10 Tips To Help You Cope With Back Labour
About 40% of babies that end up being OP (occiput posterior) in labour were perfectly positioned before labour started, so don’t skip this article because you were told your baby is in a great position at your antenatal appointment yesterday!
Skip this information and it just may come back to bite you in the back – literally…
Before Labour Starts
If possible, help baby into optimal position BEFORE labour (easier said than done for some babies). Ideally we want baby’s back in the hammock – think of your bump as a hammock, it’s not very comfy to lay face down in a hammock. When you’re watching TV, sit on a birth ball (it makes you lean forward) or spend some time on all fours watching East Enders - it may even make the characters and storyline more interesting. Do big circles on the birth ball and figures of 8.
OP babies don’t usually tuck their heads in so circles are more helpful than bouncing. Uncross legs when sitting at work – it makes the pelvis smaller giving your baby less room to rotate into the optimal position. When standing, try some hula moves in the kitchen – it’s great for the lower back too and it’ll provide some entertainment for work colleagues.
Inversions – have a look at Spinningbabies.com for more information on how to do this (have a partner handy to help you get into and out of these positions – don’t say I didn’t warn you).
When Labour Starts
One of the cardinal signs of a baby not being in the perfect position is painful backache – most mums who experience back labour are surprised that the sensation is constant, unlike a surge that comes and goes in the abdomen. A baby that starts out in what we call the OP position can take his sweet time rotating so the orders of the day are REST, EAT, REST MORE.
OP babies tend to present in ‘military’ style (head isn’t tucked in) and because a wider diameter is presenting it can take the cervix longer to dilate. The good news is that most babies do rotate with no problems at all and when they do labour, they can take off like a rocket! Conserving energy is critical. Conserving energy and staying comfortable is the challenge.
1. TENS – put it on early and use the boost button whenever needed.
2. Acupressure – there are some simple points that can really help with back labour and, yes, there’s an app for that!
3. Firm counter-pressure by your partner/doula on your lower back. This is heaven on earth. Your baby’s head is pressing against the sacrum and counter-pressure can help equalize that pressure. Dads/partners you’ll be surprised by the amount of pressure mum can take with an OP labour (enough that your wrists may hurt the next day).
4. Tennis ball – a firm rolling motion on the lower back can give great relief.
5. Heat/cold packs and even a rolling pin can feel amazing. Try them all.
6. Double hip squeeze - another ‘heaven on earth’ move – mostly used by doulas as one of their tricks of the trade. Look it up on YouTube so your partner is familiar with this technique.
7. Mobilise – when you’re moving, baby is moving.
8. Have a labour pool at home. You can change position easily as you’re weightless, the warm water keeps you more comfortable and you’re releasing oxytocin in bucket-loads to help move your baby.
9. All fours position with head lower than hips; lunges, 'duck’ walking, all can create asymmetry in the pelvis to help baby rotate just a few millimetres to descend in the best possible position.
10. The epidural can be the best thing since sliced bread when you’ve tried everything else. Get a peanut ball or stack a few pillows between your legs as you lie on each side for about 30 minutes so you’re keeping the pelvis open so your baby has more room to move. Come along to a GentleBirth workshop and learn more comfort strategies for a positive birth.http://www.GentleBirth.ie
Note: A 2009 study published in Clinical Endocrinology finds evidence that low levels of the thyroid hormone called thyroxine may be associated with more posterior positioned babies. It may be helpful to have your thyroid levels checked in pregnancy. The New England Journal of Medicine suggests a type of iodine supplementation in pregnancy. (Spinningbabies.com)