Back Labor and How to Identify It

Symptoms and Causes of Back Pain in Labor

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Identifying Back Labor - Sarah M Stewart
Identifying Back Labor - Sarah M Stewart
Back labor can result in more pain and longer labors. In some cases, it might mean that the baby needs to rotate to face the mother's back.

Mothers who have experienced back labor generally use expressions like "horrible" or "no break" from the pain when thinking back to the memory of their birth. Back labor is often the kind of labor that no one wants, not only due to the increased pain in the mother's back, but because it can cause labor to be long and grueling.

In many cases, the back labor is caused by the position of the baby's head on the mother's back. However, in some cases, the mother can feel back pain when her baby's position is actually favorable, known as anterior. In other cases, the baby may be positioned "sunny side up", which is known as posterior, yet the mother does not experience back pain. What do we know about back labor?

What is Back Labor?

Back labor is a type of labor in which the mother feels most if not all of her contraction pain in her lower back. Often the back pain not only occurs during the labor contractions, but also in between contractions so that the mother often feel continuous pain in her back throughout labor.

What Causes Back Labor?

The size of the baby can cause the mother to feel discomfort in her back. If the labor progresses and the baby's head moves down, even a baby in an anterior position can cause back pain. It is likely however that the biggest cause of back labor comes from the baby being in a posterior position, where the back of the baby's head is toward the mother's back. This position forces the heaviest part of the baby's head to rest more heavily on the mother's lower back.

The exact medical term for a baby in this position is called occiput posterior since the occiputal bone in the back of the baby's skull aligns itself with the posterior section of the mother's pelvis. A baby who has rotated around to face the mother's back (which is typically a much more favorable position) is said to be in the occiput anterior position.

What are Other Symptoms of Back Labor?

In addition to back pain, mothers who experience back labor (especially when related to a baby in the occuput posterior position) often have the following signs and symptoms that occur with back labor:

  • Slow progress of labor - it is not unusual to have slow progress or even a long break in progress during labor with back labor.
  • Going into labor after your due date - it is not uncommon to be "late" with a posterior baby.
  • No contractions after your water breaks - sometimes posterior babies/back labor causes your labor to start with water breaking but labor contractions do not begin on their own for quite awhile.
  • Irregular labor contraction pattern - another symptom of a posterior baby/back labor is a contraction pattern that is not regular, for example labor contractions that "couple" with two together and longer spaces between them.
  • Longer time pushing - it is not unusual for a posterior baby to take longer to push out since the diameter of the baby's head in the posterior position is larger as it descends.

Keep in mind that you may not have any of these symptoms if your baby is posterior. Every woman's body acts differently. For example, there is no reason to assume that you will definitely have a longer labor just because your baby is posterior.

What are Ways to Prevent Back Labor?

While there are no guarantees to prevent back labor or a posterior baby with every mother, there are some ways to learn about your baby's position during pregnancy as well as techniques to rotate a posterior baby to anterior even before labor starts.

For more information, check out Ways to Prevent Back Labor.

Brenda Lane Feature Writer , Chris Lane

Brenda Lane - Brenda Lane is a published author, Lamaze certified childbirth educator, DONA certified birth doula and approved birth doula trainer.

