Let’s talk about back labor—the notorious, deep, take-your-breath-away ache that some people feel in their lower back during contractions. If you’ve heard someone say their contractions felt like they were “breaking in half” or that they “labored in their spine,” chances are, they were dealing with back labor. It’s intense, unexpected, and can make labor feel even more exhausting. But don’t worry—there are ways to relieve and ease back labor, and I’ve got you covered!
Why Does Back Labor Happen?
Back labor happens when contractions cause intense pain in the lower back rather than (or in addition to) the front of the belly. The most common culprit? Baby’s position.
If your baby is in an occiput posterior (OP) position—meaning their head is down, but they’re facing your front instead of your back—the hardest part of their head is pressing into your sacrum. That constant pressure can make contractions feel way more intense in your lower back.
Other factors that might contribute to back labor include:
Pelvic shape – Some people are more prone to baby settling in a posterior position.
Tense muscles – If your lower back or pelvic floor is tight, it may make it harder for baby to rotate.
Lack of movement – Staying in one position too long (especially on your back) can limit baby’s ability to shift.
Now that we know why back labor happens, let’s talk about what you can do about it.
How to Ease Back Labor Pain
Change Positions
Movement is your best friend. Certain labor positions encourage baby to rotate and take pressure off your back. Some of my favorites include:
Hands & Knees (aka Forward-Leaning Inversions or All-Fours) – This gives baby more space to rotate and relieves pressure on your spine. Try swaying your hips or doing gentle pelvic tilts while in this position.
Side-Lying with a Peanut Ball – If you’re resting (or have an epidural), placing a peanut ball between your knees can help open your pelvis and encourage baby to shift.
Slow Dance – Lean forward against a wall, a birth partner, or a bed while rocking your hips. Gravity helps baby rotate and relieves back pressure.
👉 Want more labor position ideas? My book, A Doula’s Guide to Labor Positions, has a ton of options! Grab a copy here.
Apply Counter-Pressure
This is a game-changer for back labor! Have your birth partner, doula, or nurse press firmly on your lower back during contractions. Try:
Hip Squeeze – With both hands on your hips, someone can apply inward pressure to help relieve tension.
Sacral Pressure – Pressing firmly on the sacrum (that flat bony area at the base of your spine) can provide instant relief.
Rebozo Belly Lift – Wrapping a rebozo (or a long scarf) under your belly and gently lifting can take weight off your back and encourage baby to shift.
Use Heat, Cold, or Water
A heating pad or warm rice sock on your lower back can relax tight muscles.
A cold pack may numb the intense pressure and provide relief.
A warm shower (especially with the water aimed at your back) can be soothing between contractions.
Try a TENS Unit
A TENS (Transcutaneous Electrical Nerve Stimulation) unit is a little device that sends gentle electrical pulses to your lower back. It works by overriding pain signals—kind of like how rubbing a sore spot makes it feel better (hello, gate control theory!). Many people swear by TENS for back labor relief!
I have the Perfect mamaTENS by TensCare a part of my doula bag supplies! If you want to see what else I carry with me to births, check out my previous blog post!
Use a Birthing Comb or Labor Grip
It sounds weird, but hear me out. Squeezing a birthing comb in your hand can actually help block some of the pain signals from reaching your brain. This is another trick based on the gate control theory—your brain can only process so much sensation at once. Applying intense pressure somewhere else (like your hands) can make contractions feel more manageable.
Keep Moving & Stay Off Your Back
Lying flat on your back can make back labor worse because it keeps baby pressed against your sacrum. If possible, stay upright, leaning forward, or side-lying to give baby space to rotate.
Final Thoughts
Back labor is tough, but you don’t have to suffer through it! The right positions, hands-on techniques, and comfort measures can make a huge difference. And remember—your baby’s position can change throughout labor, so don’t lose hope!
Want to be really prepared? My book, A Doula’s Guide to Labor Positions, includes detailed visual guides for positioning in labor (back labor included!). You can grab a copy here.
Got questions about back labor or want to chat about birth support? Let’s connect!
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