A “transverse baby” lies horizontally across the uterus instead of in the typical head-down or feet-down position. While common earlier in pregnancy, most babies naturally shift head-down as the due date nears. If a baby remains transverse late in pregnancy, it can present delivery challenges. Always consult a healthcare provider before attempting any methods to encourage turning.
Understanding a Transverse Lie
A transverse lie means the baby is lying sideways in the womb, perpendicular to the mother’s spine. This position is common in early pregnancy due to ample space. If it persists into late pregnancy, typically around 36 weeks or later, it is diagnosed as a transverse lie.
Factors contributing to a transverse position include multiple previous pregnancies, which can loosen abdominal muscles. Conditions like placenta previa, uterine anomalies (e.g., a bicornuate uterus), or excess amniotic fluid (polyhydramnios) can also provide too much space, allowing the baby to remain sideways.
Reasons to Encourage Fetal Turning
If a baby remains in a transverse lie near term, vaginal birth is generally not possible, increasing the likelihood of a Cesarean section (C-section). The baby’s shoulder or back would present first, which cannot safely pass through the birth canal. This position increases the risk of labor complications.
One complication is premature rupture of membranes, which can lead to umbilical cord prolapse. This occurs when the cord descends before the baby, potentially cutting off oxygen supply. Turning the baby to a head-down (cephalic) position before labor significantly reduces these risks, improving chances for a safe vaginal delivery.
Non-Medical Approaches to Encourage Turning
Many non-medical methods can encourage a baby to turn, but always discuss them with a healthcare provider. These techniques often use gravity or create more uterine space. Their effectiveness varies and is not guaranteed.
Positional Changes and Exercises
Positional changes and gentle exercises are common. Pelvic tilts (hips elevated while lying on the back), hands and knees positions, and inversions (like using an ironing board propped against a couch) can encourage the baby to shift by altering uterine shape. Cat-cow yoga poses also stretch and create space.
Acupuncture and Moxibustion
Acupuncture and moxibustion are traditional Chinese medicine practices. Moxibustion involves burning dried mugwort near specific acupressure points to stimulate fetal movement. Trained practitioners typically perform these techniques.
Chiropractic Care
Chiropractic care, specifically the Webster Technique, focuses on aligning the pelvis and releasing tension in surrounding ligaments. An aligned pelvis provides optimal space for the baby to move head-down. This approach aims to remove musculoskeletal restrictions hindering the baby’s natural turning.
Other Approaches
Water-based activities like swimming or floating may also be suggested. Water’s buoyancy can reduce gravity’s effect, allowing easier movement. Some parents also try sensory stimulation, placing headphones with music or a flashlight at the lower abdomen, hoping the baby moves towards the source.
Medical Interventions for Fetal Position
When non-medical approaches are not successful or deemed unsuitable, medical interventions become an option to address a transverse lie. These procedures are performed by healthcare professionals, often in a hospital setting, to ensure the safety of both mother and baby.
External Cephalic Version (ECV)
External Cephalic Version (ECV) is a procedure performed by a doctor to manually attempt to turn the baby from outside the mother’s abdomen. During an ECV, the doctor applies firm but gentle pressure to the abdomen to guide the baby into a head-down position. This procedure is typically attempted late in pregnancy, usually around 36 to 37 weeks, when the baby is still mobile but close enough to term.
ECV has a reported success rate that can vary, with some sources indicating it works in over half of cases, particularly for transverse or oblique presentations. Potential risks, though uncommon, include temporary changes in fetal heart rate, premature labor, or, in rare instances, placental abruption. Due to these potential risks, ECV is performed with continuous monitoring of the baby’s heart rate and with emergency C-section facilities readily available.
If ECV is unsuccessful in turning the baby, or if there are other reasons that make it unsafe or ineffective, a planned C-section becomes the safest delivery option for a persistent transverse lie. This surgical delivery prevents the complications that could arise if labor were to begin with the baby in a transverse position, ensuring a controlled and safe birth for both the mother and the baby.