What is the lateral infant position?

When the fetus is turned on its side, the fetus is in a lateral position, at a 90-degree angle to the pregnant woman’s spine. A cesarean section (caesarean section) may be required if the fetus cannot be brought into a head-down position when a person gives birth. Vaginal delivery in a lateral position poses risks to both the baby and the person giving birth.

An estimated 2% to 13% of babies are delivered in a misplaced position – meaning they are not in the head position (head down).

Causes and Risk Factors

There are physiological characteristics that may cause the fetus to be in a lateral position, as well as certain risk factors that may increase the chance of this happening. These include:

  • A bicornuate uterus, which means the uterus has two separate sides, so you may only be able to accommodate a fetus in a lateral position
  • Oligohydramnios or polyhydramnios, conditions that involve abnormally low or high amniotic fluid volume, respectively, during pregnancy

Other common risk factors include:

  • The location of the placenta (especially if the pregnant woman has placenta previa)
  • premature birth
  • Pregnant with twins or other multiples
  • Pregnant woman’s pelvis
  • have different types of uterine abnormalities
  • have a cyst or fibroids blocking the cervix
  • Not a man’s first pregnancy

diagnosis

It’s not uncommon for the fetus to be in a lateral position early in pregnancy, but in most cases the baby’s position changes on its own before labor begins.

With no signs or symptoms of the fetus in a lateral position, healthcare professionals make the diagnosis through the examination method of the Leopold maneuver, which involves palpating the pregnant woman’s abdomen to determine the fetal position. Usually confirmed by ultrasound.

Timing of Lateral Position Diagnosis

An ultrasound performed at a pregnant woman’s 36-week check-up will allow a healthcare provider to see where the fetus is as it approaches labor and delivery. If it turns out that the fetus is still in a recumbent position, the medical team will make a plan for the safest possible delivery.

treat

About 97% of births involve fetal head presentation, when the baby is head down, making vaginal delivery easier and safer. But about 1 percent of births involve the fetus in a laterally recumbent position — meaning its shoulders, arms or trunk may appear first.

In these cases, there are two options:

  • trying to manually turn the baby for safe vaginal delivery
  • have a caesarean section

While it’s not always possible to manually rotate the fetus before delivery, if someone wants or needs to avoid a C-section, a healthcare provider can try to move the baby using one of the following techniques:

  • External Head Version (ECV): This is a procedure usually performed around 27 weeks of pregnancy and involves two healthcare providers: one lifts the baby’s hips to move it into an upward position, the other applies pressure to part of the buttocks. The uterus the baby is in – through the abdominal wall – in order to rotate the baby’s head forward or backward.
  • Webster Technique: This is a type of chiropractic treatment in which a healthcare professional moves a pregnant woman’s buttocks to allow their uterus to relax. Note that there is no evidence to support this approach.

Additionally, there are things pregnant women can do at home to help the fetus get into a better position—though again, there’s no guarantee these will work. Methods include:

  • Land on your hands and knees, rocking gently back and forth
  • Push your hips up while lying on your back with your knees bent and your feet flat on the floor – also known as Bridge Pose
  • talk or play music to stimulate your baby
  • Apply something cooler to the top of the abdomen (where the baby’s head is)

Can the baby return to a landscape position after being moved?

Even if the baby does change position, it’s possible that it will return to the lateral position before delivery.

complication

Whether the baby is born by caesarean section or transferred to the point where vaginal delivery is allowed, other potential complications remain.

cesarean section

While a C-section is generally safe for both the baby and the person giving birth, as with any surgery, there are some inherent risks associated with this procedure. For those who are pregnant, these can include:

  • increased bleeding
  • Infect
  • bladder or bowel damage
  • reaction to the drug
  • blood clot
  • death (very rare)

A C-section can also lead to potential (though rare) complications in the baby, including:

  • possible injury
  • Occasional breathing problems if they still have fluid in their lungs to clear

vaginal delivery

Even if the healthcare provider is able to rotate the fetus to the point where it can be safely delivered vaginally, the delivery usually takes longer, and the baby’s face may swell and bruise. If this happens, don’t worry, as these changes tend to go away within a few days of birth.

If the umbilical cord is compressed at birth, it may deprive the baby of oxygen and the baby may experience distress on a fetal monitor, which may require a C-section.

response

As with any birth, pregnant women should work with their healthcare provider to develop a birth plan. If the fetus has been in a recumbent position throughout pregnancy, the medical team will assess the position and plan accordingly at approximately 36 weeks.

It’s also important to remember that things can change rapidly during labor and delivery, even with the baby’s head down, so it’s helpful for pregnant women and their healthcare providers to discuss options for different types of births, if necessary.

VigorTip words

Pregnancy brings many unknowns, and surprises can continue into labor and delivery, including during labor.

Having a conversation with your healthcare provider about possible births early in your pregnancy can give you time to start thinking about possible outcomes. This helps avoid situations where the risks and benefits of a particular strategy are considered for the first time when a decision must be made.

Even if the fetus is in a laterally recumbent position throughout pregnancy, it may be helpful to know that only about 1% of the baby will still be in that position at birth.

Frequently Asked Questions

  • How should a 32-week baby be positioned?

    Ideally, babies should be in the head position (head down) at 32 weeks. If not, the doctor will check the baby’s position around 36 weeks and determine what should happen next to ensure a smooth delivery. Whether this involves a C-section will depend on the circumstances.

  • How often are babies born in a recumbent position?

    Less than 1% of babies are born in a recumbent position. In many cases, a doctor may recommend a C-section to ensure a safer delivery. If the baby is delivered before the due date, or if twins or triplets are also born, the risk of a recumbent birth is greater.

  • When is a caesarean section usually performed?

    A cesarean or caesarean section is usually performed in the 39th week of pregnancy. This is done to give the baby enough time to grow and develop and be healthy.

  • How to turn over a born baby?

    In some cases, physicians may perform an external cranial version (ECV) to turn a transverse infant. This involves the doctor’s hand applying firm pressure to the abdomen in order to move the baby into a cephalic (head-down) position. Most ECV attempts are successful, but it is possible for the baby to return to the original position; in these cases, the doctor can try the ECV again.