The other day a Mom came in and told me a very familiar story – “I got stuck at 8cm for hours and then had a c-section.” When I ask if she had back labor, she said “oh yes, it was the worst part, that’s why I had an epidural because the pain in my back was so bad.”
Back pain during pregnancy is common. Was your baby sunny-side-up or posterior?
“Yes, they said he was facing the wrong way, is that what you mean?”
Why posterior babies?
I was part of a research group that studied the transfer of out-of-hospital births into OHSU, a local medical school where I received my masters in nurse midwifery. An interesting discovery was that75% of the transfers were for posterior babies.
So what is happening that so many babies are posterior?
Let’s think about how we, as women, were designed to spend our days. For the most part we would be squatting to tend to our cook fires and leaning over to do our chores. This created conditions that helped the baby find the most optimal position for birth; one with their back towards our front, either on the left or right, and with their head well flexed.
Problems with posterior births
When babies are posterior, meaning their backs are towards our backs, the whole labor is slower. This is because posterior babies don’t flex their heads well and therefore don’t descend into the pelvis easily.
They are working against, instead of with, the normal physiology of labor—flexion of the baby’s head, descent into the pelvis, turning more anterior and then extending their heads on the way out. What we call tuck and dive.
Solutions for posterior babies
So what can we do? We are certainly not going back to squatting and living in caves. However, we can choose to spend time sitting forward instead of lounging back during the last month of pregnancy or sit on a birth ball. In addition, there are methods we midwives use for turning posterior babies in labor. These same techniques can be learned and used before labor starts. YOU CAN TURN YOUR OWN BABY!
During the last few centimeters, from 8-10, it is the baby’s head that dilates the cervix which is why posterior babies get ‘stuck’ and mom’s don’t dilate. In addition the unflexed head puts pressure on the mother’s sacrum causing back pain that doesn’t let up between contractions.
Our favorite technique is the rebozo. This is simply a shawl worn by women to carry not only their babies but many other things as well. Midwives use it in labor.
You can use any shawl or piece of fabric. You will need a partner.
- Get down on all fours with your head a little lower than your hips.
- Place the middle of the shawl, spread out, on your belly
- Have your partner stand behind, straddling your legs and holding one end of the shawl in each hand.
Now relax while your partner moves the shawl back and forth, in short movements, first slowly and then fairly quickly. Do this for a few minutes each day. You will know when your baby has shifted because you will no longer feel her kicking in the front but on one side or the other.
This simple technique may possibly make for an easier natural birth experience for you and your baby.
M Catherine Schaefer CNM ND