What Is Back Labor?

Back labor is a common occurrence. As many as one in four pregnant people reportedly experience intense back pain during the birthing process.

Back labor is a term that describes the discomfort that a person in labor experiences in the region of the lower back. The pain of back labor typically is felt in the lower back, but it may also occur in the hips, and it sometimes radiates (spreads) to the thigh area.

Usually, a person in labor will feel pain from contractions in the abdomen and pelvis. But, according to a 2018 study, 33% of participants felt continuous and severe pain in the lower back during labor.

back labor

filadendron / Getty Images

Is It Back Pain or Back Labor?

Most laboring people will experience some type of discomfort in their back during the labor and delivery process. This pain may be mild and may exhibit itself as soreness or slight cramps. But, in some people—those in back labor—the pain is very intense, occurring during the contractions of active labor and also present between contractions. 

Causes of Back Labor

Causes of back labor may include:

  • Being short-waisted: This may create an angle that forces the baby’s head into the pelvis, which results in the head pressing on the sacrum, a triangular bone in the lower back between the hip bones.
  • Having an exaggerated swayback: This can create an angle that may put more pressure on the pregnant person’s lower back.
  • Maternal spinal abnormalities: Such as scoliosis (a condition involving a sideways curvature of the spine).
  • Unknown causes: The elements at play in back labor may be the same as those that cause back pain with menstrual cramps.

Types of Back Labor

Back labor can refer to several scenarios during labor, including back pain that is:

  • Experienced mostly during a contraction
  • Felt during and between contractions
  • Experienced during parts of labor but not throughout labor

Symptoms of Back Labor

Some of the back pain a person feels at full term may not be related to back labor. Rather, it could be the result of general aches and pains, which commonly occur from excess weight of the pregnancy straining the back muscles.

 Back labor usually involves symptoms such as:

  • Intense pain and muscle soreness that may or may not subside between regular contractions
  • Lower back pain that feels like painful spasms and may worsen with each subsequent contraction
  • A continuous, severe pain in the lower back that worsens at the peak of a contraction
  • Intense pain located in the lumbosacral region, which encompasses the lumbar (lower back) and the sacrum

When to Call a Healthcare Provider

In general, you should contact your healthcare provider anytime you notice new symptoms during your pregnancy. Experiencing back pain for hours at full term can be an indication that labor is about to begin.

Here are signs that labor may have started and indications that your healthcare provider should be notified:

  • Regular, painful contractions occurring at least every five minutes and lasting for at least one minute
  • Sudden onset of diarrhea
  • Bloody show (blood-tinged mucus coming from the vagina)
  • Water breaking (or ruptured membranes, when the amniotic sac releases some of the fluid surrounding the baby)

Note, if you are having regular, painful contractions, accompanied by back pain, you will likely have back labor.

Complications of Back Labor

Having back labor is not known to cause any serious complications for the baby or the pregnant person, but there are some risks. This is due to the position of the baby.

The most advantageous way for the baby’s head to be positioned during labor is with the head down and the baby facing the mother’s back. When the baby’s head is down but the baby is facing the mother’s abdomen (the occiput posterior, or OP, position), back labor pain may result. This position can increase the risk of:

  • The need for pain medication or other pain management interventions
  • Requiring a cesarean delivery (or C-section, an incision in the mother's abdomen to remove the baby)
  • Needing an assisted vaginal delivery (such as a forceps delivery or vacuum-assisted birth)
  • The need for an episiotomy (a small incision at the vaginal opening that helps with a difficult delivery)
  • Perineal tears (tears between the vagina and the anus)
  • Postpartum hemorrhage (bleeding after giving birth)

Prevention of Back Labor

Prevention strategies for back labor include:

  • Avoid positions such as semi-reclining with your knees up (higher than the hips).
  • When sitting for long periods (such as when driving or at work) take frequent breaks to walk and move around.
  • Don’t cross your legs when sitting.
  • Use an ergonomic back chair if you need to sit for long periods.
  • Lean over chair backs, counters, or other objects when standing (this encourages the baby to be positioned at the correct angle).
  • During the last month of your pregnancy, practice doing pelvic tilt movements on the floor. You can find instructions on exercises to do during pregnancy (including pelvic rocking) online.
  • Sleep on your side with a pillow or other means of support behind your back, top leg resting forward (the knee of the top leg should touch the mattress). You may wish to try putting an extra pillow between your thighs for comfort, as well.
  • Swim laps by performing simple movements, like the crawl or breaststroke. The motion from swimming may help the baby move into the proper position. The buoyancy of being in water may also take weight off your muscles and back and help reduce swelling in the limbs.

Treatment

A spinal block (epidural) may be considered for pain control in people with back labor, particularly when the baby is in the OP position. When the baby is not in the optimal birthing position, known as left occiput anterior (LOA), it is more difficult for the baby to descend through the birth canal, causing an increase in the need for pain medication for the pregnant person.

Other medical treatments for back labor include sterile water injections. This can be an alternative to getting drugs for the pain. One study showed that people with severe pain from back labor exhibited lower pain scores approximately 30 minutes after the injection. This may be not commonly available or used.

Frequently Asked Questions

What does back labor feel like?

Back labor feels like very strong pain and pressure in the lower back that worsens as labor progresses. There may be continuous lower back pain that doesn't subside between contractions.

How do you prevent back labor?

There are several preventive measures believed to help prevent back labor such as doing pelvic tilt exercises and bouncing on an exercise ball.

How long can back labor last?

Back labor can last a few hours or throughout the entire labor process.

A Word From Verywell

Back labor is not easy to endure. The best way to prepare yourself for labor and its complications is to arm yourself with information beforehand.

Although it isn't easy to recall remedies while in a painful labor, practicing exercises to improve fetal positioning and learning of ways to ease discomfort in the lower back during pregnancy and while in labor can help you physically and mentally prepare. Ask your doctor if you have questions about ways to prevent back labor and how to get through it if it occurs.

Was this page helpful?
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Birthcenter. Back labor.

  2. Genç Koyucu R, Demirci N, Yumru AE, et al. Effects of intradermal sterile water injections in women with low back pain in labor: a randomized, controlled, clinical trial. Balkan Med J. 2018;35(2):148-154. doi:10.4274/balkanmedj.2016.0879 

  3. American College of Obstetrics and Gynecology. Back pain during pregnancy. Updated October 2020.

  4. Tzeng Y-L, Su T-J. Low back pain during labor and related factors. Journal of Nursing Research. 2008;16(3):231-240. doi:10.1097/01.jnr.0000387310.27117.6d 

  5. Cleveland Clinic. Labor and delivery. Updated July 26, 2016.

  6. Phipps H, Hyett JA, Kuah S, et al. Persistent occiput posterior position - Outcomes following manual rotation (Pop-out): study protocol for a randomized controlled trial. Trials. 2015;16(1):96.t study. BMC Pregnancy Childbirth 17, 377 (2017). https://doi.org/10.1186/s12884-017-1556-5. doi:10.1186/s13063-015-0603-7