Our strengths at a glance:

• An experienced team of obstetricians with many years’ expertise in advising on breech presentations
• A personalised assessment of your situation – no one-size-fits-all recommendations
• Comprehensive ultrasound diagnostics carried out during consultations
• Covered by health insurance – no additional costs for those with statutory health insurance
• Book an appointment easily via Doctolib, Docmedico or by telephone
• Centrally located in Munich, easily accessible by public transport

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What does a breech presentation mean – and why is it no cause for panic?

About 4–5 per cent of all children are still in a breech presentation (BEL) shortly before birth: the baby is lying with its bottom or feet downwards and its head upwards. Up to the 28th week of pregnancy, this is perfectly normal in around 25 % of children – Most babies turn into the head-down position on their own. If they don’t, the question arises: what options are there?

When should you come to the consultation?

We recommend that you attend the consultation between 34+0 and 38+0 weeks of pregnancy to make use of this if your gynaecologist or midwife has diagnosed a breech presentation. This will allow sufficient time to discuss all the options at your leisure and – if desired and appropriate – to plan an external version.

The consultation hours are open to all female patients, including women who are not registered to give birth at Dr Geisenhofer’s maternity clinic. You can easily book an appointment via Doctolib, Docmedico or by telephone. The consultation is a Statutory health insurance benefit – There are no additional costs for those with statutory health insurance.

Please bring the following with you to your appointment:

• Maternity record
• Insurance card
• Referral from your gynaecologist’s practice

What happens during the consultation for external version and breech presentation?

Here’s what you can expect:

• Detailed medical history: We will record your obstetric history, details of previous pregnancies and any relevant pre-existing medical conditions.
• Ultrasound scan: The baby’s position, the position of the placenta, the amount of amniotic fluid and the umbilical cord supply are checked.
• Individual assessment: Based on the findings, we will discuss whether an external rotation is a realistic and sensible option for you – and what success rate we can expect in your case.
• Information on all the options: External version, vaginal delivery of a breech baby or an elective caesarean section – we explain all the options, their requirements, risks and benefits.
• Your questions: No issue is too small. We’ll take as much time as you need.

If, following the consultation, you decide to have an external version, we will issue you with a referral to Dr Geisenhofer’s Obstetrics Clinic. The clinic will then arrange the appointment – the version itself takes place in the delivery room. Of course, there are also patients who decide against a version following the consultation. That, too, is a perfectly legitimate option.

By the end of the consultation, you won’t have a checklist – you’ll have clarity.

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External rotation: What is it – and how does it work?

The external turn is an established obstetric manoeuvre in which an experienced obstetrician guides the baby from the outside by applying gentle pressure turns the baby into the head-down position within the abdominal wall – without an incision or anaesthetic. The aim is to create the conditions necessary for a head-down delivery.

How does an external turn work?

Before the procedure takes place, a detailed ultrasound scan is carried out: the exact position of the baby, the position of the placenta, the amount of amniotic fluid and the umbilical cord supply are checked. Under ultrasound guidance the baby’s buttocks are lifted out of the mother’s pelvis and the baby is gently guided into the head-down position by means of a forward or backward roll. Throughout the entire manoeuvre, the heart rate and The child’s wellbeing is monitored. The delivery takes place in the delivery theatre at the Dr Geisenhofer Women’s Clinic – in the immediate vicinity of an operating theatre, so that immediate action can be taken in the rare event of an emergency.

At what point is an external turn possible?

It is recommended that the external rotation be performed from the 37+0 weeks’ gestation – At this stage, the baby is ready to be born, and the risk of complications is particularly low.

What are the chances of success – and how risky is a change of course?

Depending on the individual circumstances, the success rate of external rotation is approximately 50–85 % – slightly lower in women giving birth for the first time, and often higher in women who have given birth before. Factors such as the shape of the uterus, the volume of amniotic fluid and the stage of pregnancy play a role in this. We will discuss together during your consultation how realistic a change of course is in your specific case.

How safe is the external version for mother and baby?

External version is considered a very safe procedure. Serious complications are rare – less than 0.2% the attempts to turn things round lead to a significant complication. Temporary changes in a child’s heart rate do occur, but they usually return to normal quickly on their own. For this reason, the manoeuvre is always under ultrasound guidance and with CTG monitoring carried out.

The decision for or against a turn should always be based on an individual assessment – not on statistics. That is exactly what we are here for.

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When is an external turn not possible?

An external version is not suitable for every pregnant woman. Contraindications, which we assess carefully during the consultation, include, amongst others:

• Placenta praevia (low-lying placenta)
• Persistent vaginal bleeding
• Water breaking or labour contractions
• Abnormal CTG (abnormal foetal heart rate)

That doesn’t automatically mean there isn’t a good option for you – it means that we’ll work together to find the right approach for your specific situation.

External version, vaginal BEL delivery or caesarean section? The choice is yours

Many pregnant women come to our clinic asking: „Should I try to turn the baby, or would it be better to plan a caesarean section if the baby is in a breech position?“ The answer is: there is no one universally correct decision. There is the right decision for You – based on your medical findings, your wishes and your personal circumstances.

After the consultation, some pregnant women decide to attempt external cephalic version, others opt for a planned caesarean section or a vaginal birth, whilst others prefer to wait and have a further ultrasound scan. All these options are perfectly valid.

Our role during the consultation is not to make decisions for you. Our role is to provide you with the information you need to make informed decisions.

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Frequently asked questions about the external turn

Is an external rotation painful?

The sensations experienced during an external version vary greatly from person to person. Most women describe it as a feeling of pressure in the abdomen – uncomfortable, but not usually painful. The attempt to turn the baby can be stopped at any time at the pregnant woman’s request.

How long does an outside turn take?

The actual attempt to turn usually takes no more than ten minutes. Including a preliminary examination, CTG monitoring before and after the version, and a follow-up period, the cost is Staying in the delivery room for several hours to be scheduled at the Dr Geisenhofer Gynaecology Clinic.

What happens if the external turn doesn’t work?

An unsuccessful attempt to turn the baby is not a failure – and no cause for panic. If the baby remains in a breech position, we will discuss the next steps together: depending on the individual situation, either a vaginal birth from a breech position or a planned caesarean section may be considered. We will also make this decision in close consultation with you and in line with your wishes.

Is it possible to have a normal birth with the baby in a breech presentation?

That depends on your individual situation – and is one of the issues we will discuss together during your consultation. We will determine which method of delivery is suitable for you based on your medical findings and in line with your wishes.

Your team at the Dr Geisenhofer Medical Centre, Munich

At the Dr Geisenhofer Medical Centre, you will be looked after by an experienced team of gynaecologists specialising in antenatal care, located directly opposite the Dr Geisenhofer Gynaecology Clinic by the English Garden in Munich. Short distances, personalised care and the reassurance of a practice linked to a hospital go hand in hand with us.

Discover our Team Find out more and book your first appointment – it’s easy to do via Doctolib, Docmedico or by telephone.