Let’s talk about Back Labor
What is ‘back labor?’
Back labor is the experience of intense back pain during labor contractions. Many people describe it as a “bone crunching” or “pelvic cracking” feeling, though it should be noted that there is no actual bone injury taking place. For many, the back pain of “back labor” is more intense than actual labor contractions.
What causes ‘back labor?’
At the beginning of labor, most babies enter the pelvis looking towards the birth giver’s spine. The most common cause of ‘back labor’ is when the baby faces the front of the body instead. When this happens, the hard back of the baby’s skull puts added pressure on the birth giver’s sacrum and tailbone, which causes intense back pain in most situations. This is what was happening to me during my first labor. Other causes of back labor can be a history of tailbone injury or a misaligned pelvis from a prior athletic or automobile accident. Sometimes there is no obvious cause of the back pain.
What comfort measures can I use to alleviate ‘back labor?’
Change positions
Try positions that hang your belly forward and use gravity to move the baby off your back. These include being on your hands and knees, kneeling on the ground with your chest resting on a yoga ball, standing and leaning forward over a counter or sitting backwards on a chair.
Apply hot and cold compresses
Guide your support person to that place on your back that is causing you the most pain and have them apply one minute of heat with a heating pad, followed by one minute of cold with an ice pack. Continue to alternate this for as long as you desire. The hot & cold sensations can overwhelm pain sensing nerves and can decrease your pain.
Counter Pressure
Have your support person place one open hand over the other and press their flat palm firmly onto the spot on your back that is causing you the most pain and hold pressure throughout the entire contraction (about 1 full minute). Again, guide your helper to that spot on your back that, when pressed, gives you a feeling of relief.
Back massage
Your support person can use their thumbs to provide a back massage to your lower back in between contractions. Try having them move their thumbs in big and small circles to see which you like best.
Pelvic Tilts
When in a hands and knees position on the floor or bed, try performing “pelvic tilts” in between contractions (also known as “cat” and “cow” yoga positions). Check out this video for instructions.
Not only can the above techniques decrease back pain in labor, they can also encourage the baby to turn their head, which can alleviate the problem, decrease your pain and speed up your labor!
Can You Prevent Back Labor?
While the need to transfer from home to a hospital is rare in home birth, one of the most common reasons that a person in labor at home might decide to transfer to the hospital is for pain management (i.e. intravenous narcotics or epidural anesthesia, which are not available in the home setting) or for a very long labor that needs a little help (eg. Pitocin). These transfers are non-emergent and are at the discretion of the laboring person. One of the most common reasons for a very long or difficult labor is back labor.
Therefore, all pregnant people, and especially those who desire an unmedicated birth, would benefit from learning more about how to encourage their baby to get into the most desirable position for a functional, smooth labor with NO back pain! One such resource is Spinning Babies®, which is an approach that focuses on exercises and stretches that give the baby the most space to get into an optimal position for an easier birth!
If you are interested in learning more, consider taking a Spinning Babies® Parent Class near you!
