When is external cephalic version (ECV) usually performed?

External cephalic version (ECV) is typically performed around 36 weeks of pregnancy. This timing is chosen because it is close enough to the due date for the procedure to be effective, yet early enough that the baby can still turn into the optimal head-down position before labor begins. At this stage, the fetus still has enough amniotic fluid and space to perform the maneuver safely, and it minimizes the risks associated with attempting to turn the baby when labor is imminent.

Performing ECV after labor has begun would not be practical, as the dynamics of the uterus and the mother’s body during contractions can complicate the procedure and increase the risk of stress on both the mother and baby. Similarly, attempting ECV too early in the pregnancy, such as in the first trimester, would not be advisable due to the limited space and mobility of the fetus, along with the risk of miscarriage or preterm labor. After delivery is not relevant to the procedure since ECV is intended to reposition a fetus that is in a breech or transverse position pre-delivery.