Chiropractic Care In Pregnancy

I am a firm believer in Chiropractic care. Most women don’t know, or don’t see the rationale that chiropractic care is nearly as important as seeing your care giver for prenatal assessment and care.

Strong claim, I know. But, if you consider the average lifestyle choices, activity levels, and personal birth experiences, you will see that chiropractic care is vital to a healthier, easier pregnancy and labor/birth.

What It Is
Some of you might be wondering what, exactly, is chiropractic care. Chiropractic is a branch of holistic medicine which is based upon the understanding that optimal health depends, in part, upon a normally functioning nervous system. The term“Chiropractic” comes from the Greek word Chiropraktikos, meaning “effective treatment by hand.” Chiropractic practitioners understand that distresses, emotional, mental, and physical upsets, begins with the body’s inability to adapt to its environment. (definition information )

Why it Makes Sense
Ever have a neck ache that ended up giving you a headache that ended up making your whole face feel like it was stuffed with cotton? Well, we would think, by the time we got to the stuffy stage, ‘allergies are acting up again’, instead of looking back to the start of it all, that pain in the neck.
That type of situation is compounded, pressed down, and overflowing in pregnancy. Women experience so many changes during their pregnancy, and here is a short list of those changes:

• Hormones –
  • Relaxin causes muscle and ligament relaxation
  • This allows joints to hyperextend and more easily become misaligned
• Center of Gravity –
  • As your center changes, strains are put on joints that are not used to carrying the center
  • Postural adaptations equate more stresses and increase chance of subluxations to different joints and ligaments
• Weight Distribution –
  • Increased demand on spinal and pelvic muscles and ligaments
  • Joint stress, as stated previously, which increases the occurrence of joint misalignments
  • Increase in lumbar and thoracic spinal curves
• Rapid Weight Gain –
  • Demand and fatigue on spinal and pelvic muscles and ligaments

Chiropractic care during pregnancy can help alleviate all of the above strains, pains, discomforts, and stresses. Commonly, women who have chiropractic care during pregnancy can benefit by experiencing:

• Healthier pregnancies
• Less discomfort during pregnancy
• Less nausea during pregnancy
• Prevention of cesarean or aggressively controlled delivery because of fetal or pelvic misalignment
• Shorter, easier labor and birth

During Pregnancy

“Pregnancy is a natural physiological function of the woman. She should feel little discomfort during the pregnancy. You often hear of the person who has little or no discomfort during pregnancy, one who has had mild labor pains and relatively easy delivery. This is the way delivery will be if there is the proper separation of the articulations (Sacro-Iliac Joints)” - Chiropractic Care During Pregnancy, Today’s Chiropractic, September/October 1991

Yes, many women have aches and pains during pregnancy. No matter how much we love being pregnant, sometimes it can be a pain in the butt, or side, or back…

The sacroiliac joints are joints that are frequently adjusted by chiropractors. They are also the joints responsible for the majority of lower back pain during pregnancy.

Likewise, sciatica is a common complaint in pregnancy. Sciatica is caused by pressure on the sciatic nerve. Its symptoms include: pain radiating from the lower back, buttocks, and/or down the back of one leg, and sometimes into the foot, ‘seizing up’ of that appendage (an inability to move or manipulate it), aching or burning, tingling or zinging. It usually occurs only in one side. It makes sense for it to intensify with pregnancy weight gain and hormonal fluctuations.

Round ligament pain is another common complaint in pregnancy and is marked by a stretching, aching, or downright painful radiance like a girdle on the underside of your growing belly. Again, chiropractic adjustments throughout pregnancy can reduce the incidence of this occurring, or can keep it from ever occurring.

Finally, a less reported but equally as uncomfortable complaint of pregnancy is symphysis pubis dysfunction. Because of the hormones women release during pregnancy, the added weight and girth of the uterus setting upon the pelvis, and the over compensation of her posture, some women experience an intense pain of the pubic arch (the mons pubis area), popping of the hip joints, groin discomfort, and lower abdominal issues. Unfortunately, many women continue to suffer from this postpartum. The best remedy? Getting your spine and pelvis aligned properly so that it can accommodate the changing dynamics of your body more easily.

Bottom line, regular chiropractic care before any of these issues crop up are your best bet for an easier, more comfortable pregnancy!

Labor and Birth

"Chiropractic care during pregnancy greatly facilitates the delivery process. Chiropractic care during this time becomes increasingly valuable when one studies Towbin. He states, “Much of the neurological damage at birth is caused by precipitous delivery techniques-i.e. unnecessary pulling forceful traction during deliver.” He further states that most of the signs of neonatal injury observed in the delivery room are neurological and that the apgar score, now widely used in appraising respiratory action, cardiac function, muscle tone, reflex irritability, and other elementary signs of the presence of absence of neurological injury. Subluxations (spinal misalignments) can also occur due to precipitous delivery techniques.

