Pregnancy & Chiropractic

Low Back Pain

Low back pain is a common complaint amongst women during pregnancy, having a great impact on their quality of life and the joy of pregnancy.​ It has been estimated that about 50% of pregnant women will suffer from low back pain at some point during their pregnancies or during the postpartum period.
As baby grows and weight is gained, the body's center of gravity is shifted forward, causing structural changes that greatly increases the stress on the low back and pelvis. Typically, a woman's body is usually able to adapt to these postural changes, however, segmental dysfunction within the spine or pelvis can cause painful secondary conditions, such as low back pain and sciatica.
As the pregnancy advances, hormonal changes prepare the pelvis for delivery by loosening the strong ligaments that control the function of these joints. The increased elasticity of these ligaments during pregnancy is necessary for the birth canal to expand as the baby passes through it. However, the increase in motion and instability can also be a source of sacroiliac pain.
Segmental dysfunction is the most common cause of back pain in pregnancy. While it can be quite painful, this condition is treatable and tends to get better after delivery of the baby. For patients experiencing back pain during pregnancy, segmental correction chiropractic can provide effective pain relief.

Breech Position

​Approximately 4% of all pregnancies result in breech and posterior presentations which can be a source of crisis and worry for expecting mothers. The chiropractor's role in a breech presentation is to balance and correct structural dysfunction in the pelvis which removes pelvic constraint and allows the fetus to assume the correct position. At no time does the chiropractor attempt to change the position of the fetus, as is done with external cephalic version. The chiropractor simply attempts to correct a potential cause of intrauterine constraint which allows baby to reposition on their own.
​Chiropractic analysis and adjustments, specific to the pregnant patient, have been developed which enables chiropractors to establish structural balance in the pregnant woman’s pelvis. Correcting structural imbalance has been clinically shown to allow for optimal fetal positioning.
Currently, the International Chiropractic Pediatric Association recommends women receive chiropractic care throughout pregnancy to establish pelvic balance and optimize the room a baby has for fetal development. With a balanced pelvis, babies have a greater chance of moving into the correct position for birth, naturally.

Labor & Delivery

​Many women are unaware that chiropractic care can actually impact labor in beneficial ways and instead believe a specific complaint is needed in order to recommend chiropractic. ​Optimal baby positioning at the time of birth also eliminates the potential for difficult labor and, therefore, results in easier and safer deliveries for both the mother and Research has found that women receiving chiropractic care through their first pregnancy had 24% reduction in labor times and subjects giving birth for the second or third time reported a 39% reduction.

Post Partum

Regarding the postpartum patient, previous research has indicated that in patients with moderate to severe pregnancy-related pelvic pain, segmental dysfunction can cause persisting complaints in 77% of women postpartum. Likewise, the postpartum patient faces physiological changes as the body returns to normal. After delivery, rehabilitative exercises should be used to strengthen core muscles. Continued chiropractic care is also beneficial in correcting segmental dysfunction of the spine and therefore restoring normal spinal biomechanics.

Adjustments

The loose ligaments brought on by pregnancy often makes adjusting comparatively easy using the gentlest of techniques. A patient who is comfortable will relax more completely and require a less forceful adjustment to be applied. The chiropractic adjustment can be beneficial and, with proper patient positioning for comfort and relaxation, only the slightest force is needed to safely and successfully correct segmental dysfunction in the spine and pelvis.

Sources

  1. Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A, and Alpantaki K. Pregnancy-related low back pain. Hippokratia. 2011 Jul-Sep; 15(3): 205-210.
  2. Triano, JJ. What causes back pain during pregnancy? www.spine-health.com. April 22, 2000.
  3. Borggren, CL. Pregnancy and chiropractic: a narrative review of the literature. Journal of Chiropractic Medicine. 2007 Spring; 6(2): 70-74.
  4. ​http://americanpregnancy.org/pregnancy-health/chiropractic-care-during-pregnancy/
  5. ​Pettigrew J. Utilizing chiropractic for optimal pregnancy and birth outcomes. Midwifery Today with International Midwife. 2014 Summer; (110):56-57.
  6. ​Rosenberg, S. 2008. "An Expectant Parent's Guide to Chiropractic." Pathways to Family Wellness. 20.

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Leave a Reply 2 comments

Kim M. - March 27, 2017 Reply

What’s breech? Is that an issue with the baby or the mother herself? Thanks for sharing this, by the way. Very informative!

Rebecca - October 17, 2017 Reply

What is breech?

As babies grow and develop throughout pregnancy many changes are happening to their body and nervous system including how they position themselves in mom. It is normal for the baby to go through many turns and positions, including breech, up to even 38 weeks in pregnancy.

Ideal positioning of the baby, at birth, is when the head is facing down at the birth canal and feet toward the mother’s head. Breech is not a condition but a type of position the baby is in. Breech position is when the baby is not in the ideal head down feet up position. There are three main types of breech presentations: frank, complete and footling. In a frank position the baby’s bottom is toward the birth canal, the head is facing up towards mom’s head and the feet are up next to it’s head. In complete presentation the baby is sitting with it’s legs crossed toward birth canal and head towards mom’s head. Footling presentation is when one or both feet are elongated down towards birth canal and it’s head is towards mom’s head.

Chiropractic care does not turn breech babies, but produces balance in the pelvis and relieves structural dysfunction which may make the baby more comfortable and able to grow naturally. Chiropractic care in pregnancy will maximize mom’s comfort, create pelvic balance, reduce musculoskeletal complaints and produce an optimal area for their baby to develop. It’s important for moms to educate themselves on all of their options throughout their birth and pregnancy. The more planning and education a mom has on birth, the more confident and comfortable they will be at birth.

Edwards, John, & Alcantara, Joel. “The Chiropractic Care of a Pregnant Patient Experiencing Multiple Fetal Positional Changes.” Journal of Pediatric, Maternal, & Family Health. 2015.2 (2015): 77-81.

Irion O; Hirsbrunner Almagbaly P; Morabia A Planned vaginal delivery versus elective caesarean section: a study of 705 singleton term breech presentations Br J Obstet Gynaecol. 1998 (Jul); 105 (7): 710-717

Yost, Heather. Turn Turn Turn: Options for Breech Babies. Chiropractic for Life (28). 2010 (Dec). http://icpa4kids.org/Wellness-Articles/turn-turn-turn-options-for-turning-and-birthing-breech-babies.html

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