Back labor can be intense, prolonged, and for some people it causes an inability to cope with labor. Back labor is usually caused by the baby’s position in the womb. For most people, the baby will have the easiest passage through the pelvis if the back of the baby’s head is in the front of your pelvis (near the pubic bone). We find that if the back of the head is facing slightly to your left that is usually even better than the baby’s head being straight forward or slightly to the right. If the baby is in a “sunny-side up” position, then the hard part of the baby’s head (the back of the head) is against the hard part of your pelvis. Bone rubbing on bone is not comfortable in your knees, hips, back, or during labor.

Since a sunny side up position is associated with back labor, it may be helpful to confirm that your baby is in an occiput posterior position. Your provider can often confirm position during a cervical check. Don’t worry, babies can move during labor and most will move on their own even if you do nothing. Sometimes trying new positions is enough to give your baby space to reposition. If you have persistent back labor, then some of the below techniques can open your pelvis and allow baby to reposition reducing your pain. Some of the techniques simply reduce the pain so that you do not suffer.

Many hospitals have peanut balls available. Lying on your side with legs separated and resting on a peanut ball can help a baby turn. Hospitals are very familiar with this technique, because it is especially popular after an epidural. Epidurals are very common in the United States, and those who have had an epidurals are much less mobile. The following are techniques that some people may find more effective than a peanut ball in helping a baby turn. These techniques can also be used for relief prior to an epidural or if you do not have an epidural.

Frozen water bottle

Most people know to ice when they bang their head, sprain their ankle, or fall down, but it can also feel great in labor. Many people feel very hot during labor and ice helps to both cool them down and ease some of the pain. In the case of back labor, a frozen water bottle can be rolled up and down the back to ease some of the pain. Water bottles of the type pictured here have a bend in the sides that fits perfectly over the spine.

Hip squeeze

Hip squeeze was my saving grace during active labor and transition with all three of my labors. I only had back labor during my first labor, so I highly recommend including it in your toolbox and practicing it with a support person prior to labor. Basically you want the support person to find the soft area on both sides of your pelvis. To do this put the heel of your hand at pelvic bone on the side of your body with your fingers pointed down. Your palms should rest on a softer area of your lpelvis. To apply counter pressure your support person will press on both sides at the same time. Try this technique out prior to labor so that your support person really knows how to get their hands in position. It if feels good now, then it is more likely to feel good during labor even if you do not experience back labor. During labor you are likely to want A LOT of pressure applied, so practice with your support person really pushing into you. Hip squeeze can be performed in kneeling, sitting, standing, lunging, squatting, quadruped, or side-lying (support person presses with both hands on top hip).

Counter pressure

Counter pressure is another technique I used a lot during my first labor when I had back labor. This is another technique for a support person to perform. I will describe the hand positioning as if the technique was being performed on the right side, to perform on the left side just switch. With their right hand your support person will wrap their finger tips around the front of your pelvis on the right. The support person will then use their left hand to press on the back of your pelvis to the right of center. Similar to hip press, if it feels good now, it is likely to feel good in labor and it is common for the laboring person to want this technique performed with a lot of pressure and

Child’s pose

If your back labor is due to the back of your baby’s head pressing into the bony part of your pelvis, then resting in child’s pose (with or without hip press or counter pressure for pain relief) can help your baby to reposition. This position can allow your baby to move up in the pelvis a little bit to have more space to rotate.

Lunge to one side

Lunging is a good technique to open the pelvis and allow baby to rotate to a better position. If you slow progress in labor, with low back pain, and a persistent posterior presentation of your baby, then lunging into the discomfort can help your baby turn. The general rule of thumb is that a labor position should feel relatively comfortable after about 5 contractions. If you are lunging to provide more space for your baby to turn, then it is common to experience increased discomfort for a period of time. When possible, it is beneficial to select the side to lunge to with guidance based on your baby’s current position, but lunges can be beneficial without knowing the baby’s position. Physical Therapists at New Journey Physical Therapy can provide this service.

Have you experienced back labor? Did you know these techniques? Did you try any of these techniques? Let me know in the comments!