I have no idea if my daughter was actually back to back while in labour, but she was back to back all of 3rd tri, including at the 36 week scan I had a week before I had her. If she was in fact back to back during labour, the only difference I feel it really made was that I had a long 2nd (pushing) stage, which is quite typical when babies that were back to back take time to turn to get more optimally positioned for birth. That was definitely tiring and intense! I was pushing (and on my feet, squatting to push) for 4 hours, which is a long time, and my legs were so, so tired by the time I had her. But I didn't find it to be especially painful and as far as I know I didn't have any back labour, but as she was my first, I really have nothing to compare it to. I also used a TENS machine from just when contractions because regular (strong period like cramps) until I was pushing, which I think would have helped a lot, if I had any back labour (which maybe is why I don't feel like I did). I also used natal hypnotherapy, which just helped me feel really comfortable and relaxed overall, which is again why I think it was so manageable. But really, it wasn't a big deal. Other than the long pushing stage and the midwives getting a bit twitchy about me pushing so long (I had a home birth and if I had needed any intervention I would have had to head into hospital first, so they were extra cautious), I was totally fine and manageable and not that painful (didn't need any pain relief other than the TENS).