What Is a Transverse Baby Position?

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A fetus is in a transverse position when it is sideways, at a 90-degree angle to the pregnant person’s spine. In situations when a fetus cannot be turned into a head-down position by the time a person goes into labor, a cesarean section (C-section) will likely be required. Vaginal birth with a transverse position poses risks to the baby and the person giving birth.

It is estimated that between 2% to 13% of babies are in malposition at delivery—meaning that they are not in the cephalic (head down) position.

Black pregnant person with Black doctor

Marko Geber / Getty Images

Causes and Risk Factors

There are both physiological features that can cause a fetus to be in a transverse position, as well as certain risk factors that could increase the chances of that happening. These include having:

  • A bicornuate uterus, meaning that the uterus has two separate sides, so you may only be able to fit a fetus that is in the transverse position
  • Oligohydramnios or polyhydramnios, conditions which involve abnormally low or high amniotic fluid volume, respectively, during pregnancy

Other common risk factors include:

  • The position of the placenta (particularly, if the pregnant person has placenta previa)
  • Going into labor early
  • Being pregnant with twins or other multiples
  • The pregnant person’s pelvic structure
  • Having a different type of abnormality of the uterus
  • Having a cyst or fibroid blocking the cervix
  • Not being a person’s first pregnancy

Diagnosis

It’s not uncommon for a fetus to be in a transverse position in the earlier stages of pregnancy, but in most cases, the baby’s position shifts on its own before labor begins.

Because there are no signs or symptoms of having a fetus in a transverse position, healthcare professionals diagnose this through an examination method of Leopold’s Maneuvers, which involves touching the pregnant person’s abdomen to determine the fetal position. It is usually confirmed by an ultrasound.

Timing of Transverse Position Diagnosis

The ultrasound done at a pregnant person’s 36-week checkup will let the healthcare providers see the position of the fetus as it gets closer to labor and delivery. If it indicates that a fetus is still in a transverse lie position, the medical team will formulate a plan for delivering the baby as safely as possible.

Treatment

Approximately 97% of deliveries involve a fetus in cephalic presentation, which is when the baby’s head is down, making a vaginal delivery easier and safer. But approximately 1% of deliveries involve a fetus in a transverse lie position—meaning that its shoulder, arm, or trunk may present first.

In these cases, there are two options:

  • Attempting to manually turn the baby so that it can safely be delivered vaginally
  • Doing a C-section

Although it’s not always possible to manually rotate the fetus prior to delivery, if someone wants or needs to avoid a C-section, a healthcare provider can use one of the following techniques to attempt to move the baby:

  • External cephalic version (ECV): This is a procedure typically performed at about 27 weeks of pregnancy that involves two healthcare providers: one to lift up the baby’s buttocks to move it into an upward position and a second to apply pressure to the part of the uterus where the baby is located—through the abdominal wall—in order to rotate the baby’s head forward or backward.
  • Webster technique: This is a chiropractic method where a healthcare professional moves the pregnant person’s hips to allow their uterus to relax. Note, there isn’t evidence to support this method.

In addition, there are a few things a pregnant person can do at home to help the fetus get into a preferable position—though again, there are no guarantees these will work. The methods include:

  • Getting on their hands and knees, and gently rocking back and forth
  • Pushing their hips up in the air while laying on their back with their knees bent and feet flat on the floor—also known as bridge pose
  • Talking or playing music to stimulate the baby
  • Applying something that is cooler in temperature to the top of their abdomen (where the baby’s head is)

Can Babies Return to a Transverse Position After Being Moved?

Even if the baby does change positions, it is possible that it could return to a transverse position prior to delivery.

Complications

Whether the baby is born via C-section or had been moved to the point of allowing a vaginal delivery, other potential complications remain.

Cesarean Sections

While C-sections are generally safe for both the baby and the person delivering it, there are some inherent risks associated with the procedure, as there are with any surgery. For the pregnant person, these can include:

  • Increased bleeding
  • Infection
  • Bladder or bowel injury
  • Reactions to medicines
  • Blood clots
  • Death (very rare)

C-sections can also result in potential—though rare—complications for the baby, including:

  • Possible injury
  • Occasional breathing problems if they still have fluid in their lungs to clear

Vaginal Delivery

Even if the healthcare provider is able to rotate the fetus to the point where it could be safely delivered vaginally, labor will typically take longer, and it is possible that the baby’s face may be swollen and appear bruised. If that happens, it’s not cause for concern, as these changes tend to go away within a few days of birth.

If the umbilical cord is compressed during birth, it could potentially deprive the baby of oxygen, and the baby may appear to be in distress on the fetal monitor, which could necessitate a C-section.

Coping

As with any birth, the pregnant person should work with their healthcare provider to develop a delivery plan. If the fetus has been in a transverse position throughout the pregnancy, the medical team will evaluate the position at about 36 weeks and make plans accordingly.

It’s also important to remember that even if the baby is head down, things can change quickly during labor and delivery, so it’s also helpful for the pregnant person and their healthcare provider to discuss options for different types of delivery, should that be necessary.

A Word From Verywell

Pregnancy comes with so many unknowns, and the surprises can continue up until and including during labor and delivery.

Having conversations with your healthcare provider about possible childbirth scenarios early on in the pregnancy can give you the time to start thinking about possible outcomes. This helps to avoid a situation where you’re considering the risks and benefits of a particular strategy for the first time when the decision has to be made.

And even if the fetus is in a transverse lie position throughout the pregnancy, it may help to know that when the time comes to deliver, only around 1% of babies are still in that position.

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