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What to Know About the Transverse Baby Position

In most cases, baby will flip to a vertical position on their own. But if they insist on staying transverse—aka side-to-side—you might need medical intervention.
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By Dani Wolfe, Contributing Writer
Updated November 20, 2023
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Image: Hilary Walker

Babies like to kick, do somersaults and perform acrobatics in utero during pregnancy (especially when you’re trying to sleep, of course). But toward the end of the third trimester, they tend to settle into a vertical and head-down (as opposed to breech) position—usually, that is. Once in a while, baby stays put in the transverse baby position: In other words, they remain horizontal. But what does this mean for your labor and delivery experience? Read on to find out the potential risks and complications of the transverse baby position, how to try to turn a transverse baby and more.

What Is a Transverse Baby?

A transverse baby is positioned horizontally. Basically, they’re resting side-to-side instead of up-and-down in the uterus, according to the Icahn School of Medicine at Mount Sinai in New York City. Transverse lie is more common when you deliver before your due date, or have twins or triplets. While many babies are horizontal early on in pregnancy, most flip vertically toward the end of gestation. In fact, less than 1 percent of babies are in a transverse position by the time of delivery.

What Are Transverse Lie Baby Symptoms?

It’s not always easy to spot signs of transverse baby yourself, says Andrea Braden, MD, IBCLC, an ob-gyn, lactation consultant and CEO and co-founder of lactation company Lybbie. Typically, she says, you’ll notice a wideness in the center of your abdomen if baby is transverse.

Here are some other transverse lie baby symptoms to look out for, according to Ellen Smead, CNM, a certified nurse-midwife at Pediatrix Medical Group in Atlanta:

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  • The top part of your uterus might feel flatter and be positioned lower in your abdomen
  • You might feel baby stretching out to the sides, but not top-to-bottom
  • There may be an improvement in your breathing due to baby’s position

Keep in mind that where baby’s kicking isn’t always a reliable predictor of transverse baby position. “Feet can kick in all different directions,” says Braden. “Sometimes their feet are at their heads, and sometimes they’re out to the side and sometimes they’re down below.”

Causes of Transverse Baby Position

A transverse baby position can happen for both anatomical reasons or circumstances, like having had many children. Here are the most common reasons, according to experts:

  • The expecting person’s anatomy. Narrow hips can mean less space near the pelvic opening, which might make it harder for baby to flip vertically, says Braden.

  • Uterine fibroids. Uterine fibroids are (generally harmless) growths that can take up space in the uterus and limit baby’s movement, notes Smead.

  • Uterus shape. Uteruses with a heart shape or a slight separation in the middle can increase the chance that baby will settle sideways, says Smead.

  • Multiple past pregnancies. A uterus that has supported the growth of several children can sometimes be more elastic, and baby can then move, turn and change positions frequently as there’s more room and ability to do so, explains Smead.

It’s important to note that, more often than not, the transverse baby position is temporary. “It’s pretty common to have a baby transverse at different points throughout the pregnancy,” reassures Braden. She adds that, sometimes, babies hang out horizontally for a bit before eventually going vertical and head-down. “If they’re moving between breech to cephalic, or head-down, that transitional point in-between might have baby set up in a transverse way,” she says.

Potential Risks and Complications of Having a Transverse Baby

A transverse baby increases the risk of umbilical cord prolapse (when the umbilical cord comes out before baby), says Braden. This can be an emergency situation because it can cut off oxygen supply to baby. If labor begins when baby is still in transverse lie, a c-section is generally necessary, says Smead.

Some practitioners will try to turn baby first “if it’s not a difficult reach, and if there’s enough fluid around baby,” says Braden. “Otherwise, a lot of people will just move towards a c-section to prevent breaking water and having a cord prolapse-type of complication.”

How to Turn a Transverse Baby

There are some things you can do to help baby move from a transverse position into a vertical one. Options include gentle movements at home and medical interventions when necessary. Consult with your medical provider if you’re unsure of which method to choose.

Safe DIY ways to encourage transverse baby to turn

At home, pregnant people can try a couple of things to encourage baby to move into an up-and-down position. “[Lean] far forward over a couch or chair and [rock] the hips while gently massaging the sides of the abdomen,” says Smead. “Usually positioning and stretches involving inversion, or having the hips and bottom higher than the belly, encourage changing fetal position.”

Medical interventions to get a transverse baby to turn

Your provider can also try out a few things to help turn baby. One is an external cephalic version (ECV). The Cleveland Clinic notes that with an ECV, a prenatal specialist will place their hands on the belly to twist and turn baby to a head-down position gently. The entire procedure is done externally by applying firm pressure to the stomach. “Typically, you want to do this when you’re past 37 weeks, but you don’t quite want to be 39 weeks where the baby is really settled into position,” says Braden. Studies show that ECV has a success rate of 59.7 percent.

Another intervention is the Webster method, in which a chiropractor focuses on adjusting your hips and pelvis to encourage more space for baby to turn head-down, says Smead. “This often requires several sessions over a week or more to get the desired outcome,” she adds.

It’s important to remember that a transverse baby at delivery is very rare, and that in the vast majority of cases, baby will flip on their own before making their debut. But if baby stays transverse, your provider will recommend the optimal option for you and your little one.

FAQ About Transverse Lie Baby

You might have a few remaining questions about the transverse baby position. Here are some more things you might want to know.

What are all the possible fetal positions?

The most common delivery presentation, according to Mount Sinai, is cephalic, or head-down. In about 3 percent of cases, babies present as breech, or feet-down. A transverse presentation occurs in less than 1 percent of cases.

Is transverse position dangerous for baby?

Babies often move into the transverse position throughout pregnancy. But if baby settles into a transverse position toward the end of the third trimester, this can increase the risk of umbilical cord prolapse or c-section during labor.

When do transverse babies typically turn?

According to the Cleveland Clinic, most babies assume a head-down position by 36 weeks of pregnancy.

How should you sleep with a transverse baby?

There’s not much you can do while sleeping to help baby turn, says Braden. But sleeping on your side can help you feel more comfortable during pregnancy, notes Smead. “This position involves lying on one side with your top leg bent and pulled up as far as you can comfortably stretch over a pillow in front of your belly,” she says.

Where do you feel kicks with a transverse baby?

You could feel baby kicks anywhere with a transverse baby, notes Braden. A better sign of the transverse baby position is where the head and bottom are located, she says.

When is a c-section necessary for a transverse baby?

A c-section is often necessary for a transverse baby after other options—such as turning the baby—have been exhausted. “Often it’s important to recognize the transverse baby well before this time and have discussions about delivery mode prior,” says Smead. “Planning for a c-section is a good idea so that all involved can prepare. However, that doesn’t mean that the baby couldn’t turn on its own or in response to interventions before that time.”

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Sources

Ellen Smead, CNM, is a certified nurse-midwife at Pediatrix Medical Group in Atlanta, Georgia. She graduated from Emory University in 2011 and is an advanced practice midwife with the American Midwifery Certification Board.

Andrea Braden, MD, FACOG, IBCLC, is an ob-gyn, breastfeeding medicine specialist, board-certified lactation consultant and CEO and co-founder of the lactation company Lybbie. She earned her medical degree from the University of South Alabama School of Medicine.

Icahn School of Medicine at Mount Sinai, Your Baby In the Birth Canal

Mayo Clinic, Uterine Fibroids, September 2023

Cleveland Clinic, External Cephalic Version (ECV), May 2022

Cureus, Assessment of the Successful External Cephalic Version Prognostic Parameters Effect on Final Mode of Delivery, July 2021

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