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Back Labor Explained: What is Back Labor, Symptoms, Prevention, and Myths

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Labor, one of the most dreaded experiences of pregnancy, in some cases translates into a kind of labor most mothers tend to be unprepared for, known as, ‘back labor.’ Back labor is a kind of labor that essentially takes place when the back of the baby’s head pushes against the mother’s spine and the tailbone as they try to make their way out into the world through the birth canal.

Is Back Labor a Myth or For Real?

You might have been told that back labor is a myth and that it does not exist, however, 

through this blog, we are going to not only explain to you how real it is but also how it can be dealt with.

A woman essentially goes into her ‘labor’ when the muscles of her uterus begin to contract. Labor starts seemingly ‘not as bad’ but gradually tends to become more severe and more intense with each passing contraction. As your uterus works hard to tighten and push the baby into the lower birth canal, the contractions increase in frequency,  in pain, and also begin to last longer than the previous contraction.

For a woman going through regular labor, the pain is mostly felt in the central region, the lower abdomen region, and the pelvis region of the body. However, some women might also feel a piercing pain in their lower back due to the baby’s positioning in the stomach – called back labor pain.

Ideally, babies are supposed to be in an upside-down position in the stomach, and their face positioned towards the mother’s cervix, However, some rebellious babies are positioned a little differently- instead of their face being positioned towards the cervix, the back of their head (the hard, skull portion), tends to face the cervix. In other words,  instead of facing the cervix, the baby faces forward, towards the stomach.

This irregular and unideal positioning, hence, causes back labor and so, back labor is not a myth – it is very much real as it is very much painful. However, for the good part, most babies tend to turn their faces backward on their own by ’showtime’ or delivery time. 

How is Back Labor Different From a Regular Back Pain or a Regular Labor?

As a mother who likes to be informed about what’s happening inside her and with her baby, you might be wondering how to tell back labor pain from regular pregnancy back pain or regular labor. Here are the differences that could help you differentiate the three from one another-

Back Labor v/s Regular Pregnancy Back Pain

Back labor, as the name suggests, happens only during active labor and is not a pain that can otherwise be felt during pregnancy. While we already have established what causes back labor, regular back pain during pregnancy occurs due to strain on back muscles, weak abdominal muscles, and pregnancy hormones.

Regular Labor v/s Back Labor

The contractions during regular labor occur in a fixed pattern: they come and go, allowing the mother some time in between to rest and to cope. During back labor, however, the pain is felt constantly in the lower back, only to increase and reach its peak at the height of a contraction.

It should also be noted that back labor typically occurs in post-term pregnancies, that is pregnancies that last beyond 40 weeks.

What Causes A Back Labor?

As mentioned, the main and primary cause of back labor remains the baby’s body position during labor. The baby, when positioned in a “sunny-side up” manner, that is, they have their head nestled down by your cervix, facing the stomach instead of the back, the back of the baby’s head pushes down on the mother’s spine and tailbone., pressing the nerves in the spines, causing the piercing pain. (Ouch, isn’t it?)

During regular labor, in contrast, and for better understanding, their head is positioned downwards, facing the mother’s back, chin tucked up into their chest and hence, the head is less likely to press on the spine causing back labor pain.

A baby’s unideal sunny side up positioning that causes back labor is medically known as occiput posterior position. Whereas, in the ideal labor position, the baby’s head is lined up to fit through the pelvis, which is medically termed as the occiput anterior position.

It should also be noted, however, that women who regularly suffer from menstrual cramping and are giving birth for the first time, maybe more likely to experience back labor regardless of the baby’s positioning. Even women with a higher body mass index (BMI) were more vulnerable to suffer from pain in the lower back during labor.

How To Prevent Back Labor Pain?

Unfortunately, since it is the baby’s rebellious unideal and unusual positioning that causes back labor pain, back labor pain cannot really be prevented. However, here are some tips that can help encourage a baby switch back into the ideal occiput anterior position to avoid back labor pain prior to going into actual labor-

  • Pelvic rocks or Pelvic Tilts

Getting on all fours and rocking your pelvis back and forth, arching your back, might encourage the baby to take a delivery-friendly position

  • Warm and cold towels

Babies do not like cold temperatures and hence, placing cold towels on the front of your belly and warm towels on your back might help the baby take an accommodating position

However, if your rebellious baby fails to switch positions and you do happen to go into active labor, there still are some tactics that can help you ‘manage’ back labor pain.

