What is Back Labor? Must-Know Tips for Every Mama

What is back labor? I’m so glad you asked, and I’m so glad you’re here!

You see, a lot of mamas don’t hear anything about back labor as they prepare for birth. And if it happens to you, it can seriously catch you off guard!

The truth is, back labor seriously sucks. Mamas that have experienced regular labor vs back labor will tell you that it really does take you into a whole different ball game. And regular labor is hard enough!

The good news is that if you learn about back labor ahead of time, you’ll have some strategies ready to go! And this will help you manage the pain – or maybe avoid it all together!

Today we’re going to talk about what it is, why back labor happens, and ways to prevent it. Perhaps most importantly, we’ll cover how to cope with back labor if it happens to you!

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What is back labor and what does it feel like?

Back labor is almost exactly what it sounds like – labor pain that you feel in your back. What we think of as typical contractions are mainly felt in the low belly – kind of like where you feel a menstrual cramp. In fact, the best way I can describe contractions are like really intense menstrual cramps!

But when someone has back labor, they’ll feel intense pain in their low back in addition to those low belly pains. Some mamas (myself included!) describe it as an intense pain that kind of wraps around their entire back as a contraction peaks.

The other thing that makes back labor really tough is that for many there isn’t really a break in the pain. The pain lingers during the entire labor, intensifying with the waves of your contractions.

So, how common is it?

According to the American Pregnancy Association, most mamas will feel some degree of back pain during their labor, but only an estimated 20-25% will have the severe discomfort that accompanies true back labor.

And from what I see at the hospital, I would say that estimation definitely holds up! Other sources estimate that back labor occurs in as many as 1/3 of all births.

What causes back labor to happen?

Nobody who hears about back labor wants it to happen to them. And if you’ve experienced back labor and are set to give birth again soon, you might be seriously dreading it!

So let’s talk about factors that may increase your risk of this happening.

1. Baby’s position

Baby’s position when you go into labor (or when you’re induced) is hands down the most common culprit of back labor. In short, if baby is in an Occiput Posterior (OP) position, back labor is far more likely.

So, what am I talking about here?

Well, baby’s position actually matters a lot for birth! Ideally, we want baby to be positioned head down, and looking at your back. This is known as an Occiput Anterior (OA) position.

When baby is positioned this way, you are more likely to go into labor spontaneously, and you are less likely to have instances of intervention such as forceps delivery, C-section, epidural use, and more.

And, yep. You are far less likely to experience back labor, too! This is because when babies are looking out in an OP position, the backs of their little skulls are in the perfect position to put a lot of pressure on your spine and tailbone. They can often hit nerves in your spine which contributes to the excruciating pain.

Overview of the different positions

Let me give you a quick overview of some different ways baby can be positioned in there:

  • Left Occiput Anterior: Head down, facing towards the back, head tilted slightly so the back of the head is towards mama’s left thigh
  • Right Occiput Anterior: Head down, facing toward the back, head tilted slightly so the back of the head is towards mama’s right thigh
  • Left Occiput Posterior: Head down, facing out, head tilted slightly and looking at mama’s right thigh
  • Right Occiput Posterior: Head down, facing back, head tilted slightly and looking at mama’s left thigh

Remember, OA positions are more ideal than OP positions (aka sunnyside up) in general because Occiput Posterior positions can be associated with back labor, higher rates of intervention, and more difficult vaginal births.

This knowledge is important, because there’s actually a lot you can do to try to get baby into an optimal position (and thus lower your risk for back labor!) – we’ll talk about this a bit more below.

2. Your anatomy

So, another factor in your likelihood of experiencing back labor is your anatomy. Mamas that are on the shorter side, or have a shorter torso tend to be more prone to back labor, especially if they’ve got a long baby in there.

Basically what happens is there’s just not enough room for baby to engage down into your pelvis without putting some pressure on your spine internally – even if they are in an optimal OA position!

In addition to a short torso, a history of back pain, weak muscles in your pelvic floor, and the shape of your pelvis all might also play a role in your risk for back labor.

3. History of back pain during your period

Interestingly, an older study from back in 1989 found a correlation between the experience of back pain during your period with an increased likelihood of back labor.

The same study found a correlation between women who experienced low back pain throughout their pregnancy and an increased risk for back labor, too. Definitely noteworthy and something to keep on your radar as you prepare for birth!

Childbirth education can help!

If you’re reading this and any of these risk factors have you nodding your head, the tips in this article are a great starting point, but a birthing class can really help!

A thorough understanding of the anatomy of labor, labor positions, and pain coping strategies to relieve the pain of back labor can make a huge difference on the big day – especially if your plan is to birth without an epidural.

Learn more about Mommy Labor Nurse’s affordable and comprehensive online birthing classes to find the one that’s right for you!

Can back labor be prevented?

So now that you know the risk factors that make back labor more likely, you’re probably wondering if there’s anything you can do to prevent it. And the answer is: maybe. Hah. Let me explain.

At the end of the day, anyone can experience back labor, and if your anatomy makes you more prone to it, there’s not a whole lot you can do to decrease the risk. But – there are two things you can do proactively that will decrease the risk significantly:

  • Encourage baby into an optimal position for birth (and decrease the likelihood of an OP baby putting pressure on your spine)
  • Strengthen the muscles in and around your pelvic floor (so that during labor your body can more effectively move baby down into your pelvis and reduce the risk of pressure on your low back)

Let’s unpack these a little more.

