CHIROPRACTIC AND PREGNANCY
(ante- and post-natal care)
During pregnancy, most women experience a number of body structure and function changes that respond favourably to gentle chiropractic care:
- Muscle and ligament relaxation due to release of relaxin hormone.
- Increased weight gain and postural changes leading to increased demand on spinal and pelvic ligaments.
- Changes in weight distribution and associated increased joint, ligament and muscle stress.
Studies suggest benefits of Chiropractic during Pregnancy
A survey of nurse-midwives in the US4 showed that 93.9% of them recommended chiropractic, along with herbal therapy and massage, to mums-to-be.
A study in 19915 reported that chiropractic care during pregnancy can reduce the likelihood of experiencing back pain during labour.
Further research6 confirmed this, and suggests that chiropractic can help with low back pain during pregnancy.
Recently it has been reported that chiropractic care can help with migraine headaches during pregnancy7, reducing the need for medication at this significant time. The above evidence strongly points to Chiropractic being an effective form of care to help ease the journey of pregnancy. When compared with the possible side-effects of medication, Chiropractic care can help ease low back pain and headaches, and is extremely safe for both mother and foetus. Please ask to see our pregnancy DVD when in clinic for more information to help you make your decisions about the health and wellbeing of you and your baby.
The Webster Technique, Breech Birth and Pregnancy
I often get asked questions about the Webster Technique by the pregnant women who come to the Cambridgeshire Family Chiropractic Centre in Linton. Webster’s has gained world-wide attention because of the apparent link between poor pelvic alignment, pregnancy related pelvic and lower back pain and the breech presentation of babies.
First up, the Webster Technique has never claimed to be a breech baby turning technique and there is no forceful manoeuvring of the baby performed during the procedure. Webster’s technique is a very gentle yet effective technique designed to ensure that the mother’s pelvis is well aligned and that the muscles and ligaments that surround the pelvis and womb are under normal tension. As a result of the reduced strain placed upon the pelvis and womb some women report a more comfortable pregnancy and delivery with its use and in some cases there are reports of babies turning naturally on their own. There is a correlation between a poorly aligned and conditioned pelvic structure with breech presentations (explained below) and that if the Chiropractor is able to restore normal alignment then there is a chance that the baby will be able to turn naturally of its own accord. Here is the official description of the Webster Technique from the International Chiropractic Paediatric Association (ICPA):
The Webster technique is a specific chiropractic analysis and diversified adjustment. The goal of the adjustment is to reduce the effects of sacral subluxation/sacro-iliac joint dysfunction. In so doing neuro-biomechanical function in the pelvis is improved.
So in a nutshell the Webster Technique is a specific Chiropractic technique used to analyse and correct pelvic imbalances found in any person at any age. Yet it is commonly applied to pregnant women because of the gentle ease of application that is well suited to pregnant bodies.
What is a breech baby?
A baby is breech when their bottom, or legs are presenting into the lower part of the uterus rather than its head, which is the most advantageous position for natural delivery. Many breech babies spontaneously correct before (or even during) labour, without assistance. It is, however, ideal for baby to be head down and engaged when labour begins to facilitate delivery and minimise the potential need for interventions like Caesarian Section or forceps.
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Why is back pain during pregnancy and breech presentation so common?
In my clinical experience the complaints of back pain, pelvic pain, pubic symphysis pain (PSD) and breech presentation are very common reasons for women to seek the help of chiropractors. This really is not at all surprising when you consider the dramatic changes in weight, centre of gravity and loosening of the stabilising ligaments of these joints. However not every pregnant woman experiences these pains, and many go on to have complication-free natural deliveries.
The real question is what goes wrong in the women who do? There must be a logical explanation as to why some go on to develop pelvic pain, lower back pain or sciatica. Why do some babies fail to turn and remain breech and why do some mothers go on to have difficult labours requiring interventions like C-Section, ventouse and forceps? This is important because the research shows that difficult labours represent a traumatic start in life for the developing child and may have repercussions for future health.
