Before an ECV: What can nurses do?

Recently after a Spinning Babies class, a nurse asked me what can be done for families waiting for an External Cephalic Version (ECV) before the doctor arrives to turn the baby.  She said she usually had about an hour with them before the procedure.  I thought about all of the things that we can do using anatomy and physiology for a breech release, but for nurses, their time is usually limited. 

Here are my top suggestions after checking to make sure baby is still presenting breech:

  1. Be present with parents.  Connection to a staff member increases the likelihood for relaxation.  Relaxation allows for space.  Also, reminding them of their breath now can be useful for later.  Breathing allows the space to continue to be dynamic.  Release can happen from within as well.
  2. Assist them in doing Spinning Babies 3 Sisters of Balance.  These activities can help restore balance and space for the pregnant body.
  3. Notice the restrictions for this baby!  If the bum is deep in the pelvis the parent can do an extra Forward Leaning Inversion with some manteada of the buttocks.  More importantly, the breech tilt (Trendelenberg position) can be used putting the feet high and the head low.  The parents can sit in this position while awaiting the care provider to arrive.
  4. Icing on the cake: While the parent is lying at this angle, the nurse can do abdominal release.  Sometimes this can be a useful time to also release the round and inguinal ligaments.  
  5. If the head is high under the ribs and not moving, ask them to lie with the side with the head under the rib to be superior.  As the uterus has now fallen out from under the rib, massage the respiratory diaphragm (a little oil makes this smooth).  Softening this area may allow the head more freedom.  The provider might even choose to consider supporting the head out from under the rib before they flip back to their back.  

There is much more that can be done with time.  We know many soft tissues can interfere with the space available.  The respiratory diaphragm, the psoas, and the QL may also be key for release of a head.

(Releasing the round ligaments and inguinal ligaments are not part of the Spinning Babies Workshop.  It is part of the Spinning Babies Aware Practitioner Course and Breech Body Balancing Courses as well as something that chiropractors, massage therapists and many others already safely know how to do! If you don’t know how to meet the resistance and allow it to release, feel free to go to a training and learn!  If you have any questions about these activities, take a Spinning Babies Workshop.  

Please note there are contraindications for people to have their head below their heart.  If you are unsure of these, please ask the provider for approval of such positions.)

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