The vast majority of babies (90 per cent or more) are born in the anterior posterior position - which means the back of your baby’s head is facing your front.
This is good news because it means the narrower frontal part of your baby’s head will be born first. The head should pass through the birth canal easier and labour is generally shorter and less painful.
Back to Back Labour
What does back to back mean?
However, if your baby is in the back to back position sometimes known as occipito –posterior or OP, this means the back of your baby’s head is facing your spine and will cause considerable pain in your spine during contractions. It also means the wider part of your baby’s head will be born first.
Why can back to back labour be a problem?
As mentioned briefly above, OP labours can be longer and more painful, as the baby’s skull is pressing into your spine and the widest part of their head will be born first. This is why OP labour is sometimes referred to as ‘backache’ labour, as more pain is felt in the lower sacrum area of your spine.
Can I do anything to encourage the baby to move into a better position for labour?
Your baby can still change position late in labour, but there is little hard scientific evidence that changing your posture will encourage them to shift.
However, anecdotally some midwives suggest the following are worth a try:
- Sitting with your knees lower than your hips wherever you can.
- Put a cushion under the small of your back when sitting at a desk, dining table or car seat – this will encourage your body to tilt forwards.
- Sit upright on a Swiss birthing ball
- Try crawling around on all-fours or scrubbing the kitchen floor for 10 minutes a day.
Tips for coping with a back to back labour
- Avoid lying on your back to avoid pressure on your spine;
- Try rocking or rotating on all fours as it will give the baby more room to move around.
- Get your partner to massage your lower back, applying pressure to counter the pressure of the baby’s head.
- Stay upright and walk around if possible
- Epidurals or pethidine may help you cope better if your labour turns out to be long and painful
A mum says...
‘My baby was in the back to back position – I didn’t find out until I was in labour and was examined by my midwife. I’d had two babies before so I thought by the amount of pain I was in that I was already quite far on in labour, but in fact I was only 4cm when examined. I remember the pain as being in my back and quite excruciating at points. My obstetrician was standing by for a caesarean as the labour was quite long and painful, but my midwife suggested I tried pethidine, a sedative and I relaxed and the baby turned around and was born normally within an hour.’
Jo Barton mum to Phoebe three months, Oscar, two and Harry, four