Transverse baby-should I worry? - Mothering Forums

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#1 of 11 Old 11-15-2013, 07:38 AM - Thread Starter
 
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Hi there. I'm 35 weeks today and found out yesterday at my midwife appointment that baby has likely turned transverse. he or she was head down two weeks ago.  There was a bit of fear mongering yesterday which got to me a bit but I am trying not to worry.  At the same time, I started doing some inversions as described on the spinning babies site, and I took a dose of pulsatilla last night. I also emailed my former midwife who is a friend of mine on facebook and asked her what her advice is.  My current midwife is just not into homeopathics but I felt they really helped me in the past and my former midwife was amazing with knowing what to recommend.  She's about 6 hours away now so that's why she isn't my midwife anymore.  I've never had an issue with baby turning head down with my other two, although they were both posterior.

 

does anyone have any advice or insight? Should I worry? I wonder when I will know for sure that what I am doing is working.  It took a midwife and a student to figure out which way baby was positioned. The midwife was way too rough and I had to ask her to stop.  I'm still not convinced baby is still transerve, because of the fact I am still feeling movements everywhere and baby is very active. I think there is still a lot of room in there for baby to move.  My coworker just told me all of her babies moved everywhere until the end, and they had her do a couple of contractions on her side during labor, and the baby turned no problem.  She said not to worry.

 

I'm supposed to start going for appointments every week now and I really think I want to skip it every other week at least, without having to fight and explain myself constantly. I find I am very stressed after each appointment and it just gets me out of that zone where I am trusting in myself and God and just letting things happen as they should.  I think I could however be more active and start walking again and maybe that will help baby turn.

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#2 of 11 Old 11-18-2013, 10:07 PM
 
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I don't have any advice. But I am hopeful your baby will get into a good position for you! Keep us posted and Good luck smile.gif
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#3 of 11 Old 11-18-2013, 10:44 PM
 
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IF you have an US , would not you know for sure?

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#4 of 11 Old 11-19-2013, 04:26 AM
 
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I hope the baby turns back head down for you.

Transverse breech is a thing I would worry about - maybe not now, but by 37-38 weeks, I'd find it hugely worrying. An ultrasound might help you determine if there's a reason, like a short or tangled cord - and whether the baby has moved head down again. I would personally want that reassurance before labor. A persistent transverse lie isn't a situation midwives can resolve (they can't count on getting lucky like your coworker did), and they have to warn you about that.
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#5 of 11 Old 11-19-2013, 07:07 PM
 
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I would be concerned. One of my twins was transverse at 37 weeks, the other was complete breech. I took pulsatilla and did the lying-on-an-ironing board inversion exercise to turn them, and it did not work. I got the sense that they could not turn, and stopped trying to intervene. I also had anterior and posterior placentas, which may have played a role. At any rate, neither turned, and I was sectioned.

One thing in your favor is that you're carrying a singleton. Twins obviously have much less room to manuever.

Going into labor with a transverse baby can set you up for a cord prolapse. The risk of a double cord prolapse made me uneasy about attempting a vaginal delivery, and none of the OBs I talked to were willing to. I had been planning a homebirth. My midwife offered to try to deliver my daughters at home, but I felt it would have been way too risky. If you can't turn a transverse, you have to be sectioned. There is no guarantee that that an OB or midwife, even a very skilled one, could turn the baby.

I am not trying to scare you, but to honestly share my experience. I would have considered a homebirth had both babies been vertex or the first vertex, the second breech. I hope that your baby will move. My babies were both vigorous movers and neither was able to turn.

An ultrasound would tell you for sure if your baby has turned. You could even go to one of those 3D imaging places, as they do not require a prescription.

Good luck!

TizTaz5, wife of a wonderful husband and mother of an angel (lost June '09) and two rainbow1284.gif babies born in July '13. Great things really do come in pairs!
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#6 of 11 Old 11-20-2013, 12:39 PM - Thread Starter
 
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Thanks everyone. I contacted my former midwife and she said not to worry, that this is very normal for women who've had a few babies.  She suggested continuing to take the pulsatilla.  My baby moves a lot so honestly I'm notworried now.  I am not planning on getting any ultrasounds unless there is a real concern, as there are risks I really wasn't aware of last time.  U/S are not as safe as they are made out to be.  I guess I will cross that bridge when I get to it.  I was reassured that often subsequent bbies don't settle head down until 38 weeks.    I do trust her judgement and know she would tell me for sure if there was something to worry about, whereas my current midwife is overanxious about everything.  I will not get a c section unless my baby is still transverse when I go into labor.  Babies can and do move even when you go into labor so I am not willing to be cut open through how many layers of muscle and tissue for a non emergency situation.  We do'nt have any family to help us out and we have two other kids so it would be difficult to recover. I think I will take  wait and see approach and will consider an ultrasound if baby is still not head down by about 38 weeks.

