Back to back baby, labour more painful

[AverageSnowflake01]

Did anyone with a baby back to their back have a really painful labour? I've been trying to get baby to face my back for weeks, but even now at 40+3 she's still not facing my back and I could go in to labour any minute.

[Etak15]

All my 4 were back to back but I never knew that until I was actually in labour, it was very painful but labour is so different for everyone and everyone's pain threshold is different one of my friends likened her labour to Her IBS pains! So I thought I must be a wuss! I found that the two of mine that I had diamorphine with I found slightly easier it just took the edge off, but then you see some amazing women on one born every minute that just 'breath' the baby out with no pain relief at all. I don't know if mine being back to back made it worse or not? Try not to worry about it, just take it as it comes, you'll be fine!

[theredlion]

My 2nd DC was back to back, my 1st wasn't.
Labour was longer.

[Coldest]

Mine was back to back. It felt like I was being ripped apart from behind with each contraction. I don't have anything to compare it to though. And also I wanted lots of pressure on lower back. It helped a bit. She did get stuck when I was fully dilated. It ended being an emcs

[Elledouble]

I've only had one baby so have nothing to compare it to, but I did find my back-to-back labour pretty painful. My body was pushing before I was fully dilated so I was pretty exhausted and ended up with a shot and a half of pethidine and an episiotomy. Far from having the active birth I'd planned, I ended up on my back with my feet in stirrups because it was the only position I seemed to be able to push in!

By all means try to get the baby turned (my antenatal yoga teacher said circling your hips on all fours and generally avoiding leaning back) but it can definitely be done without too many interventions and pain relief! The one upside to giving birth back-to-back is that you get to see the baby's face (and sex) first as the midwife lifts them up as they are born!

[LizzieLou3]

My second was back to back and very different from my first and third but not more painful. It was just a different pain. It was fast (the fastest of my three).

[PinkFondantFancy]

Two back to back babies, both straightforward waterbirths with no pain relief. Make sure you stay mobile, it will be fine

[MargaretCabbage]

I've only had one baby, and he was back to back. I don't have anything to compare it to, but I didn't find it too bad. I actually got to the pushing stage at home just by having a warm bath, and he was born in hospital with me using gas and air - which I loved! He turned at some point during the labour, not sure when.

I tried everything I could to get him to turn as I was worried about everything I'd read about back to back labour, but it was honestly fine and looking back I've even convinced myself I kind of enjoyed it.

Good luck!

[Junosmum]

How do you know baby is back to back?

[Runningupthathill82]

My only tip would be to have pain relief if you need it. Back to back labours can be fine, but can be excruciating. It's down to luck.

I'm not usually a wimp at all, but my back to back labour was very long and horrific. Horrific in part because I didn't help myself by having the lovely pain relief available to me for far too long.

I was so stuck on the hypnobirthing, yoga, water birth approach that I didn't listen to DS telling me he just wasn't coming out that easily.

I could've saved myself a lot of trauma if I'd accepted earlier that there is no medal for martyrs, gone with the birth that I was dealt, and been much more pragmatic in accepting the epidural. By the time I finally had it, I was delirious and knackered, and I don't even remember DS being born.

My next baby is due very soon and my birth plan is simply to go with the flow. I really hope it works out well for you.

[DoctoraNova]

Hi Average,

I posted on your other thread too. Like I said, we're at exactly the same gestation, so I totally understand the emotional roller coaster you're on right now.

I've had two so far and both were back to back. I'm presuming and accepting that this one will be too. I really wish I had known before my first labour that the baby was back to back, because I think it did influence the pain I experienced and the outcome, so I think you're right to prepare yourself mentally for that.

You've got to remember that posterior babies are perfectly capable of being born vaginally, if that's your concern. They do represent a higher proportion of sections for sure, but I think if the labour woman is aware of the position and how that may change her experience of the pain, it can be a much more positive experience.

