Transverse Baby Position in Pregnancy

As you approach your due date, your doctor will want to know what position your baby is in. Most babies will turn to the head-down position, which is the safest position for birth. Some babies do not turn to face down. A baby who lies horizontally is said to be in the transverse position.

It's normal for babies to change positions and move around throughout pregnancy. But once it's time for labor and delivery, head-down is optimal. If you baby is in the transverse position, a healthcare provider may be able to help turn them. If not, a C-section may be recommended.

Learn more about the transverse position and what could mean for your birth.

What Is a Transverse Baby Position?

Baby position is the way the baby faces in the uterus—if the baby is facing your bottom, they are anterior, and if they face your belly, it's called posterior. (This is based on the position of the back of your baby's head.) The transverse lie position is where the baby's head is on one side of the mother's body and the feet on the other, rather than having the head closer to the cervix or the heart. The baby can also be slightly at an angle, but still more sideways than up or down.

Before birth, your baby is in many different positions in the uterus. When talking about where the baby's head is, doctors use the terms cephalic (head down) and vertex (crown of the head down), which as noted above, means the head is towards your feet, and breech, which means the head is up towards your heart.

Checking Baby's Position

Your doctor or midwife will typically be able to tell the position of your baby by placing their hands on your abdomen in a series of movements known as Leopold's Maneuvers. They may also request an ultrasound exam be done to confirm the position of your baby.

Typically the position of the baby is not a concern until the last trimester of pregnancy. At this point, the doctor or midwife may check your baby's position at every visit. As noted above, the vast majority of babies will be head down at birth.

Why Babies May Be in a Transverse Lie

Sometimes, it is unknown why a baby is in a malposition, other times there are contributing factors, such as in the case of an atypically-shaped uterus or pelvis. Some of the more common reasons why a baby may be in the transverse lie position include the following:

• Abnormality of the uterus
• Having a cyst or fibroid blocking your cervix
• Pelvic structure
• Polyhydramnios (too much amniotic fluid) or low fluid levels
• Position of the placenta
• Second (or more) pregnancy
• Twin or multiple pregnancy

The biggest factor in whether or not your baby is in a transverse lie position (and if they will turn to another position on their own) is why the baby is transverse in the first place. For example, having a bicornuate uterus, where the uterus has two sides, can mean that your baby fits better inside when in the transverse position. Sometimes, it is due to an issue like low amniotic fluid not giving your baby the room to turn head down or vertex.

Potential Complications With a Transverse Baby

A baby who is transverse will not fit in the pelvis, making a safe vaginal birth very difficult, if not impossible. A baby in the transverse position simply doesn't fit through the vaginal canal. Additionally, there is added risk of cord prolapse and other complications.

Turning a Transverse Baby

There are things you can do to help your baby rotate into a more favorable position if they don't do so on their own. Your doctor or midwife may suggest exercises or positions you can do to promote repositioning. If your baby stays transverse, your doctor may do an external cephalic version (ECV), this is where they attempt to turn the baby from the outside using pressure on the baby's head and buttocks. This procedure can be painful for the mother, but pain relief may be used and complications are rare.

However, some babies are easier to turn than others. Plus, the procedure can not be done in certain circumstances, such as with twin or multiple pregnancies. That said, this procedure is often successful, particularly if the doctor is experienced in the technique. Typically, it is performed anywhere from around 36 weeks until delivery as long as the water has not broken and other conditions are favorable. However, it's easier to turn a smaller baby than a full or post-term one.

One 2013 study, whose authors advocate for practitioners to learn and use repositioning methods more often, reported a 100% success rate in turning babies in the transverse lie position. However, generally, success rates for ECV are around 65%, with even higher positive outcomes for women who've given birth before.

A Word From Verywell

A transverse baby may turn (or be turned) into a head-down position before birth, but if not, a c-section will likely be necessary to ensure the safe birth of your child. Remember, the end goal is a safe delivery, and ultimately, all that matters is ending up with a healthy baby in your arms.