Is Your Baby in a Transverse Lie?

A diagram showing an external cephalic version, turning a breech baby
Photo © Dorling Kindersley/Getty Images

Before birth, your baby is in many different positions. We talk about the baby's position in a variety of ways too. We talk about where the baby's head is - vertex means the head is towards your feet and breech means the head is up towards your heart. We talk about which way the baby faces - if the baby is facing your bottom, he or she is anterior, but 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 close to the cervix or close to the heart. The baby can also be slightly at an angle, but still more sideways, than up or down. This side ways position in the uterus is more common earlier in pregnancy when the baby has space to move around freely. Very few babies are in this position at term.

How Do Practitioners Know the Position of the Baby

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. 

The vast majority of babies will be head down at birth. About 3-4% of babies at the end of pregnancy are not head down. Some are breech, which is feet, knees, or buttocks first. And some are lying sideways in the uterus - transverse.

A baby who is transverse will not fit in the pelvis, therefore making a vaginal birth impossible in this position.

What Can You Do If Baby is Transverse

The biggest factor in whether or not your baby will turn or chose another position is why the baby is transverse in the first place. Is your baby in this position because of the size or shape of your uterus? Sometimes 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.

That is not to say that there is nothing that you can do to help your baby rotate into a more favorable position in some cases. There are exercises, positions, and even help from professionals that may be helpful in getting your baby to turn to a head down position. Some babies are easier to turn than others. It may also depend on if you have had a baby before or where your placenta is located.

Sometimes your doctor may suggest an external cephalic version (ECV), this is where they turn the baby from the outside.

Even if the version or other methods of getting the baby to turn work, some babies will revert back to the transverse lie or a breech position. There may be ways to help prevent this from happening, but that may depend on many factors. 

When Baby Doesn't Turn

If your baby is in a transverse lie at term, a cesarean section may be recommended if the baby doesn't turn or if other measures are not successful in turning the baby. You are more likely to have a baby in a transverse lie if you have multiples in this pregnancy, if you have had many term pregnancies, have an abnormality in your uterus, or a cyst or fibroid blocking your cervix.


Fetal Positions Before Birth. Mayo Clinic. 2015.

Obstetrics: Normal and Problem Pregnancies. Gabbe, S, Niebyl, J, Simpson, JL. Sixth Edition.

Spinning Babies. Gail Tully. Boston, 2013.

Continue Reading