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#7 of 11 Old 11-21-2013, 06:50 PM
 
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My first 2 babies were vertex from 20 weeks on (as far as I could tell, the 2nd for sure). So when my current one was breech at 20 weeks, I did freak out a bit. Mostly because no one will vaginally deliver a breech (that I could find locally). I don't think breech is a good reason for a c-section. That was part of why I decided on a UC instead of a midwife (but since then, I'm not sure I'd be comfortable with anyone helping who isn't my husband... They can do some serious damage to you... It's scary to trust someone you don't really know with the future of your reproductive health!) Anyway, baby 3 turned and has stayed vertex since about 32 weeks. All that worry for nothing!

 

A transverse baby at time of labor has made my list for going to the hospital for a c-section. I do think it's smart to wait some and labor with movement to see if baby will move first though. Awesome plan! I read one birth story where a woman was pushing for 5 hours before going to the hospital and finding out her baby was transverse. *!* I don't think I'd like to wait that long.

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#8 of 11 Old 12-09-2013, 06:27 PM
 
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No you should not worry.

However, from what I understand, it is impossible to deliver a transverse baby vaginally. You may try to alter the position of the baby with help of contractions early in labor, but this is a serious condition. I would not proceed at home without the ability to assess the baby's heart rate and knowledge of how to interpret the signs. If you are unconvinced that this is a potentially serious situation, I would simply look up images on google of a transverse lie. They are sobering.

 

A baby in a transverse lie would present similarly as an obstructed labor; I've included what I know about this below:

 

Pelvic Dystocia

Cephalopelvic disproportion occurs when there is incompatibility between the size of the baby’s head and the maternal pelvis. When a labor stalls, parents are often afraid of cephalopelvic disproportion or a true boney obstruction, which is a serious condition that grows progressively worse the longer it is undiagnosed and untreated. Thankfully, true cephalopelvic disproportion is extremely rare[i] and the condition is actually highly over diagnosed.[ii] Two thirds of mothers diagnosed with CPD go on to deliver larger infants vaginally in subsequent pregnancies.[iii] Obstructed labors began to be attributed to cephalopelvic disproportion in an era in which most mothers suffered from malnutrition disorders such as rickets. (Rickets is a vitamin D/ calcium deficiency that affects the bones, specifically the pelvis.) A mother may be at risk for pelvic dystocia if she has had a previous pelvic fracture or a known pelvic type other than the ideal gynecoid pelvic shape. A mother with this history can make a pelvimetry appointment; pelvimetry is the assessment of the female pelvis for labor and delivery where a practitioner may predict CPD. (Though finding a skilled practitioner may be difficult; it is becoming something of a lost art.[iv])

Pelvic dystocia can be identified by frequent, long lasting contractions over many hours without any change in the position of the baby, or the behavior of the mother, or the cervix. Often an active labor contraction pattern reverses; contractions grow further apart. Contraction pattern may be erratic in intensity and duration and often cluster, with two or three very close together, followed by noticeable pauses. Highly localized pressure or pain is felt; back pain is also common. Rupture of amniotic sac is common, so is evidence of meconium. The baby’s presenting part often cuts off circulation to pelvic region, causing vagina to feel dry and often hot while swelling in the external genitals (the vulva and labia) and cervix is also seen. The baby will usually begin to show signs of distress and the mother will ‘know’ that there is something wrong. A retraction ridge often forms between the thicker and contracted upper uterine segment and the thinning lower uterine segment. “In normal labor there is no need for the lower segment to become unduly distended, because the fetus is gradually being expelled through the dilating cervix. In cases of obstructed labor, where the fetus cannot descend to pass through the cervix, the lower segment must stretch to accommodate it, because the fetus is being pushed out of the shortened upper segment.”[v] When the normally occurring retraction ring becomes visible, it is called Bandl’s ring. One of the easiest to identify and most common signs of pelvic dystocia is a lack of fetal engagement. The baby’s station remains high and stays the same over time. This is only a sign of obstructed labor at the pelvic inlet, though most cases of obstructed labor occur at the pelvic inlet (thus preventing engagement). The pelvic inlet is the line between the narrowest bony points of the sacrum and the inside pubic bone; ideally this plain should measure 10-11.5 cm or more. [vi],[vii] 

 

(SB: Signs of Obstructed Labor:

1.      Contraction pattern is erratic in intensity and duration. Contractions often cluster, with two or three very close together, followed by noticeable pauses.

2.      An active labor contraction pattern reverses; contractions grow further apart.

3.      Lack of fetal engagement: baby’s station remains high and/or the same over time. Most cases of obstructed labor occur at the pelvic inlet thus preventing engagement.

