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I scared i might have a c-section

Posted by on Mar. 28, 2011 at 3:30 PM
  • 19 Replies
So I had a doctors appointment today and everything went good. But she scared me by saying that Natalie is laying side ways. The doctor said she has time to turn but if she doesnt by 36weeks than ill have a c-section. Im scared to have a c-section. And the doctor didnt give me any tips on how to get her to turn. So does anyone have any tips?
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by on Mar. 28, 2011 at 3:30 PM
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evansmommy03
by on Mar. 28, 2011 at 3:32 PM

Mine was transverse as well but she moved on her own pretty quickly.  It is actually common for them to be sideways when you are early in the pregnancy.  I wouldn't worry just yet about it.

doulala
by on Mar. 28, 2011 at 3:33 PM

You can not vaginally deliver a transverse-positioned baby.
BUT babies tend to turn in time, by labor or at least with pre-early labor contractions.   That is part of their job.
:-)

Of course your baby & body may not be ready to deliver until 40 weeks, or 41 or so...   so electing to birth surgically before the opportunity of labor adds unnecessary risks!
:-(

It happens and for the safer route, consider letting Nature do it's work~

;-)

Wishing you the best!

doulala
by on Mar. 28, 2011 at 3:34 PM
Transverse Lie, or baby lying sideways PDF Print E-mail

“Transverse Lie” means a sideways position. The baby has his head to one of his mother’s sides and the bottom across her abdomen at her other side.

The word transverse is also used in phrases describing two of the normal head down positions. Left occiput transverse (the ideal starting position) and right occiput transverse. These head down babies facing the mother's hip. The side of the mother’s body that the back of the baby’s head is on is indicated by the first word, left or right. The baby faces the opposite hip. To see several different fetal positions go to Belly Mapping. Look at the end of the article for emailed advice.

 

 Here are some images to help you understand the lie of a baby in relation to the pelvis.


      left occiput transverse (lateral)Transverse lie

 Left: The baby on the left is in the ideal start position - left occiput transverse. The head is transverse but the head is down. This baby is in a vertical lie, meaning the baby lies up and down. One end or the other points towards the pelvis.
Right: The baby on the right is lying sideways in the womb - transverse lie.

In a Transverse Lie the baby's head is on one of the mother’s sides and the baby's bottom is on the other side. For instance, one mom with a transverse baby will have the head on her left side and the baby's bottom on her right. The hands and feet may be kicking and waving towards her cervix (in the lower part of the uterus) when the baby's belly is down. Another transverse baby may have the head on her mother's right and kick upwards or towards the front.

 

 

 

What’s the problem with a transverse lie?

The baby who is lying sideways cannot be born vaginally. The baby has to get vertical to fit through the pelvis. A breech or vertex (head down) baby can usually fit. The baby in a transverse lie can not fit. Labor contractions cannot bring this baby through the pelvis. Perhaps the arm or umbilical cord would come through the pelvis. Or the shoulder might block the opening. We can try to help this baby move to a head down, or cephalic, position so that a cesarean can be avoided.

When is transverse lie a problem?

It is normal for a baby to be transverse in the first and second trimester. We hope that the baby is in a vertical position between 26 and 31 weeks gestation. The breech position is considered normal when found between 26 and 31 weeks gestation. Most babies are head down by 28-30 weeks gestation; a few babies wait to settle head down until 31-34 weeks. And only a few babies who aren't head down after 36 weeks can get there on their own. After 30 weeks, it may be good to do some exercises to help your baby get head down.


Late in pregnancy it is more difficult to help the side ways baby to become head down.
When the baby has been transverse in the last trimester, the womb becomes shaped for a transverse baby. Conversely, the baby will stay transverse when the pelvic inlet (brim) is not symmetrical or the lower uterine segment (the lower part of the womb where the head would normally settle) is not symmetrical. Crossing our legs, holding toddlers on our favorite hip, a fall, etc. can put a twist in the lower uterine segment.

