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  • I-Shun Yang

37 Weeks Pregnant in Hong Kong - ECV Procedure

Ever since early pregnancy, I have never thought about caesarean section, even though I am fully aware that it is a possibility with unexpected complications/emergency, but I have never prepared myself mentally. All I focused on was to have a birth as natural as possible, with minimal medical intervention.


I was not too prompted on having many checkups during the pregnancy (Hong Kong's public clinic checkup is very basic, most pregnant ladies would go to private clinics for extra checkups). Around 32 weeks I was told the baby's position was still breeched by the nurse from public clinic after an obstetric abdominal exam. I did not think much of it, there was still plenty of time for that to change. Not until I had an ultrasound at 36 weeks, the hospital confirmed that baby still not turned, I started to get worried.


I went to the appointment alone that day and the doctor gave me the ECV option after ultrasound. Briefly read through the procedure to get a basic understanding, I immediately decided to go ahead with ECV (External Cephalic Version) the following week. My husband was not exactly happy for me to make the decision alone but he was supportive of the decision, since it is our first baby, having a virginal birth is most ideal.


The days leading up to the ECV procedure, I looked up online to know more on the success rate, risks and the full procedure.. also started to mentally prepare for the possibility of caesarean section. I tried to communicate internally to check where did my emotions came from? Why would I be upset and disappointed? It is now nearly the end of my pregnancy, gaining more knowledge or shopping for baby items is no longer my top priority... but the mental preparation.


After reading through information in both English and Chinese, I estimated my success rate to be around 50/50 (first baby/37 weeks/baby size is normal/fluid level is normal/BMI is normal) and the risk of emergency operation is low. Caesarean section is widely accepted in Taiwan/Hong Kong, sometimes even preferred so there is very little understanding of ECV procedure or people would worry about the risks, but the procedure is pretty standard in the Western countries. I heard that only a few public hospitals in Hong Kong offers the procedure, my hospital happens to be one of them.


I had to check-in at the maternity ward quite early on the day of my ECV procedure, also began to fast after breakfast, in case of having an unexpected operation. I was assigned to a bed next to the window, needed to drew and get some IV fluid. There were many intern doctors/nurses in the hospital, my blood was dripping everywhere when the intern drew my blood, a little scary to witness but luckily my pain tolerance is on the higher side and I did not want to make the intern too nervous, just quietly waited for him to finish the procedure.



Before noon, I had an ultrasound to confirm baby's position, size and my fluid level. The doctor informed me that the procedure will be conducted in early afternoon. I was also put on baby monitor to check baby's heartbeat and movement for around 30 mins. The rest of the morning I just waited by my bed, also did some work on my laptop. Around 2pm I was called, time to go to the delivery room. They sat me on a wheelchair and pushed me downstairs. I was trying to notice if there were any baby noise, none, it was very quiet day in both maternity ward and delivery room.


I laid down on the bed in the delivery room, wearing nothing under the hospital gown. Looking at the baby incubator in the room, everything became very real. I was injected with fluid to relax my pelvic muscle, felt my heart beating a lot more faster (normal side effect) and I heard it so clearly, but not feeling uncomfortable. The intern doctor made sure everything was ready, pushed the ultrasound machine closer to bed. I was telling the baby in my head if its possible, she can turn her head around, but if its really uncomfortable, its all good. Next, two doctors entered the room, asked if taking a video of the procedure is alright without my face in the shot, purely for educational purpose, I agreed and finally we can start the procedure.


One doctor quickly checked the baby's position with ultrasound, decided to try turn the baby anti-clockwise. I felt the doctor's fingertips pushing my belly with quite a bit of force, I could even felt her fingernails, it did not really hurt but quite uncomfortable. The whole process was very fast, not even half a minute maybe. I remember seeing the doctor's eyes expressing joy, it was a success in the first attempt! The baby's head turned! I was still processing the information, the doctors quickly explained what will happened next and left the delivery room. They monitored the baby's heartbeat for another one hour, luckily the baby was quite active and doing well. I was sent back to the ward.


At this time of the day, I was ready to go home. The nurse gave me a box of milk and some crackers, did a quick workshop on breastfeeding next to my bed for other two pregnant ladies and I. I had to rest for a bit more before they agreed to release me.


The cost of the procedure was around HKD 200, it was my first time paying in the public hospital as other checkups were all free. The whole experience was overall quite positive, I now feel much more confident with the hospital. I have not yet given birth as of today but I am very grateful for the experience, to have prepared myself mentally, to all sorts of possibilities about giving birth, I would say that is my biggest learning.


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