Transverse Lie at 38 weeks - Mothering Forums
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#1 of 5 Old 09-29-2002, 02:24 AM - Thread Starter
 
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Hi Everyone,

I must apologize in advance for the number of questions I have. I have posted to other mothering forums before, but am hoping that someone here can help me find some answers for a friend of mine.

My name is Jeanette and I am a mother to a beautiful one year old girl named Isabella. I had a beautiful home waterbirth with Bella, and have ultimate respect for the process of pregnancy and birth.

A good friend contacted me today, having just learned her baby is in a transverse lie. She is 38 weeks and the doctor is having her come in next week for an ultrasound, followed by an external version if baby is not vertex. He warned her that the procedure only has a 15-20% success rate, and if baby remained transverse he would schedule a c-section. If she goes into labour prior to the version or scheduled ceserean, doctor told her they would need to do an emergency ceserean. In addition, she is being treated as GBS positive, as she cultured positive with her first baby (normal vaginal delivery).

Her doctor did an ultrasound today and told her the baby was positioned in this manner:

Hands down where the head would normally be.

Head under her right breast.

Back curving under her left breast.

Bottom under her left breast/left ribs.

Baby is facing downward.

Can anyone give me some ideas of positions, techniques, etc that she can try to encourage the baby to turn. Does anyone have any opinions on whether a scheduled c-section is warranted in this case, or if they should wait for labour to begin on its own and find out if the baby has turned by that point.

Any facts, stats or ideas would be really appreciated, as I really want to help her advocate for herself and do the right thing for both her and the baby.

A few problems/questions:
-Her mother and sister and both pushing for a c-section and trying to convince her a version is too risky. Any quick stats I can throw at her to convince her that a c-section carries much higher risks?

- Her husband is opposed to trying the Webster Technique as they would not be in the hospital and he is afraid to try this without monitoring. I have tried to find a brief description of the Technique in order to show him it is safe but have had no luck. Can anyone help?

-My friend also asked how she would be able to tell the baby had moved. Aside from feeling the move, would their be any obvious signs she would be able to notice without a trip to the doctor. If she thinks that baby has moved to a vertex position, is there anything she can do to help her stay there?

Thanks so much in advance, sorry for all the questions!

Jeanette
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#2 of 5 Old 10-01-2002, 02:46 AM
 
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Hi there,

My dd was transverse lie too...what a bummer! I'm a doula and love to doula mamas at home for their births- I love the process too. We were planning on birthing our sweet one at a free standing birth center in a really neat tub they have.

I tried alot of things. I tried swimming, doing "dolphin" type dives, accupuncure, moxibustion, hip tilts, using heat and cold, standing on my head- some crazy yoga position...I didn't try the "Webster Technique" which is done by chiropracters. The one in town that knew how to do it called me back AFTER dd was born...We tried 2 versions- one without meds and one when I was in labor with an epidural (versions without meds is VERY painful, with the epi was uncomfortable- it should be her decision and not anyone else's- tell her to follow her heart)...obviously in the hospital. It didn't work and dd was born via cesarean section at 37 weeks 5 days.

Try this link:
http://www.childbirth.org/AskACBE/labor/labor6.html

I really was disappointed but knowing birth and my baby's position I knew there was nothing we could do. If csections didn't exist...we wouldn't be here right now!

I do have a bi-coronated (sp) uterus and that could pose a problem.

Is this her first baby? I would imagine so.

The position of her baby is exactly like my dd.

The risk involved is that if she goes into labor there is nothing in the way to block the umbilical cord from slipping (prolapse cord) out. This is very dangerous for the baby.

I think at this point in the pregnancy- the baby is so big that if the baby did move she would know it and her belly will change shape. She'll probably feel the baby's head engaged since it will be such a new sensation.

If the baby does turn my midwives gave me this big back support thing to wear and then we were going to induce with castor oil.

I was told if I did go into labor to try to keep my butt up to prevent the cord from slipping.