Gravity helps, but there is less room to navigate the womb. First time mothers and women with tight, sturdy musculature, spasming ligaments or  tight fascia can do exercises or have body work or both to loosen these soft tissues and allow more fetal movement. Women who have birthed before, and who have loose soft tissues (this includes a few first time mothers, but mostly experienced mothers) may actually need to prop their wombs and abdomens up to let the baby get head down!


After 32-34 weeks, I am quite concerned to find a transverse baby – except when the baby was breech recently and is now in a leisurely process of flipping to head down. The breech to head down process shouldn't take more than 3 days (when it doesn't happen instantly).



 

 Breech lie or transverse lie?

The transverse lie position is sometimes loosely called breech. This seems more common among ultrasound technicians. Midwives and doctors do not use these terms interchangeably. They are not the same.

The breech baby lies vertically, the transverse lie baby lies horizontally.

 

The breech baby has an easier time getting head down than the baby who has been transverse into the third trimester. An interesting point is that a breech baby may move to the transverse lie for a couple days before finishing the flip to head down. If your transverse baby was just recently breech wait a couple days before worrying, and keep up the techniques you are using to help baby into a head down position.

A confusing variation: One woman had weak uterine ligaments. She was a strong woman, athletic. Perhaps the jolting stops of sports effected her uterine ligaments in this way. Her first baby was head down, but with her little bottom resting on her mother's right hip. The baby was folded over at her waist in this way for the entire third trimester. I wondered how it would effect birth. I suggested a pregnancy belt but the mother wasn't concerned. Her labor advanced beautifully and the baby came down through the pelvis perfectly. I was happy to see how well birth works in a fetal position variation that I had never noted before in a first time mother. The baby had seemed somewhat in a transverse lie, but since the head was in the pelvis, wasn't. The mother used active labor positions and free movement, instinctively moving with her labor and the baby came down well. 




Techniques to correct a transverse lie when the belly seems tight


Things you can do yourself:


•    Use the Inversion off the couch, as shown in the video, for 30 seconds, 2-3 x a day,
or
•    Do the Breech Tilt for 5-10 minutes, 2-3 times a day. (Dr. Carol Phillips says the ironing board technique is not as effective as the forward leaning inversion.)
•    Stand on your head in a pool of warm water, such as a backyard swimming pool or a therapeutic pool at a hospital or rehabilitation center. Some hotels will let you join a swimmer’s club.

 

When you are using an inversion by laying on your back, the Breech Tilt,  you can place a very cold item, like frozen veggies wrapped in a thin dish towel (don't freeze your skin!) on your abdomen in the place that is BEHIND and ABOVE the baby's head. At the same time, place a very warm item, like a toasty rice sock, BELOW and IN FRONT OF baby's face. We are hoping that the baby moves towards the warmth.So the warmth must also be between the baby's face and the pubic bone. The warm object can be right over the pubic bone if the baby's head is down by the hip socket, almost to the brim. This is a helpful addition to other techniques and is not likely to work just by itself. Inversions are recommended unless your bodyworker or care giver says specifically that you have medical reasons not to do an inversion.

Adjust the placement of the warm and cold items according to your individual situation. For instance, you might know from an ultrasound where the placenta is. Putting warm or cold items on top of the placenta may not be effective. Don't worry if you don't know where your placenta is.

 

From a comment on the Forward-leaning inversion video on Gail's blog post:

  .

thank you SO much for posting this! for the past couple i've been alot of pain but i didn't know that all the pain was coming from my son being transverse. i knew he was lying like that but i never knew it could cause all the pain it was causing. i was even sent to L&D to see if i was in preterm labor. at my follow-up OB appt she told me that if he didn't move that A.) i'd be in pain until i went into labor and B.) it'd be a mandatory c-section. i'm only 36 weeks along and was missing tons of work along with sleep and just turning into a nasty woman to be around in general. after leaving the OB's office and learning that this was the reason for all my pain, i texted my doula who told me to look up your website. after learning that our son was in a "transverse lying position" i found the video of the lady doing the modified headstand off the couch and decided to try it off a bed. i was able to hold the pose for (30) seconds but i didn't think anything had happened. my hubby checked the babies position and sure enough he was in the perfect occipital posterior position! it's been over (4) days now and he hasn't moved back so i'm praying we are safe.