How to encourage baby into an optimal position for birth?

First of all, you’ll need to know that your baby isn’t positioned optimally for birth. Often, your provider can help you figure this out with an ultrasound or with touch, but you can also try something called belly mapping at home.

What is belly mapping?

belly mapping infographic

Belly mapping is a technique created by Gail Tully from Spinning Babies that helps you figure out which way your baby is positioned in the womb.

Basically, you’re going to feel around on the outside of your belly to notice things about the contours of baby’s body and help figure out how they’re in there. You’ll couple what you feel externally with where you’re feeling things like kicks and wiggles, too.

You can hear Gail talk more about this process on EP38 of the Mommy Labor Nurse podcast!

How to encourage baby into an OA position?

spinning babies infographic

There are a lot of different techniques and ideas out there to help you turn your baby and/or get them more optimally positioned for birth.

Here’s an overview of some things that you can try:

  • The Miles Circuit: This is a series of stretches and positions that help to get baby into an optimal position for birth, and even start labor spontaneously. Sometimes, these positions are used during labor to jumpstart a stalled labor or help move baby from an OP to an OA position while you’re in labor
  • Spinning Babies: If you’re trying to turn a breech baby (as opposed to just turning from OP to OA) their forward-leaning inversion technique is something I highly recommend! Learn more here
  • Pelvic Rocks: Basically, you want to spend time on hands and knees, alternating from arching your back to rounding (known as cat/cow poses in yoga)
  • Sleep on your left side, with your top leg supported by a pillow: This can encourage baby into an OA position
  • Sit with your pelvis tilted forward: Basically, when we’re lounging, reclining, and slouching, it can make baby more prone to an OP position. By consciously sitting with your pelvis tilted forward you can help avoid this. Spending time sitting on a birth ball regularly is a great way to ensure you’re sitting properly!

How to strengthen your muscles in preparation for labor?

The best way to do this is with prenatal exercise during pregnancy! Exercise programs that are specifically designed for pregnant women do an excellent job of strengthening and preparing the pelvic floor and core in pregnancy-safe ways.

By targeting those muscle groups, you can prepare your body to have even more effective contractions. What’s more, many prenatal exercises get you on your hands and knees and in other positions that naturally encourage baby into the ideal positions for birth.

The prenatal fitness program I love is the Juna App. Head over there to learn more ?

Related: Benefits of Prenatal Fitness

Tips to cope with back labor!

Alright, now that you know that even with the best intentions and practices in place, back labor can still happen to anyone, so learning pain-coping tips is a must!

Here are the top tips I like to teach mamas. This is coming from my practice as a labor and delivery nurse, but also a mama who’s dealt with back labor and still managed to birth without an epidural.

On the whole, many of the pain coping mechanisms you may already be learning in a childbirth class will help with back labor, but let’s take a look at some ideas that specifically dial into that low back pain.

Back labor tips for your birth

  • Lots of hands and knees: Gravity will help get baby’s head off of your spine and may alleviate some back labor pain. This is a great position to combine with heat therapy, hydrotherapy, or counterpressure
  • Draping over a yoga ball: Similar to hands and knees, but in this position, your upper body is draped over a yoga ball. It’s another position that’s perfect to combine with some of the other techniques
  • Counterpressure on your low back: Having your partner learn how to do counterpressure is so helpful for labor! Often your L&D nurse or provider can help, too! Basically, while you’re on your hands and knees, a support person will squeeze the sides of your hips, pretty firmly, to provide counter pressure to the pain you’re feeling in your back. This was one of the only things that even touched my back labor pain!
  • Abdominal lifts and tucks: This can be with your hands or with a rebozo, basically you want to lift your belly out of your pelvis during contractions! This is most helpful if baby is still very high in your pelvis!
  • TENS unit: TENS units are a labor pain coping mechanism that are common in Europe and gaining popularity here in the US, too. Basically, they work to provide nerve stimulation and effectively disrupt pain signals to your brain. So a TENS unit won’t take away labor pain, but can distract your brain and kind of reduce awareness of the back labor pain. Learn more here
  • Heat: Heat can help relieve some of your back pain. This might be a heating pad, hot water bottle, warm compress, or heat from a tub or shower
  • Hydrotherapy: Yes! Water jets or removable shower heads can feel SO good on back labor. Even just laboring in a tub can make a big difference during back labor
  • Peanut ball/Fire hydrant: Basically a position where you’re laying on your left side with your right leg elevated and supported. This can help turn a baby from OA to OP while you’re in labor!
  • The Miles Circuit Positions: I know we talked about these above, but they can be used during labor too to help get that baby to rotate as they move down into your pelvis!

Ready to rock your back labor?

Okay, okay. I know a better heading might have been – please god spare me from back labor. But mama, if back labor does happen to you, it’s going to be okay!

With an understanding of what it’s all about, plus tips for how to cope, you’re going to be able to rock your back labor – no matter how you plan to give birth, or how it unfolds.

Let’s keep the tips rolling! If you’ve experienced back labor in the past, share what worked (and what didn’t!) in the comment below ?

Happy birthing!!

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Liesel Teen, BSN-RN
Founder, Mommy Labor Nurse

Meet Liesel Teen

Hi there. I’m Liesel!

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

When you know what to expect and have the tools to navigate the experience, you’ll feel confident and in control.

I believe you deserve a better birth — no matter how you deliver.