The baby's position is crucial for a safe and easy delivery at the end of a pregnancy. Babies roll around and keep moving throughout the pregnancy. As the due date gets closer, they slowly start getting into position. What if the baby does not get into position? What if the head does not engage when labour begins, and the baby is in a transverse position? Read this before panicking.
A transverse baby position occurs when the baby is lying sideways in the womb at a 90-degree angle to the mother’s spine.
It is common for a baby to keep moving around and be sideways during the pregnancy. However, most babies will start turning into the head-down or head-up position in the last few weeks of pregnancy. When the baby does not get into position even towards the end of the pregnancy, it can lead to complications during the delivery.
No one can predict the position of the baby towards the end of the pregnancy. Babies can turn and get into the correct position even after labour starts. Some risk factors that increase the chances of a transverse baby position are:
● Uterus Shape—A bicornuate uterus has a deep V shape on top that separates the uterus into two sides, thus creating space for the baby to lie sideways.
● Amniotic Fluid – When the amniotic fluid is too high (polyhydramnios), the baby can keep moving till the end of pregnancy and be in a transverse position before the delivery. Similarly, when the amniotic fluid is too low (oligohydramnios), the baby’s movements reduce, and they may be stuck in the transverse position.
● Placenta Previa – When the placenta is too low and is blocking the vaginal opening, the baby cannot get into the head-down position for delivery.
● Preterm Labour – When the mother goes into labour early, the baby may not have the chance to get into the right position.
● Multiple Pregnancy – When there is more than one baby in the uterus, there may not be enough space for the babies to change positions.
● Pelvic Structure – An abnormal pelvic structure of the mother can prevent the baby from descending into position.
● Blocked Cervix—If a cyst or fibroid is blocking the cervix, the baby may stay in the transverse position.
Some transverse baby position symptoms are:
● You can feel the baby stretching out to your sides instead of top to bottom
● You can feel their head or the kicks on your sides
● The top part of your uterus can be lower in your abdomen, thus making both feel flatter on top.
Also known as a transverse fetal lie, this position is not suitable for a vaginal delivery. If the baby does not turn into a head-up or a head-down position by week 30 or 31, the following can happen:
● The baby can get into the right position on its own. This can happen any time before or even after labour starts. However, the chances for the baby to turn on its own from a transverse position in late pregnancy are very slim.
● The doctors may try to turn the baby within the womb by using the External Cephalic Version or the Webster technique, to get the head towards the vaginal opening.
● Your doctor will deliver the baby via C-section.
A transverse baby position can increase the risk of placental abruption, foetal distress, preterm labour, irregularities in the fetal heart rate or premature rupture of the membranes.
This position can also have the following complications during or after the successful delivery of the baby:
In the case of a successful vaginal delivery –
● The labour is usually longer
● Baby’s face may appear swollen or injured for the first few days
● The umbilical cord may exit before the baby, thus cutting off the oxygen supply to the baby
In the case of a successful caesarean delivery:
● Injury to the baby
● Breathing issues in the baby in case of fluid presence in the lungs
● Change in the C-section cut to suit the baby’s position
● Increased bleeding in the mother
● Injury to the mother’s bladder or bowel
● Blood clots or infection in the mother
● In very rare cases, it can also be fatal.
If your last scan shows the baby in the transverse position, your doctor will start tracking the position. At every prenatal visit, they will check if the baby’s position is changing or even try to turn the baby.
Developing a birthing plan a few weeks before the due date can help you and the healthcare provider prepare for the transverse position delivery and reduce last-minute risks and complications.
Discuss what you want to try and what you want to avoid. Even if the baby comes into position, these discussions can help handle complications more smoothly.
A transverse baby position is not the optimal position for a vaginal delivery. However, if you are with a well-experienced doctor in a good hospital with all the facilities to handle emergencies, then you need not worry about the baby’s safety. If feasible, the doctor may try to turn the baby or opt for a C-section delivery to ensure the baby’s safety.
A standard delivery is highly unlikely if the baby is in a transverse position during the time of delivery. In very rare cases, the doctors may try and successfully turn the baby’s position for a vaginal delivery. The only other option is delivering the baby through a caesarean section.
Yes, a woman can go into labour when the baby is still in a transverse position. However, this can quickly become an emergency situation as the contractions can obstruct or cut off the oxygen supply to the baby.
The reasons for a baby to lie in a transverse position can be plenty. It could be due to the placenta position, the lack of space, going into preterm labour before the baby had a chance to turn around, too much amniotic fluid could enable the baby to keep moving around, the pelvic structure of the mother that prevents the baby from moving into position, or some uterine abnormalities that are preventing the baby’s head from engaging.
A transverse position is when the baby is lying sideways in the womb. During delivery, this position can cause a lot of issues, like the umbilical cord exiting the vagina before the baby, thus cutting off the oxygen supply. It can also cause uterine rupture, injury to the baby during the delivery, stillbirth, birth defects, infection, obstructed labour or postpartum haemorrhage.