thank you SO much for saving me all the pain of carrying him sideways and avoiding a c-section!! - The McGuire's December 28, 2009 12:45 PM

 

 

Inversion is an excellent thing to do, but may not be enough on its own. If using the inversion doesn't work after 3-4 days, when you are 32 or more weeks pregnant, then I would suggest getting professional body work. See more about this lower down in this article, and see more fun things to help baby flip head down under the Breech category.

Release your psoas muscles.

  • You can help by taking brisk walks. Swing the weight of your legs from the thigh. Each day, lay on the floor on your back for no more than ten minutes with your ankles resting on a chair. Your knees are bent to a 90-degree angle.  Breath slow and deep from your belly. See your belly rise and fall like a sleeping toddler.
  • There are several yoga extensions of the legs that help.
  • Massaging your own psoas is quite effective. Also, a myofascial massage person, or a chiropractor who includes hands on massage, pressure point release, etc. can accelerate your psoas release with their skills.
  • Wear a pregnancy belt to actually give a slight pressure that may relax the abdomen. The "slope" of the abdomen with a belt, supports the baby dropping down into the pelvic brim.

 These techniques will relax your psoas muscles over time.

If the womb seems tight around the baby (chronically, not just during Braxton-Hicks contractions) in pregnancy, then professional help is needed.



 

Techniques to correct a Transverse Lie when the belly seems loose

For women who have given birth before, and a very few first time moms, the trouble may not be with tightness, but rather with looseness. The techniques then have to adapt to the mother.

The idea is that once the baby is head down, support the abdomen with a pregnancy belt and perhaps a rolled hand towel (Brust pad) so that the baby stays head down and in a vertical lie. 

A manual version may also be successful in helping baby get head down. The looser the mama, the more likely the success. Anterior placenta may be a reason not to do a manual version.



 

Using a pregnancy belt for transverse lie

When the lower abdomen is loose, as with a pendulous uterus, add a pregnancy belt to create an improved slope to the lower uterine segment.
A pregnancy belt helps the uterine ligaments hold the uterus upright so the baby can get into an upright position.
For the mom with loose ligaments, I would suggest wearing a pregnancy belt in the fifth month through to labor, and for very loose moms with a pendulous womb, then wearing the belt through pushing the baby out is safest.
Women with tight ligaments can wear a pregnancy belt too for the support is actually relaxing.


 

Professional help for a Transverse Lie

Bodywork can correct the length of the uterine ligaments so that they are all symmetrical. Chiropractic adjustments align the pelvic bones so the joints are symmetrical and this, in turn, helps the uterine ligaments become symmetrical. Doing both the bony adjustments and the soft tissue work is the most time efficient and successful, if the mother’s Inversions don’t work in 3-4 days.
Some chiropractors and craniosacral therapists know how to do myofascial release of the round and broad ligaments. Certainly, a myofascial massage worker can do this.
Maya abdominal massage is another excellent choice for symmetry.

  • Acupuncture, effective for fetal positioning, especially when done by an experienced professional.
  • Moxibustion, heating the acupuncture points with a stick of mugwort incense, can be done at home inexpensively. Best results from 20 minutes a day during the 34 and 35th week.
  • Chiropractic, neck and pelvis, including SI, Symphysis Pubis, Webster and other areas as individually needed.
  • Myofascial, buckled sacral release and diaphragmatic release
  • Homeopathy, Pulsatilla or other remedies can help with malposition. See a professional for best results.

 

This work is specifically for you pelvis, neck and soft tissues (sacral fascia, round and broad ligaments of the uterus, cervical ligaments and sacrotuberous ligament).


