In this blog post I want to highlight labors that cause severe back pain, labors that are slow to progress and especially difficult labors. These are a few circumstances that can happen during labor that [in my opinion] need special attention and education.
You may be wondering, “Jerica, why are you talking about these circumstances all in one blog?”, and that is because there are a few specific comfort techniques that can be done in any or all of these situations to help you if you are going through it. Also, these may seem like unrelated birth circumstances when actually they potentially can all occur together.
Back pain in labor and how it relates to slow and more difficult labors, let’s talk about it.
You probably have heard a birth story of a mama who had ‘back labor’ or at least heard the phrase ‘back labor’. The most common contributor to a mama experiencing much of her pain in her back during labor is due to her baby’s occiput posterior (OP) position in the uterus. A baby that is OP is facing up towards mama’s belly button rather than facing down towards mama’s back. OP is not the most favorable position for your baby to be in for birth. This is because the OP position does not allow for the more natural flexion of the baby’s neck as he/she descends down through the birth canal. Approximately 25% of babies are in the OP position when labor begins and only 3% – 5% are born OP at birth (Simkin et al., 2018). Mama’s who labor and birth an OP baby tend to have their labor slow after a period of progress, have irregular contractions, experience back pain (even between contractions) and likely have prolonged labor (especially during stage 2 of pushing).
The many difficulties that can arise when laboring with an OP baby are why it is very important that you recognize them if they are happening in your own labor and then implement techniques to change baby’s position to the more favorable occiput anterior (OA) position. Your birth care provider will most likely be able to confirm your baby’s positioning by assessing and touching your baby belly or by doing a vaginal exam once your water bag has broken to feel your baby’s head positioning.
If you have a confirmed OP baby then implement the following techniques as soon as possible to encourage your baby to rotate into a more favorable position. If your baby’s position is not confirmed but you are having difficult labor signs we discussed above (labor slowing after a period of progress, irregular contractions, back pain or prolonged labor), you too should implement the following techniques as soon as possible to encourage your baby to rotate into a more favorable position.
- Stay off your back
- Spend time on all fours
- Rock your hips back and forth
- Walk & keep moving
- Consider getting into the tub
- Ask for counterpressure, back massage, double hip squeeze, rolling pressure, hot/cold compresses, TENS unit or shower hose sprayed on your back
Now here is the why behind that list of techniques to implement. Keeping off your back should decrease your pain but importantly keep you off of your tailbone that needs to be able to flex to allow for your baby to more easily descend into the pelvis. Getting into all fours positions includes: being on hands and knees, getting on your knees and leaning over completely onto something, standing and leaning over completely onto something or getting on your knees and placing your elbows down onto a pillow with your bottom up in the air. Rocking your hips, walking and continuing to move helps your pelvis flex more freely encouraging your baby to get into the best position for descent. Getting into a tub of water can help you feel weightless, help you move & flow with contractions and as a result help baby’s positioning. Counterpressure, back massage, double hip squeeze, rolling pressure, hot/cold compresses, TENS unit and a shower hose sprayed on your back can offer relief and help you cope.
Here is a graphic of several active birthing positions created by the Royal College of Midwives. Each of these positions are particularly great to try if you are experiencing back pain in labor but also helpful at any point you want to try them.
I want to give you a great resource and direct you over to Evidence Based Birth to check out their research blog written on birthing positions. Be sure to pay special attention to the last section where resources and links are given. I’ve linked it here.
Remember mama, the circumstances we talked about above do NOT happen in the majority of labors (thank goodness for that!). But, I do want to remind you that the techniques I have recommended here can be implemented into your labor even if you do not experience back pain, slow labor or difficult labor. Take advantage! Be an active birthing mama! Help your baby [using these techniques] the best you can to get into a position that will promote a shorter and smoother labor and delivery.
Comment on this blog any ideas you have for promoting a shorter and smoother labor and delivery! Let’s share our knowledge and help other mamas! What worked for you?
Resources
Sears, W., & Sears, M. (1994). The birth book: Everything you need to know to have a safe and satisfying birth. (1st ed.). Boston, MA: Little, Brown & Company.
Simkin, P., Whalley, J., Keppler, A., Durham, J., & Bolding, A. (2018). Pregnancy, Childbirth, and the Newborn: The Complete Guide (5th ed.). New York, NY: Da Capo Press, Incorporated.
