If possible, sprinkle some talcum powder on the motherâs belly before proceeding.
Through the motherâs belly, the doctor uses both hands to hold the babyâs buttocks, using the wristâs strength to lift the buttocks and turn them in the opposite direction to the babyâs head. One hand then cradles the babyâs head to keep it in a downward position, while the other hand continues to rotate the buttocks until returning to the correct position of the occipital anterior position. This step is the famous External Cephalic Version.
There is the External Version Technique, and correspondingly, there is the Internal Version Technique. The internal version requires general anesthesia and is relatively complex, generally not used during clinical vaginal deliveries. Sometimes, it may be used during a Cesarean Section.
For transverse positions, a partial version technique might be attempted to reposition the fetus. In the past, senior midwives dared to try it themselves. Now, with tense doctor-patient relationships throughout hospitals, obstetrics being a major conflict area, midwives donât dare to try, and only doctors can attempt it.
Doctors are also very apprehensive about trying, given the obstetrics field where "two lives are at stake," and any minor incident can cause significant family disputes.
The External Cephalic Version sounds miraculous as it doesnât require surgery, but the actual procedure entails many restrictive preconditions, and high risks during operation.
First, for the version to be performed, the uterine space must be large enough to allow the doctorâs hands room to maneuver the baby. Additionally, there must be enough amniotic fluid, as too little will prevent the baby from rolling and could cause uterine damage.
During the version procedure, there is a risk of causing tears to the uterine wall, leading to premature placental abruption, among other risks. The risks to the baby are equally significant. During the repositioning, it is possible the baby could become severely hypoxic from the umbilical cord wrapping around the neck, which would require an emergency Cesarean Section. This is why proceeding directly to a Cesarean Section might be safer.
Therefore, many doctors prefer to directly recommend a Cesarean Section to the family and patients instead of taking this risk.
This shows that only doctors with sufficiently strong and confident skills dare to continue performing versions on mothers under difficult conditions, striving to preserve vaginal delivery. In the doctorâs view, the best scenario for performing a version is when the doctor doesnât have to force the baby to change position. It is most stable if the baby can reposition itself correctly in the motherâs uterus, avoiding any external force from potentially harming the mother and child.
Since the baby canât be forced to turn, how do you make the baby turn on their own? The baby canât understand the words of the doctor or mother. Getting the baby to comprehend the information from the doctor and mother is indeed a high-level skill, an area of intense study for many in the medical field.
In clinical practice, some experience accumulated by predecessors can serve as a reference for doctors on site.
The baby lying in the motherâs uterus can be thought of as a self-aware sphere. If thereâs a relatively spacious area, itâs more comfortable for the sphere to roll in, and thus, naturally, the baby will turn itself. Based on this premise, in clinical practice, when an abnormal position is detected earlier in the late pregnancy, doctors begin by teaching the mother prenatal exercises to correct fetal positioning. The most common is the knee-chest position exercise mentioned earlier.
After clearing her thoughts, Xie Wanying said to Bed Number Three: "Come, Iâll help you change your position, teaching the baby how to turn back to the correct position on its own."
Her eyes were firm, and her tone was strong and powerful.
Bed Number Three felt a powerful strength infused through her clenched hand, and couldnât help but nod.