Generally speaking, a pregnancy will simply follow a natural course. The process unfolds as nature would have it, and there are few surprises. But, like any other natural process, there are all kinds of things that can happen that we may not expect. Back labor is one of those things. 

Back labor happens for some women. It is not pleasant by a long shot. But there are ways to deal with back labor. And like the many other things that can occur during an otherwise routine pregnancy, understanding back labor is half the battle. 

For many women, back labor is something that brings on anxiety along with the pain and discomfort. Sometimes understanding things takes a lot of the fear and power out of them. This guide will help you understand back labor. What is back labor? What causes back labor? And what are the best ways to help alleviate or treat back labor? 

What is back labor?

Labor happens when the muscles of the uterus begin to contract. These contractions begin as small twinges and progress to a peak phase, then they will ease off. As contractions become more frequent and more intense, the process of birth will progress. Painful as it may be, contractions are what you want to happen. 

What the contractions accomplish is to push the baby into the birth canal. Active labor involves intense pain, cramping, and pressure. This pain generally is centered in the lower abdomen and pelvis. However, about 33 percent of women will feel more pain in their lower back. This is called back labor and it occurs because of the way the baby is positioned. 

There is a common misunderstanding that back labor is a myth. Some believe that back labor does not happen and what some women feel is little more than pains that spread from the more common areas of labor. This is absolutely wrong. Back labor is very real, it is a function of the position of the baby. 

Ideally, a pregnancy would follow the common course of things, and the baby will be positioned exactly where he or she needs to be; head down and facing the mother’s cervix. But nature unfortunately does not work this way. Sometimes the baby is positioned with his or her skull against the cervix, and this leads to painful back labor. 

You may hear your doctor, midwife, or doula say the bay is in the occiput posterior position. This is the medical term for the bay’s head against the cervix. This is not the way the baby should be positioned. The good news about this is that the baby can easily turn during birth. About 15 percent of babies positioned in this way spontaneously turn to the correct position in the course of labor. 

Back labor causes

When the baby is positioned with his or her head against the cervix you are much more likely to experience back labor. However, this does not mean you will experience back labor. Some women never feel anything other than the normal labor and contraction pains. These are hard enough. 

There are some risk factors for back labor. Women who experience pain during their menstrual cycle are more prone to back labor. First-time mothers are also more likely to experience back labor. And if you have gone through back labor with a previous pregnancy, you are likely to experience back labor again. 

One study showed that women who have a higher body mass index were much more likely to experience back labor. 

Back labor symptoms

The signs of back labor are easy to detect. However, when your labor begins you may feel pains in your lower back. These are not necessarily back labor. The symptoms of back labor include:

Regular contractions come and go. That is the natural progression of labor. Back labor may not abate. It will likely be fairly constant. So as your contraction ease up if you still feel pains in your back these are likely back labor. The pains in your back become increasingly intense as contractions build to a peak. 

Preterm labor does not lead to back labor. Back labor only occurs at about 40 weeks. 

Back labor relief

Most often back labor cannot be prevented. But there are some things you can do to help. There are some things you can try to help prevent or alleviate back labor. 

Pelvic tilts

This is a simple exercise. Get on your hands and knees and simply arch your back up like a cat. Then straighten out your back. This will stretch your pelvis and allow the baby to position properly. 

Hold your knees lower than your hips

You can do this on an exercise ball. You can also straddle a chair backward holding your head and arms on the back of the chair. Another way to do this is by sitting backward on the toilet. 

These exercises are meant to help your baby get in the proper position. By manipulating the position of your pelvis and back, you may make it easier for the baby to turn to a more comfortable position. 

Walk around

If you are already experiencing back labor, try walking around and let gravity do some of the work. Sometimes simply moving around a room is enough to reposition your baby. 

Warm showers

This also helps loosen the tension in your body. This may not reposition the baby, but it may relax you enough to ease the pain of back labor. 

Heating pads

A doula or midwife can help you by placing heating pads or a cold compress against your body. You can try both to see which works best. 

Massage

Again, this will require the help of a midwife or doula, but a massage works well for alleviating the pain of back labor. 

Counterpressure

Have a doula or partner stabilize one hip with a hand and apply steady pressure on whatever area of the lower back where the pain is acute. Using the heel of a hand or a fist, apply pressure on the area where the pain is most intense. As labor progresses, the spot where the pain is most intense will likely change as the baby begins to move through the birth canal. Someone may be able to apply pressure to the sacral joint near the bottom of the tailbone. This can relieve pressure. 