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37 Comments

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Feb 5, 2009 2:50 AM
Guest :
i had my little girl, 3 months ago now, and had not one contraction in my stomach so i wasnnt quite sure if i was in labour, the pain in my pain was continuous, there was nothing i could do to ease the pain! my labour was 17hours and worse thann i cud imagine, even though my baby was facing the right way, so why did i have back labour, the thought of having this with my second baby terrifies me!
Feb 13, 2009 6:39 PM
Guest :
I can relate to what you are saying, the continous back pain exhausted me and in the end it was not a positive experience for me. She was anterior too, like you. From what I have read, women can have very different experiences with each baby. I would hate to think my next labour being like the first, but second babys are nearly always easier to give birth to people say.
Feb 19, 2009 6:43 PM
Guest :
I gave birth to my son in December of 1997. When the labor pains started they were in my back - and never stopped. I had one great bit giant 18 hour contraction. Two epidurals weren't even effective. After delivery we came to discover that my pelvis had totally separated. The ligaments had shredded out of the right pelvic bone and the SI joints had separated. The distance of separation in the pubic symthesis was almost 4 sonimeters. Two major surgeries and 11 1/2 years later I still live with unbearable chronic pain,and an unstable, disconnected pelvis. Has there ever been anything else like this? No one has ever been able to explain or identify what happened? My son was sunny side up.
Feb 28, 2009 10:20 AM
Guest :
I got delivered to baby girl on Dec 7th 2008 through back labour.I didnt had contractions, so I was not sure i was in labour I had terrible pain with 15 min gap in back and pelvic area for the first 2 nights and continuous pain in the 3rd night that is not tolerable at last I went to hospital , they said am fully dillated and the labour took 3 hrs and I had back labour.whenever i remember my labour ,back pain am afraid to think of my second baby.
Feb 28, 2009 10:11 PM
Guest :
i had only back pain labour, no belly pain,, and discovered the benefits of "water injectons". They are just sterile water injected into the skin in your back,, very painful, like a wasp sting,, but geezzz what relief. I couldnt have gone any longer without drugs and its such a relief knowing i only had to do it with water injections! I know for sure next time if it happens, ill have water injections a lot sooner!
Mar 10, 2009 5:27 PM
Guest :
I've had 3 babies and am pregnant with my 4th. All three labors were entirely in my back (I've never felt a uterine contraction). I'm still trying to discover the reason for it and haven't found anything useful on the web yet. All my babies were early and small and in the correct birthing position. I'd be curious to hear if anyone knows anymore about what causes it?
Mar 14, 2009 6:34 AM
Guest :
I was in labor for 20 hours with contractions in my stomach and had the epidural. Unfortunatly it didn't work and when it came time to push, i started feeling this pain in my back that was so unbearable that it felt like an elephant was pushing on my lower back. I thought that i was going to break my back. I pushed for 2 hours, until the dr realised that my baby's head was side ways and that's why I was having a hard time. They ended up using forceps to deliver her. All I have to say is that the epidural didn't even work during the pushing. I felt EVERYTHING. Even the forceps...
Mar 17, 2009 9:38 AM
Guest :
Hi everyone, I will be 38 weeks in one more day and the other night I was having contractions in my back I tried everything to realive it because I didnt know that could happen, but when I went to the hospital they sent me home because the contractions didnt have a pattern and they wasnt dilating me now today my back is still hurting so bad I cant get any rest at night. I am so tired and miserbale, did any of you experience anything like this? Am i going to have back labor?
Mar 18, 2009 4:41 PM
Guest :
I had a membrane sweep 5 days ago, i am now 40+4 days. The past 3 days i have had back labour. All the contractions are in my lower back and my hubby has to hold my hand while i try and gasp for breath as the pain is agony. I dont know if im in labour, or whats happening. The contractions are so irregular, coming ever 20 mins, then maybe have 2 whoppers ones in the space of 10 mins. Had a false alarm 4 nights ago and ended up in hospital.They told me i wasnt in labour, but i was almost 2cm dilated and sent me home with painkillers (which arent helping at all). So now i dont know if im in labour or what. Dont want to go to the hospital again to be sent home. How will i know when im in labour? So frustrating!!
