Challenging Labor
Back labor, slow progress, and what to do when things get hard
The Take-Charge Routine
Use this when your partner has lost your partner's rhythm and cannot recover it on your partner's own, most often in transition or a difficult stretch of active labor. It is not aggressive. It is focused and anchoring.
Back Labor
Back labor happens when the baby is in a posterior position (facing forward instead of toward the spine). The baby's skull presses on the sacrum with each contraction. Pain does not fully ease between contractions.
A Note on Epidurals in Back Labor
The instinct when back labor is relentless is to ask for an epidural. But an epidural removes the ability to use hands-and-knees, the standing lunge, and pelvic rocking, the tools most likely to rotate the baby. If position changes have not been tried systematically, exhaust them first. Once the epidural is in, those options are gone.
Slow Progress in Active Labor
If dilation stops for 2+ hours with adequate contractions, caregivers will discuss interventions. Before escalating, try:
Slow-to-Start Labor
Irregular, infrequent contractions that aren't progressing are common and frustrating.
Very Rapid Labor
Sometimes labor goes from irregular to almost-pushing within a couple of hours. Rapid labor is often harder than long labor, there's no gradual buildup.
Your Stamina Matters
Stalled labor is discouraging and exhausting for you too. Eat when your partner eats. Rest when your partner rests. If a doula is not present and labor has been long, this is the moment to seriously consider calling one.