Back labor: why it happens and how to manage it
Childbirth is a transformative and beautiful journey, but it can also bring intense physical sensations and challenges. One such challenge is back labor, which occurs when a laboring woman experiences intense pain and discomfort in her lower back during contractions. Back labor can be caused by various factors, including the position of the baby, the mother's own physiology, or a combination of both. In this article, we will delve into why back labor happens and explore several effective pain management strategies to help mothers cope during this phase of childbirth.
why does back labor occur?
Back labor occurs when the baby's head presses against the mother's lower spine or tailbone, causing intense pain and discomfort in the back instead of or in addition to the front of the abdomen. Several factors can contribute to the occurrence of back labor:
Baby's Position: A baby positioned with their back against the mother's back can increase the likelihood of back labor. This position, known as occiput posterior (OP) or sunny-side up, can result in increased pressure on the spine and nerves, leading to back pain during contractions. If you are interested in learning more about baby’s positioning inside the womb, sign up for my monthly newsletter and look out for the optimal fetal positioning post to come.
Pelvic Structure: A woman's individual pelvic structure can influence the way labor progresses. A narrow or asymmetrical pelvis may increase the chances of back labor as the baby's head puts more pressure on the lower back.
Additionally, the strength and stability of muscles throughout your body can play a role in how your pelvis is structured and how the uterus sits within it. This can manipulate the shape and pressure felt from your baby within your womb.
If you have experienced any major spinal or back injury, it could be helpful to meet with a physical therapist or other functional practitioner to learn positions and movements to support your individual needs.
Uterine Contractions: The intensity and frequency of uterine contractions can also contribute to back labor. Strong, prolonged contractions may cause more significant pressure on the back, leading to heightened discomfort.
pain management strategies for back labor
Now that we have an understanding of why back labor occurs, let's explore several effective pain management strategies that can provide relief during this challenging phase of childbirth.
optimal positioning
Encouraging the mother to adopt different positions can help alleviate back labor pain. Learn more positions and daily stretches to support optimal positioning at the Spinning Babies website. Here are a few positions that may provide relief:
leaning forward:
Leaning forward while resting on hands and knees or over a birth ball can help relieve pressure on the lower back, promoting optimal positioning for the baby and reducing pain. Trying to hold more of these positions while pregnant can encourage your baby into this optimal position. Forward leaning during labor can reduce this discomfort and encourage your baby to move even after contractions have begun.
sitting backwards on a chair:
Sitting backwards on a chair, straddling it with the chest resting on the backrest, can help open up the pelvis, allowing the baby to shift into a more favorable position. Opening different levels of the pelvis change the space your baby has to occupy.
side-lying:
Lying on the side with a pillow or cushion between the legs can help reduce the intensity of back labor by encouraging the baby to turn away from the mother's back. Placing many pillows may be necessary to find a comfortable and open position for you and your baby.
counter pressure
Applying counter pressure to the lower back during contractions can offer substantial relief. This technique involves using the hands or a massage tool to apply firm pressure to the lower back, counteracting the pain caused by back labor. A birth doula or birth partner can provide this support, or the mother can use a tennis ball or a specially designed tool for self-massage.
To apply counter pressure, first always ask for consent when touching someone else’s body and make sure your hands are clean. There are several different counter pressures to try, but two that are most helpful are: double-hip squeeze and tailbone pressure. Both counter pressures should be held for the entire length or a contraction and can be performed for hours on end, there is no limit, and it has been done. As a birth doula, I have done the double hip squeeze for hours and hours throughout different labors.
double hip squeeze:
The double-hip squeeze is performed exactly how it sounds, however, correct placement is harder to find than it seems. Aiming for the meatier side booty (gluteus medius and gluteus maximus), spread your hand wide like a fan and firmly grasp their body. Checking in with the birthing woman as you apply pressure, firmly press into their hips inward and slightly upward, without pulsing or changing intensity of pressure (unless the woman tells you to relax or increase intensity!!). You may notice that you can feel the hips bones moving slightly, this is totally normal. This should be held throughout the entirety of a contraction. Be prepared to have your forearms burn!
tailbone pressure:
The tailbone pressure, again, asks for clean hands and consent! As a birth doula, I personally like to use one hand, but you may find it helpful to place one hand on top of the other. Finding the sacrum (lower vertebrae in between the pelvic bones) firmly press into the spine and slightly upward. Check in with the birthing woman to see if you need to increase or decrease the intensity of your pressure. This counter pressure should also be held for the length of a contraction.
Hydrotherapy
Water has long been known for its therapeutic properties during labor. Immersing in warm water, either through a birthing pool or a warm bath, can help relax the muscles and provide pain relief. The buoyancy of water can also alleviate the pressure on the back, making it an effective tool for managing back labor pain.
Trying various positions in water can also add in providing relief. Combine different types of forward leaning positions with the buoyancy and comfort of water and you will find a winning combo!
heat therapy
The application of heat can be a soothing and effective method for managing back labor pain. Using a heating pad or a warm compress on the lower back can help relax the muscles and alleviate discomfort. The warmth increases blood flow to the area, which promotes relaxation and provides relief from the intensity of contractions. Ensure that the heat source is not too hot and use it intermittently, allowing breaks to prevent overheating the area. Heat therapy can be combined with other techniques like counter pressure or hydrotherapy for enhanced pain relief.
Bonus! stop back labor with movement
Back labor can present a significant challenge during childbirth, but with the right support and pain management techniques, mothers can find relief and navigate this phase more comfortably.
By understanding the causes of back labor and employing strategies such as optimal positioning, counter pressure, hydrotherapy, and application of heat, birth doulas can provide invaluable assistance in helping mothers cope with and manage the pain associated with back labor. Every woman's labor journey is unique, so it's essential to explore various techniques and adapt them to the individual needs and preferences of each mother.
movement and position changes
Encouraging movement and frequent changes in positions can help manage back labor pain. Movement can facilitate the baby's descent and alleviate pressure on the lower back. Here are a few movement and position suggestions:
walking:
Taking short walks during labor can help shift the baby's position and stimulate contractions while providing a distraction from the pain. Walking also encourages the release of endorphins, the body's natural pain-relieving hormones.
Rocking on a Birthing Ball:
Sitting and gently rocking back and forth on a birthing ball can help open up the pelvis, relieve pressure on the back, and provide a sense of comfort and stability during contractions. This also enacts different muscles in the body, relaxing and tightening them, which may help you narrow down the location of pain.
Lunging or Squatting:
Lunging or squatting positions can help widen the pelvic outlet, allowing the baby to rotate into a more favorable position. These positions also help to relieve back pressure and increase the efficiency of contractions.
Standing and Leaning:
Standing and leaning forward onto a sturdy surface, such as a bed or a table, can help take the pressure off the back while still allowing the force of gravity to aid in the progression of labor.
conclusion
Remember, it is crucial to listen to the laboring woman's body and preferences when suggesting movement and position changes. Every woman's comfort and pain tolerance levels differ, so encourage her to explore different options and find what works best for her.
Notice what all of these movements have in common: change and gravity. Changing movements, positions, and comfort about every 30 minutes has been a proven way to help labor progress and encourage your baby to get into positions that are more optimal and MORE COMFORTABLE! Gravity is also used in all of these movements. Gravity is a key player in adding pressure to the cervix, bringing your baby down further into the birth canal, and speeding up that natural cycle of oxytocin release, which is a VIP in labor progression.
Back labor is an additional challenge to overcome during labor and childbirth, but it doesn’t have to be excruciating pain. Take in these lessons now, practice these comfort measures, and you will surely leave birth feeling RADIANT and confident in how your body works!