Some babies will lie posterior because of postural habits of the mother, but not all. Do not blame yourself. There may be other reasons: anterior insertion of the placenta can encourage a baby to face into it, i.e. away from the mothers back; the shape of the woman's pelvis and/or the baby's head may influence the position too (we can suppose). What I'm saying is, there may be unavoidable factors at play. Don't beat yourself up if you don't manage to change the position, your baby can still be born, and there are things you can do to improve your chances of a non-traumatic birth, whatever the route may be. I don't know how you feel about sections, but maybe you need to consider that as an outcome and how you would respond to that because it will influence your memory of the birth. Try to discuss all these things with your partner and work though any fears/expectations, I say that in a completely non-judgmental way by the way.

In terms of labour with a posterior baby, the rhythm and progression may be completely different to the standard 1cm dilatation per hr partograms. The baby's head doesn't put as much pressure on their cervix and can cause a later start to labour, slow and uneven dilatation, and a so-called anterior lip of cervix when at apparent full dilatation. This is important to remember if the hospital put you on a clock, and claim you're not progressing "nicely enough" and push for intervention. Babies don't have to turn in labour, but they may. To encourage turning, the baby needs room. You need to stay off your back, a position that closes the pelvic outlet, and the baby needs waters to provide a cushion for the head to turn on. I would avoid artificial rupture of the membranes for this reason. The waters provide a cushion for the baby to swivel on, and after they are gone turning becomes more difficult. With a long labour it can be hard to stay upright for so long, but posterior babies can turn if the mother adopt the left lateral position with the legs open and the right leg supported in abduction and external rotation. All fours and a knee chest position can also help. You're body will tell you what feels good, and that's likely the position the baby needs to turn. Listen to your body! I cannot give any stronger advice than that in terms of turning the baby. Think of it like a dance - the baby is moving and turning and dropping while you move around.

Your baby may very well turn before labour, or may have even turned already before this post, or maybe he never was posterior. It's not that easy to diagnose without an internal exam on a dialed cervix with broken waters... Just to bear in mind. However. Personally think it's very good to positive, but it's also useful to be mentally prepared for and accepting of what MAY happen.

Just like the rhythm of a back labour may be different, the pain experience can be very different too. Pain may be mostly felt in the back, a constant pain, often described a pretty bad. It can even block out entirely the pain of the contractions. Natural methods to cope with this pain include, counter pressure, heat, water.

Obviously an epidural will block the pain, but I would strongly advise against an epidural too soon. You may need to cope and manage with a back labour for quite some time before it's advisable to get the epidural, simply because it will make it harder for the baby to turn, which mean lead to baby get stuck in half-turned positions (such as a transverse arrest) and not being able to be born vaginally. With an epidural you numb the signals that tell your body what position you need to adopt, and you're more likely to be "stuck" on your back. My advice is to hold off on the epidural until the baby has turned, or unless you are exhausted. Posterior + early epidural increases rates of instrumental births, particularly high rotational forceps, which are to be avoided at all costs. Please try to use other methods of pain relief to get you to the magic point when the epidural is a massive help and not a risk factor for intervention. I'm NOT for one moment suggesting that you sacrifice yourself on the alter of motherhood and forgo all medical pain relief, but it is my belief that in a posterior labour, the mother needs to do a certain amount of painful work in labour before an epidural is indicated.

Counter pressure is very useful: look up acupressure for labour, and explain really clearly to your birth partner that you need very strong pressure for this to work. The idea is to counter the pressure of the baby's head. It can be done in almost any position you adopt. Practice before hand. On all fours over a birth ball, or over the edge of a bed or sofa is easiest but it can also be really successful in the side lying position. As the baby moves down, pressure needs to be increased, and to move down further towards the buttocks. Your partner could start with his palms, then fingers, then knuckles, then elbows to exert enough pressure, leaning with his/her whole body onto your back. Bruising is likely, but this is ok. A tennis ball can also be used in the same fashion. Pressure should be keep up during the entire contraction and contact remain during the contraction. Alternately a hot water bottle between contractions can be useful. In fact, don't under estimate at all the pain relieving effects of a hot water bottle, especially in the (most likely) long prelabour stage of a posterior delivery in a first time mum. You cans trap the hot water bottle to your lower back with a summer scarf tied low below your bump, for mobilising and for lying down. Being in water, be it a birth pool or your bath tub or even the shower can help ease the pain of back labour. Try directing the show head at your lower back; side lying in the bath; whatever position you like in a pool. You can bring a stool or birth ball into the shower to help support you. Or your partner.

