Back Labor: Causes, Complications and Prevention
Labor and giving birth are some of the most physically demanding events a woman will experience. Many women try to prepare for the experience by working on their health, exercising and becoming more educated on labor.
One thing many women hope they can avoid is “back labor.” Many are unaware of solutions and remedies for this common condition in the labor experience.
What is Back Labor?
“Back labor” refers to the pain and discomfort that laboring women experience in their lower back. Although most women will feel a degree of soreness or slight cramping in the back at some point during labor, about a quarter of women report experiencing severe discomfort in the lower back that is most intense during contractions and often painful between contractions.
Back labor can often be accompanied by an irregular contraction pattern, a labor that is slow to progress, and a prolonged pushing stage.
What causes Back Labor?
A frequent cause of back labor is the position of the baby. Positions such as occiput posterior (when baby is facing the mother’s abdomen) can cause pressure from the baby’s head to be applied to the mother’s sacrum (the tailbone).
The result can be intense discomfort during labor. However, a baby in an odd position does not always result in back labor. Similarly, back labor is not always the result of a baby’s positioning. Some research has shown that a woman who experiences back pain during her menstrual cycle may be more likely to experience back labor regardless of the baby’s position.
Can it be treated or relieved?
The best way to relieve back labor is to get the laboring mother off of her back. If the back labor is thought to be caused by fetal position, there are techniques that can be used to change the position of the baby. If the cause of back labor is unknown, using the proven techniques for repositioning the baby is a good place to start. Other comfort measures can also be helpful.
Techniques to help improve fetal position:
- Squatting and lunging
- Sitting on a birth ball
- Using a rebozzo or sheet to shift the pelvis
- Pelvic tilts and hula-hoop dancing
- Sitting backwards on a chair or the toilet
Techniques to ease discomfort:
- Hot or cold compresses applied to the lower back
- Strong counter-pressure
- Hydrotherapy using a shower, warm bath, or birth pool
- Heated rice sock
- Applying pressure with something that rolls down the back such a water bottle, beverage can, tennis ball or hollow rolling pin.
- Using a combination of techniques for positioning and comfort measures increases the chances that the woman experiencing labor will get some relief from her back pain. Taking a comprehensive childbirth class prior to labor and/or having professional labor support by a doula can also be beneficial.
Can it cause complications for me or my baby?
Back labor by itself cannot harm the baby or the mother.
However, research shows that a baby in an undesirable position in the womb (the most common cause of back labor) is more likely to experience difficulty descending through the birth canal leading to interventions and complications that include:
- Need for pain medication if the mother had not received any previously
- Prolonged labor putting the mother at increased risk for fatigue
- Use of forceps or vacuum assisted birth
- Need for an episiotomy
- Cesarean delivery
Can Back Labor be prevented?
A woman will not be able to know prior to labor if she will experience back labor. However, some studies show that a woman who has experienced back labor in the past is more likely to experience it in the future unless preventative measures are taken.
Because back labor is most often caused by the position of the baby, steps can be taken to help increase the chances of a favorable fetal position.
Such steps include:
- Do pelvic tilts—Get on your hands and knees, curl your back up and then resume a straight position. This exercise not only helps loosen ligaments but can also provide relief for an aching back after a long day.
- Spend time each day sitting on a birth ball/exercise ball.
- Sit in positions that keep your knees lower than your hips—However, avoid spending too much time sitting deep in your couch or other recliner chairs!
- Have chiropractic treatments and/or massages throughout pregnancy.
- Regularly ask about the position of your baby as your pregnancy progresses.
- Get off your back!! Being in the supine position (lying on your back) during labor increases the possibility of back labor and can make it much more painful. If you need to lie down, choose a position on your side or some sort of tilt position.
- Use gravity friendly positions early in labor—This includes walking, swaying, sitting on a ball, semi-sitting or leaning.
- Pelvic tilts ( as previously described).
- If you feel the need to sit, try sitting backwards on a chair or on a toilet.
Compiled using information from the following sources:
Mayo Clinic, http://www.mayoclinic.com
Spinning Babies-Easier Childbirth with Fetal Positioning, http://spinningbabies.simplwebsite.com/
Posterior Labor: A Pain in the Back ,Valerie El Halta, Midwifery Today, Number 36, Winter 1995, p. 19Ð21.