B is for Back Labor
The dreaded back labor, enemy of laboring women. You have no power here!
Too nerdy? Right, moving on.
Back labor is serious business. 25% of all laboring women experience intense pain in their lower back during and between contractions. If this persists, it can throw off a woman's labor process entirely. So for the second installment of my Alphabet series, I'm going to give you all the tips on how to avoid and eliminate back pain during childbirth.
Back labor can stall progress, causing irregular contractions, labor that is slow to progress, and a longer pushing stage. These things can all potentially cause interventions such as administration of Pitocin to strengthen contractions, an episiotomy, vacuum or forceps assisted delivery, or an unplanned cesarean birth.
Women who cannot find relief from the pain often ask for pain medication or an epidural, and this leads to other interventions such as intensive fetal monitoring, movement and dietary restrictions, and more. In the birth world, we call this the "intervention snowball." For someone wanting to achieve natural delivery, this can be a huge roadblock.
So, what causes the discomfort? We don't know the exact cause, although two known indications can be the position of the baby's head, or a predisposition to back pain during menstrual cycles. Though there's not much we can do about a predisposition to stress in that area of the body, I'm going to show you how to work with your body and get past this obstacle.
If the pain is directly due to baby's head pressing on mom's back, we simply need to assist her body in making space for baby to move downward. Some ideas on how to help yourself or your birth team to do this (and most can be used at the same time to increase comfort):
Get her off her back! Hands and knees, squatting, lunging, walking, and sitting or leaning on a birth ball are all effective labor positions to open the hips.
Pelvic tilts, such as a Cat/Cow pose in yoga class. Tilt your hips forward and then back as far as possible to relax your ligaments help your body move in the ways it needs to.
Rebozo sifting the abdomen is one of the most effective ways to relax the belly muscles. It's gentle and helps the baby move into the most optimum position.
Hydrotherapy, or utilizing a birth tub can assist in positioning through relaxation, buoyancy, and increased ease of position changes.
If making space in itself isn't solving the problem, use additional comfort measures as needed.
Counter pressure should only be used at mom's comfort level. If she is uncomfortable, stop immediately. Use firm pressure two to three inches above the mother's hip bones, or directly on her sacrum. You can also use pressure on the sides of the buttocks to aid in opening her hips. Ask your doula or midwife to assist you in applying pressure if you're unsure how to do this safely or effectively.
Hot and cold packs can be applied directly to the area of discomfort. Heat therapy seems to be most effective, but rotate in ice packs to increase the effectiveness and avoid burning the skin. Mothers are experiencing a lot of sensations and may not notice right away if it's too hot.
Don't forget to keep her breathing, drinking sips of water, and using the bathroom frequently. Make it part of your rhythm to check these things every half hour or so. This will help her be more comfortable and assist labor in progressing.
Don't forget the power of mental relaxation and reassurance. Help her to focus and stay positive by holding space, breathing with her, and offering positive statements and affirmations.
Nothing beats having a doula by your side to help you and your birth team figure out all these details in the heat of the moment. Here's the details about my services through Sublime Motherhood if you're interested in personalized care and assistance, learn more about Doula Support in Delmarva.