Remember the time to hire bodywork for transverse babies would be between 32 weeks and birth. The sooner the better! Begin at or after the middle of the seventh month. If you want to try things at home in weeks 32 to 34 that seems reasonable, though if baby is big, and/or mom is tight I would start getting professional help earlier. Starting in mid pregnancy isn't too early.

 

 Next year at this time, would you like to look back and feel satisfied that you did all that you could do at this time in your life?

Here is my answer to a woman writing who is 34 weeks along with a transverse baby. That's about 8 1/2 months.


"Do you know how long your little girl has been lying transverse?
You are doing the forward-leaning inversions for 30-seconds ?
You may also do the breech tilt inversion for 5-20 minutes, longer as you get used to them. After about 3-6 times (in 2-3 days), you might start putting a lightly wrapped cold pac on your upper uterus, above the baby's head (not directly over it, just above it). At the same time, putting a warm pac behind your baby's head and towards your pubic bone. Close enough for the heat to radiate to the baby's head.
I don't know which way your little one is facing, but I suppose it doesn't matter. The idea is that the baby feels that it is warmer towards your pubic bone.

Moxibustion is so helpful in weeks 34-35 and beyond, but particularly these two weeks are more successful to get baby head down. Use in addition to other methods of helping baby get head down.

Add myofascial release to the Chiropractor's adjustments. Ask the chiropractor to add Websters to both sides in one visit, if they would please.

Craniosacral work can make chiropractic more effective and visa versa.

Head stands in a warm pool of water. Hanging from a yoga sling (1 minute) or inversion table (1 minute).

Learn to release your psoas. CoreAwareness.com with Liz Koch. A tight psoas my hold the baby's head back above the brim to the side.

Talking to your baby, too. Whether out loud or by journaling. See what you can learn about your self this way, too.

If your daughter has been transverse all along do everything you can, all of the above you can. If she was breech last week and transverse this week, she is likely to get head down with less to do. But it sounds like she's been transverse a while.

Very often this is from a soft tissue issue in the lower uterine segment which can be caused by torsion in the pelvis and the surround soft tissues (ligaments, fascia, muscles etc.) Addressing these issues will likely allow the baby to move into a head down position.

Exceptions, if the placenta is below the baby covering the access to the cervical area. An unusual uterine shape, a partial septum or a fibroid blocks the baby's attempts to get head down. Ultrasound would reveal something as obvious as these. Ultrasound is unlikely to reveal a twist in the lower segment of the uterus which is one of the soft tissue issues I mean.

Please let me know if any of these or another suggestion helps you. I will hope for the best and expect the best for you and your baby,  - Gail"

 

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A-K posted on the website,

I am 40 weeks pregnant with my 2d child (first one born naturally) and was told today by my OB that baby is now transverse. This was also confirmed by an ultrasound (at my last visit a week ago, baby was in the heads-down position and had been so for several weeks).

I have been given three more days to see if the baby will turn before my dr wants to schedule at C-section (at 40+3). I have already visited a trained acupuncturist and am doing the inversions on your site to try to prevent this. I would just like to know:
- How common is it for a transverse position to appear so late in the pregnancy, and what are the odds of turning the baby back down?
- Which of the inversions tend to be the most effective at 40 weeks, given the more limited room for the baby to move? The dr tried to externally manipulate the baby to move down today but failed.
Thanks so much for a lovely website!


Gail wrote back something like this, but this is better:

A-K, I hear the surprise you are suddenly faced with. I will try and answer your questions.

Why now, in late pregnancy? A baby will move from a good or reasonable position to a posterior, breech, oblique or transverse position in late pregnancy when there is,

A.)  An existing reason, usually a twist in the lower uterus or other reason the area of the pelvic inlet is compressed or twisted. Balance the area with body work and forward-leaning inversions and baby will return to a head down position.

B.)   The baby will pull away from the pelvis (tailbone, sacrum) if something happened such as a fall, twist, impact, or a significant emotional stress about parenting. It can happen to any of us.

C.)  Some event may trigger an old injury. A long car ride can be the culprit. If this is the case, addressing the trigger is likely to allow the baby to settle back head down quickly.

