Most pregnant women expect labour will cause them some discomfort.

Pain, however, is a very subjective thing; one woman’s experience won’t be the same as another’s.

There is a great deal of fear about the pain of labour and a focus on how to minimise it.

Although it’s understandable you might want to avoid any kind of discomfort or pain during labour, the truth is, it’s part of the process.

Back Labour – What It Is And How To Manage It

An undisturbed labour gives you the best chance of having a birth that leaves you feeling positive about your body’s ability.

Some women, however, experience what is known as ‘back labour’ and find the pain associated with it more challenging than they expected.

Let’s look at back labour and what it means.

What Is Back Labour?

During labour most women feel some type of cramping or discomfort in the back. Most often it happens in early labour and subsides over time.

Around 25% of women experience what’s known as back labour, which refers to severe discomfort felt in the lower back. This pain is most intense during contractions but it can also continue between contractions.

What Does Back Labour Feel Like?

During labour, most women feel their contraction pain quite low down, where the cervix is located. The cervix is dilating and causing the pain of the contractions, while the uterus is tightening and releasing.

In women who experience back labour, there is intense lower back pain during contractions. The pain might still be there, but less intense, between contractions.

Usually, contraction pain gradually increases to a peak then subsides. Women with back labour say the pain starts as soon as a contraction begins. Often women will describe the pain as so intense they feel their back is breaking.

What Causes Back Labour?

It’s commonly believed baby’s position is the reason why mothers experience back labour. When baby is face up, or in a posterior position, the head is pushing against the mother’s spine. This can lead to back labour pain.

However, many women have back labour when their babies are not in the posterior position. Some women have posterior babies but don’t experience any back labour.

This is because there are other factors which might contribute to back labour:

A woman who is short or has a shorter torso might experience back labour because a long baby hasn’t enough room to turn or descend into the pelvis.
Women who stand with their knees locked, with the pelvis tilted forward and the bottom tucked are more likely to experience back labour.
Tight or weak muscles and ligaments in a woman’s back can affect baby’s ability to get into a good position. These factors can even influence the shape of the pelvis and how a baby is able to descend.

What Are The Signs Of Back Labour?

Back labour has a pretty bad rap as being excruciating, and pregnant mamas might be worried if they feel any pain in the back during labour.

It’s a good idea to know how to distinguish back labour from other kinds of back pain.

Here are some of the signs of back labour:

It usually occurs during the active stage of labour but can also occur in early labour
Generally, back pain will be most intense during contractions and ease off between them
Active labour might be slow to progress, if baby isn’t in a good position
Back labour can occur with irregular contractions
There might be a prolonged second or pushing stage

Can I Prevent Back Labour?

There are no guarantees you will have back labour, or avoid it either. Based on the reasons why back labour might occur, however, you can at least reduce the chances of it happening to you.

During pregnancy, it certainly helps if you focus on your posture and keep your pelvis aligned. This will ease pregnancy aches and pains and make for an easier and more positive birth.

Encouraging optimal fetal position doesn’t hurt either.

It’s important to remember, though, there is only so much you can control during pregnancy and birth. If you do all the ‘right’ things and end up having back labour because of a persistent posterior baby (rare) or a short torso/long baby situation, it does not mean you are a failure.

During pregnancy you can:

Have regular treatments with a osteopath or chiropractor who specialises in pregnancy care
Be aware of your posture while standing. Keep your knees soft and don’t tilt your pelvis forward
Check out optimal fetal positioning and be mindful of this as you go about your day
Have your belly mapped to find out where your baby is in utero. Learn how to do this for yourself
Practise gentle daily exercise, to keep your muscles and ligaments supple and not locked
Try massage or acupuncture for tight muscles

How Do I Deal With Back Labour Pain?

We know there’s a number of reasons why back labour occurs, and how to be proactive about reducing the chances of it happening.

But what if back labour does occur during labour?

There are several techniques you and your support people can use to ease the pain of back labour:

Heat, such as a hot water bottle, hot compresses or wheat packs on the back
Counterpressure, applied to the lower back by a support person during contractions
Double hip squeeze, applied by one or more support people
Water therapy, such as warm pool or shower
Water saline injections, which are reportedly painful when inserted but can give relief from back pain for several hours
Massage and pressure – especially from something like a tennis ball or water bottle being rolled across the lower back– can provide relief

It might have been determined your baby is in a posterior position. During labour, babies often rotate into the anterior position. This can take time and a lot of support.

Babies who are high and not engaged might be encouraged to turn with position changes. Once they are in the pelvis rotation is much more difficult.

If you know or suspect your baby is in posterior position in labour you can encourage rotation by keeping your pelvis aligned and open:

Be active upright (standing, sitting on a birth ball, or leaning forwards over the bed). Don’t lie on your back
Use a wall to squat against
Keep your hips higher than your knees when sitting
Try pelvic tilts
Lift your belly up during contractions (abdominal lift)
Try belly dancing or hip circles
Use the hands and knees pose
Try using a rebezo or sheet to shift the pelvis.

Does Back Labour Cause Complications?

By itself, back labour won’t put you or your baby in any danger. Having back labour doesn’t mean something is wrong; it is a variation of normal birth.

However, a lot depends on the support women are giving during labour. This includes taking time to allow baby to rotate, and avoiding interventions such as augmentation to speed up contractions, or breaking the membranes to hurry things along.

Many women find back labour painful and tiring and might ask for pain medications or an epidural. These can increase the need for more interventions later.

There is a fine line between experiencing labour pain and suffering. It’s important women are supported as much as possible to avoid this line being crossed.