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What Does Back Labor Actually Mean? A Midwife Explains

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Back pain sucks, and at some point, most people will experience it in some form or fashion. For pregnant women, it's often just a fact of life. Your entire body shifted its position, your back muscles aren't up to the task of holding you upright, and your body lets you know. It aches, it burns, and don't even get me started on the sciatic nerve. However, it can be much worse during childbirth when women experience the phenomenon known as back labor. It sounds ominous, right? But what does back labor actually mean?

Back labor is the term used for the painful type of childbirth that is accompanied by an intense pain in the lower back. The contractions are often less regular and slower to progress than traditional labor, and traditional pain medicine may be less effective for the treatment of these contractions, according to The Mayo Clinic. The reasons for back labor vary, but are sometimes related to the position of the baby in the birth canal. It can also be triggered by the physiology of the mother; a short torso, weak musculature, and narrow hips can all be possible contributing factors to the pain and complex nature of back labor.

In an effort to better understand back labor, I spoke with some of my friends who experienced it, and it sounds positively dreadful. More than one of them noted how it felt like their back was on fire with every contraction, and that the epidural was not as effective as they'd hoped. Only one of my friends actually had a baby in the "sunny side up" position. The rest were all left wondering how and why they were stuck with the slamming pain of back labor.

The worrisome bit about back labor for me is that several of my friends, and many women online in message boards, report that they were unsure for a prolonged period of time as to whether or not they were actually in labor. Many of them thought they'd thrown their back out or slept incorrectly when actually, their baby was on the way. So what does back labor actually mean if mothers aren't sure they're even in labor?

I spoke with certified nurse midwife Danielle Kline CNM, DNP, and she tells Romper that back labor is often misunderstood. "People hear the words 'back labor' and they immediately think something's gone wrong. That's not usually the case. Many times it's just a run of bad luck making an already painful time more difficult."

"Sometimes the baby is in a position known as 'occiput posterior,' and the head is resting on the lower part of the spine, flaring pain with each contraction and slowing the progress. This isn't actually very common." Kline says that, more often than not, it has to do with maternal posture, weight, structure of the pelvis or back, or very loose ligaments. "If you get a lot of pain in your back with your period or with exercise, you're more likely to go into back labor."

Thankfully, there are methods to not only mitigate your risk to experience back labor in the first place, but also to alleviate the pain during labor. "It starts before you even become pregnant. Work on your posture — a swayed back or slumped and rounded shoulders put you at risk. Build your core muscles and those all-important corset muscles that wrap around your body and meet at your spine." She says once you're in labor, the key is to keep your hips open and wide, whether you're in a squat position, or resting on a ball. Your pelvis needs to be open and loose. "You can also stretch on your hands and knees, rocking and tilting your hips and pelvis back and forth. This can decrease the stress on your lower back and bring it back down into your lower abdomen."

There's one big no-no to back labor, and that's laboring on your back, Kline explains. "The traditional American birthing position of knees up, butt forward, on your back will be the most painful possible position for you and should be avoided."

Back labor isn't fun, and it's a crappy hand to be dealt, but hopefully these strategies, plus your doula or provider, can ease your discomfort if you must go through it.

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