Transverse - consultant appointment

[WindFlower92]

So I'm 36 weeks pregnant. Had a scan last week - baby transverse. Midwife appointment today - baby oblique/midwife not sure. I asked about hospital admission from 37 weeks as I've read on here that that seems to be standard for these positions. Midwife says nothing needs to be done, all is fine. I later call the maternity unit to ask for clarification, and the lady on the phone tells me that I should have been referred to a consultant, and to come in to speak to one. I go in and talk to a midwife. She all but tells me I'm wasting her time and that I'm being ridiculous, and that everyone is at risk of cord prolapse and they can't admit everyone from 37 weeks. I told her I wanted to speak to a consultant, as that is what I was advised over the phone. I know have an appointment for Thursday, which she begrudgingly made while telling me it was a waste of time.

I've now looked at NHS, NICE and RCOG(?) guidelines and advice, and they all say women from 37 weeks should/may/must be admitted for observation due to risk to baby. Where do I stand with this with my hospital? Can they refuse this? And what do I do if they do? I have a nearly 2 year old and my husband works far away some days and doesn't know where he will be sent day to day. MIL lives round the corner but also works and can't just stay at home in case I call for the next 3 weeks. I don't want to be in the situation where I can't get into hospital because I'm waiting for someone to come and get DD, and in any case the thought of having to wait for an ambulance before getting my baby seen to is filling me with anxiety and is something I would rather avoid. How can I persuade the hospital to admit me for those 2 weeks? Has anyone been in this situation before?

Sorry, that was a bit of a ramble, but I'm feeling quite stressed now!

RCOG guidelines say “elective admission to hospital after 37+0 weeks of gestation should be discussed and women in the community should be advised to present urgently if there are signs of labour or suspicion of membrane rupture” and if membranes rupture then admission recommended.
Baby was oblique at 37 weeks for me but have been head down since shortly after. There is still time for baby to turn so don’t panic but the important thing is to get in ASAP if any signs of imminent labour.
Also, have you looked at Spinning babies? Lots of techniques to get baby to move that seem to work well.

Hi Op, my baby was transverse all the way until 37 weeks and it’s now head down. Could you ask for an ECV to try and turn it?

My hospital does admit women who have a transverse lie in some circumstances.

If your waters go at home, go down on all fours, bottom in the air and call an ambulance.

@Teakind

Hi Op, my baby was transverse all the way until 37 weeks and it’s now head down. Could you ask for an ECV to try and turn it?

My hospital does admit women who have a transverse lie in some circumstances.

If your waters go at home, go down on all fours, bottom in the air and call an ambulance.

This sounds more panicked than it needs to be. I didn't know at the time but my boy was transverse with a prolapsed arm. On his due date I was asleep when my waters went with an almighty splash - the head isn't plugging the exit so it pours out. It still took six hours before I went to hospital and they found out his position (when the midwife examined me and he grabbed her finger with the prolapsed arm! She screamed) I was just taken for a csection and we're both absolutely fine. Don't panic.

Hi @Teakind, I don't want to try an ECV as they have a very low success rate and I don't like the risks associated with them in any case!

What will the ambulance do if I have DD with me and no one is available to look after her until later?

Sorry @legalseagull but that doesn't reassure me at all! How come it took 6 hours for you to get to the hospital if you don't mind me asking? The cord could have prolapsed and that's not a risk I would want to take given that I do know baby's position and don't feel like I can just ignore this.

My daughter was transverse, which was discovered in labour. Like a previous poster said, my waters were absolutely gushing.

I'd be very firm and clear about what you'd like. Prepare for an elective section potentially. I was forced to push my transverse daughter and I had an emergency section in the end where she was stuck because of her position once pushed and they caused a lot of damage to my womb, resulting in huge blood loss and a transfusion.

Do not be fobbed off and do not give in. Transverse babies can be a very difficult labour and are also extremely painful, due to positioning.

Luckily I have a c section booked in for 39 weeks already @Chanel05, so that's one thing less to worry about! But everyone I spoke to today said that as that was booked in there was nothing to worry about. My concern is the 2 weeks leading up to that c section which they seemed to dismiss!

My second was transverse and I was given the same advice to call an ambulance and get onto all fours with bum in the air if my waters broke. First was ELCS for breech (hospital wouldn't even try to turn) so although they offered to turn the second (different hospital) they said they wouldn't try very hard. I declined and we were booked in for another ELCS with no problems. I wasn't admitted until the day of the op.

@WindFlower92

Sorry *@legalseagull* but that doesn't reassure me at all! How come it took 6 hours for you to get to the hospital if you don't mind me asking? The cord could have prolapsed and that's not a risk I would want to take given that I do know baby's position and don't feel like I can just ignore this.

Because there was nothing wrong and I had no idea he was transverse. As far I was concerned it was a normal Labour so I just waited until my contractions were at a point where I was told to go in

Hi OP my second no third babies were both transverse.

I had consultant led care in an NHS hospital because I was over 40. I was told I ‘might’ need to go in and rest because of the risk of cord prolapse but I was reluctant to stay in hospital so instead I was told to carry my notes with me everywhere I went just Incase I went in to labour or did have a cord prolapse and needed to be rushed in. With both pregnancies I had a planned Caesarian at 38 weeks to avoid going in to labour and ending up with an emergency Caesarian and everything was fine.

Oops sorry typo my second and third babies!

@legalseagull That is the medical advice I was given for what to do in that situation. Obviously yours was different as you didn't know your baby was transverse but if you knew, it's the safest thing to do. Cord prolapse is a real risk in an unstable lie.