My beautiful girl was alert and looking around right after she was born. We have had an AWESOME nursing relationship and we both still love it and she is 19 months old!

My dd face was disformed from being in such an odd position and her hand was swollen from being so low. Her hand was fine the next day and after a month or so her face was normal. She did also have hip dysplacia due to the positioning. She wore a harness/brace for the first 4 months of her life. It was a pain, but well worth it. Your friend should definitely have the staff- wherever she births to feel for that since it is common among breech babes. If babies wear the harness like instructed and wear it early in their lives it is ALOT easier. Once they are mobile it would be REALLY heartbreaking.

Ok, I'm really tired and must go to bed. I hope this is of some help and let me know if I can help out any further.

Julie
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#3 of 5 Old 10-10-2002, 11:05 PM
 
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It's probably too late to help you by now, so I hope that all has gone well with your birth (or is about to!) and that everyone is healthy.

We discovered at 32 weeks that our daughter was breech and also had a consultation for version. This is one of those things that varies WIDELY according to who is doing it. Our doctor claimed a much higher success rate and was very adamant that version was an art that has to be done VERY gently. He said that he never forces the issue because some babies just need to be in there the way they are and often we'll never know why.

In our case, the why became self-evident. At 34.5 weeks my water broke and I went into labor. The baby was still breech and our version wasn't even scheduled until 37 weeks. We had a C Section and discovered that our poor baby had a cord of only "10 cm maximum" according to the surgery report. She was stuck! Really really stuck! It makes me really sad that I was a passive observer, a bystander, really, for the birth of my daughter. On the other hand, I am SOOOO very thankful that God was looking out for her. With such a short cord, she could have easily been a stillbirth.

So I guess the lesson is that sometimes things are weird for reasons that we can't anticipate or fix. I'm happy to report that our new baby seems to have plenty of room to move around inside and I'm feeling kicking at the top of my uterus for the first time! So hopefully our plans for a HBAC will be as wonderful as I'm imagining!

Blessings to you and your baby!
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#4 of 5 Old 01-17-2003, 09:00 PM
 
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Suppose a mom is just allowed to go into labor with a transverse baby and then they do a c/s if the baby doesn't turn when the mom reaches 10 cm? Would that be safe? If not, what are the risks involved?
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#5 of 5 Old 01-18-2003, 12:15 AM
 
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With nothing engaged in the pelvis (ie neither head nor butt) cord prolapse is a very real and very serious risk once waters break. And I have no evidence to back this up but I think that babies in strange positions can be more likely to start labour by breaking the waters - and often early. I have a friend whose twins were both transverse and although she fought really hard to birth her twins in the birth centre and found a supportive OB to back this up he started talking to her about c/s - or rather he said they may need to discuss it at the next apt. Well a couple of days later her waters broke late at night and one baby's cord came fully out with the liqour. She called the hospital she was supposed to go to and the hospital had already called an amublance to take her to a different closer hospital before they had finished talking to her (she found this out because her DH called too and was told the ambulance had already been dispatched). She shoved the cord back in and stuck her butt in the air, when she got to hospital (delayed by arguing with the dumb ambos who wanted her to lye flat on her back) she was under general within minutes. Apparently when her babies were taken into NICU they asked "whose babies are these" because they thought/assumed her babies had died!! she realised after all this that her OB had known she would have cord prolapse if her waters broke while the babies were in that position and this is why he started raising the c/s idea. Sometimes it really is the right thing to do. If it were me I don't know what I would do, I think I would want to wait for labour to start, but only if I was VERY close to my hospital and I would certainly go in at first signs of labour not wait around till the last minute as I did with DD.

all that said twins are a lot harder to reposition than just one, I would be doing all the postural stuff, seeing my chiro, sometimes babies are transverse or breech for good reason, but sometimes they just seem to like it that way (ie no medical reason). My dd turned from breech during a massage and quickly found she had more room so she stayed head down.
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