Coping tips for back labour?

[AutumnAir]

Okay, I keep telling myself that 'This is a new birth and a new baby' and what happened last time won't necessarily happen again, but this is a fear I'm having a hard time letting go of.

Last labour started fairly normally (though I'd had a really long stressful day leading up to it) with on and off contractions all day that established a pattern of about every 5 minutes for 45-60 seconds at about 6 pm. Normal progression from there for the next 6 hours with contractions getting steadily and slowly stronger, longer and closer together. I was having to concentrate and breathe through the contractions but was coping reasonably well. Then about midnight it all changed. Suddenly there were no breaks between contractions at all - it felt like one non-stop all-encompassing pain, as the pain wasn't localised to my 'birthing muscles' anymore, but seemed to be everywhere.

At first I thought - this must be transition, but then it went on, and on, and on...

Ultimately it ended in my being coerced into transferring and having an extremely traumatic birth, which is something I'm sure would never have happened if I hadn't been so utterly exhausted and worn down by the unrelenting pain. That started at 12 am and the decision to transfer was made at 2pm the next afternoon so I did manage to 'tough out' 14 hours of it, but because of the pain and exhaustion I was also unable to communicate properly, got really dehydrated because no one thought to give me anything to eat or drink all that time... (FWIW I dilated to 10 with a lip, about 10am, but never felt the urge to push)

I really need to feel as prepared as possible this time around - to know that at the very least I've done everything I can to a) prevent such a tough labour and b) to be prepared to cope with it if it does happen again.

I figured out (too late) that at least part of the reason for the last labour was that DD was both posterior and asynclitic - this despite my doing *everything* right OFP-wise for the last few months of pregnancy. So, of course, this time around I've been even more diligent about positioning - but baby has an anterior placenta and flips around all over the place, so not sure how much good that's doing. I've been seeing a chiro and an osteopath too. I'm planning a homebirth and have a birthing pool (which I didn't have last time, so hoping that it's really as good as it's cracked up to be!). I have a lovely doula, who knows my previous story and has made a bit of a speciality out of helping moms with back labour - she's got lots of good techniques, all the stuff off spinningbabies, rebozo sifting, etc. I've been studying the Hypnobabies course (which is great, but it keeps talking about 'in between birthing waves' and 'when a birthing wave ends' and I keep going 'But what if it doesn't end?')

Okay, so to the point of this long rambly post! Can anyone think of anything else I can do to either prevent such a horrible labour from happening again, or alternatively, anything else that I can do for comfort/coping while in labour? I think I'm just looking for reassurance that I've done everything that I possibly can, and that somehow or another I'll get through it even if it does turn out the same way again.

[porcelina]

I totally know what you are talking about -- I had a very similar experience with my first birth. He was posterior, contractions went from 10 to 2 mins apart within half an hour. They were unrelenting, often waving one on top of the other. I got to 8 cm within like 6 hours, but bag of waters bulging. Midwife broke them and I then started to swell (down to like 5-6 cm). I also thought I might have reached transition when it turns out I hadn't, transferred to hospital (because I wanted the pain to stop) after about 9 hours or so, then got epi and finally vaginal birth with vacuum. It was also very traumatic for me.

I have also been doing everything you mentioned to avoid the same thing happening. I have been following the spinning babies advice, going to chiro once a week, and doing the hypnobabies course. I am now in a much better place about this birth. First, I feel better equipped to deal with the pain using the hypnobabies relaxation. I also feel like the affirmations have been very helpful, and am really trying to believe in the power of the mind. Second, I have also read up on and plan to bring a list of positions to use if baby is posterior to get him to turn. I am trying to train DH in these so that he will be helpful this time around. I also know that I need to be able to relax in any of these positions, as much as possible. Third, I know my body has done it before, and, even if baby is posterior again, it can do it again. So I guess I am feeling confident that most likely, I will have a much better experience. However, even if I run across the same problem (or some other), I know that my body has done it before and have confidence in that. (you didn't mention if you ended up with vaginal or c-section)

So, maybe when you are listening to the hypnobabies, try to follow the advice of "don't analyze or what if" and just "concentrate on each word as they say it." Maybe the message will get through. And, in the end, if it turns out being difficult again, make sure to have some other techniques available. However, from everything I have read, the best thing you can do to facilitate birth is do your darned best to relax your muscles. This will be my biggest challenge, but I think hypnobabies is the best preparation for that.