How many times do you need to do the inversion? How quick can baby get head down again? You see the range of success in the comments to the Feb. 9th 2007 blog post from one inversion, to three, to several. It doesn’t always work, but it seems to work often.

I’d add what else can I do?

Professional help: Myofascial release, chiropractic, and craniosacral therapy along with your acupuncture may increase chances of success. I can’t promise, of course. But these are efficient ways to address the cause.

Self help: Begin with the Rebozo sifting, go to the forward-leaning inversion and follow it with the breech tilt using hot and cold pacs.  Then I’d add a pelvic floor release.

How often does a baby go transverse at the end of pregnancy? It is uncommon.

Still you are likely to get the baby head down even in three days with several short, forward-leaning inversions and addressing the soft tissue cause, assuming that something was, or became, twisted near your cervix or brim.

A twist in the cervical ligaments will twist the lower uterine segment where the baby would like to put his or her head. Depending on the amount of twist the baby may back up and go transverse or breech. This is fixable with the right body work for you.

 

Be kind to yourself as you try to take on this challenge. You are doing the best you can with a suddenly complex situation. Keep breathing and talking to your baby. Together you will find your way to the other side of the transverse lie.

 

 

 

  I'd also ask a woman who is scheduled before 41 weeks for a cesarean for a transverse lie or breech presentation:

 

Is convenience the most important thing to schedule your baby's birth around? If not, you might ask for a postponement. You'd be taking additional responsibility for your birth. But this is something to research adn to discuss with your doctor.

 

angela.bouchard
by on Mar. 28, 2011 at 3:35 PM

how far a long are you? one thing the instructor from my birthing class said was when you are getting farther a long some things you can do to help get baby in to position are getting on your hands and knees tilting your pelvis up for a few seconds. this also worked for me when my son was in uncomfortable positions, it'd get him to move.

doulala
by on Mar. 28, 2011 at 3:35 PM

please stay hopeful~ and consider getting a birth advocate, this care provider doesn't sound as helpful as she could be!
>:-(




At 20 weeks, about one in four pregnancies are breech presentation. By full term, the incidence is about 4%.

Graph of presentation by gestational age









"If you don't know your options you don't have any"          ~Korte & Scaer

"If you choose not to decide you still have made a choice."    
           ~Rush

Pandapanda
by Amber on Mar. 28, 2011 at 3:37 PM
Um.. babies that are transverse can turn DURING labor. Why put a timeline on yourself?
I would refuse. There's no way to force a surgical delivery on you, and especially when there are things that can change baby's position.

Go to spinningbabies.com.
If needes, accupressure and moxibustion are known to change a baby's position!
Also, there are things your doctor can do to help baby move.

Do not do not agree to surgery until you've gone through a trial labor and baby hasn't turned. I have a friend who's baby went from fully breech to head down during labor and was born vaginally.
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olivejuicebby
by on Mar. 28, 2011 at 3:43 PM

They can make that call @ 36wks... Hmm... Well, I hope she moves herself around!! Good luck =)

rugrat-mama
by on Mar. 28, 2011 at 3:45 PM
im 24 weeks

Quoting angela.bouchard:

how far a long are you? one thing the instructor from my birthing class said was when you are getting farther a long some things you can do to help get baby in to position are getting on your hands and knees tilting your pelvis up for a few seconds. this also worked for me when my son was in uncomfortable positions, it'd get him to move.

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olivejuicebby
by on Mar. 28, 2011 at 3:47 PM

24wks sounds early to me... I bet she moves! There is still so much time to do so ::Hugs::

rugrat-mama
by on Mar. 28, 2011 at 3:47 PM
your ways so helpful. Thank you.Maybe i should talk to you first. Lol

Quoting doulala:

please stay hopeful~ and consider getting a birth advocate, this care provider doesn't sound as helpful as she could be!
>:-(














At 20 weeks, about one in four pregnancies are breech presentation. By full term, the incidence is about 4%.


Graph of presentation by gestational age













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