Babies move and groove in the uterus throughout pregnancy. You may feel your baby’s head down low in your pelvis one day and up near your rib cage the next.
Most babies settle into a head-down position close to delivery, but you may notice your doctor checking your baby’s position from time to time. This is partly because your baby’s position in the womb affects your labor and delivery.
Here’s more about different positions your baby may move into in later pregnancy, what you can do if your baby isn’t in an ideal position, and what options are available if your baby won’t move.
Transverse lie is also described as lying sideways or even shoulder presentation. It means that a baby is positioned horizontally in the uterus.
Their head and feet may be at either the right or left side of your body and their back may be in a few different positions — facing the birth canal, one shoulder facing the birth canal, or hands and stomach facing the birth canal.
Favoring this position close to delivery is relatively rare. In fact, only around one out of every 500 babies settle into a transverse lie in the final weeks of pregnancy. This number could be as high as one in 50 before 32 weeks gestation.
What’s the issue with this position? Well, if you go into labor with your baby settled this way, their shoulder may enter your pelvis before their head. This could lead to injury or death for your baby or complications for you.
A less risky — but still very real — concern is that this position can be uncomfortable or even painful for the person carrying the baby.
There are several other ways babies can position themselves in the womb:
- Vertex. Baby’s head is pointed down toward the vaginal canal.
- Anterior: head is down and facing down (away from your belly button)
- Posterior: head is down and facing up (toward your belly button)
- Breech. Baby’s bottom is pointed down toward the vaginal canal. This is the case in only 3 to 4 percent of births at full term.
- Frank breech: head is up and bottom is closest to the vaginal canal, feet are up toward the head
- Complete breech: head is up and knees/feet are closest to the vaginal canal (incomplete breech means only one knee/foot is below the buttocks ).
Related: Why vaginal pressure during pregnancy is totally normal
Determining baby’s position
You may feel lumps and bumps all over your tummy. Movements of fingers … or are they toes? It’s hard to tell sometimes. So, how can your doctor tell what’s what?
They use Leopold’s maneuvers, which is the term used to describe how your provider feels around for different landmarks in your belly. With enough practice, your doctor can tell a head from a bottom from a foot.
However, if it’s difficult to tell for whatever reason, your doctor can also send you for an ultrasound to get a clearer picture of exactly how your baby is positioned in your uterus.
Some babies may just settle into a transverse lie for no specific reason. That said, certain situations make this position more likely, including:
- Body structure. It’s possible to have a pelvis structure issue that prevents your baby’s head from engaging in later pregnancy.
- Uterine structure. It’s also possible there’s a uterine structure issue (or fibroids, cysts) that prevents your baby’s head from engaging in later pregnancy.
- Polyhydramnios. Having too much amniotic fluid later in your pregnancy can allow your baby room to move when they should start engaging the pelvis. This condition occurs in only 1 to 2 percent of pregnancies.
- Multiples. If there are two or more babies in the uterus, it may mean that one or more is either breech or transverse simply because there’s more competition for space.
- Placenta issues. Placenta previa is also associated with breech or transverse presentation.
Related: Difficult labor: Birth canal issues
Again, babies can enter this position earlier on in pregnancy without it being an issue. It may be uncomfortable for you, but it’s not risky for your baby to be positioned this way.
But if your baby is transverse in the last few weeks before delivery, your doctor may be concerned about delivery complications and — if not caught soon enough — stillbirth or uterine rupture.
There’s also a small chance of umbilical cord prolapse, which is when the cord exits the uterus before the baby and is compressed. A cord prolapse can potentially cut off oxygen to the baby and be a contributing factor to stillbirth.
Related: What is abnormal labor?
If you’ve recently learned that your baby is lying transverse, don’t fret! Various techniques can be used to adjust your baby’s position in your uterus.