Mar 24, 2009 5:07 PM
Guest :
I am 36 weeks pregnant with my first and started having lower back pain yesterday. I went to the hospital last night and I was sent home at only one centimeter dilated. I'm hoping this will be over soon so the back pain will go away. Could anyone tell me possibly how much longer I will have to go with this disturbing pain?
May 21, 2009 7:06 PM
Guest :
My last baby was born sunny-side up a couple of years ago, and it was hellishly painful, but what made it worse is how the hospital handled it. I had just about every symptom listed above, but the doctors weren't sure how to handle themselves. They refused to let me stay in the hot shower that helped so well to reduce the back pain, they forced me to lie down for both monitoring and delivery, etc. I have since learned (from midwives, doulas, and other natural birthing coaches) that the best two strategies to handle back labor (other than "spinning" before labor or early on) are to A) stay in water--shower or bath--as long as possible, and B) try to deliver on hands and knees, or at least relatively upright, especially if the baby is big (mine was over 9 pounds). Pain meds can make these options impossible, but I think I actually would have been in less pain for less time if the hospital staff had cooperated when I had listened to how my body was reacted and made these requests. It was their lack of support that actually resulted in me finally requesting an epidural at 9 1/2 centimeters. I hope to deliver in a hospital with more midwives and with a doula this time around! I hope other people will read this and benefit.
Jun 20, 2009 10:53 PM
Guest :
i am 36 weeks and 6 days and i am known for fast and arly labor with no contractions. i am not haveing contractions right now but my back hurts so bad that i can barley stand up and walk could this bee back labor oh yeah i am also dialated 1 centmeter and half as of last tuseday.
Jun 28, 2009 8:45 PM
Guest :
I've had two children, one weighing 8lbs.1oz., the second was 8 lbs.12 oz. With both girls, I had extreme back labour and never felt a "contraction". I was told when to push. The pain never let up until the babies were born. Luckily, mby first child's labour was 5 hours and the second was only 2 hours, of which one hour I spent pushing. I was told they were both facing the "wrong" way which is why I had the back labour. The pain was excruciating, and neither prenatal classes or my doctor ever mentioned anything about "back labour" before my first child was born.
Aug 26, 2009 4:26 PM
Guest :
I had back labor with my first child. I'm not sure why because I was not told that she was in an incorrect position or anything like that. My labor was only three hours from start to finish. I am now pregnant with my fifth child. Each labor keeps getting shorter so I am down to about 45 minutes on average start to finish now! But I mainly wanted to tell those of you that are concerned about having a second child because you had back labor, do not be scared. I have had all mine without any pain reliever or epidural or anything and I'm happy to report that I have never had back labor since the first. So, just because you've had it once doesn't mean it will happen again. I definitely would say that the back labor was the most painful out of all my labors, but that could have also been a combination of it being the first child plus the back labor on top of that.
Sep 9, 2009 8:07 AM
Guest :
i'm having back labor since friday so 5 days now they are 3 minutes apart but im not dialated! it hurts sooooo bad!
Oct 9, 2009 11:34 AM
Guest :
I had back Labour with my now 4 year old son. I was 35 weeks pregnant and from 6am one morning started with severe lower back pain but no other symptoms, it got to 11pm that night and I couldn't take the pain anymore so went to the hospital and was told I was 5cm dialated, I gave birth to my son at 6am. I had a 24 hour labour. I didn't have a single stomach pain and had very few, and irregular contractions. The back labour was much worse then the "normal" labour I had with my first son.
I am 27 weeks pregnant now and just preying this labour isn't going to be like the last!
Oct 15, 2009 10:48 AM
Guest :
i was in back labor for 3 days had no contractions in my stomach but when i was fully dilated it only took 30 min to have her
Dec 26, 2009 4:45 PM
Guest :
I had back labor with all four of my children. I could not tell you what a contraction feels like as I have never had one. All four babies were text book deliveries with no complications, each child was a different birth weight, and all were in different positions. I have always dealt with slight lower back pain before and after my first child. However, after children the pain increased gradually over time...I thought it was due to having 4 children and the chores, and lugging around them as well as all of the stuff that goes with them. I was told years later by a Chiropractor (whom I visited as a last resort when the pain became unbearable) that I have an extra vertebrate in my lower back that feels squished in there. He also said that the back labor I experienced with all of my children was due to this extra vertabrate. Has anyone else ever heard of or experienced this?