In earlier studies Duncan found that it takes about 120 pounds per pull pressure to initiate spinal damage with this injury (cord subluxations) occurring most often in the cervical spine. Towbin states that he feels 120 pounds pull pressure is not uncommon in a normal delivery. The normal delivery process herein is described as the doctor pulling on the fetus. This pull now can see the need for chiropractic care during pregnancy. Chiropractic care aids in maintaining the integrity of the lumbar-pelvic area. Therefore, chiropractic care facilitates delivery, lessens intervention, lessens the need for pulling on the fetus and, according to Towbin’s Less Precipitous Deliver Technique, lessens neurological damage to the newborn child." -Chiropractic Care During Pregnancy, Today’s Chiropractic, September/October 1991

"There are two things quite apparent for a “normal” birth—one is chiropractic care during the pregnancy for correction of subluxation to allow the pelvic outlet to be at its maximum and a proper birthing position (squatting) to allow gravity to do its job. Chiropractic is always a value during the birth process, but it is even more during or after a supine (lying on the back) delivery. It would seem logical that chiropractic care during pregnancy, chiropractic care for the child and the squatting position for birth are all logical. Let’s be logical for a change." - Modern Day Birthing Techniques Can Produce Subluxations in Both the Mother and The Baby, Webster, L., D.C., International Chiropractic Pediatric Association January 1993

Misalignments can:

• Cause unnecessary pain and discomfort in labor and birth
• Cause a woman’s body to not go into labor at the right time for her body (indicative by start and stop labor or prodromal labor)
• Cause baby to be in a malpresentation or malposition
• Cause a disrupted or inconsistent labor pattern
• Cause slow decent of baby during 2nd stage

Yes, we childbirth professionals tout that, basically, any position except the supine position facilitates an easier birth. Add to that the caring of your spine and pelvis to ensure that everything points directly and easily to the straightest path out of your body, and you have a great chance for an easier, shorter birth.

Additionally, looking at the physiology of labor and birth, the mechanics of the uterus, spine, and pelvis, how they are all interconnected and interrelated, it is easy to understand how even a minor subluxation can be disruptive to the natural process and biological timing of labor and birth.

Baby’s who are carried in uterus’ supported by misaligned spines and tipped pelvis’ tend to favor positions that are not optimal (breech, transverse, posterior, cranial hyperextension, shoulder dystocia, or asynclitic positions). Baby’s who are carried well supported uterus’ by well aligned spines and proportionately stable pelvis’ tend to favor optimal positions for their exit strategy.

Ideally, the well aligned spine, pelvis, and uterus will give optimal room for a well positioned, well supported baby to move easily down the birth canal. It will mean less aches and pains that are not related to physiological labor, meaning less physical and hormonal distraction from the work at hand – resulting in an easier labor and birth.

What About After Birth
Don’t stop going to the chiropractor just because you have given birth! Your body is constantly in a state of motion, shift, and change. Also, immediately following birth, as your body attempts to move back into its pre-pregnancy state, chiropractic care can prevent muscle tension, headaches, rib discomfort, and shoulder problems. This means that your body can continue to benefit from adjustments with a skilled provider.

Likewise, just because you didn’t get care during your pregnancy, it doesn’t mean you can’t start now! If you didn’t get care, or had a large baby, chiropractic care can help get you back on the road to healthier living. Oftentimes, pregnancy and birth can cause long-term neuromusculoskeletal problems if not corrected.

In Closing
Pregnancy, labor, and birth are wonderful and beautiful times in a woman’s life. Natural, physiological pregnancy, labor, and birth should be relatively free of aches, pains, detours, and disruptions. Our lifestyles, the way that we were born, and our daily habits influence how far we have deviated from natural and normal. Chiropractic care can help set right that which is wrong, set straight that which is crooked, and make normal that which has gone awry.  



Resources:

• Fallon J. International Chiropractic Association. 1994 – Arlington, Virginia.
• Bery G, Hammar M, Moller-Nielsen J et al. Obstet and Gynecol, 72:71-75, 1988.
• http://www.chiroweb.com/find/whatischiro.html
• http://en.wikipedia.org/wiki/Symphysis_pubis_dysfunction
• Lisi AJ. Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. J Midwifery Womens Health. 2006 Jan-Feb;51(1):e7-10.
• http://www.americanpregnancy.org/pregnancyhealth/chiropracticcare.html
• http://www.planetc1.com/chiropractic-articles/pregnancy-chiropractic.html
• Östgaard HC, et al. Prevalence of Back Pain in Pregnancy. Spine 1991;16:549-52.
• Berg G, et al. Low back pain during pregnancy. Obstet Gynecol 1988;71:71-5.
• Mantle MJ, et al. Backache in pregnancy. Rheumatology Rehabilitation 1977;16:95-101.
• http://www.acatoday.org/pdf/jacaonline/Jan07/107Pregnant.pdf