I had no idea that my baby's back-to-back position would cause such a slow and painful labor. It turns out, there are several things I could have done differently to make my back labor experience much more bearable.

By Becky Kleanthous
Updated April 09, 2020
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In the early hours of my due date, I was awoken by cramps. "She's right on time," I grinned when my husband's alarm went off at 7 a.m. I was gloating, blissfully ignorant of my pending date with back labor and how dramatically it would slow down our baby's arrival.

That morning, we walked and walked until the contractions were every three minutes and strong enough to double me over. At 3 p.m., we drove to the birthing center where my water birth was planned, and they measured my dilation. I wept when the midwife told me I was at 1cm. I'd been contracting for 12 hours, the gaps between contractions growing ever smaller. 1cm?! I had friends who'd got to 3cm without even noticing.

They sent us home to make progress, and it was during this period that my back began to hurt intensely. Warm baths and acetaminophen didn't help, and by 8 p.m., 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.

I insisted my husband head for the hospital 10 minutes away. The staff couldn't understand my agony. I was 2cm. We were sent home again, and between episodes of excruciating back pain and that worrying pushing feeling, I was panicking. Something wasn't right.

At 11 p.m., we went to hospital number three, as the local place had no beds left. We drove for 35 minutes as I clung to the ceiling of the car like a tortured spider.

I was finally at 3cm, which meant I could be admitted. It was scant relief after a whole day laboring, but at least I could now request an epidural. When the anaesthetist arrived, it was 24 hours since the contractions had begun. He attempted to position the needle in my back, but became frustrated that my contractions—which were close together and long-lasting—were causing my whole body to clench and bear down. Somehow, the epidural went in. My body transformed from a tempestuous ocean to a still lake.

I was able to rest, napping intermittently, but after a few hours, I felt a building pain in my lower back. The sledgehammer effect was no more, but it felt like someone in heavy boots was standing on my tailbone, refusing to move.

Progress was slow, and 43 hours since labor began, I was only at 5cm. I hadn't slept in more than scraps for two nights, and doctors finally decided to do a c-section.

"She was back-to-back," they nodded afterwards, "with her head tilted, so she couldn't angle herself out."

Discovering My Baby Was in the Posterior Position

My daughter's position (sometimes called "sunny side-up," though it didn't feel very sunny to me) is what made my back hurt so horribly. It's also what caused the bearing down during contractions and what had significantly slowed progress.

About 25 percent of women experience severe back pain in labor. The American Pregnancy Association suggests exercises (such as pelvic tilts and hula-hooping) to try to reposition the baby. It's recommended to change positions, because lying on your back can substantially exacerbate back pain during labor.

Logan Van Lessen, a consultant midwife for the U.K.'s Nursing and Midwifery Council, confirms a baby's "posterior position" can in fact cause back labor and can make for a "longer labor." Adopt the "all fours position where possible," adds Logan, supporting the APA's advice to stay off your back. And finally, "consider pain relief."

If only I'd known all this before I gave birth in 2013. My experience could have felt so different if I'd been better informed. An examination or scan could have identified my baby's position before delivery, which would have given me a chance to try exercises to turn her around. And I'd have stayed off my back during labor.

Mostly, though, if I'd known about back labor, I'd have been less afraid. Instead of feeling frightened that something was dangerously wrong, I could have focused on the grueling task at hand with positivity and hope. I'd have known that she and I were quite safe, but simply having to work extra hard to meet one another.

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