4.      Sufficiently strong uterine contractions make no changes in cervical dilation for over 4 hours.

5.      Poor cervical effacement (thinning); the cervix retains shape as it dilates giving the feeling of an ‘empty sleeve’.

6.      Back pain is experienced during and between contractions.

7.      The presenting part cuts off circulation to pelvic region causing vagina to feel dry and often hot.

8.      Pressure or pain is felt in a specific location.

9.      Maternal sense of exhaustion, anxiety, and sense of a worsening condition. 

10.   Rupture of amniotic sac is common. 

11.   Abnormal maternal vital signs: pulse above 100 bpm, low blood pressure, and respiration rate above 30 bpm, possible raised temperature.

12.   Meconium.

13.   Swelling in the external genitals (the vulva and labia) and cervix.

14.   Swelling on the baby’s head (a caput).

15.   Premature urge to push.

16.   Bandl’s ring may be present.)

 

 

Preventative treatment include this exercise, and excellent chiropractic care. Handstands in the pool also wouldn't hurt.

 

Supine Inversion Technique

 

This exercise has an excellent success rate for gently turning engaged babies with malpresentations.[i]

1.    Ensure the mother’s bladder and stomach are empty.

2.     Place three firm pillows under her hips to raise them about a foot off the ground.

3.     The rest of the body should be on the bed or floor with no supporting pillows to create a gentle supine inversion.[ii]

4.     Stay in inversion for 5-15 minutes.

5.    As an alternative, the mother can use an inversion table if she has access to one.

 

[i] Khorsan R, Hawk C, Lisi Aj, Kizhakkeveetil A. “Manipulative Therapy For Pregnancy And Related Conditions: A Systematic Review.” Obstet Gynecol Surv. 2009 Jun; 64(6):416-17.

[ii] Ridley, Renee T. “Diagnosis And Intervention For Occiput Posterior Malposition.” Journal Of Obstetric, Gynecologic, Neonatal Nursing, Volume 36, Number 2, Pp. 135-143(9) Blackwell Publishing March/April 2007

 

 


[i] American College Of Obstetricians And Gynecologists: Dystocia And The Augmentation Of Labor. Technical Bulletin No. 218, December 1995a

[ii] Cunningham Gf, Gant Nf, Leveno Kj. Section V. Abnormal Labor. In: Williams Obstetrics. 21st Edition. New York 7 Mcgraw-Hill; 2001. P. 425–67.

[iii] Brill Y, Windrim R. “Vaginal Birth After Caesarean Section: Review Of Antenatal Predictors Of Success.” J Obstet Gynaecol Can 2003;25:275–86.

[iv] Maharaj D. Assessing Cephalopelvic Disproportion: Back To The Basics. Obstet Gynecol Surv 2010; 65:387.

[v] Myles, Margaret F. Textbook For Midwives: With Modern Concepts Of Obstetric And Neonatal Care. 10th Ed. Churchill Livingstone. 1985 P249

[vi] Kaltreider Df: Criteria Of Midplane Contraction. Am J Obstet Gynecol 63:392, 1952

[vii] Mengert Wf: Estimation Of Pelvic Capacity. Jama 138:169, 1948

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#9 of 11 Old 12-27-2013, 07:09 AM
 
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My second baby was transverse for much of the pregnancy, but moved around a lot. Midway through labor, I noticed she was transverse and asked her to move head down. She did, and was born head first about an hour later. No problems. 


Mom of two kids, expecting again in June or July 2014. 
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#10 of 11 Old 12-27-2013, 01:42 PM
 
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Originally Posted by Crunchymama3 View Post
 

Hi there. I'm 35 weeks today and found out yesterday at my midwife appointment that baby has likely turned transverse. he or she was head down two weeks ago.  There was a bit of fear mongering yesterday which got to me a bit but I am trying not to worry. 

 

I'd be interested in hearing exactly what they said.  Without knowing that, I can only assume that what they told you is that if your baby is still transverse when you go into labor, you will need a c-section.  That doesn't strike me as "fear mongering."  You can't fit a square peg into a round hole.  Period.  If you go into labor with a transverse baby, you need to transfer.  Delaying this decision will not only be pointless, but will also increase your risk of complications.

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#11 of 11 Old 12-28-2013, 06:29 PM
 
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If baby was transverse when labour started I would try or a bit to see of baby turned and if not i would transfer to hospital for a c-section.
I have a short list of things I'd get sectioned for and persistent transverse is one.

Don't worry, it's way more likely that baby will turn than not, and if you do need a section it's totally not your fault as this isn't one of those flimsy reasons, it's bona fide.
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