You really do have lots of resources to help you get through this, much more than you can imagine right now. Again, I recommend reading positive birth stories of women with posterior labours, such as on the home birth uk site. They often describe in detail positions and methods of coping with the particular pain of back labour.

One things that stuck in my mind for my second posterior labour was someone's statement that the pain of a back labour doesn't necessarily get worse, the way it does with an anterior labour, i.e., the pain starts and pretty suddenly it ramps up and before you're even dilated to 1cm or 2 or 3 or whatever, is pretty bad, maybe even excruciating and you think "Fuck, if this is just the beginning -" and next thing you know you're in panic stations. Well, with back labour it may not get that much worse, it's just a long, constant struggle. Bear that in mind. I actually found that very comforting. The rhythm of your labour may be different to what you expect, and the pain may be worse than you were expecting but I think you're already aware of that, you just don't realise yet that you CAN do it.

Please don't panic and please listen to your body. That's all there is to it. You're going to do great. Whatever way it goes. You'll have a baby in your arms soon and you won't even know yourself, a newborn in your arms is pure divinity.

I really wish you the best of luck xx


(Haven't proofread, please excuse any typos)

[Indantherene]

My 3rd was back to back. We got to hospital at 10cm and he was with us 50 mins later. Nowhere near as painful a labour as no 1 and faster than 1 and 2.

[pleasegotowork]

My one and only labour was bak t back but I didn't know it at the time. The labour was slow, waters trickled out over 18 hours. Ony 3cm when I got to the hospital after bearable pains for about 12 hours and pain pain for about 6 hours. Got to the hospital and told the porter at the door to phone them ahead to have the epidural ready!! Had the epidural at 4am and it was wonderful. It had worn off by about 8am and I could feel the contractions again but the rest was what I had needed. Started pushing at 10am- long after I'd wanted to push but I had a wonderful wonderful midwife who knew exactly what she was doing. The pushing part was slow and exhausting. Ds was born at 12.20 so over 2 hours of pushing and I was really tired and ready to give up. I was begging for a section because I really thought he would never come out. He kept slipping back up. They gave me an episiotomy and he was born quickly after that. Ds was a total cone-head for a couple of days so prepare yourself for that! My friend nicknamed him Mr Whippy

I had ony one labour so nothing to compare it to but for me the pain was bearable (just!) but it was the exhaustion of the pushing after a long labour that was difficult. Be as rested as you can going into it, eat well, lots of protein. And have something to eat before you go to the hospital because they won't let you eat during labour and I was starving!!

The midwives are just brilliant and will guide you through it. And at the end of it all, whatever way he or she comes out, you'll have a beautiful baby and will be so proud of your body for growing a beautiful little person.

[confusedandemployed]

My only DC was B2B. I have a very high pain tolerance generally but yes, this broke me.

All my contractions were in my back - I got absolutely no bump tightening. DD got stuck and I spent 36 hours of active labour getting to 3cm. Registrar took pity then and did an EMCS. Oh, and my epidural failed - but obviously that was just bad luck!!

All that aside I know plenty of people who birthed naturally with B2B. It does generally tend to be more painful though.

[Runningupthathill82]

Really great post, DoctorNova. Wish I'd read that before my back to back labour.

Also yy to those who have said that b2b labours progress differently to "normal' labours. I spent 8hrs or so in agony, stuck at 5cm, wondering why nothing was progressing. Friends who've had ordinary births say that they were barely in any pain at 5cm!

