Slow Progress and Back Labor

When Labor Is Slow

If the cervix is not dilating at the expected rate (about 1 cm per hour in active labor), do not panic. Slow progress is common and often responds well to simple changes.

Strategies for Slow Labor

• Change positions every 20-30 minutes, upright positions (walking, swaying, squatting) use gravity to help the baby descend
• Get into a warm bath or shower if available
• Encourage your partner to relax completely between contractions, tension fights dilation
• Try the open knee-chest position if the baby is posterior (back-to-back), this uses gravity to encourage rotation
• Nipple stimulation can strengthen contractions, use gentle stimulation through clothing for 10-15 minutes
• Decrease distractions, dim lights, reduce noise, create privacy

Back Labor (Posterior Baby)

When the baby is facing the birthing person's front (occiput posterior, or OP), the bony part of the head presses against the lower back, causing intense back pain that often continues between contractions.

• Counterpressure is the most effective hands-on tool. Use firm pressure on the lower back during and between contractions.
• Hands-and-knees position or leaning forward on a ball takes pressure off the back
• Pelvic rocking (cat-cow) helps the baby rotate, do it during contractions, not between them
• The double hip squeeze can provide real relief
• Back labor is harder but it does not mean anything is wrong, the baby will often rotate during pushing