News and Events

New Clinic Enhances Options for Natural Birth Opens

Publication Date: 6/3/2021 10:30 AM

A recently opened clinic at Rambam helps alleviate the need for Cesarean sections in pregnancies where the baby is in either breech or bottom first position.

Staff in the new clinic. L-R: Dr. Roni Avrahami, Dr. Udi Ergaz, Dr. Nadir Ghanem, Dr. Yaniv Zipori. Photography courtesy of Rambam HCC.
Staff in the new clinic. L-R: Dr. Roni Avrahami, Dr. Udi Ergaz, Dr. Nadir Ghanem, Dr. Yaniv Zipori. Photography courtesy of Rambam HCC.

In approximately 3% of all pregnancies, the unborn baby is in either a bottom first or breech position. Frequently, such pregnancies end in a Cesarean section because vaginal delivery would put the baby or mother at risk. However, in many instances, a vaginal birth is possible by performing a non-invasive procedure that moves the baby into an optimal head first position, referred to in medical terms as an external cephalic version (ECV). Women in the late stages of pregnancy can now undergo this procedure in a new clinic at Rambam Health Care Campus. The clinic is the only one of its kind in Northern Israel and brings together all the necessary medical consultants, so that pregnant women can to obtain the required preliminary tests and post-procedure follow up, all within a single framework.

Performed at about the 37th week of pregnancy in a specially equipped delivery room, ECV requires experienced, highly skilled practitioners. The procedure, which takes just a few minutes, uses ultrasound to monitor the unborn child while controlled pressure is applied to the mother’s abdomen to coax the baby into a head first position, allowing for a normal vaginal delivery. The mother and baby are then monitored for a period of time following conclusion of the procedure.

While this approach is successful in the majority of fetal breech cases, it is not always an option. In accordance with the guidelines of the Israel Society of Obstetrics and Gynecology, ECV cannot be used in particular cases, such as the presence of other conditions that prevent a vaginal birth.

“In recent years, the Division of Gynecology and Obstetrics at Rambam has encouraged vaginal deliveries, including for breech births, when conditions permit,” explains Dr. Yaniv Zipori, attending physician in Rambam's Division of Obstetrics and Gynecology. “Although we have been performing ECV for some time, allowing pregnant women to enjoy the benefits of vaginal delivery, the new clinic has made this delicate procedure easier, more personal, and comfortable for the expecting mother.”

“It is our philosophy at Rambam to give expectant mothers a wide array of options, even those which, in the past, were unavailable to us,” states Dr. Nadir Ghanem, attending physician. Dr. Roni Avrahami, Director of the Delivery Room, in the Division of Obstetrics and Gynecology adds, “We have the knowledge, the experience and the relevant expertise, all of which are available to women giving birth, round the clock. We are committed to giving choices to women giving birth – each one in her own way.”