Know how to move baby from transverse to head down position
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Author:
Khushboo Kirale
- >> Post Created: March 2, 2022
- >> Last Updated: January 21, 2025
Medically Reviewed by: Dr. Veena Shinde (M.D, D.G.O, PG – Assisted Reproductive Technology (ART) from Warick, UK) Mumbai, India
Table of Contents
A mother’s womb is an unborn baby’s playground; it keeps moving inside and does not really settle in one particular position until the final trimester begins. That’s when the baby’s position begins to matter, as it has a major role to play in the labor and delivery process.
A transverse position of baby is one of the uncommon baby positions that a baby may adopt between 37–40th week of pregnancy. Merely 2% babies take up an undesired or malposition and out of these, only 20% are in a transverse position.
We mention this just to make sure you understand how rare this baby position is. We don’t want you worrying over nothing.
The transverse fetal position or the transverse baby position comes with its share of complications. A transverse lie makes a normal vaginal delivery practically impossible.
This article will provide you with all the information that you need to know about the transverse position, the concerns that come with it and also ‘how to move baby from transverse to head down position’. So, don’t worry, go through this article. Am sure it will surely help you.
What is a transverse baby?
Understanding transverse baby position
A baby’s position is determined based on where the baby is facing and in what direction its head lies. If the baby is facing the mother’s back, then it is in the anterior position and if it is facing the mother’s belly, then posterior position .
You are aware that the very natural position the baby takes before birth is the cephalic position and the vertex presentation. When it comes to baby malpresentations, generally the baby takes up a vertical kind of position, with either its head or feet toward the cervix – Breech position.
However, in transverse position, it adopts a sideways lie or horizontal position, with the head on one hip and feet on the other.
The sideways lie/position of the baby in the womb is common in the earlier stages of pregnancy when the baby is still small and has plenty of space of move.
However, only few (by which we mean really very few) babies take transverse position by the end of pregnancy, which becomes a concern.
Essentially for a vaginal delivery, the baby has to be in a head-down position/ cephalic position and a vertex presentation.
A transverse position/ sideways lie of a baby definitely makes it difficult or impossible for the baby to enter the cervix during labor.
Types of transverse position
In a cephalic position/head-down position, the vertex (top of the baby’s head or crown) is the first body part to enter the cervix during labor, meaning the presentation is the vertex here.
In transverse position/ transverse lie, there are these common presentations/ positions:
Right-shoulder presentation
In the right occiput transverse position, the baby’s right shoulder is at the opening of the cervix.
If the baby does not change the position from right shoulder presentation to vertex presentation, then the only way out is a caesarean delivery.
Left-shoulder presentation
The baby’s left shoulder is toward the opening of the cervix i.e. the shoulder is the first thing to present into the cervix instead of the head.
If your doctor can change the position slightly also through ECV or manually(if possible) then there are chances you could have a vaginal delivery. Else c-section is the only safe way for your child’s delivery.
While your baby is in the left shoulder presentation, one of the biggest concerns is that if the umbilical cord prolapses and exits the birth canal before the baby does while trying for a vaginal delivery, then it could pose greater danger to the baby’s life.
Back-down presentation/ Back-down transverse lie
If the baby is lying on its back with no shoulder toward the birth canal, i.e. the baby is facing up towards your chest and back toward the birth canal, then that’s a back-down presentation.
This position is impossible for labor to progress in as there is absolutely no way that the baby can move out in this position.
UP transverse position – hands & feet facing the birth canal
If the baby is lying on its stomach with no shoulder toward the birth canal, i.e. the baby is facing down – i.e. its hands and legs are towards your cervix and back toward your chest, then that’s the up-transverse position.
There are chances that your baby may naturally move into the vertex presentation before birth facilitating a vaginal delivery.
Your doctor could also move your baby through ECV if possible, to face down.
Otherwise, the up-transverse position of baby is next to impossible for labor to progress as there is absolutely no way that your child can move out vaginally while remaining in this position.
By the 37th week of pregnancy, your doc tor should be able to determine the position of your baby. You can also use belly mapping technique to understand your baby’s position.
If your baby is in a transverse position, then they may try to turn the baby by applying required amount of pressure by hands on your belly called as the ECV technique (external cephalic version).
This procedure will, of course, take into consideration the baby’s health before and after and in case required, a C-section may be performed to avoid complications.
