When pain in the lower back presents with other symptoms during pregnancy, it could be a sign of labor. Lower back pain tends to get more intense with contractions and does not go away when they ease.

If a pregnant person is experiencing back pain and is unsure whether they are in labor, they can look out for other signs and symptoms. The American College of Obstetricians and Gynecologists (ACOG) note that these include the water breaking and the sensation of the baby dropping lower into the pelvis, which they say might make a person feel “lighter.”

This article discusses the type of back pain that could signal the onset of labor and how to reduce the pain. It also explains when to go to the hospital.

A woman who is pregnant who may be experiencing back pain.Share on Pinterest
nazar_ab/Getty Images

According to the ACOG, the following factors can contribute to back pain during pregnancy:

  • Hormones: Some hormones that prepare the pelvic ligaments for labor can make the pelvis unstable, leading to back pain.
  • Increased body weight: The extra weight places more stress on the spine when a person stands up.
  • Expanding uterus: As the uterus and fetus expand, a person’s center of gravity shifts, weakening the abdominal muscles and placing more strain on the back.

Back pain can occur throughout pregnancy. During labor, research suggests that continuous and severe back pain will affect about 33% of people.

During labor, back pain is often severe and sharp during contractions. Unlike other pain, it does not necessarily subside between contractions. Due to this, lower back pain can be a constant source of discomfort throughout the entire labor process.

The ACOG suggest that a person who experiences intense back pain should speak with their obstetric care provider about pain relief.

During labor, the most common source of back pain is from the baby’s head exerting pressure on the lower back, which happens when the baby’s head is down and facing forward.

Some underlying health conditions, such as scoliosis and exaggerated swayback, or lordosis, may also cause lower back pain during labor.

Having a small waist can exacerbate back pain as this may cause the baby’s head to exert more pressure on the lower back when giving birth.

Lower back pain on its own does not necessarily mean that labor is imminent. However, a person should call their obstetric care provider if they notice other symptoms of labor, such as new onset back pain and cramping that occurs about every 10 minutes and lasts for 40–50 seconds.

The ACOG recommend that a person go to the hospital if:

  • fetal movement is less frequent
  • the water has broken, and no contractions are occurring
  • there is heavy vaginal bleeding
  • they experience severe pain with minimal relief between contractions

Back pain symptoms from pregnancy and labor can be similar, so in some cases, it can be difficult for a person to tell the difference between the two.

However, although lower back pain during labor is likely to last between contractions, it will typically get more intense during them.

Learn more about different types of contractions here.

If a person experiencing intense back pain thinks that they might be going into labor, the ACOG recommend paying attention to the following signs:

  • regular contractions that are increasing in frequency
  • a feeling that the fetus has dropped lower in the pelvis
  • the water breaking
  • loss of the mucus plug

A person who experiences back pain during labor can ask for pain medication. People who want limited or no medication may find relief from adopting different positions that support their back.

Doctors generally suggest analgesics, which reduce pain without affecting movement or muscle control, or anesthetics, which block pain and touch sensations.

The medical community does not consider certain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, to be safe during pregnancy. A person should always consult their doctor before taking any medication when pregnant.

In addition to medication, a person may wish to try using natural methods to manage their pain.

Doctors at the University of Texas Southwestern Medical Center suggest the following methods to ease pain during labor:

  • taking a warm shower or bath
  • trying different positions, such as sitting on a birthing ball or squatting
  • walking during labor
  • using breathing techniques, such as Lamaze
  • massaging the back or other areas where pain occurs
  • using essential oils or aromatherapy
  • using calming techniques, such as hypnosis, meditation, and music therapy

In most cases, back pain during pregnancy and labor is unavoidable. However, a person can take steps to try to lessen the discomfort.

Some methods that could reduce back pain during labor include leaning over sturdy objects while standing and avoiding crossed legs while sitting.

A person should talk with their obstetric care provider if they have any questions or concerns about their pregnancy, no matter what stage of pregnancy they have reached.

Attending prenatal appointments and regular checkups will help ensure that the pregnancy is progressing healthily.

If a person experiences unexpected bleeding, severe pain, or other symptoms that may indicate a medical emergency, they should go to the emergency room.

Back pain is a common symptom of pregnancy and labor, but it is not a sign of labor on its own.

Other signs of labor include the water breaking, regular contractions, and the loss of the mucus plug.

A person should call their obstetric care provider if they think that they are in labor or have concerns about their pregnancy.