A transverse lie occurs when a baby is positioned horizontally across the uterus instead of the typical head-down or feet-down position. While it is common for babies to be in this sideways position early in pregnancy, most will shift to a head-down position as the due date approaches. However, if the baby remains transverse in the later stages of pregnancy, it is considered a less common fetal presentation. Awareness of this position is important for expectant parents as it impacts birth planning.
Recognizing Maternal Signs
Pregnant individuals might notice sensations or physical changes that could suggest a transverse lie. Fetal movements often feel different, with kicks and punches primarily perceived on the sides of the abdomen rather than towards the pelvis or ribs. There might be an absence of strong, directed movements in the upper or lower parts of the abdomen.
The shape and feel of the abdomen can also provide clues. The pregnant belly might appear wider from side to side rather than longer from top to bottom. Some individuals report feeling an “empty” sensation in the pelvis or the upper part of the uterus, while simultaneously feeling the baby’s head or bottom distinctly on either side of the belly. This horizontal positioning might also lead to discomfort, such as pressure on the hips or ribs, from the baby’s back or head. These observations are indicators and should prompt a discussion with a healthcare provider for assessment.
Clinical Confirmation and Next Steps
When a transverse lie is suspected, healthcare professionals employ methods to confirm the baby’s position. A physical examination involves the doctor or midwife palpating, or feeling, the abdomen to locate the baby’s head and bottom. In a transverse lie, the head or buttocks cannot be felt at the bottom of the uterus, and the head is usually felt on one side.
An ultrasound scan provides definitive visual confirmation of the baby’s orientation within the uterus. This non-invasive technique allows healthcare providers to assess fetal lie, presentation, and other factors, providing objective, reliable information. If a transverse lie is confirmed, continued monitoring is necessary. Healthcare providers will discuss the implications of this diagnosis and explore management strategies tailored to the individual’s situation.