Pregnancy & Baby 

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Baby in transverse position

A transverse lie is, as I am sure has been explained to you, a very serious presentation of your baby in relationship to any normal and spontaneous delivery, but safe delivery can always be carried out by other means if this becomes necessary, so don’t worry too much. It is not common to find this position - in which your baby is lying across your tummy instead of the accepted head down (or less common, bottom down position) - in women having their first baby, as the muscles are usually much too supportive and firm.

There are several causes for this transverse presentation, and I am sure that these, too, will have been looked for. It is quite common where the womb is large and of poor tone, as in women who have had many babies, it also can occur in a similar situation where there is excessive birth fluid, or a multiple pregnancy. If the afterbirth is lying very low, covering the lower area of the womb, a transverse lie can also develop. In very rare cases, there may even be an abnormal development of the womb, which therefore prevents the baby from assuming the accepted position, or there may even be a reduced size of the bony birth canal – the pelvis- that will also encourage a transverse lie. Large fibroids in this lower part of the womb can also have a similar effect.

If there are no ‘mechanical’ reasons to prevent your baby from turning spontaneously, bedrest can certainly help. The fact that your abdominal and uterine (womb) muscles are much more relaxed, and without tension, during bedrest, means there is a much greater chance of your baby making this return to a head up/head down position – which itself, it would prefer to do! In some cases, after full examination, and under very strict control the obstetrician may even attempt to turn your baby for you.

A persisting transverse lie would always necessitate an abdominal delivery of your baby – a Caesarean section. It is for this reason that continued bedrest is encouraged - sorry, it can be very boring, but the baby will then be as mature as possible before that delivery takes place.

Whilst a baby is certainly viable at 28 weeks gestation with modern foetal and infant care facilities, they do remain very vulnerable at this stage, and all attempts will be made to continue your pregnancy, as long as possible, even if this does mean a prolonged period of bedrest.

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