Best of luck!

[LiLStar]

My first birth was a posterior, asynclitic baby (and ended in a transfer and c-section) and know all too well how awful that labor can be. It was exactly like transition except for.. like a whole day.

For my 2nd, my plans were chiro (which I see you're doing) a TENS unit (I bought my own) and a mw who could do sterile water injections, if needed. Then, I told my doula and my mw to be as coercive and mean as necessary. Meaning, if back labor was so horrible that I couldn't bear to do things that might facilitate correcting the baby's position (walking up and down stairs or whatever) ..they were to MAKE ME! The purpose of having a TENS and the *possibility* of sterile water injections available was so that, if they took the edge off enough, it'd be easier for me to try spinning babies techniques or whatever was needed to turn the baby.

In the end, I had no back labor I had prepared to use hypnobirthing with my first labor, but it was impossible to not tense up my leg muscles. There was no way I could do it. I tried so hard to relax them but it wouldn't have been any easier to relax my uterus! My anterior labor though, I would catch myself tensing and tell myself, no reason for that, that will make the pain worse, and would just let go of the tension and relax, fairly easily! Anterior and posterior labors are such wildly different beasts.

[dannic]

I have had back labor with all three of my births. I like my fishy pool for that. I labored in a jacuzzi tub with my first and the hard lines of the tub made it uncomfortable. I like the soft edges for lean forward on and keep the pressure off my back. GL!

[Sudonk]

Wow, I haven't encountered many women who had an experience like mine, so I was oddly happy to read your post, while also sorry to hear it happened to you, too.

During my first birth, things went pretty much the same as yours, except it was a planned hospital birth and though I was using self-hypnosis, I didn't have anything close to the number of skills in Hypnobabies. Things started out pretty normal, and after about 6 hours, I began to get double and triple-peak waves. My birthing waves were 2 minutes apart, lasting 90 seconds for a couple hours, but I was pretty sure I wasn't making much progress, so I didn't run off to the hospital right away. I finally decided to go and just get the baby checked, since he wasn't getting much time to relax in-between waves, either. I was 3 cm when I checked in. Shortly after that, my uterus spasmed, clamping down and just staying in a constant contraction for around the next 7 to 8 hours. The staff initially freaked a bit, because that is usually associated with fetal distress within minutes, and mine just went on and on. The OB seems to think that my relaxation from self-hypnosis was not only keeping me comfortable, but was also increasing blood flow to the baby and avoiding the need for a c-section. It was a challenge, but it wasn't painful or traumatic or anything. Just a bit annoying, because I wasn't getting a break and it was hard to gauge how long it would take until I could meet my baby. But the self-hypnosis kept me comfortable, despite the intensity and back labor.

During my second birth, I had a similar experience with a uterine spasm, but I was using Hypnobabies for that birth and, while challenging again, it was such a small deal compared to the first time. I was able to use my center switch to move easily into whatever position felt right for me, I was much more comfortable and responded really well to the "release" and "relax" cues from my husband. Through Hypnobabies, I knew about the Belly Lift (which I didn't learn about for my first birth), and that really helped ease the intensity and increase my comfort. Overall, it was actually a really smooth birth that happened to have about a 3 hour uterine spasm at one point. In fact, when my baby was born (6 minutes of pushing - no problems!), I initially felt a little guilty about how easy it had been, since most women seem to find birth so challenging. Pretty funny, considering the midwives were concerned about how "difficult" my birth must have been, given the circumstances, even though I remained happy and relaxed the whole time.