If you are beyond week 37 of your pregnancy and your baby is transverse, your doctor may want to do an external cephalic version to coax your baby into a more optimal position. External cephalic version involves your doctor placing their hands on your tummy and applying pressure to help your baby rotate into a head-down position.
This procedure may sound intense, but it’s safe. Although, the pressure and movement can be uncomfortable, and its success rate isn’t 100 percent. For example, with breech babies, it works only around 50 percent of the time to allow for vaginal delivery.
There are some instances in which your doctor may choose not to try to move your baby this way, such as if your placenta is in a tricky location. Regardless, it’s important to note that when this procedure is done, it’s done in a place where an emergency C-section could be available if it’s needed.
You may have heard you can encourage your baby into a better position from the comfort of your home. This may or may not be true depending on the reason why your baby is transverse, but it’s worth a try.
Before you try these methods, ask your doctor or midwife about your plans and if there are any reasons you shouldn’t do things like inversions or certain yoga poses.
Inversions are movements that put your head below your pelvis. Spinning Babies suggests trying a “big turning day” routine approach. Again, you don’t necessarily need to try these things until you’ve gone beyond the 32-week mark in your pregnancy.
To do this move, you’ll carefully kneel at the end of a couch or low bed. Then slowly lower your hands to the floor below and rest on your forearms. Do not rest your head on the floor. Do 7 repetitions for 30 to 45 seconds, separated by 15-minute breaks.
To do this move, you’ll need a long board (or ironing board) and a cushion or large pillow. Prop the board at an angle, so the center of it is resting on the seat of a sofa and the bottom is supported by the pillow.
Then position yourself onto the board with your head resting on the pillow (get additional pillows if you want more support) and your pelvis is toward the center of the board. Let your legs hang on either side. Do 2 to 3 repetitions for 5 to 10 minutes a repetition.
Yoga practice also involves positions that invert the body. Instructor Susan Dayal suggests trying mild inversions, like Puppy Pose, to encourage good positioning with transverse babies.
In Puppy Pose, you’ll start on your hands and knees. From there, you’ll move your forearms forward until your head rests on the floor. Keep your bottom up and your pelvis directly over your knees, and don’t forget to breathe.
Massage and chiropractic care
Massage and chiropractic care are other options that can help manipulate the soft tissues and encourage your baby’s head to go into the pelvis. In particular, you may want to seek out chiropractors who are trained in the Webster technique, as it means they have specific knowledge of pregnancy and pelvic issues.
Related: Chiropractor while pregnant: What are the benefits?
Whether these methods help with positioning is a bit of a grey area. Although, there’s a good deal of anecdotal evidence to suggest they’re worth trying.
But even if all these acrobatics don’t turn your baby, you can safely deliver via C-section. While it may not be the birth you had planned, it’s the safest route if your baby is persistently sideways, or if there’s some reason he cannot move into a more optimal position.
Be sure to ask your healthcare provider plenty of questions and voice your concerns with a change in your birth plan. A safe mom and healthy baby are important beyond all else, but your doctor may be able to help alleviate some of your worries or demystify the process to make you feel more comfortable.
What about twins?
If your lower twin is head down during labor, you may be able to deliver your twins vaginally — even if one is breech or transverse. In this case, your doctor would deliver the twin who is head down first.
Often the other twin will then move into position, but if not, the doctor can try using external cephalic version before delivery. If this does not coax the second twin into a better position, your doctor may perform a C-section.
If the lower twin is not head down during labor, your doctor may advise you to deliver both via C-section.
While rare, your baby may decide to settle into the transverse lie position for a variety of reasons, including simply because they’re most comfortable there.
Remember that being transverse isn’t necessarily a problem until you reach the end of your pregnancy. If you are still in the first, second, or early third trimester, there’s time for your baby to move.
Regardless of your baby’s position, keep up with all of your regular prenatal care visits, especially toward the end of your pregnancy. The sooner any issues are detected, the sooner you can create a game plan with your healthcare provider.