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Reasons for transverse baby position
A malposition like transverse baby position may not have any particular reason; but most of the times, these could be some of the contributing factors for the baby to be in a transverse position or a transverse lie –
- Abnormality of the uterus: The shape of the uterus has a role to play in the baby’s position. Some mothers may have a bicornuate uterus, which has two separate sides, and therefore, can accommodate the fetus only in the transverse position.
- Abnormally low or high amniotic fluid: Low amniotic fluid (Oligohydramnios) can make it difficult for the baby to turn to a desirable position from transverse lie, whereas high amniotic fluid (Polyhydramnios) may make it difficult for it to stay in a desirable position and come back to transverse position.
- Cyst or fibroids blocking cervix can force your baby to stay in transverse lie.
- If the pelvic structure of the mother is atypical, then too the baby might adopt this position.
- Position of the placenta: Sometimes the placenta position may not allow the baby to turn to the desired position, and therefore, it may remain in transverse lie.
- Second (or more) pregnancy
- Twin or multiple pregnancy
It is necessary to know the reason why the baby is in transverse position in the first place to know what exact solution might work to turn it in a head-down position by labor. Yes, that is possible!
So we can go to the obvious question now…
How to move baby from transverse position to head down?
There are a few things that your doctor might be able to do, while there are some things you could actually do (with your doctors permission) at home to encourage the baby to turn to a more optimal position from a transverse position.
So to answer the question ‘how to move baby from transverse to head down position’, here are some important tips that can definitely help you do so:
A. Inversions & exercises you could do at home to move a baby from transverse lie to head down position
These may or may not work depending on the reason behind transverse position of baby.
However, you may try it, provided you consult your doctor about it first. If you are asked to avoid certain exercises or movements, then it is because your doctor understands the reason behind the transverse baby position.
What do you mean by Inversions?
Inversions are movements where you put your head below the pelvis. You can do the following exercises only after getting a go-ahead from your doctor.
You can begin doing them after 32 weeks of pregnancy.
How to perform forward-leaning inversions?
Kneel at the end of a low bed or a couch. After that, slowly lower your hands to the floor and rest on your forearms. Do 7 of these repetitions for 30-45 seconds, without resting your head on the floor. Take 15-minute breaks between every 30-45 second round.
Yoga Poses
Few yoga positions are also known to engage the body in inverted positions which can help in moving transverse baby position to head down position.
So, if you have a transverse position of baby, then yoga instructors suggest doing the puppy pose.
How to perform a puppy pose?
Start with going on your hands and knees i.e. your all fours, and then move your forearms forward such that ultimately your head rests on the floor.
With your bottom up and pelvis directly over the knees, keep breathing.
Doing Breech Tilt
The next move is called the breech tilt, in which you will need a long support – something like an ironing board a long or a large cushion.
How to perform a Breech tilt?
As mentioned above to perform a breech tilt which will move your transverse baby position to head down you will need a hard support like the Ironing board.
Prop it at an angle such that its center is resting on the seat of a sofa, while the bottom is supported by a pillow.
Now place your head on the pillow (more pillows if u need more support) and pelvis toward the center of the board, letting your legs hang on either side of the board. Repeat this 2-3 times repeating every 5-10 mins.
We suggest you check out with a professional before adapting any of these exercises by yourself or by just looking at videos. You need to understand exactly how it is done, but only after you get a nod on them from your doctor.
B. ECV a Medical option to be done only by your doctor or a professional
The External cephalic version (ECV)/ version, is when your doctor will use their hands with appropriate pressure on your belly to lure your baby into the head-down or the best possible position from a transverse baby position.
This method may be a little uncomfortable, but it is safe. However, know that it does not have 100% success rate and only about 50% of times does it actually lead to baby moving from transverse fetal position to head down position paving way for a vaginal delivery.
Also, if your placenta is located in a complicated position – like fundal placenta or placenta previa, then the doctor might avoid using this method.
Additionally, when performing ECV, it is necessary to have an emergency C-section option available, if required, as in certain scenarios it might lead to complications, leading to a c-section.
So discuss all the possible options & complications related with ECV procedure to move your baby from a transverse fetal lie to with your doctor so that you are well prepared.
