A baby’s position in the uterus influences labor and delivery. As pregnancy progresses, the baby’s orientation becomes important for a smooth birth. Most babies move into a head-down position by full term, but variations can occur. Identifying a non-ideal position allows for assessment and interventions to support a safe birth.
What “Sideways Baby” Means
A “sideways baby” is medically known as a transverse lie. In this orientation, the baby lies horizontally across the uterus, with its head typically on one side and its feet on the other. This contrasts with the more common longitudinal lie, where the baby is positioned vertically. A transverse lie is common in early pregnancy, but it becomes less frequent as the due date approaches. By the final weeks, only about 1 in 300 to 1 in 500 babies remain in this position, which is not conducive to a vaginal delivery as it can lead to complications for both mother and baby.
Feeling for Position: What to Look For
A pregnant individual might notice signs if their baby is in a transverse lie, such as the abdomen appearing wider than tall, and the top of the uterus feeling flatter or lower. When feeling the belly, there might not be a distinct head or bottom in the lower or upper pelvis. Instead, a firm, rounded shape (head) might be palpable on one side, and a softer, wider area (bottom) on the opposite side. Kicks and movements may be felt primarily on the sides. These observations provide clues but are not definitive for diagnosis.
Medical Diagnosis of Fetal Position
Healthcare providers use specific methods to determine fetal position. One common technique is Leopold’s Maneuvers, which involve palpating the abdomen to feel for the baby’s head, bottom, and back. If a transverse lie is present, neither the head nor bottom will be felt in the upper or lower uterus. Ultrasound is the primary diagnostic tool for confirming fetal position, providing a clear visual of the baby’s exact lie. These assessments are typically performed around 36 weeks of pregnancy, when the baby’s position is more stable for birth planning.
Next Steps for a Sideways Lie
Once a transverse lie is identified, particularly in the later stages of pregnancy, various factors are considered. Reasons a baby might remain in this position include too much amniotic fluid (polyhydramnios) or too little (oligohydramnios). Uterine abnormalities, such as fibroids or an unusually shaped uterus, can also influence fetal positioning. Multiple pregnancies and placenta previa (where the placenta covers the cervix) are additional factors.
If a baby remains in a transverse lie, an external cephalic version (ECV) may be attempted. This procedure involves a healthcare provider applying gentle, external pressure to the mother’s abdomen to manually turn the baby into a head-down position. ECV is typically performed in a hospital setting with continuous monitoring of the baby’s heart rate. The success rate for ECV varies, with studies reporting rates ranging from 35% to 86%, though a common figure is around 50-60%. It is often more successful for transverse lies than for breech presentations.
If ECV is not possible or is unsuccessful, a planned Cesarean section (C-section) is generally recommended for delivery. A vaginal birth is typically not safe for a baby in a transverse lie due to the risk of complications such as umbilical cord prolapse, where the cord drops before the baby, or uterine rupture. Working closely with a healthcare provider throughout this process is important for monitoring the baby’s position and making informed decisions about the safest delivery plan.