The truth about ‘back to back’ birth

Before having children I had only ever heard a couple of references to ‘back to back birth’. These were vague and pretty much just about where contractions are felt during a labour, where the baby is lying on the mother’s spine. Phrases like ‘back contractions’ and the description of the location of the pain being ‘all in the back’ were used.

I never gave it much thought.

I filed it away safely at the back of my mind along with the description of newborn poo and the fact that the car park machine at the hospital required several £1 coins.

I knew that in order to prevent a back to back delivery, I needed to get my baby into the ‘optimal’ birth position and well, I had been swimming; in the gym; taking aqua natal sessions and pregnancy yoga so I had this optimal birth position thing nailed right anyway?



Baby number 1

My first baby was two weeks late and following multiple sweeps and several goes at induction, labour spanned the best part of four days and resulted in a very tightly wedged back to back baby that had to be dragged out with forceps.

Baby number 2

A breeze in comparison to the first – not easy, as I would never describe giving birth as being easy, 9 days late and a sweep later he finally got moving and was born in water.

Baby number 3

Now, clearly I was hoping things would be getting easier, or at least that this would resemble baby 2’s arrival, more than baby 1’s. 12 days late and three sweeps later, nothing. Received a date for induction which seemed to frighten me into action. One very long, drawn out labour later, another tightly wedged back to back baby arrived, narrowly avoiding the need for forceps.

Baby number 4

I knew this would be the last baby, so was clearly once again hoping for the relaxed, hypnobirth in water. Baby had other ideas and decided to be 12 days late just like his brother. This time five sweeps and lots of trampolining didn’t move anything and I ended up being induced again. Another back to back baby started coming quickly and then got stuck and delayed things somewhat in the latter stages of labour, causing some concern, before eventually making an appearance, thankfully without the forceps.

I lost count of the number of people who told me after my first baby that they would all “fly out” or that I would only be in labour for 30 minutes. That’s just not how I have my babies clearly, they like to make me work hard for them.

I can tell you that a back to back labour is hard work. It can last a very long time and you can feel you make very little progress for all your hard work. A baby is in the ‘back to back’ or ‘occipito-posterior’ (OP) position when he/she is lying head down but instead of the back facing frontwards it faces the mother’s back. About 10% of labours involve babies in the ‘back to back’ position and in over half of these cases the baby will turn around naturally.  None of mine did.

If you have a back to back baby you might be asked if you lounged on the sofa a lot, as this can cause the baby to go into that position. That couldn’t have been further from the truth with me, I’m not exactly a lounging on the sofa kind of person, quite the opposite. So not only will you be tackling a back to back birth, but you might also be fighting off disapproving and unwarranted comments.


A back to back baby might mean that the head does not engage fully; it might mean you have a longer early labour phase; you might have a longer pushing stage; you might feel the bulk of your pain in your back – for me it was in my back and the tops of my legs. Leaning forward helped hugely, as did having the TENS machine on my back, and firm pressure being applied to the base of my spine gave some relief as well.

With this type of birth you are more likely to tear, more likely to need an assisted delivery and more likely to have a birth that ends in in a c-section, BUT this is not always the case. I had an episiotomy with my first baby, only 5 stitches with my water birth, and then quite a substantial tear with both the following back to back births, but nothing that didn’t mend pretty quickly. Out of three back to back births, only one of them was assisted and I managed with Gas and Air with all of them.

It can be done, it doesn’t feel like it at the time, but it can be. It was without a doubt the most pain I have every experienced, and each time I said “never again”.

If you’ve been told your baby is back to back don’t panic. There is lots of time for the baby to turn before labour and if they don’t you can still do it. There were a few concerned looking faces during my last two births but I was so determined to get my babies out without forceps that eventually started to shift them in the right direction.

Good luck and trust your body! It will all be worth it.

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6 comments on 'The truth about ‘back to back’ birth'

  • Two out of my five were back to back and I had natural deliveries with just gas and air and no stitches either. The pain was very different to my other three labours, it was all in my back and bum but still no more painful than the others really? I think that there is such a fear of back to back babies when actually, your body just does what it is supposed to!! Thanks for sharing! #sharewithme

  • Oh just reading this makes me hold my breathe. I won’t say I can relate I have heard so much about back to back labor being the hardest and toughest labors. You are so strong and brave to go through it four times. Mother of steel I call you. While I think I am a big wimp and couldn’t handle that I had my babies both very quickly so I think the big man upstairs knew I was a wimp and helped. You really did work hard for your babies darling. :) Impressive. Thank you so much for linking up to Share With Me blog hop. I hope to see you again this week for another great round. #sharewithme

  • Both my girls were back to back, with my first I had very poor midwife care and was kept on my back with feet up in stirrups!!! Pushing for over an hour before forceps delivery in theatre :-( but with second I was determined to have minimal intervention and got to hospital only an hour before delivery! :-) which was waterbirth with only small tear. It can be done without intervention but good midwifery care plays big part. Midwives at hospital I had my second were amazing! They also explained to me that some ladies just have pelvises that have back to back babies and also having a toned tummy can also encourage back to back baby! Far from lounging on sofa!! 😉

    • Thanks for sharing your experience Anna – the stirrups are familiar as that happened with my first and third. You are right about the pelvis too I’m sure, I think mine were always going to be that way by preference lol. Sounds as if you had a much better experience second time around which is so great to hear :)

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