Double hip squeeze

While leaning forward on your hands and knees, or straddling a straight-back chair, have a partner stand behind and press both sides of the buttocks with the palms of their hands. Do this during contractions. This can help the sacral joint ligaments to relax which is likely where the baby’s head is putting pressure. 

Birth dance

This can be a pleasant experience for both mom and dad. You simply get close as if you were dancing, but the mother should allow her arms to relax and hang down at her sides. Rest your upper body against your partner. Shift your weight from one leg to the other gently. Do this while slowly measuring your breath. The birth dance offers the same basic benefits of walking with the added comfort of the support. 

Back labor vs back pain

Some women who have experienced back labor describe it as some of the worst pain during labor. Just knowing this can cause anxiety and fear for women who are pregnant. During normal labor and contractions, it is completely normal to feel some level of back pain. Contractions are painful and they can be intense. It is common for women to have back pain even during normal labor.

Some things to keep in mind as you begin to experience contractions include: 

If the back pain peaks with your contractions this is likely back labor. Ordinary back pain will remain constant. Back labor will come and go with your contractions. 

Feeling the back pain while you are in active labor. This may seem obvious but it is important to know that back labor will persist and be evident during active labor. 

Other aches and pains that persist throughout your labor and delivery are most often simple back pain. If you feel back pain even when you are not experiencing contractions, this is simple back pain and not back labor. 

Whether we like it or not, labor and contractions are painful. The pain of contractions can radiate into other areas of your body, specifically your back. This is normal if unfortunate. However, learning to distinguish between ordinary back pain and back labor may take some of the anxiety out of your birth experience. 

Back labor risks

Back labor simply in itself will not harm your baby or you. It is just painful. However, some studies have shown that anytime a baby is in an uncomfortable position in the womb there is a risk of increased difficulty as the baby makes his or her way through the birth canal. This can lead to complications. 

• Increased need for pain medications
• Prolonged labor with an increased risk of fatigue for the mother
• Increased need to use forceps or vacuum-assisted birth
• Increased need for an episiotomy
• Higher risk of the need for a Cesarean delivery 

Preventing back labor

There are some things you can do to help prevent back labor. These are prevention strategies and there is no guarantee any of these will prevent back labor. But these strategies have been shown to prevent back labor for some women. 

Avoid sitting in any semi-reclining position. This means not sitting with your knees higher than your hips. If you sit a lot, or if you spend a lot of time driving a car, take time to move around and extend your legs. 

Do not cross your legs when you sit. Sit up straight in a chair, legs slightly open. 

When standing, lean over things like kitchen counters and chair backs. This encourages your baby to move toward the pelvis at the ideal angle. 

Start doing pelvic rocks while on all fours. Stretch your back upward like a cat and relax, bringing your back straight. 

When laying down or sleeping, make sure you are on your side with back support. Keep your top leg resting forward so that the knee touches your mattress. This will keep your abdomen in a forward position and allow your baby to effectively rest in a “hammock” You can place an extra cushion between your thighs for added comfort. 

Swim laps using the crawl or breaststroke. This encourages your baby to swing back and forth in the womb and move toward the front. This has the added benefit of relieving pressure and swelling during your third trimester of pregnancy. 

Conclusion

The idea of a textbook normal pregnancy, labor, and delivery carries a range of things that some may not fully expect. While most women will go without labor, experience contractions, and proceed to delivery with nothing out of ordinary, other women will experience some difficulties along the way. One of these difficulties is back labor. 

Back labor is not dangerous for you or your baby. Unfortunately, back labor is extremely painful. Back labor happens when your baby is turned so that his or her head is against your back. This causes the baby’s head to put pressure on your back during contractions. As if contractions were not hard enough, back labor can add more pain and discomfort. 

There are some steps you can take to help prevent or minimize back labor. Thankfully, all of these things are simple, and you can do them at home as you prepare for your big day. Something as simple as back stretches may relieve strain on your back and nudge your baby into a more comfortable position that prevents back labor. 

If you have a good doula or midwife, they will certainly be able to ease you through back labor if you happen to experience it. Otherwise, there are medical steps that can be taken if the pain becomes too much.