Right Occiput Transverse

ROT baby position belly mapping

Baby On The Right Side

The Right Occiput Transverse (same as Right Occiput Lateral) position is often associated with extension of baby’s spine. The right side of most uteruses may be steeper (dextrorotation and right obliquity of the uterus). Leaning against a steeper wall of the uterus straightens baby’s back and lifts their chin. 


The longer, flatter portion of baby’s head into the pelvis first. The wider part of baby’s head takes longer in this position to swing forwards, if it can. If their isn’t room in the pelvis, the wide part of the head may swing towards mother’s back turning baby to the posterior position.  

Another reason that labor can take longer or baby stays on the right side may be when muscles supporting the pelvis are tight. Tight muscles pull the bones closer, giving baby less space to turn themselves around. For both these reasons, when baby’s back is on the right, the head is more likely to remain longer at the brim or top of the pelvis. Babies have to get INTO the pelvis to get through the pelvis.

But baby also has to pass between muscles. The pelvic floor is a series of layered muscles opening to a guiding shape that turns baby’s head once deep inside the pelvis. Tight or twisted muscles (from sports, falls, etc.) can slow down the birth process and even make labor hurt more than they would if they were simply muscles at work. 

The front or left areas of the uterus are typically rounder due to more space in those areas in the mother’s body. Babies leaning into the left or front are typically more curled which tucks their chins and aims the smaller crown of the head into the pelvis first. Entering the pelvis (engagement) is typically easier. The head measures smaller all the way through the pelvis.

Spinning Babies® offers several techniques, positions, and knowledge to help baby turn and come down the pelvis. Preparing before labor and doing activities in labor will both help those babies on the right side rotate either to the front or the left side. Once baby can tuck their chin they are more likely to enter the pelvis with their head in position to fit the rest of the path through the pelvis. 


Also see Right Occiput Anterior or Right Occiput Posterior. 


We recommend body balancing in various ways to allow baby to rotate with more ease. Combine body balancing  and smarter birth positions to decrease pain in labor and allow your body to give birth more optimally.  https://www.spinningbabies.com/pregnancy-birth/the-three-principles-in-pregnancy/


Belly Mapping® Method tips:

The right side of the abdomen is fuller and firmer. The uterus is not smooth over all, but has dips and bulges that are different from side to side. Kicks are towards the left but not the front. A rare flutter might be felt on the lower left and common kicks occur in the upper left. The baby’s bottom rises up underneath the right ribs once in a while.

  • Baby is on the mother’s right
  • Baby faces and kicks towards the left side
  • Baby may not engage before labor even in a first birth
  • There may be a long early labor, even a long strong early labor to engage baby


Attention: Help your body balance before trying to engage baby with activities. Figure-8 belly dancing moves, Dip-the-Hip and psoas release are added to the Three BalancesSM. Side-lying Release is especially helpful and you may like to learn how and do this a couple of times a week before 39 weeks and daily after that if this is a first baby or first vaginal birth after having a baby by cesarean.

In Labor/Labour, be patient as your uterus tries to align baby (Side-lying Release will shorten this phase). Open your upper pelvis to help engagement with Abdominal Lift and Tuck before an epidural, or use Flying Cowgirl, Froggie Walcher’s or other tips under Techniques,

Pushing? Check out the special positions on our Opening the Outlet page.


“Please explain why it is better for a baby to be positioned LOT (Left Occiput Transverse) as opposed to ROT (Right Occiput Transverse) for birth? What can be done to encourage baby to turn from ROT?”

Drawing of 5 fetal positions

Left Occiput Transverse (LOT) is when the occiput is towards the mother’s left and baby faces and kicks towards her right side.

No kicks are felt on the left of her belly, but the baby’s buttock may rise up on her left which she may have thought was a kick until comparing that bulge with the smaller parts on the right.

Sometimes both feet kicking together, though, can feel as big as baby’s hips when they push upwards and outwards. LOT is one of the anterior positions.


