We all know labour can be gruelling, but what if you have excruciating back pain at the same time? This was Wendy Burch Jones’s experience with her first pregnancy. “I had a birth plan worked out from my first trimester—I was going to use a yoga ball and breathe my way through the contractions. Ha! Needless to say, my plan didn’t work out so well.”
Burch Jones’s son was in the posterior position, meaning the baby was facing toward the stomach instead of the spine, which is the most common cause of back labour. “As the uterus contracts and squeezes, the baby’s back and spine can press against mom’s spine,” says Laurie Hintzen, a midwife at Diversity Midwives in Scarborough, Ont. The pain can come and go as the baby rotates and descends down the birth canal, causing extreme discomfort in the lower back that is the most intense during contractions but often felt between contractions as well. Estimates say back labour affects about a quarter of women giving birth.
Besides soreness and cramping in the lower back, some women can also have pain that radiates to the buttocks and even down the legs. What’s more, this labour can last longer than usual, as progress is stalled due to the baby’s more difficult angle.
Burch Jones says she was in severe pain for eight hours before she discussed interventions with her midwife. She hadn’t wanted to have an epidural, but the pain was relentless. The first epidural didn’t take; the second one didn’t numb her completely. “It was like taking Aspirin for a migraine,” she says. “It took the pain from a 10 to a six or seven. It took the edge off, but I still felt it all down my legs.”
While there’s no way to know in advance whether a woman will experience back labour, a midwife or obstetrician will usually check the baby’s position at every appointment, says Hintzen. If they notice an unfavourable position, they may suggest exercises such as pelvic tilts to rotate the baby, but nothing can guarantee the baby will turn around.
During back labour, there are several things you can try minimize pain.
Don’t lie on your back “Get on your hands and knees or on one side or the other,” suggests Hintzen. “This can help the baby rotate and also relieves pressure on your lower back.”
Switch positions Go through five contractions lying on one side, five on your hands and knees and then five on the other side. “I call this ‘the pancake.’ This can also encourage the baby to move,” says Hintzen.
Have your back massaged Ask your support person to massage your back or roll a tennis ball around your lower back to provide some relief with counterpressure. Doulas sometimes carry wooden rollers they run along a labouring woman’s back.
Hug your hips Between contractions, get on all fours and ask your support person to place their hands on your hips and push inwards, which can alleviate pressure in your lower back, says Hintzen.
Soothe with heat Take a warm shower or bath to soothe your body and help decrease the pain. You could also put a warm compress or water bottle on your lower back.
Keep moving Walk through the contractions, or sit on an exercise ball and do hip rotations or pelvic tilts, which can allow space for the pelvis to expand.
Drink up Your body needs proper hydration to help it endure labour and to help your muscles work effectively. Don’t forget: Your uterus is a giant muscle contracting and squeezing during labour.
Water injections Some midwives use a technique called sterile water injection, in which they inject a bit of water under the skin of the sacrum in the lower back. “This blocks the pain sensation somewhat. It stings when it goes in, but it can give the woman a couple of hours’ relief,” says Hintzen.
Consider an epidural “If you’re fighting your body, you won’t labour properly,” says Hintzen, especially if the pain is unbearable. “If you are coping, you can soldier on, but a woman can’t be that stressed in labour for that long. The epidural relaxes the body, and you often see this play out in the baby’s heart rate.”
Looking back, Burch Jones admits she was hard on herself for “caving” by taking pain medication. “My midwife explained that after labour like mine, some women are so exhausted they can’t push and end up having a C-section... An epidural seemed less invasive than surgery,” she says.
“After Mason was born, I felt guilty. I was baffled women were able to do it 100 percent naturally.” But two years later, with the birth of her second son, Zach, Burch Jones had something to compare it to. “We got to the hospital at 6:45 p.m., and he was born at 7:05. I understood how women could do it without meds. There was no stabbing pain in my spine.”
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