Mar 13, 2010 12:38 PM
Guest :
I gave birth to my son on the 2nd of jan 2009. He was back to back with me and unaware that my waters had already broken i started to have contactions in my stomach which then carried in to my back. As i was dilatating far to slowly i was given morphine to allow me to sleep on the first day!! As they decided it was time to break my waters 4 hours before my son was born and realised that they had already broken!! My labour lasted 50 hours and the best way i can describe this was excruciating. I would love to have another child but im terrified of labour now. Should i have been left for this amount of time?? Afte my son was born he was taken away n given anti biotics to fight of any ifnections he could have picked up as they had no idea how long my waters had been broken!! To top it all of he did the toilet while inside which shows a baby is in distress!! The whole ordeal was terrifying.
Mar 22, 2010 1:39 AM
Guest :
I had a similar experience to guest above. I had a back labour, baby in posterior. Labour laster 46 hours. Contractions got worse and worse in my back until it felt like my back was going to break. Pain was indescribable. Hospital ran out of beds, so was back and forth to hospital screaming in car! On all fours and hysterical with pain. Was eventually given dimorphine but the pain still came through. It's the sort of pain where you have no place to go mentally, you're at a point of desperation but can do nothing. Anyway, water broke late in established labour which eventually stopped the back pain and the pushing seemed very easy with baby arriving 3 short hours after waters breaking. I was falling asleep during pushing contractions with exhaustion! However, a beautiful little girl arrived - I can't complain, but, I don't think I could bear labour again. I'm terrified and traumetised of it happening again.
Mar 26, 2010 7:52 AM
Guest :
How does one know when to go to the hospital with back labor if they can't time uterine contractions? I'm almost 41 weeks along and for the past 2 or 3 nights I've had extreme lower back pains along with low cramping. But then by morning it's pretty much gone. Although, today my back is still in pain. I probably shouldn't read these horror stories of back labor.
Apr 3, 2010 11:17 AM
Guest :
I am 40 weeks and 4 days pregnant and think i am having back labor...it has been a day and a half, with last night being the worst pain until about 10 o'clock, when i went to lay down and fell asleep for 9 hours- no pain while sleeping. This morning after getting up the pain is worsening as i move around, sitting doesn't help it feel better either. Rocking on my yoga ball does help for a short time, but not for long. I also had trouble timing contractions last night, as they never ended, just changed from one kind of pain to another! OUCH!
Apr 11, 2010 12:37 AM
Guest :
For the ladies that are questioning if they had/are having back labor. If you have to ask, then the answer is no, your not having back labor, you would know if you were and would have no doubt in your mind...back labor with a posterior/sunny side up babe is one word......... brutal!!!
Apr 12, 2010 11:57 AM
Guest :
not entirely true. Im 39 weeks with my first and I have had severe back pain my entire life and now that it is worse, I'd have to say I wouldnt know for sure if I was or was not having back labor. All I know is that I have uterine contractions that do not hurt but I feel the tightening and then its all in my back.
Nov 26, 2010 12:37 AM
Guest :
I am 28 1/2 weeks pregant..my ob feels i will go before i am 32 weeks pregant..3 weeks ago my cervix measures 2.4 cm and i was dilated 1cm at 70%...for the last 24 hours I have had bad lower back pain it sometimes is in my legs as well but mostly stays in my lower back,it's constent but at times its so bad i want to cry then goes back to just hurting..i cant sleep its worse when i lay on my back or right side...can anyone help
Nov 28, 2010 3:10 PM
Guest :
I'm 38 weeks pregnant and can't even tell if I'm in labor or not because the pain. It occurs mainly in my back and a little bit in my lower abdomine. Occasionally, I can feel my stomach tighten, but not all the time. Last I knew I was 1 1/2 cm dilated, but that was over a week ago. So, I'm still trying to figure out if this is labor or just pain.
Jan 4, 2011 10:09 AM
Guest :
