What is back labor pregnancy?

Back labor refers to the intense lower back pain that many women feel during (and even between) contractions when they're giving birth. It can be very uncomfortable, but it doesn't mean that anything is wrong with your baby.

What causes back labor pain? 

This pain is usually attributed to the pressure of your baby's head against your lower back, but other factors may be at work, too.

One unproven but interesting theory is that the pain is "referred" to your lower back from your uterus. That idea is supported by the fact that some women complain of low back pain when they have menstrual cramps. One study found that women who had back pain during their periods were more likely to have back pain during labor.

What does back labor feel like? 

Back labor feels like intense pain in your lower back that continues between contractions. Regular labor pain often feels like strong menstrual cramps that start and stop, and increase in intensity over time. In contrast, moms say that back labor feels like a continuous, strong pain focused on your back. It tends to get stronger during contractions and can become especially uncomfortable at the height of a contraction.

Moms in the BabyCenter Community describe back labor like this:

"It feels like someone is ripping your spine out. The best thing that worked for me was counterpressure. My husband would press as hard as he could against my lower spine and it relieved a lot of the pain."

"It was a constant baseline of pain that would come in intense waves on top of the labor pain."

"My little guy was sunny-side up, and I had my mother-in-law rubbing my back hard the entire time I was in labor. If she stopped for a second, I squealed."

"The pain level went up with each contraction. The birthing ball helped, and while I bounced, my mom had a tennis ball in a sock that she rubbed on my lower back."

Is back labor related to the baby's position?

Back labor has long been thought to be more common when the baby is facing up during labor, with the back of the baby's head pressing on the bony part of your spine. But there are no studies to support that idea.

Is there any way to tell if I'll have back labor?

No, experts don't know of any proven risk factors to give you a heads-up beforehand.

One small study found that women who had back pain during pregnancy and women who were overweight were more prone to have back pain during labor.

You may not be able to prevent low back pain during labor, but you can try one or more of these tactics to help relieve it:

• A new position. Get up on all fours. This position may relieve back pain by reducing the pressure of your baby's head on your spine. Other positions that may help are the standing forward lean and the exercise ball kneel. (Take a look at our video on positions to ease labor pain.)
• Pelvic tilt exercises. These simple exercises also may help minimize the pressure on your spine.
• Massage. Ask your labor coach to rub your lower back between or during contractions – or both, whatever feels best to you.
• Counterpressure. Many women find that steady counterpressure on the lower back relieves some of the pain. Ask your labor coach to push on this area with his or her fists during contractions or massage it with a tennis ball.
• Hydrotherapy. Take a warm bath or shower (aim the showerhead at your lower back).
• Heat or cold. Apply warm compresses or a hot water bottle to your lower back. Heat may ease the achiness and bring you some comfort. On the other hand, some women find cold packs more soothing or that alternating heat and cold is helpful. You may want to give both a try. Just be sure to use a towel to protect your skin from direct contact with heat or cold.
• Water injections. Sterile water injections have been shown to provide some relief from back pain. This is a procedure in which small amounts of sterile water are injected just beneath the skin in four places on the lower back. The injections are temporarily painful, but afterward, the pain relief lasts for a few hours. No one knows for sure why it works, and it's not available everywhere.

Check out some other natural childbirth techniques that may help you deal with labor pain.

If you don't have your heart set on natural childbirth and nothing is helping you manage your back pain, consider getting an epidural. In most cases, it provides total relief from all kinds of labor pain, including back labor.

Learn more:

Positions your baby might be in during birth

Signs of labor

Top pain-management techniques during labor

Pregnancy massage for labor pain

Pregnancy & Motherhood

Back labor—A Mayo Clinic specialist offers tips to manage back pain during labor.

Pregnant women don't always feel contractions solely in their belly. Indeed, about 25 percent experience back labor, which happens in their lower back, just above the tailbone. Back labor may be a sign that your baby is in the occiput posterior position—or "sunny-side up" (head down but facing your tummy instead of your back), says Logan Van Lessen, a consultant midwife for the U.K.'s Nursing and Midwifery Council.

Back labor can be extremely uncomfortable for you, but it's not a problem for your baby. Nearly 90 percent of babies rotate on their own during labor or can be shifted by your doctor. Your doctor or midwife can help you relieve back labor pain in the meantime. Here's what you need to know.

Ordinarily, if you are lying on your back during delivery, your baby will be facing down toward the floor. This is called the occiput anterior position. But some babies face up toward the ceiling (occiput posterior position). Laboring with a face-up baby causes more back pain, since the baby's head can press painfully against the spine and tailbone, says Laura Riley, M.D., medical director of labor and delivery at Massachusetts General Hospital in Boston.

Pain is concentrated in your lower back because the back of the baby's head is pressing against your tailbone or spine, says Dr. Riley. Some women who have experienced back contractions say they're excruciatingly painful, while others find that the pain of back labor isn't worse than ordinary labor (merely different). Women might have back pain instead of or in addition to lower abdominal discomfort.

Back labor pain often gets worse with each contraction, and it might not let up between contractions. Some women also get painful spasms as a back labor sign. According to mom Becky Kleanthous, who experienced back labor herself, "I was writhing around, screaming. It felt like my lower spine was being hit with a sledgehammer, and with every contraction, I could feel my pelvis bearing down, like I was already pushing the baby out."

Back pain is a common symptom of pregnancy; doctors say at least half of pregnant women experience this soreness and cramping. Pregnancy back pain has a few culprits: belly weight gain that affects the center of gravity and the pregnancy hormone relaxin that loosens ligaments. So how can you tell if you're experiencing normal back pain or back labor? Many women can easily tell the difference, since back labor feels much more intense. It also gets worse with contractions leading up to delivery. Call your doctor if you're unsure.

Although back contractions can be painful, there's no special guidelines for heading to the hospital. In fact, if you visit the hospital too early, they might send you back home until labor progresses further. Simply follow your doctor's or midwife's advice regarding the timeline. Oftentimes, they'll admit you when you're having frequent contractions that are getting closer together. You should also contact your doctor if your water breaks, or if you're experiencing other strange symptoms.

Back labor usually lasts longer and may require more pushing than ordinary labor, says Dr. Riley. Most babies in a posterior position will rotate the necessary 180 degrees on their own as labor progresses, especially if the mom's pelvis is not completely relaxed with epidural anesthesia. Sometimes a doctor or midwife will attempt to rotate the baby with her hand.

If the baby stays in a posterior position, they can be delivered if they fit through the birth canal. However, if a posterior baby is angled in such a way that they need a little extra space, and there is not enough room in the birth canal, the doctor may recommend a cesarean delivery. Back labor also increases the risk for prolonged labor, episiotomy, assistance with forceps or vacuum extraction, and the need to induce labor.

If you have back labor signs, it's recommended to change positions, because lying on your back can substantially exacerbate back contractions during labor. Try kneeling on all fours, rolling onto your side, or squatting.

The American Pregnancy Association suggests exercises (such as pelvic tilts) to try to reposition the baby. To do a pelvic tilt, get down on your hands and knees and gently rock your pelvis by tucking your bottom in and then releasing it. This tips your baby slightly out of the pelvis and relieves some pressure. It also gives the baby optimal room to rotate.

Your labor coach or doula can apply ice or heat to your low back, massage your low back, or press on it with a tennis ball or other round object. This is called counter-pressure, and it sometimes reduces the pain of back labor.

Pain medications or an epidural will also help. If your birth plan includes an epidural, know that the pain may be relieved once it's administered.

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