[ChablisTyrant]

First baby was back to back. Very painful first stage of labour at home while the baby turned. Spent it in the bath and shower. The whole thing took over 24 hours because there was a bit of a lull after the turning was done. Did the whole thing with gas and air though.

The most important advice i got was to prepare for a longer labour by resting and sleeping as much as possible in the early stages of labour.

[AverageSnowflake01]

Thanks for that doctornova, my midwives have told me baby is in posterior position and to try and get her to turn by sitting up straight and swaying my hips on all fours but I know she hasn't turned because I'm still getting kicks on the sides of my belly. I'm also scheduled for a sweep tomorrow and in your post you advise against this. I'm worried now, I don't want to decline a sweep I want my baby out now.

I will check out that site :)

[AverageSnowflake01]

fay Oh I thought rupture of membranes was a membrane sweep.

[Jenijena]

I had a b2b first birth, and have recently gone through my notes with a midwife in prep for DC2.

DS had meconium in his waters - which got darker - and had a heartbeat which got increasingly erratic. I was put on a drip after my dilation went 7cm-6cm-7cm-9cm-7cm etc - in talking with the afterthoughts midwife this may have been due to the changing position of his head against my cervix througb labour.

Despite the drip and the b2b I did it on gas & air. I spent much of my time either standing/bending over the bed, swaying hips, or kneeling on the bed over the pillow. At the end, as his heartbeat was crazy, they were going to use forceps to get him out - as I was moved round to sit up for the forceps, he slid round and came out.

So it wasn't uneventful, but it was fine - I had three tiny stitches and barely any undercarriage trauma. I sort of expect this one to be the same but I'm not 'scared'...

[DoctoraNova]

Sorry for confusing you, Average, Fuckit is correct. A sweep is when a midwife inserts a finger through the cervical opening and tries to gently separate the membranes from the cervix a bit to encourage release of prostaglandins and induce labour. It's a relatively gentle induction method, in that it's unlikely to set off labour with a bang like the oxytocin drip can, but may be quite uncomfortable, just so you are mentally prepared (that will depend on the hands of the person who performs it). Artificial rupture of the membranes is when a small nick is made in the bag of waters to break them. I would avoid this until it is known that the baby is in the most favorable position possible to come through the pelvis. Your waters may break spontaneously after a sweep, but this is more likely when the head exert a more uniform pressure on the cervix in an anterior position, than posterior.

Another thing I should mention is that it's not unusual for the labouring woman to feel the urge to push to help the baby turn, even on a partially closed cervix. This is controversial but I'm just pointing out there that I pushed for two hours at 5cm, baby turned nicely and then I flew along to 10cm and pushed him out in 20 minutes. Midwife Rachel Reed has blogged about back to back labours here midwifethinking.com/2010/08/13/in-celebration-of-the-op-baby/ and here midwifethinking.com/2011/01/22/the-anterior-cervical-lip-how-to-ruin-a-perfectly-good-birth/ (don't know how to tidy up links on phone sorry, halfway down a mountain trying to get things going ).

Please don't let a strange labour pattern undermine your confidence in the process and your ability to give birth.

I too have a sweep booked for tomorrow, fingers crossed, legs uncrossed for both of us. BRING IT ON!!!

(Sorry if previous post of overly long. I do tend to get carried away ... )

[Coldest]

DoctorNova I will be copying your post. Pregnant with my second and ant placenta. That is a very helpful post.

[DoctoraNova]

Glad it was helpful for you Coldest. I loved my labour with my second child, I really did. I felt phenomenally strong and powerful. I felt in control. I felt primal and wild. It was incredible. Even a posterior labour can be amazing.

[AverageSnowflake01]

Haha yes fingers crossed, legs uncrossed

[Coldest]

I had very strong urge to push but she hadn't descended at all and her heart rate was dropping and not recovering hence the emcs. Is this something related to back to back labour? I was fully dilated though.