well write know i am having really bad pain in my lower back no where else an a little crampin in the front i feel constapated but when i go to the bath room i dont have to take number 2 an i only urin a little an i get preashure an fell more pain in my back an i dont no if i an going into labor but i am nervouse .........
Jan 9, 2011 5:56 AM
Guest :
I had back labor with my son and it was awful. The pain was so bad that even with meds and epidural I was vomiting on and off the entire time I was in labor (24 hours). Then when it came time to push I was exhausted. I pushed for an hour before delivering my son. Also my water broke but only a little came out so I wasn't even sure it had. If I hadn't asked the nurse to check they probably would have sent me home even though I was clearly sick from the pain. The cotractions had started to slow but the back pain was constant.
Jan 18, 2011 8:21 PM
Guest :
I began my back labor pains at 1am. I felt a pop sort of below my rib cage and then the pains began but water did not come out except when I took a bath the next day. Because I was taking a bath, it was not obvious when water came out. Pains were similar to kidney stone pains, (breath-taking, sharp, body racking) but worsened and continued, irregularly for 22 hours. At 11pm the next night, I went in to the hospital. They put a device on my lower abdomen to measure contractions. Several doctors and nurses came in to rearrange the device and to switch out to different ones. I was spotting fresh blood. Their device measured no uterine contractions. They convinced my mother that I was not in labor and my mother actually asked me if I could be making up the pain in my head. They took urine and because there was blood in my urine, asked me if I had a low tolerance for pain and told me I was having a urinary tract infection. This seemed so ridiculous to me I thought I was going insane. I told them that I had experienced recurrent UTI's and NEVER had pain like that. I told them about all my symptoms, including believing my water had broken, but they told me that it was just urine seeping out. I was in so much pain that my whole body was shaking violently. Because I was not having uterine contractions, they could not believe I was having a baby... I was @ 2 weeks early, first baby. They then proceeded to catheterize me for urine. (Surprise! No blood in urine! only in vagina!) But, since their machine measured no uterine contractions, I couldn't possibly be having a baby! They gave me some drug to help the pain, but it only made me drowsy... did not stop the pain or lessen it much at all. It lasted an hour or two and wore off. Finally, the nurse checked me and felt the baby's hair. She was shocked and asked me when my water broke... it had been 30 hours since it broke. The pain was always in my back, such that when they came, I lifted myself off of the bed and my body was shaking so much the nurse kept putting a blanket on me which I immediately threw off. I think I began to beg and curse the staff at this point. They gave me something to speed the dilation and gave me the epidural and within a few minutes it was very easy. The pain was like 95% relieved. The uterine contractions came, I had little difficulty pushing- it was 3 hours of pushing max. So... 36 hours from the time of the water breaking and first back pains. They were -never- regular, and I never had uterine cramping or contractions until the very end after the epidural... and those were like nothing to me, especially with the epidural. And the epidural -did not- affect my ability to push, except that it made it possible for me to push because I honestly think after all that I would not have been able to do it without the epidural. My son weighed 7.5 lbs, and I do not know how he came out. My husband was there the whole time, but I needed more support... like a dula or midwife or -something-. It was horrible. Why were they so ignorant?
Feb 16, 2011 4:56 PM
Guest :
I was having horrible back labor with my son and after trying a hot bath, birth ball, getting on all 4s, counter pressure and everything else I was taught, I decided to have the epidural. Because I had been in so much pain, I couldnt relax enough to dialate. Once I got the epidural I went from 3 cm to 10 cm in about 30 mins (if that) and after about an hour of pushing, LO was born.
Feb 21, 2011 6:17 PM
Guest :
I had back to back labour with my daughter and I seriously thought I was gonna die. It was my first (and last) delivery. I remember hubby rushing me to hospital b/c I was in that much pain I thought I was well on my way to deliver in the next hr. When we got there I just barely made it to 2cm. Omg! That was devastating to find out knowing that I had another 8 cm of dilation to go through. I might as well have a steel drill shoved into my lower back slowly. Nitrous Oxide and Pethidine didn't do jack! The mid wife checked my baby's positioning and said she was facing upwards towards my belly and her skull and back was pressed against my pelvis. I was in very painful labour for 14 hrs and finally had an epidural to ease it for the next 2 hrs. When it wore off the pain came back and soon it was time to push. Push with the contraction?? What contraction?! I was in constant pain again that the mid wife had to feel the contraction for me, on the top of my belly. Thank god it was over in a matter of 5 minutes. I don't ever want to go through that again. Time to look for a surrogate!