Right Occiput Transverse Babyausc ROT

I consider ROT to be one of the posterior positions, first upon Jean Sutton’s advice and also on my observations. Typically, the ROT baby, and especially when a mother’s first baby is ROT, will rotate to the posterior as labor proceeds. The reason is that the ROT baby more often has an extended back, which then extends the head.

Whether your baby has his or her chin up depends on your pelvis, which baby this is for you, whether you labor in bed on your back or up and moving freely, how tight or symmetrical your pelvic floor may be, the amount of extension of the baby’s head, and so on.

A previous vaginal birth makes the posterior position less troublesome.

Fetal chin tucking regardless of which baby this is makes the ROT (ROL) position less troublesome, too. Read a doula’s story about a birth in which the baby “got stuck” for a while in the Occiput Transverse late in labor, and how she used inversions to prevent a cesarean.

Midwife Jean Sutton cites the firm liver sharing the room on the right and making an extended back likely in a first time mother.

The top of the head rather than the crown may enter the pelvis, making the head diameter larger than when the chin is tucked (or flexed).

If a pelvis is smaller than average, a baby has a greater chance of becoming wedged in the pelvis, stopping descent. This is true for all the posterior positions.

Read about posterior positions to understand more about ROT (ROL).


The Right Occiput Transverse Baby in LaborFour posteriors by Gail Tully

To avoid a stall in labor progress, body work on the abdominal ligaments is good now. Inversion on the stairs for 5 minutes a day will help release a twist in the lower uterine segment that is caused by sitting in cars, crossing our legs, holding a toddler or other weight on one hip, or twisting to work (whether at our computer or doing care for others who are lying down).

The drawings show what I call the four posterior positions. You can see the Right Occiput Transverse baby in the third circle from the top.

You can encourage rotation before descent in labor. Be upright, leaning forward, and doing the 3 Principles of Spinning Babies®. If the baby descends before rotation, try the lunge and other things that keep the pelvis open in the middle. Eating small amounts of good food every two hours will help keep contractions strong. Be sure to sip electrolyte drinks, like Recharge, Alacer Emergen-C, diluted Gatorade or the like.

NOTE: Give yourself time in labor to let the baby rotate before you expect much dilation. Especially if this is your first birth.

During pushing, squatting will help, as will standing and hanging on to a person’s neck or a sheet thrown over the bathroom door and knotted (so you can’t pull the sheet over the closed door). Try a vertical position change every 3-6 contractions, moving your legs in between contractions. When you find one that really works stick with it for 6-10 contractions and if the baby isn’t born, be sure to keep changing positions. Keep a straight back during pushing; don’t curl, as commonly instructed.

In general, it is easier to help the baby in a left-sided position in your 2nd trimester. Most women can achieve this goal in the third trimester with bodywork and maternal positioning with gravity, but some can not.

Labor helps babies rotate. If you loosen up any tight ligaments and get your pelvis joints loosened up and labor in vertical positions with good support, periodic small meals and electrolyte drinks, you are likely to find that your baby rotates as he or she needs to get through the pelvis. It may or may not take a long time.

Individual differences in pelvic shape and size, baby’s head flexion (chin tucked), amniotic fluid levels, location of the placenta and relaxation of the pelvic floor and abdominal wall are some factors that determine whether or not this will be an issue. Too loose in the abdomen and you may need to wear a pregnancy belt to support the baby’s proper descent.

My observations, like Jean Sutton’s who proposed the association of ROT with a posterior result, show that if labor is treated with typical habits (resting in bed, semi-sitting, lack of food or lack of movement), that labor is often longer, and babies can turn posterior easily. Instruments, medications or even a cesarean is more likely than when the baby STARTS labor on the left.

Leaning forward during contractions is a comforting  and simple way to help a baby rotate or descend to support a labor that is progressing on its own with gravity.

With active labor habits, most ROT babies will succeed in coming out OA at the end. To reduce the time this takes, or the pain involved, do the suggested techniques on the posterior page, including the more involved, Forward-leaning Inversion.


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