Managing Back Labor Pain: How To Help Yourself Through Back Labor Pain

  • Take advantage of gravity

In order to ease yourself back labor pain, try to take a walk, albeit slow and struggled, or try bouncing on a birthing ball, or lean against a wall. This will help keep your baby’s head away from the spine

  • Lie in the spider position

Do not lie on your back because that will put more pressure on the spine. Instead, try lying down in a spider position, that is, lie on your side (almost on the belly), keeping the bottom leg extended and the top leg bent towards the belly. You could also use a pillow for support

  • Hydrotherapy

That is, relaxing in warm tubs or taking warm showers can help relax the pain

  • Reflexology

 This involves having your birthing partner use a finger to apply strong pressure directly below the center of the ball of the foot. This acupressure technique is said to help relieve back labor

  • Double hip squeeze

You could ask your partner or anybody from your friends/family to place pressure on your hips as you simultaneously lean forward onto something during contractions to help ease the pain

Getting down on hands and knees, leaning over, or crouching also helps as it releases the pressure. You could also take your partner’s help for a hot compression pack or a back massage 

Relieving Back Labor Pain: Medical Help

Apart from helping yourself, you could also reach out to your doula or the doctor and ask them to help you through back labor pains. They might advise sterile water injections or an epidural for relief.

Final Thoughts: Is Back Labor Harmful?

Do not worry sweet mamma, there’s nothing harmful about back labor (apart from the excruciating pain of course). However, back labor may cause some complications during delivery.

  • Back labor may take longer versus regular labor since it requires the baby to put in extra work and for them extend their head from under your pubic bone
  • Back labor increases the chances or the need to go for a C-section or an assisted vaginal delivery (that is, a normal delivery done using the help of forceps or vacuum extraction)
  • Your labor might also need to be induced via oxytocin
  • The mother might also feel third/fourth-degree perineal tears or might have to suffer from an early, postpartum hemorrhage

But all said and done, if you happen to be a mother suffering from back labor pain, let us tell you one thing: though back labor could be an unsolicited challenge, remember what it is for! You finally will see your little one and you know it’s going to be worth it all!

FAQs- Back Labor Explained: What is Back Labor, Causes, Symptoms, and Prevention

1. Do sunny side up babies get a low APGAR score?

Yes, usually, babies delivered in the unideal/sunny-side-up/occiput posterior tend to get a lower five-minute Apgar score when checked immediately after birth. However, there’s nothing a parent needs to be worried about as the score usually normalizes ten minutes post-birth.

2. What are the signs of back labor pain?

The most common signs of back labor pain include-
  • Severe pain in the lower back
  • Excruciating pain during contractions
  • Pain often doesn’t let up between contractions
  • Back contractions/ back spasms
  • Reviewed By:

    Esha Chainani - Obstetrician and Gynaecologist

    Esha Chainani - Obstetrician and Gynaecologist

    Dr Esha Chainani is an Obstetrician, Gynaecologist and laparoscopic surgeon practicing in Mumbai. She aims to break the stigma around women’s health by advocating an inclusive and open practice of obstetrics and gynaecology. Esha is the author of several internationally published research papers and health articles in the media like the Swaddle. She founded Premaa, a non profit to reduce maternal morbidity and eventual maternal mortality by providing lower income pregnant women living in urban areas cell phone access through an app, to medically correct information proven to influence the outcomes of both mother and child. Her app Premaa pregnancy also has an entire section about contraception as well for a whole gamut of reproductive health. She has been on the panel for multiple health sessions including with the UN, USAID, BMC, gender at work and multiple non profit organisations. She’s also on the advisory panel of the South Indian medical students association. She is also an editor at the MAR Journal of Gynaecology. She advocates for accessible healthcare through her instagram account as well posting about reproductive health, mental health and sexual health.

    On behalf of the editorial team at Parenthoodbliss, we follow strict reporting guidelines and only use credible sources, along with peer-reviewed studies, academic research institutions, and highly respected health organizations. To learn about how we maintain content accurate and up-to-date by reading our medical review and editorial policy.

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