Why Is My Baby Transverse? Causes and Solutions for a Transverse Lie Pregnancy

Why Is My Baby Transverse? Understanding Transverse Lie and What It Means for Your Pregnancy

During pregnancy, your baby’s position is something your healthcare team will closely monitor as part of your antenatal care. Most babies settle into a head-down position towards the end of the third trimester, which is ideal for a vaginal birth. However, some babies lie sideways in the uterus, known as a “transverse lie”. This is a cause for concern for many expectant parents, as it may affect the method of delivery.

If you’ve been told that your baby is in a transverse lie position, you may be wondering what this means for your pregnancy, delivery, and what options you have. In this article, we will explain why babies may be transverse, the potential risks, and how antenatal support can help you navigate the situation, as well as the possible interventions or strategies to help encourage your baby into a more optimal position for birth.

What is a Transverse Lie?

A transverse lie refers to when a baby lies horizontally across the uterus, with their head on one side and their feet on the other. This is different from a breech position, where the baby is positioned with their bottom or feet down, or the ideal head-down position for birth. Transverse lie occurs in about 1 in 200 pregnancies at full term (Royal College of Obstetricians and Gynaecologists, 2020), although it is more common in the earlier stages of pregnancy.

It’s important to understand that the position of your baby during pregnancy can change frequently, especially in the earlier stages. However, as you approach the third trimester, the baby typically moves into the head-down position in preparation for labour. If your baby remains transverse beyond 34 weeks, it may pose a challenge for delivery.

Why Is My Baby Transverse?

There are several reasons why a baby may lie in a transverse position during pregnancy. Some of the most common causes include:

Excess amniotic fluid (polyhydramnios): If there is more amniotic fluid than usual, there is more room for the baby to move around. This can make it harder for the baby to settle into the head-down position.

Multiple pregnancies: In the case of twins or multiples, there is often less space in the uterus, and the babies may have more room to move into different positions, including transverse.

Uterine abnormalities: Certain conditions, such as fibroids or a septate uterus (a uterus that is divided by a fibrous wall), can restrict the space available for the baby, making it more likely to be in a transverse position.

Previous pregnancies: Some women, particularly those who have had several pregnancies before, may have a uterus that is more relaxed, leading to more space for the baby to move into unusual positions, including transverse.

Placenta previa: This is a condition where the placenta is positioned over the cervix, potentially blocking the baby from engaging in the right position. This can lead to the baby remaining in a transverse lie.

Premature labour or early delivery: If the baby is born early, they may not have had enough time to rotate into the head-down position before birth.

What Are the Risks of Having a Transverse Lie Baby?

While many babies that are transverse early in pregnancy do turn into the right position before birth, if your baby remains transverse as you approach term, it can complicate delivery. Some of the risks associated with a transverse lie include:

Failed vaginal delivery: A transverse baby cannot be delivered vaginally because their body is sideways in the birth canal. Attempting to deliver a transverse baby vaginally could cause serious complications, such as cord prolapse or fetal distress.

Caesarean section: The most common mode of delivery for a transverse lie baby is a caesarean section. This is because the baby’s position makes vaginal delivery unsafe. Although a C-section carries its own risks, such as longer recovery times and potential complications, it may be necessary for the safety of both the baby and the mother.

Cord prolapse: With a transverse lie, there is a risk that the umbilical cord could slip through the cervix before the baby is delivered, which can be dangerous and lead to a lack of oxygen for the baby.

Injury to the baby: Since a transverse lie does not allow the baby to pass smoothly through the birth canal, there is a risk of injury during delivery, especially if the baby is in distress or if interventions are required.

Preterm birth: In some cases, transverse lie babies may be more likely to be born prematurely, particularly in the case of multiple pregnancies, where premature birth is more common.

How Can I Know If My Baby Is Transverse?

Your healthcare provider will likely be able to detect the baby’s position through an antenatal checkup. This may involve palpating your abdomen (feeling your tummy) or using antenatal scans (ultrasound) to confirm the baby’s position. If your baby is transverse, your midwife or doctor will monitor their position carefully as your due date approaches.

If your baby is in a transverse lie position during a routine antenatal scan or checkup, your healthcare team will discuss the next steps with you. This might involve trying to turn the baby or planning for a caesarean section if the baby doesn’t turn naturally.

What Can I Do If My Baby Is Transverse?

If you are told that your baby is transverse, don’t panic. There are several strategies your healthcare team might recommend to encourage the baby to move into a head-down position:

External cephalic version (ECV): This is a procedure where your healthcare provider will try to turn the baby manually by gently applying pressure on your abdomen. ECV is usually performed at around 37 weeks gestation and can be successful in moving the baby into the right position for delivery. However, not all babies are candidates for ECV, and it depends on factors such as the baby’s size, fluid levels, and the shape of your uterus.

Antenatal yoga and exercises: Practising antenatal yoga and certain stretches may help encourage your baby to turn into the right position. Specific movements like the “forward leaning inversion” or “pelvic tilts” may help create more space in the uterus for the baby to rotate. Pregnancy yoga classes can be a good way to safely practice these moves under professional guidance.

Moxibustion: This traditional Chinese medicine technique involves applying heat to specific acupuncture points on the little toes. Some studies have suggested that moxibustion may help encourage babies to turn from a breech or transverse position.

Acupuncture: Similar to moxibustion, acupuncture is sometimes used as a complementary treatment to help encourage the baby into the correct position. Consult with a practitioner who is experienced in pregnancy-related acupuncture.

Sleep position: Some women find that sleeping in certain positions, such as leaning slightly forward or spending time on hands and knees, may help encourage their baby to turn.

Antenatal massage: While prenatal massage is mostly known for relaxation and reducing pregnancy discomforts, it can also help relieve tension in the pelvis and encourage proper positioning of the baby.

Conclusion: Preparing for Birth with a Transverse Lie

While having a transverse lie baby can be concerning, there are options available to try and correct the position. Working closely with your antenatal clinic and following their advice will help ensure the best possible outcome for both you and your baby. Regular antenatal checkups, combined with the right antenatal care, will help monitor your baby’s position and allow your healthcare provider to discuss the safest way to approach your birth.

Ultimately, while a transverse lie may require special attention, it doesn’t necessarily mean a problematic outcome. Keep an open line of communication with your healthcare team, explore the options available to you, and remember that antenatal support is there to help you navigate this challenge with confidence.