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Back Labor. It's Real and It Can Suck.

Back labor. It’s more than just a birth story talking point. It’s real, and it can suck.

But, there are things you can do to get through it.

What is back labor?

The intense lower back pain that some people experience during labor occurs when the baby’s head puts pressure on the lower back. More specifically, when your baby is in the occiput posterior position, the back of their is head putting pressure on your spine during and even in between contractions (I know, sounds great right). In the birth world, we usually call babies in this position “sunny side up.” 

Now before you get too worried, it’s important to know that while a posterior baby can lead to a longer and more painful labor in some cases- not all labors will be affected! It all depends on the baby’s position. 

managing back labor and back pain during pregnancy

Distinguishing back labor from back pain

Most of the birth stories we hear depict back labor as the worst pain ever. For some though, this description can lead to unnecessary worry that we’re in for a terrible labor if we begin to feel normal back aches and pains due to pregnancy. A few things to look for to tell normal pregnancy back pain from back labor

 back labor Vs. back pain during pregnancy:


  • Pain peaks with your contractions = back labor 
    • Back labor will most often ebb and flow with contractions
  • Feeling the pain when you’re actually in labor = back labor
    • This may seem like a no brainer but it can be hard to tell when you are in early labor. Luckily (unluckily?) most women will be in the active labor phase when it really kicks in. 
  • Other little aches not associated with labor or contractions = likely just normal back pain
    • Pain in the absence of positive labor signs and contractions that aren’t increasing in intensity is likely a normal pregnancy ache.

managing back labor and back pain during pregnancyMinimizing the pain of back labor

Back labor doesn’t have to be a big fear.

In most cases, the best way to minimize and relieve pain is to move baby. Position changes can encourage baby to move before they are engaged in the pelvis. 


Techniques and recommendations  for navigating back labor:
  • Hands and knees position – This will help open the pelvis and allow baby into the optimal position.
  • Abdominal Lift and Tuck – Done with your partner or the help of your doula and a rebozo, this technique is used during a contraction to help baby into the pelvis by creating space for baby to tuck their chin and rotate their head.
  • Counter Pressure Counter pressure can be a game changer! You’ll have your partner or doula provide counter pressure by doing what’s often referred to as the double hip squeeze or providing steady pressure with the heel of the hand at the small of the back.
  • TENS UnitThis is a non-pharmacological way to manage pain using mild electric pulses administered via pads placed on the back. It can be utilized or stopped at any point in labor without any lasting effects.
  • Heat Therapy– A heated rice sock or hot water on the lower back from a shower can be a great tool during labor.
  • Be Mobile– Try squatting or sitting on a birth ball, standing and swaying, kneel and lean on the back of your hospital bed or birth tub. Use gravity to your advantage, open the pelvis, and stay mobile!

(Check out the super helpful links too!)


managing back labor and back pain during pregnancyPain does not have to equal suffering. 

If one of your goals is limited interventions, rest assured, many women experience back labor and have unmedicated births. But, if you’re experiencing back labor and find that you’re struggling, even if you’ve tried every coping technique, an epidural may be a good option for you. 

Ultimately it’s your birth and back labor is no joke. Don’t hesitate to take charge and utilize the tools you have available to achieve the birth experience you want. 

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Amber Navarro

About Amber

Amber Navarro is a birth doula and certified lactation educator & counselor. She graduated from the University of California, Irvine with a degree in Psychology. She currently lives in Orange County, Ca with her husband and three boys where she's found a home within the birth community. Her work as a doula allows her to utilize her passion for pregnancy, birth, babywearing, and breastfeeding to support new parents.


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