Back Labor
Everyone knows that the process of labor and birth are one of the most physically demanding things a woman will ever experience. Many woman try to prepare for this the best way they can by doing things like staying healthy, exercising and being well educated on how to handle their labor. The one thing many woman hope they don't have to deal with is the dreaded "back labor." Many women feel powerless to this phenomenon that occurs during many labors, without realizing that there are in fact things they can do to help avoid this pain or relieve it.
What is Back Labor?
Back labor is the term used to describe when laboring women experience most of their pain and discomfort in their lower back. Although most women will feel some achiness or slight cramping in their back at some point during labor, about 1 in 4 or 25% of women will experience severe discomfort in their lower back that is most intense during contractions and often still painful even between contractions.
Back labor often can be accompanied by an irregular contraction pattern, a labor that is slow to progress, and an extended pushing stage.
What causes Back Labor?
Often back labor can be related to a positioning issue with the baby. Positions such as occiput posterior (when baby is facing the mother's abdomen) can cause pressure from the baby's head to press directly on the mother's tailbone or sacrum. This can result in intense discomfort during labor.
But a baby in an odd position does not always cause back labor and back labor is not always the result of a baby's positioning. Some research has concluded that a woman who experiences back pain during her menstrual cycle may be more likely to experience back labor, regardless of the position of her baby.
How can Back Labor be treated or relieved?
The best way to relieve back labor is to get mom off her back. If the back labor is thought to be related to fetal position, then techniques should be used to help move baby into a more optimum position. If it is unknown what is causing the back labor, using the techniques for optimum fetal positioning is a great place to start, and then the comfort measures can also be used.
Techniques to help fetal position:
- Walking
- Squatting and lunging
- Sitting on a birth ball
- Using a rebozzo or sheet to sift the pelvis
- Pelvic tilts and hula-hoop dancing
- Hands and knees and/or open knee chest
- 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 either by shower or warm bath or birth pool
- Heated rice sock
- Apply pressure with something that rolls down the back such a water bottle, beverage can, tennis balls or hollow rolling pin.
- Using a combination of both the techniques for positioning and the comfort measures, increases the chances that the laboring woman will get some relief from her back pain. Taking a comprehensive childbirth class where these techniques are taught and/or having professional labor support by a doula can also be very beneficial for a woman experiencing back pain.
Can Back Labor cause complications for me or my baby?
The back labor itself cannot harm the baby or the mom, but research does show that a baby in a non-optimum position, which is the most common cause of back labor, is more likely to have problems descending through the birth canal. This can then lead to interventions and complications such as:
- Need for pain medication if the mother had not received any previously
- Extended labor time which can cause the mother to become extremely fatigued
- Use of forceps or vacuum
- Need for an episiotomy
- Cesarean delivery
Can Back Labor be prevented?
Obviously a woman can't know beforehand if she will experience back labor until she is actually in labor (although some studies do say that a woman who has experienced back labor with a previous baby are more likely to experience it again unless measures are taken to try to prevent it). However, since back labor is often related to a positioning issue with the baby, there are steps that can be taken to help increase the chances of a favorable fetal position.
During pregnancy:
- Do pelvic tilts—get on hands and knees, curl your back up and then bring back to a straight position. This not only helps loosen ligaments, but also provides relief for an aching back after a long day.
- Spend time sitting on a birth ball/exercise ball each day.
- Sit in positions that keep your knees lower than your hips—(don't spend too much time sitting deep in your couch or other recliner chairs!)
- Have regular chiropractic and/or massage work done throughout pregnancy.
- Ask about the position of your baby as you get further into pregnancy.
During Labor:
- Get off your back!! Being in the supine position (lying on your back) during labor not only can increase the chances of experiencing back labor, it can also make it much more painful. If you need to be lying down, lie on your side or in some sort of tilt position.
- Use gravity friendly positions early in labor—walking, swaying, sitting on a ball, semi sitting or leaning.
- Pelvic tilts ( as described above.)
- If you need to be sitting, sit backwards on a chair or 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.
