Choices in Childbirth

COMFORT MEASURES FOR BACK PAIN RELIEF IN LABOR

by Victoria Macioce-Stumpf

 

Labor with the baby in an occiput-posterior position--the back of the baby's head presses into the mom's lower spine--may cause back pain and is usually referred to as "back labor".

 

Back labor is characterized by back pain both during and between contractions. Back labor can be very painful and tiring because it may take a long time for the baby to turn to the proper anterior position and the unrelenting pressure and pain can be frustrating. However, even when the baby is in the anterior position, the laboring woman may feel back pain from the pressure of the baby's descent through her pelvis. Hands-on help from your partner or doula can be especially useful in this situation.

 

Try any of the following techniques for coping with back labor or back pain:

 

CHANGE POSITIONS FREQUENTLY--Try walking, climbing stairs, resting on your hands and knees, knees/chest positioning, kneeling or sitting while leaning forward with support or laying on your side. Any position that takes the weight off of your lower back can be very helpful if you are experiencing back pain during contractions.

 

KEEP YOUR BLADDER AS EMPTY AS POSSIBLE.  Regardless of what comfort measures you are utilizing for back pain relief, your bladder must be emptied frequently.  Try and go to the bathroom at least 1-2 times per hour, if possible.  A full or even slightly-full bladder can be felt as back pain during contractions.

 

PELVIC ROCKING---Try rocking your pelvis while standing, in an all-fours position (the "angry cat" posture), or while lying on your side in bed.  In a side-lying position, your partner can rock  your pelvis for you as you relax.

   

                                                        

 

 

          

PICTURE: Hands and knees pelvic rocking  (“angry cat” posture)

 

 

 

 

STAND OR SIT IN THE SHOWER WHILE YOUR PARTNER OR DOULA DIRECTS HOT WATER ON YOUR LOWER BACK.  You can also sit on a birth ball in the shower.

 

RELAX IN A TUB OR JACUZZI IF ONE IS AVAILABLE.  The water may be warm but definitely not hot...the usual pregnancy guidelines still apply.

 

YOUR PARTNER OR DOULA CAN ALTERNATE HOT AND COLD PACKS ON YOUR LOWER BACK--hot packs may be made out of socks filled with rice or flax seeds, heated in the microwave and rolled or pressed on the lower back.  Make sure to cover your hot pack with a pillowcase or towel so that your skin doesn't get hurt or damaged.  An insulated ice bag may be filled with hot water and used as a source of heat as well...it has a very flexible shape that conforms to your body without pressure.  If you are using heat, make certain your birth partner or doula cools your back off in between contractions with a cool or cold washcloth to avoid over-heating your skin.

 

Regardless of whether you prefer heat or cold for pain relief on your lower back, make certain you cover your heat or ice pack with a pillowcase or towel so that you protect your skin.

 

TRY SITTING ON A BIRTH BALL (A 65 cm. PHYSICAL THERAPY BALL)--the ball provides  flexible yet strong support for your back when you are carefully seated upon it. The ball can provide tremendous back pain relief by sitting upon it, rocking gently from side to side, or gently rocking your pelvis. You may also lean your upper body over it--while in a hands and knees position--to utilize a good position for back pain relief without carrying all of your weight on your wrists.

 

YOUR PARTNER OR DOULA MAY APPLY COUNTERPRESSURE ON YOUR LOWER BACK with a firm hand, rice sock or massage tool during contractions.

 

 

YOUR PARTNER OR DOULA MAY PROVIDE FIRM COUNTERPRESSURE WITH A REBOZO SHAWL OR A BED SHEET  ON YOUR LOWER BACK during contractions.

 

UTILIZE MASSAGE TECHNIQUES-- Your partner or doula may use long, sweeping massage motions on your lower back during contractions. Give feedback for positioning and strength of the hands during massage.  Always use massage lotion or oil to increase comfort and decrease friction. 

 

TRY BACK PAIN COMFORT TECHNIQUES LIKE THE "DOUBLE HIP SQUEEZE", "STANDING/KNEELING LUNGE", "KNEE PRESS", "ABDOMINAL LIFT" OR UTILIZE THE "DANGLE" OR "ASYMMETRICAL SITTING/KNEELING/STANDING POSITION" as described in the book "The Labor Progress Handbook--Early Interventions to Prevent and Treat Dystocia" by Penny Simkin and Ruth Ancheta).

 

 

 

 

© Copyright, 2016, Victoria Macioce-Stumpf.  

Permission granted to freely reproduce with attribution.