C. Chiropractic care & Massages to turn your transverse baby position to head down
Chiropractic help and gentle massages are the few other options that can help influence the soft tissues in a way that your child’s transverse baby position is encouraged to turn head down and move into the pelvis.
Look for chiropractors who specialize in the Webster technique, as they possess the know-how related to pregnancy and pelvic related issues.
What to do If the baby does not turn and is in transverse lie during labor?
As mentioned before, having a transverse baby position in labor is a cause of concern.
However, your baby can still safely be delivered through a C-section. It might not be the exact way you thought of bringing your baby into this world, but it is the safest way if your baby is persistent in remaining sideways for some reason.
Always discuss your concerns and fears with the doctor; whether or not he can make the labor and delivery process any easier, but he can definitely help in putting your mind at ease. A relaxed mother definitely benefits the baby during delivery.
Delivering twins when one or both are in a transverse position
If you are carrying twins and if the lower twin is head-down, then there is a good chance that both twins can be delivered vaginally. Once the lower twin is out, the other baby takes the head-down position too (even if it is transverse or breech), to be delivered the same way,
However, if for some reason the other baby does not take the same position after the first is delivered, then the doctor may perform ECV or if this does not work, then they may opt for a C-section.
If the lower twin itself is not in a head-down position, then the doctor will suggest going for a C-section to deliver both the babies.
Potential complications with a transverse baby position
A transverse fetal position will not allow your baby to fit in the pelvis, making a safe vaginal delivery extremely difficult or just impossible!
With a transverse baby position, the risk of cord prolapse is just one of the many complications that could arise.
Many times, the baby does turn to the optimal position before birth on itself and may have to be turned manually by medical professionals. As such, always remember that a C-section is always a safe option that is there in case the baby continues to stay in a transverse lie.
However, even if the baby is manually rotated or is delivered vaginally or through a C-section, there are some complications that can arise. Its always good to understand and be aware of these complications so you can be better informed and prepared with your doctor to sail through them.
Listing the various complications that can arise while delivering a transverse baby vaginally & through a c-section respectively:
- Transverse baby position Vaginal delivery complications:
While having transverse baby If your doctor is successful in rotating the transverse baby to an optimal position for a vaginal delivery, then too, labor will take a longer time and cause of all the initial manual rotation of the baby.
It is also likely that the baby’s face may be swollen and may look bruised at birth. However, this should not be a matter of great concern for you, as this will go away in a few days.
What can be a more serious complication here is if the umbilical cord gets compressed during birth, then the baby might lack oxygen and could go into distress. This situation calls for an immediate C-section.
To sum it a Baby transverse position vaginal delivery can lead to the following 2 main complications:
- Low oxygen and blood supply to the baby if there is umbilical cord prolapse, which can possibly result in the baby’s death
- Prolonged labor can cause infections
- Caesarean/ C-section complications in case of transverse fetal lie at birth
A C-section is usually safe for the baby and the mother, but it is a surgery after all! And like any other surgery, it might involve the following risks:
- Infection
- Excessive bleeding
- Bladder/bowel injury
- Reactions to certain medicines
- Blood clots
- Death (though very rare)
C-sections also have a rare chance of causing complications for the baby like:
- Possible injury
- Occasional breathing issues, if there is still fluid in the lungs that needs to be cleared
So what can you do to ensure a safe delivery if the baby is still in transverse position? That’s the next thing we discuss.
Key Takeaway
Having a Transverse position of baby in pregnancy is rare, and though the reason for them to opt a sideways position can be one of the few mentioned above, sometimes it can only be because they are comfortable that way!
Do not panic if you get to know your baby is in the transverse lie before the third trimester ends, as the baby keeps moving until then.
It is only after the third trimester does the baby settles in a particular position.
And even if you get to know that you have a transverse position of baby there are ways in which you can turn your baby from transverse to head down position before birth – as mentioned in the section ‘How to move baby from transverse position to head down?’ Further also know that C-section is a safe option.
Knowing that you have a transverse position of baby might stress you out a bit, but think a little into the future and imagine the joy that a happy, healthy baby in your arms will give you.
So, go past the transverse lie/ transverse fetal position fear. Relax and be regular with your prenatal care visits to identify any issues, so that you can discuss it with your doctor and prep yourself with a proper plan.
Happy Pregnancy!
Khushboo Kirale
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