Back labor is pain in your lower back that begins during labor. It’s thought to be caused by your baby’s position within your pelvis. In this case, the back of your baby’s head presses against your spine and tailbone. There are many positions to try to reduce your pain. These positions might also rotate your baby into a more favorable delivery position.
Back labor is pain and discomfort in your lower back that happens during labor. Back labor may be most uncomfortable during contractions but can also remain painful between contractions.
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People who have experienced back labor describe it as:
Back labor is thought to be caused by the position of your baby within your pelvis. Pain develops when the back of your baby’s head presses against your lower spine and tailbone while you’re in labor. Technically, this is called the occiput posterior position. Its nickname, the “sunny side up” position may refer to your baby’s face facing upward at birth, like the yolks of sunny side up eggs. The preferred position for easier delivery is the occiput anterior position, which means your baby’s head is down in your pelvis with their face and front of body facing toward your back.
Several recent studies suggest that factors other than baby positioning may contribute to back labor. These factors include:
According to published literature, the number of pregnancies in which the baby is in the occiput posterior position at the beginning of labor ranges between 15% and 32%. However, this number decreases to between 5% and 8% at the time of delivery. Most of the time, the baby eventually rotates to a more favorable position during labor.
Back labor begins when you’re in active labor and sometimes earlier. Back labor remains present during labor and may become more intense during contractions.
Understanding when back labor begins makes it easier to sort out other types of back pain you may feel. While back labor can be continuous once labor begins, regular labor pain happens during contractions. Other types of back pain are muscle aches and pains that come with the strain of pregnancy.
Back labor can be extremely uncomfortable for you, but it doesn’t harm your baby. Most babies turn their bodies to the preferred position (back of their head/back of their body against the front of your belly) during labor.
Usually, but if your baby doesn’t rotate, your labor may last longer, be harder and require more pushing than what would be otherwise expected. Your healthcare provider may attempt to rotate your baby with their fingers or hand.
However, there’s always a chance that you’ll need a cesarean delivery. Back labor may increase the chances for an assisted vaginal delivery (assisted with the use of forceps, vacuum extraction) and more vaginal tearing.
An ultrasound is the most reliable way to tell. Also, it’s possible — with some training — that you, your partner, doctor or midwife can sometimes feel the shape of your baby through your skin and figure out how your baby is positioned. Keep in mind that your baby’s position continues to change throughout your labor. During the end stages of labor, your midwife, doula or doctor can see or feel how your baby is positioned.
You may not be able to prevent back labor — or can you? Here are some techniques you can try to help slip your baby into a better position for delivery, which will also relieve your back labor. All of these positions help open your hips, which can help your baby more easily move and rotate into a face downward (baby facing your spine) position. Your baby’s position can continue to rotate any time before you begin labor and during labor.
Let gravity help reposition your baby. Hang your belly from any position.
Use a birthing ball as your baby repositioning assistant.
Other partner-assisted techniques:
All of the exercises and techniques discussed above not only help reposition your baby but also relieve pain. However, you can try other methods.
Additional pain-relieving tips include:
A note from Cleveland Clinic
Back labor is painful and is caused by the position of your baby’s head against your spine and tailbone. There are many techniques your can try to reposition your baby, which will also reduce your discomfort. The most important message is not to get too worried about your baby’s position. Your baby twists and turns throughout your pregnancy and even during labor. Your partner and healthcare team are here to support you and will help you remain as comfortable as possible through the delivery process.
Last reviewed by a Cleveland Clinic medical professional on 09/17/2021.
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