@WindFlower92 I'm afraid I don't know what would happen in that situation. Do you have any friends or family close by who could come and sit with her?

I have family close, but they all work relatively far away so would have to hope they were close by, if not we could be waiting at least an hour! @Teakind

Are hospitals not obliged to follow NICE guidelines then? I've seen that they don't have to only if it's in the patient's best interests, which I don't think staying at home would be! I get that there's a low chance of cord prolapse and baby could still turn, but I think I'm too anxious about it to just take my chances because other people have been fine if that makes sense? I want to know if I have any leg to stand on it the hospital actually refuse to admit me from 37 weeks.

No your hospital don't have to follow NICE guidelines, they will have their own guidelines for babies with an unstable lie which you can ask the midwife and consultant about.

With regards to your DD, I sympathise (often on my own with 2 small DC, husband out of country, lots of people I can call but all an hour away).

I think if you need an ambulance then you need an ambulance and they will have no choice but to take your DD. They aren't going to leave her alone and only other option would be to wait til someone arrives.

Here would be my plan.

Waters break call 999 (assuming still traverse and this is the advice you get)... tell them you have DD and it will be an hour before she can be collected. Ask if she can come in the ambulance to be collected at hospital. Call family to collect DD from hospital.

Also, try to remember that its reasonably likely (though of course not guaranteed) that you'll have contractions before your waters break.

I could have written this post OP! I had scan and consultant appointment last Thursday and I was 36+6. The scan was for growth but they informed me baby was transverse/oblique and initially the registrar I saw told me they would have to admit me the next day for 2 weeks until I could have a c-section! Was so upset but once the registrar consulted with another doctor my trusts guidelines were to admit after 38 weeks. So was preparing for an admission this Friday instead. Was made aware of all the risks and what to do if I thought labour was imminent etc. Went in to be checked over Sunday night as was having lots of tightenings and they wanted to check me over. We're about to admit me just for the night when they quickly scanned me and baby was now head down! I couldn't believe it!! So after all that stress, all is well again and can go for a natural birth once again! I guess I would just say take it day at a time as babies can literally move right up to the big day! X

My fourth was traverse and I didn't know anything about being admitted. He turned the day before my due date!

My second was head down but I had a history of fast labour and PPH so the consult advised me to call an ambulance if I went into labour when my husband was at work. She said they would have brought me and the toddler in and I would have been expected to have her collected at the earliest opportunity- if husband was the first one to get there then he was toddler removal not birth partner.
In the end none of that was necessary but it was good to have a plan. Good luck for your new arrival.

I was admitted for transerve/oblique position at 37 weeks following reduced movements and then when monitoring it was found that I was having regular tightenings so not allowed to go home. Baby was also predicted to be around 11lb so that was an additional factor.

If I didn't have any other risk factors I probably would have resisted admission to the antenatal ward. It's difficult spending the last few weeks of your pregnancy in hospital, no privacy, interrupted sleep from other labouring women on the ward, also I didn't like the random men staying on the ward with their partners and all you had was a thin curtain between you all night. Also I didn't see the same doctor twice on the ward so continuity of care was a bit all over the place. I know it's superficial but hospital food is also terrible for pregnant women (heartburn central) and I lived on toast and cornflakes for weeks. Communal toilet/showers which I wouldn't like with covid now. I'd avoid it again if I could but I live very close to the hospital so it's easy for me to say that.

Oh I'm sure the stay at the hospital would be torture @Deftly! Not something I especially want, but if it keeps baby safer then worth it surely?

Thanks for the replies, I'll make sure to ask that DD will be able to come with me if they don't let me stay, as there's no way I'm waiting! The midwife over the phone told me I should have been referred to a consultant and offered a plan going forward, so hopefully it is actually in their policy to at least advise me in some way rather than my midwife telling me that 'everything's fine'! Annoyingly their maternity section on their website is down for updates, so I can't look up any information there.

Once you reach 37 weeks that’s when the advice starts from as so many babies turn before this. Also, as stated above it says admission should be “discussed” not that it is essential or recommended. My opinion is that this discussion would address all risk factors and come to a conclusion from there.
If you were admitted as a precautionary measure you would have to find childcare 24/7 for those 2 weeks regardless, so why not have that childcare in place whatever they recommend if it alleviates your anxiety. I understand how worrying it is but there are actions you can take to help yourself if they don’t want you admitted, like the exercises etc

So after my post the other day, had another presentation scan and baby back to transverse! Now been admitted to just keep an eye on me until my c-section is booked! Feel bad being here as not in any pain or ill but I guess they wouldn't have me here unless they were concerned! Hope baby does stick head down for you!! X

I had my meeting with the consultant who said I could be admitted from 37 weeks which is Sunday! He told me that with each patient they weigh up the individual risk, so as I have a toddler with no guaranteed immediate childcare it would be fine for me to go in, but my choice. So now I'm sad about having to leave DD for 2 weeks and wondering if I'm making the right choice! Aaagh! My stomach muscles have apparently stretched apart so much that he reckons baby probably won't turn as it's comfier to lie in between them

@SingingWaffleDoggy it's easier to get guaranteed daily childcare than emergency - my MIL would be my first call but she works about 45-60 mins away and likes to go out when she's not working for long walks. Not sure I can ask her to sit at home for 2 weeks and literally not go out just in case. She's happier to not go into work and take DD with her so that seems to make more sense. I have DH here in the evenings and weekends, so he can obviously look after her then.