What Is a Transverse Baby Position?

A transverse baby position, also called transverse fetal lie, is when the unborn baby is sideways—at a 90-degree angle to your spine—instead of head up or head down. A transverse baby can't be delivered vaginally without posing major risks to both you and the child.

Sometimes, a transverse baby will turn itself into the head-down position before you go into labor. Other times, a healthcare provider may be able to turn the baby.

If a transverse baby can't be turned to the right position before it's ready to be born, you're likely to have a cesarean section (C-section).

This article looks at causes and risk factors for a transverse baby position. It also covers how it's diagnosed and treated, the possible complications, and how you can plan ahead for delivery.

Causes and Risk Factors

Physiological issues can cause a transverse baby position. These include:

• A bicornuate uterus: The uterus has a deep V in the top that separates the uterus into two sides; it may only be able to hold a near-term baby sideways.
• Oligohydramnios or polyhydramnios: Abnormally low or high amniotic fluid volume (respectively).

Several risk factors can make it more likely for your baby to be transverse, such as:

• The placenta being in an unusual position, such as blocking the opening to the cervix (placenta previa), which doesn't allow the baby to reach the head-down position
• Going into labor early, before the baby has had a chance to get into the right position
• Being pregnant with twins or other multiples, as the uterus is crowded and may not allow for much movement
• An abnormal pelvic structure that limits the baby's movements
• Having a cyst or fibroid tumor blocking the cervix

Transverse baby positioning is also more common after your first pregnancy.

Diagnosis

It’s not uncommon for a baby to be in a transverse position during the earlier stages of pregnancy. In most cases, though, they shift on their own well before labor begins. The transverse baby position doesn't cause any signs or symptoms.

Healthcare professionals diagnose a transverse lie through an examination called Leopold’s Maneuvers. That involves feeling your abdomen to determine the baby's position. It's usually confirmed by an ultrasound.

You may also discover that your baby is transverse during a routine ultrasound.

Delivery

Approximately 97% of deliveries involve a baby that's head is down. That makes a vaginal delivery easier and safer, as the baby is in the best position to slide out.

A transverse baby position only happens in about 1% of deliveries. In that position, the baby's shoulder, arm, or trunk may present first. This isn't a good scenario for either of you—it's nearly impossible for a transverse baby to be vaginally delivered.

In these cases, you have two options:

• Turn the baby
• Have a C-section
  

Turning Your Baby

If your baby is in a transverse position late in pregnancy, you or your healthcare provider may be able to turn it. Getting the baby into the proper head-down position may help you avoid a c-section.

Medical Options

A healthcare provider can use one of the following techniques to attempt re-positioning your baby:

• External cephalic version (ECV): This procedure typically is performed at or after 36 weeks of pregnancy; involves using pressure on your abdomen where the baby's head and buttocks are.
• Webster technique: This is a chiropractic method in which a healthcare professional moves your hips to allow your uterus to relax and make more room for the baby to move itself. (Note: No evidence supports this method.)

A 2020 study reported a 100% success rate for trained practitioners turning transverse babies. Real-world success rates are closer to 60%.

At-Home Options

You may be able to encourage your baby to move out of the transverse position at home. You can try:

• Getting on your hands and knees and gently rocking back and forth
• Lying on your back with your knees bent and feet flat on the floor, then pushing your hips up in the air (bridge pose)
• Talking or playing music to stimulate the baby so it gets more active
• Applying some cold to your abdomen where the baby’s head is, which may make them want to move away from it

These methods may or may not work for you. While there's anecdotal evidence that they sometimes work, they haven't been researched.

Talk to your healthcare provider before attempting any of these techniques to ensure you're not doing anything unsafe for you or your child.

Complications

Whether the baby is born via C-section or is successfully moved so you can have a vaginal delivery, potential complications remain.

Cesarean Sections

C-sections are extremely common and are generally safe for both you and your baby. Still, some inherent risks are associated with the procedure, as there are with any surgery.

The transverse position can force the surgeon to make a different type of incision, as the baby may be lying right where they'd usually cut. Possible c-section complications for you can include:

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

In rare cases, a C-section can result in potential complications for the baby, including:

• Injury
• Breathing problems, if fluid needs to be cleared from their lungs

Most C-sections are safe and result in a healthy baby and parent. In some situations, a surgical delivery is the safest option available.

Vaginal Delivery

If your child is successfully moved out of the transverse baby position, you'll likely be able to deliver it vaginally. However, a few complications are possible even after the baby has been moved:

• Labor typically takes longer.
• Your baby’s face may be swollen and appear bruised for a few days.
• The umbilical cord may be compressed, potentially causing distress and leading to a C-section.

Studies suggest that ECV is safe, effective, and may help lower the c-section rate.

Planning Ahead

As with any birth, if you have a transverse baby position, you should work with your healthcare provider to develop a delivery plan. If your baby has been transverse position throughout the pregnancy, the medical team will evaluate the position at about 36 weeks and make plans accordingly.

Remember that even if your baby's head is down late in pregnancy, things can change quickly during labor and delivery. That means it's worthwhile to discuss options for different types of delivery in case they become necessary.

Summary

A transverse baby position is the term for a baby lying sideways in the uterus. Vaginal delivery of a transverse baby usually isn't possible.

If the baby is in this position near the time of delivery, the options are to turn the baby to make vaginal delivery possible or to have a c-section. A trained healthcare provider can use turning techniques. You may also be able to get the baby to turn at home with some simple techniques.

Both c-section and vaginal delivery after the baby is turned pose a risk of certain complications. However, these problems are rare and the vast majority of deliveries end with a healthy baby and parent.

A Word From Verywell

Pregnancy comes with many unknowns, and the surprises can continue up through labor and delivery.

Talking to your healthcare provider early on about possible scenarios can give you time to think about possible outcomes. This helps to avoid a situation where you’re considering risks and benefits during labor when quick decisions need to be made.