Many pregnant individuals experience sensations in their rectal area during contractions. Understanding why these sensations occur can help in navigating labor.
Understanding Contractions
Uterine contractions involve the tightening and relaxing of the uterine muscles. They help thin and open the cervix, guiding the baby downward. Contractions vary in intensity and pattern.
Two types of contractions occur during pregnancy: Braxton Hicks and true labor. Braxton Hicks, often called “practice contractions,” are irregular, mild, and do not increase in intensity or frequency or cause cervical change. In contrast, true labor contractions are regular, become progressively stronger and closer together, and cause the cervix to dilate and efface. These can range from a dull ache to intense cramping in the abdomen and lower back.
Why Rectal Pressure Occurs
Pressure in the rectal area during contractions arises from several physiological mechanisms. The uterus, rectum, and sacral nerves are anatomically close. As the uterus contracts, pressure can be referred to adjacent areas, a type of referred pain where the brain interprets sensation from one area as originating from another due to shared nerve pathways.
As the baby descends deeper into the pelvis, their head can directly press on the rectum, sacrum, and surrounding nerves, intensifying rectal sensation. Pelvic ligaments and muscles also play a role; stretching and pressure on these structures during contractions can radiate sensations to the rectal area.
Back labor is a specific type of pain that often includes intense lower back and sacral discomfort, frequently extending to the rectal area. This occurs when the baby is in an occiput posterior position, meaning their head is down but facing the mother’s abdomen, causing the back of their head to press against the spine and tailbone. This positioning can lead to persistent pain in the lower back and rectal region, which might not fully subside between contractions.
Recognizing True Labor Sensations
Rectal pressure can be an indicator of true labor, particularly as it intensifies and becomes consistent with contractions. During active labor, this pressure often feels like a strong urge to have a bowel movement, directly resulting from the baby’s head pressing down.
Other signs of true labor include contractions that are regular, increase in intensity and frequency, and do not subside with changes in position or rest. These contractions last between 30 and 70 seconds and may come every 5 to 10 minutes, becoming closer together over time. Additional signs can include cervical changes like effacement and dilation, the expulsion of the mucus plug (a “show” or “bloody show”), or the rupture of membranes, commonly known as “water breaking.”
Contact a healthcare provider when contractions become regular, strong, and consistent, lasting about a minute and occurring every five minutes for at least an hour. Immediate medical attention is needed if the water breaks, especially if the fluid is green or brown, if there is significant vaginal bleeding, if the baby’s movements decrease, or if any other concerning symptoms arise.
Managing Discomfort
Several comfort measures can help alleviate rectal pressure and general discomfort during contractions. Changing positions provides relief; examples include kneeling on hands and knees, leaning forward, or using a birthing ball to sit and sway. Applying counter-pressure to the lower back or sacrum, either with hands or a firm object, is also beneficial, especially during back labor.
Warm baths or showers can help relax muscles and reduce pain. Applying warm compresses to the lower back or abdomen, or even cold packs, can also offer comfort. Staying hydrated and resting between contractions can support the body’s endurance during labor. Discussing comfort preferences and techniques with a healthcare provider or birth partner beforehand can help ensure effective support during labor.