Mar 25, 2011 6:03 PM
Guest :
I had my first child 28 years ago. I had terrible back pain, 24 hours of labor and no desire to push. He was born on the due date. 19 months later I had my second child a week early only 2 hours of labor and definitely the desire to push. Our final child was born 20 years ago and she had to be induced because she was 10 days late and I told the nurse I was going to push now. She said wait the doctor's not here yet. I said I don't care, I'm pushing. In my case none of my pregnancies or deliveries were the same. Now, I'm going to have my first grandchild in August and my daughter in law is asking questions about that first delivery. I know she'll do fine and I'm extremely excited to have another baby in the family.
Apr 12, 2011 4:59 AM
Guest :
There are aspects of this article that is very true! I had 4 days of back labor and it has put me off having kids again my fear of birth is minimal but my labor was just as the add mentioned HORRIBLE!!!! I tried rocking, bending, to top it off I was very late and also had a minor infection which made my labor even worse! The pain suffered was unbearable and I hope no lady has to deal with what I did!
Jun 9, 2011 10:05 PM
Guest :
This article is right on, I had back labor with my daughter 15 months ago and it was HORRIBLE!! I was in constant pain for 30 hours. My contractions started in my back and went down my thighs. I didn't feel one uterine contraction. Many times I had back to back contractions and even when I wasn't having a contraction it was constant pain. After laboring at home for 20 hours I finally went to the hospital not because my contractions were getting closer together (still 4-5 min apart) but because my doula wanted to make sure the baby wasn't under too much stress since I was in so much pain. When I got to the hospital I was only 4cm dilated, I wanted to cry. It took 10 more hours before I was dilated to 10 and then I pushed for 2 hours. My birth plan was to go all natural and I did! But honestly I can't believe I made it through. It was through the help of my doula and the hospital staff that were amazing! The pain felt like someone was hitting me with a hammer non stop. The next day my back was so swollen from all the counter pressure my husband and doula were giving. My husband even said he was so sore from how hard he was pushing, he thought he was going to break my back because i kept telling him to push harder. I just pray with my next baby I don't have to go through that again.
Jun 15, 2011 6:42 AM
Guest :
i went to the ER on Nov. 4th 2007 around 8pm.. i wasn't hurting just felt little pressure in my lower stomach area. they checked me out admitted me. the nurses hooked me up to a vital machine and it showed i was in full blown labor.. I felt no contractions, no pain any where.. i didn't know i was even in labor when i went to the ER. i only had a little touch of pressure on my back as though i was walking all day.. i only dilated 1 cm though the whole pregnancy.. the nurses kept coming in asking me if i needed anything for pain..i kept saying no i don't feel anything at all..so finally around 4pm the next day my ob-gyn said we had to have a c-section done.. i said ok. they did the epidural i didnt even feel that pain either.. so after the c-section was done..within a few hours i was up walking around.. so not everyone can have a baby natural like i wanted to or feels the pain of birth..i guess i was one of the lucky ones...my son weighted 7 lbs 9oz..healthy boy.
Jan 30, 2012 2:02 PM
Guest :
im 28 weeks and i lost my mucus plug yesterday... has this happened to anyone this early? today i am having horrible back pain that wont stop or release and im not sure if it might be the start of labor.
Feb 3, 2012 4:20 PM
Guest :
i was getting back pain for 3 days no contractions in my belly all in my back and the pain was getting stronger so the point i wainted to die i could not take it no more went to the hospital after 40 houe of agony put me on the monitors and said i was not in labour and i said i have had 6 children b4 i am even though the pain was in my back took the monitors of me and i deliverd my son still in the water bag on a toilet in the hospital it was the worst thing ever and i am now 10 weeks pregnant again and i really cant do that again
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