With my third, I did not have a uterine spasm, and I know part of it was positioning. But part of it was mental, too. I talked to a hypnotherapist about my situation and was interested in getting an additional script to help me prepare for a very different birth with actual "normal" birthing waves that come and go. We talked for about 45 minutes, and she told me that I had everything I needed through Hypnobabies and didn't need another script. But what helped me the most was when she said, "You've handled the complication really well twice now. What's the worst that can happen? You handle it a third time." It made me realize that my "worst case scenario" wasn't a big deal, and I felt like I gave myself permission to relax about it and accept that it may happen again, but I was still stronger than that complication, and it wasn't worth stressing about. It was a huge weight off my shoulders. I wound up having a very comfortable, easy, 3-hour start-to-finish birth with birthing waves that went away! It was great!

I encourage you to keep up the preparation. I really do think that Hypnobabies is the best approach in a situation like ours, since I know it works beautifully whether there is a "repeat performance" or not!

[limette]

I've had two posterior babies. Honestly nothing helped the pain in either case. Having a doula for the second kept me from the getting the drugs (that don't work anyway) and having a successful vbac. So for me the only thing that helps is a really good coach (the doula).

[AustinMom]

I haven't read the replies, but i can relate as our first was a planned out-of-hospital birth, malpostioned baby, never recognized, so never fixed, so I got exhausted, transferred and had a CS.

This time we are HBACing, so I'm feeling way better about that, as our MW actually had a CS with her first for the same reason we did (acynclitism) and then an HBAC with her second. So she really gets me. Our Doula is also a MW, and the leader of our local ICAN, and is very knowledgeable in fetal positioning. So I have a bionic birth team as my husband put it.

I did a lot of looking into spinning babies. Our first was 9lb 8oz (not big to me) and we got a lot of, 'well he was so big' etc crap, and this link really helped me:
http://www.spinningbabies.com/baby-positions/cpd

I'd do belly mapping also and get really familiar with what position the baby is in. I will say this, when I have prodromal labor (been having it a lot) and if baby IS in a posterior position, it's is HIGHLY uncomfortable, and it feels like a constant contraction all down my hips, thighs, calves, etc. So I get that. We do some hands and knees, rebozo sifting, and some belly rubs and that turns baby, and then the 'rushes' feel only like tightening. So I would say that is what sounds like what happened to you last time.

It's not necessarily about coping with back pain, but more so about identifying the cause and fixing it so you can focus on birth and not 'coping'.

Much LOVE! Happy Birthing!

[nia82]

DS was posterior and back labor hit me like a truck. My water broke first and it was a planned hospital birth. Hours after it broke, contractions started and were 3 minutes apart for 2 hours and then back labor hit full blown. I had contractions on top of each other, sometimes 20 seconds in between, but then for one hour straight, no break. I had no jacuzzi as they were all taken. All I could do was putting my torso on a birthing ball, being on all fours, swaying to make him turn and having DH put a super hot compress on my lower back. I couldn't care less whether I'd have blisters. Heat was wonderful. They didn't try anything else at the hospital, though the nurse did stay with us at all times and felt really bad for us. It went on for not too many hours, somewhere between 2am and 10am, then I pushed which was a piece of cake painwise!
I had an instinct that a tub of hot water would help me or a strong counterpressure massage on my back, but nobody there was skilled in that nor did I have access to the water. I had no idea DS was posterior. He did turn though, but not entirely and was somewhat crooked and kept his hand in front of his face. I pushed him out without assistance, but had two tears (2nd degree), not too bad which healed quickly.
This time I will be delivering at a birthing center and the midwives there are really skilled at position changes, knowing baby's position and such. I do plan to work on baby's position with the chiro starting around 34 weeks or so (DS lodged into place at 24 weeks!!!). I will be asking my midwives more about this. I will have the tub with hot water there... I'm not sure hypnobirthing would work with me, I'm too controlling for that.