As a woman who endured 2 back labors myself, I know first hand just how painful and unrelenting those contractions often are. Personally, I feel it is important to give pregnant women every possible opportunity to avoid starting labor with a posterior baby. Some women birth posterior babies without any back labor but generally, with a posterior baby, labor tends to last longer, be more painful, and results in a higher rate of Cesarean – so why wouldn’t we do all that we can to try to change the babies position? Obviously, just as with breech babies, sometimes there is absolutely nothing we can do to change the position – perhaps there is a reason the baby is choosing the posterior position? It is best to be aware and proactive but try not to be fearful.


A posterior position simply means that instead of the baby’s face facing the mother’s sacrum, the back of the baby’s head is pressing against the sacrum, which typically causes contractions to be irregular and concentrated in the lower back. A classic sign of posterior labor is when the mother is unable to rest between contractions because the pain never seems to subside completely. She can be distraught with the discomfort and nothing seems to help.


There isn’t enough research to determine the exact reason why so many women end up with back labor (15-30%). It is thought that our sedentary life style contributes to a more common posterior presentation. We do a lot of sitting – at a desk, driving cars, on the couch, eating meals at a table – and it becomes easier for the heaviest part of the baby – the back – to drift toward the back of the mother as she reclines. A baby can get quite comfortable in this position making it hard to reposition once labor starts. 


Just as there are interventions to change the position of a breech baby and avoid a potential Cesarean birth, there are also ways to shift a posterior baby into a more optimal position. Here are 8 things you can do prenatally if you suspect a posterior baby:
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The birth of my fourth baby was so much more than the birth of one sweet, squishy baby boy. His birth summed up so much of my adult life. I've now birthed four babies of my own, been witness to the births of many babies and with them the births of many mothers and fathers and grandparents and sbilings, and I've given birth to my passion and career as a doula. So I went into this birth, the birth of my last baby, with much intention and reflection. I felt that I could draw on the strength and courage (not to mention fantastic playlist ideas) I'd witnessed in all the women I'd supported. In a way, I felt surrounded and lifted up by these women. And I had no fear. I've personally had so many varied experiences during birth, foley catheter, pitocin, cervidil, preeclampsia, waterbirth, and I've witnessed so many other variations during birth that I was mentally prepared. I was ready and the raging cold I had that lasted weeks and turned out to be pneumonia made me even more ready.
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As a busy Asheville doula, I have been to long births and fast births.  I have been to a super speedy, precipitous birth that was over in under an hour, and a long marathon of prodromal labor which lasted 3 days. Most women hope their labors will be on the quicker side of this spectrum. The length of your labor is not something that can be predicted, but there are a few very simple things that you can do that can contribute to faster labors.

It's finally here. You have been waiting for weeks, paying strict attention to every Braxton Hicks contraction,  every nesting urge, and going to bed every night wondering if you will finally wake up in labor.   Now, the contractions are here, consistently 8-7-6 minutes apart, and they aren't letting up. Awesome! The party has started! Now what? Keep timing contractions? Go hike some hills to get them stronger? Easy now, mama. There's a marathon in your immediate future and it's important that you to try to relax and rest.  Getting too ramped up in the early stages of labor can wear you out before you reach active labor, sabotaging your long term efforts.  Sleep deprivation, hunger, and physical exhaustion can make coping with the contractions even more difficult.  Here are some tips for early labor: