version means that we turn a baby that is in breech position, from the outside of the belly. We are part of a collaborative partnership in the region. Together with our partners, we have created a “version team”, of a few specialised obstetricians who perform versions.
How common is a breech position?
3 to 4% percent of all babies is in a breech position near the end of the pregnancy. There is usually no reason for this, it is just a coincidence. The big advantage of a head down position during childbirth, is that the biggest part of the baby will push through the pelvis first. This way, the head makes space for the rest of the body. With a breech birth, this is the other way around, which makes it more difficult.
In case of a breech position, there are 3 options:
- External version
- A vaginal breech birth
- A C-section
There are different kinds of breech positions
- An incomplete breech position; the bottom in the pelvis, both legs folded upwards.
- A complete breech position; the legs next to the bottom in the pelvis.
- A half incomplete breech position; one leg next to the bottom in the pelvis, the other leg folded upwards.
- A feet down position; both feet in the pelvis.
The external version
This version is done some time between 35 and 37 weeks of pregnancy. It can also be done later, as long as the baby has not descended into the birth canal. The further into the pregnancy, the smaller the chance of a successful version. Furthermore; if you water breaks or your contractions start, there will be little/no more risks involved with the early labour.
The chance of success is around 50%. With your first child it is around 40%, from your second child it is 60-70%. The version is performed by two specialised obstetricians (version specialists). Sometimes it is done in collaboration with the gynaecologist.
Before the version is carried out, you will have a consultation to check if you want to have a version. There will be an ultrasound to check the breech position again, and the specialist will listen to the baby’s heart.
Afterwards, you will be placed in a relaxed position, with cushions under your feet. Then the baby will be turned, this will take between 10 and 30 minutes (it depends on how the baby feels about it).
After the baby has been turned, we will listen to the heart again, and check the position of the baby.
If the version is successful, the obstetrician will do an ultrasound a week later, to see if the baby is still in the correct position. If the version is not successful, you will be informed about a second attempt.
Advantages of a version
- We will externally try to turn the baby into a head down position.
- You can give birth anywhere you want, with the help of your obstetrician.
Risks of a version:
- Water breaking spontaneously.
- The baby having a slow heartbeat after the attempt.
- Contraction activity.
However, the chance of complications is very small and almost negligible. The most common risk is the baby having a slower heartbeat after the attempt, which is usually temporary, so not dangerous. The external version is not completely painless. Most women experience is as an unpleasant, uncomfortable feeling.
A vaginal breech birth
- Your child is born in the natural way.
- During the next pregnancy/birth, there will be no risks for childbirth.
- Higher risk of complications during childbirth.
Specifically because the head of the baby (the biggest part of the body) will come last.
- You have to give birth at the hospital, with the help of your gynaecologist.
- Less chance of complications for the baby during childbirth.
A C-section is a large abdominal surgery with many possible complications, such as:
- Heavy bleeding.
- Damage to the bladder.
- ‘Wet Lung’ for the baby, which will cause him or her to have difficulty breathing, and sometimes they will need extra oxygen.
- Bigger risk of the next child dying during childbirth (because of a tear in the uterus).