Back labor is a term that describes that unique challenges and discomfort that can occur if your baby is malpositioned, with the back of their head facing your backside, during the course of labor. While this position is a normal/common variation of labor, it can cause additional challenges like heightened pain and/or longer labors. Or it may pose no additional challenges at all! Getting through a challenging back labor is better when you have good support. Here are some key tips for supporting someone during back labor.
Learn the ins-and-outs of labor support by taking a good childbirth class. A quality childbirth class teaches you all about finding comfort and coping in labor through many different scenarios, including back labor. You’ll learn the specifics of different positions that provide back labor relief and help progress labor, as well as practice hands-on techniques, like massage and counterpressure, that provide acute relief to the low back.
Lead and support with authority and compassion. When supporting someone who’s experiencing a challenging labor, it helps to be able to “take charge” by leading the person in labor with confidence as well as compassion. By doing this, you provide an “anchor” — a safe space and guiding presence, which helps the laboring person feel more calm and grounded.
Encourage position changes. Position changes during any labor are helpful for finding comfort as well as to help keep labor moving forward. During back labor, certain positions provide more comfort than others. The best positions for back labor are those that take the pressure off of the lower back as much as possible. This includes standing, leaning over, sitting backward on a chair, down on all fours, open knee-chest position, and side lunges. (See this post for more details on these and other positions.)
Provide hands-on support. Providing direct, hands-on relief in back labor is not only helpful, but essential for comfort. Things like massage, using a double hip squeeze and/or counterpressure, applying ice or heat, and getting into water (tub or shower) can all help relieve pain. Try different techniques throughout labor — what works for a span of time may eventually cease to be helpful and you’ll need to try something different.
Medicinal pain relief is a valid and effective option. Back labor can be intense and long lasting. Sometimes, despite all efforts, non-medicinal comfort measures may not provide enough relief and a person’s pain/discomfort can turn to suffering. Things like an epidural and IV analgesics can help a person find significant relief, rest, and allow the body to find the relaxation that’s needed to let labor progress as needed.