When you are pregnant, one of the biggest concerns is undoubtedly your baby’s position inside you, and one of them is called transverse lie (córmica presentation). It’s important to understand that there are various fetal position variations and each one will require different care, since the baby’s position directly affects and practically defines how your delivery will be.
Fetal Position During Pregnancy
Up until the 32nd week of pregnancy, your baby has plenty of space to move around inside the uterus, so at this point the position isn’t very important yet, even though there may be signs of how the baby might settle later on.
When you have an ultrasound scan after the 32nd week, that’s when we have a better idea of the baby’s position, although there’s still a chance the baby can move and completely change position.
What Is Córmica Presentation
The vast majority of babies stay in a breech position1 (sitting) for much of the pregnancy, but switch to the cephalic position at the end of gestation, turning head down2 to facilitate natural childbirth. However, in some cases, transverse lie (córmica presentation)3 happens, where the baby assumes a horizontal position, with the buttocks, shoulders, and head at the same level, which can make vaginal birth more difficult.
When you and your doctor notice that a transverse lie is happening, there are some steps that can be taken to try to reverse this situation.
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Advantages of Vaginal Birth
Many people may wonder what’s the big problem if you can’t have a vaginal birth, since a cesarean section exists for just that reason. This is a good point, but it is also important to understand all the benefits of having a vaginal birth. Some of the main advantages include:
- Lower risk of infection, since there’s no surgery;
- Speeds up the woman’s physical recovery;
- The baby has more natural immunity;
- It stimulates increased production of the hormone oxytocin, which helps emotional bonds form more easily between mother and baby;
- The baby finds it easier to breathe;
- The mother and baby feel calmer.
These are just a few of the advantages of having a vaginal birth, but you can already get a sense of the importance of trying to change the baby’s position when there is a transverse lie. Besides all these factors, many mothers desire a natural birth, which is why there are some exercises that can be done to try to change the baby’s position.
Exercises to Reverse the Baby’s Position
When there is a case of transverse lie, the first step is without a doubt to practice exercises that can help the baby turn head down, that is, assume the cephalic position. These exercises use various elements like water, gravity, and the woman’s own body to help the baby turn. The main exercises are:
- Postural Inversion Method
- Forward Leaning Inversion
- Exercises in the Pool
- External Cephalic Version
For these exercises to be successful, it’s important to make sure the baby is awake and to wear comfortable clothing so you can move freely. You should also have an empty stomach when practicing. It is important to have someone with you while doing these exercises to turn a transverse lie, to make sure nothing goes wrong.
ATTENTION: Never try any exercise before talking to your doctor. They will tell you which are the best options for your situation and for how long you should practice them.
Postural Inversion Method
This type of exercise basically consists of raising your hips 35 to 40 cm above your head, usually by lying on the floor and placing cushions under your hips, although there are other ways, such as reclining in a tilt-back chair. Doing this 3 times a day for about 10 minutes can help the baby move out of a transverse lie and into the cephalic position.
Forward Leaning Inversion
To do this exercise for reversing a transverse lie, use a surface like a bed or sofa to support your knees and rest your chest on it, with your hands on the floor. Hold for about 30 seconds. Do this exercise 3 to 4 times a day as well.
Exercises in the Pool
The pool is a great place to do exercises to help change the baby’s position. Water can be a great ally, as it encourages the baby to move. Regular swimming styles like crawl and breaststroke are welcome, but you can also squat in the water to encourage your baby.
External Cephalic Version
External cephalic version is not an exercise you can do alone. It consists of specific techniques your doctor uses to try to turn the baby inside your belly, usually when no other exercises have worked by the 37th week of pregnancy.
When Does the Baby Drop?
The moment of engagement is when the baby gets into the cephalic or sometimes breech position (since some births happen that way) and becomes fixed in the mother’s pelvis, which means they stop moving. Engagement happens because the bottom part of the uterus gets wider as your body prepares for delivery.
Of course, no two pregnancies are the same, which means babies don’t engage at the exact same time for every woman, although it usually happens around 36 or 37 weeks of pregnancy. It’s also common—especially for mothers who have had other babies—that the baby only drops when labor begins.
How Do You Know If the Baby Has Dropped?
When the baby engages, women typically notice symptoms such as less heartburn and easier breathing. It’s also possible to notice that the baby’s movements are much more restricted. However, the urge to pee normally increases a lot, as does difficulty moving around, since the belly tends to drop lower.
Having a child is a unique experience, even for those who have already gone through it—it’s always different. Naturally, all mothers are concerned about aspects of their pregnancy like the baby’s position and when the baby drops, especially first-time moms.
A transverse lie doesn’t mean your delivery will be difficult or more complicated; it just means you need to take certain precautions and that there’s a risk your birth might not be vaginal. Remember: it’s very important to follow your doctor’s instructions so that your pregnancy occurs as smoothly as possible, with no complications.
See Also: Cephalic Position – The Healthiest for Birth
Photos: Internet Archive Book Images, Thomas Pompernigg