The main differences are all to do with the way the spine, pelvis and nervous system are functioning. Let’s take a look at these things in turn:
The main job of the pelvis is to provide a foundation for the spine and body. If this foundation is well aligned and stable then there are likely to be fewer problems when increased stress and load are added later in pregnancy. Now, imagine if the foundation to your house was un-level? Surely this would risk structural problems developing in the future? Well, this is exactly what I see in clinical practice. If the structure is poorly supported you run the risk of developing problems as the bio-mechanical stress placed on the pelvis and lower back gradually increases throughout pregnancy.
Another role that the pelvis plays is to be a ‘bowl’ to support the developing baby. Connecting the womb to the pelvis are specific ligaments known as the ‘round ligaments’. If the pelvis gets twisted or distorted in an unusual way, a couple of key things are going to happen. There will be a torsion or strain placed upon the uterus through these ligaments, thereby effectively decreasing the room available for the baby to develop and move around in. This is known as ‘intrauterine constraint’ and is one of the many reasons for why a baby can present breech. Secondly, during labour the baby’s head must descend through the bottom of the pelvis, so the birth canal is ultimately bordered by these bones. Pelvic misalignments may therefore affect the size of the birth canal and may lead to difficult deliveries.
The spine and the sacrum play a very important role acting as a bony protective tube for the nervous system, the communication system between your brain and body. The theoretical model on which chiropractic works is that spinal misalignments (which chiropractors call subluxations) can result in an imbalance in surrounding muscles and ligaments. Additionally, the resulting nervous system stress may affect the body’s ability to function optimally. Therefore it is likely that pelvis subluxations may contribute to difficult labour for the mother.
The Importance of the Webster Technique during Pregnancy
Enter the importance of Chiropractic care. Doctors of Chiropractic work with their hands to correct spinal, pelvic and cranial misalignments (subluxations) so that the body can function normally and reach an optimal state of balance and stability. With Webster’s Technique the mother’s body is carefully assessed for positional (postural) changes, areas of ligamentous laxity and muscle weakness. Safe, light, non-manipulative techniques are then applied to the mother’s body to rebalance it.
There is no contact with the baby, and therefore is not stressful to the unborn child at all, and the baby will only move when it is ‘ready’. This is a different technique to external cephalic version (ECV) which is only performed by qualified obstetricians and midwifes, and involves manually manoeuvring the baby out of breech position. Webster’s Technique should not be interpreted as an obstetric “breech turning” technique. It simply allows the baby to have maximum space in which to turn themselves, if possible.
The importance of lifestyle and helping yourself at home
Once we have helped you to achieve proper stable alignment it is important that we help to find out why these problems started in the first place. For most people it is due to a slow, steady accumulation of lifestyle stresses over many months to years. At Cambridgeshire Family Chiropractic Centre we work really hard to teach you how to live a healthy life and how to avoid the myriad of physical, chemical and emotional stresses that bombard the average person daily. When pregnant this means learning how to do the right kind of gentle spinal and pelvic hygiene exercises, how to exercise safely, how to eat the right foods to nourish yourself and your child optimally and how to handle emotional stress effectively to stop the negative effects of stress hormones on your health. We like to call this eating well, moving well and thinking well.
Ideally a pregnant woman would be having regular chiropractic care throughout her pregnancy, and afterwards as her body adapts to motherhood, to maintain an optimally healthy spine, pelvis and nervous system in face of all of these stresses.
What to do next
If you are suffering with lower back pain, pelvic pains or breech presentation it is absolutely worth seeking the advice of a qualified chiropractor who is proficient in treating pregnant women.
The best thing to do is simply call our office on 07870 568548, and ask to have a consultation. If we think we can help you we will explain everything in advance and do our very best. If we don’t feel that chiropractic is right for you at this time, we are committed to find the next best place for you.
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4 Allaire AD, Moos MK, Wells SR; Complementary and alternative medicine in pregnancy: a survey of North Carolina certified nurse-midwives; Obstet. Gynecol. 2000 (Jan); 95 (1): 19-23
5 Diakow et al; Back pain during pregnancy and labor; J Manip Physiol Therap 1991 (Feb); 14 (2): 116-118
6 Fallon JM. Chiropractic and pregnancy. Int Rev Chiro 1990;46(6):39-42
7 Alcantara J, Cossette M; Intractible migraine headaches during pregnancy under chiropractic care; http://www.icpa4kids.com/research/published_papers/Migraines_Pregnancy_RAC_2008.htm (2008)