As many new mothers can attest, the muscle strains of pregnancy are very real and can be more than just a nuisance. The average weight gain of 25 to 35 pounds, combined with the increased stress placed on the body by the baby, may result in severe discomfort. Studies have found that about half of all expectant mothers will develop low-back pain at some point during their pregnancies.1-3 This is especially true during late pregnancy, when the baby’s head presses down on a woman’s back, legs, and buttocks, irritating her sciatic nerve. And for those who already suffer from low-back pain, the problem can become even worse.
During pregnancy, a woman’s center of gravity almost immediately begins to shift forward to the front of her pelvis. Although a woman’s sacrum-or posterior section of the pelvis-has enough depth to enable her to carry a baby, the displaced weight still increases the stress on her joints. As the baby grows in size, the woman’s weight is projected even farther forward, and the curvature of her lower back is increased, placing extra stress on the spinal disks. In compensation, the normal curvature of the upper spine increases, as well.
While these changes sound dramatic, pregnancy hormones help loosen the ligaments attached to the pelvic bones. But even these natural changes designed to accommodate the growing baby can result in postural imbalances, making pregnant women prone to having awkward trips and falls.
Is chiropractic care during pregnancy safe?
There are no known contraindications to chiropractic care throughout pregnancy. All chiropractors are trained to work with women who are pregnant. Investing in the fertility and pregnancy wellness of women who are pregnant or trying to conceive is a routine care for most chiropractors.
Some chiropractors take a specific interest in prenatal and postnatal care and seek additional training. Below represents designations of chiropractors who have taken advanced steps in working with infertility and pregnancy wellness.
Chiropractors that have been trained to work with pregnant women may use tables that adjust for a pregnant woman’s body.
A chiropractor who is trained in the needs of women who are pregnant will also provide you with exercises and stretches that are safe to use during pregnancy.
Why should I have chiropractic care during pregnancy?
During pregnancy, there are several physiological and endocrinological (hormonal) changes that occur in preparation for creating the environment for the developing baby.
The following changes could result in a misaligned spine or joints:
- Protruding abdomen and increased back curve
- Pelvic changes
- Postural adaptations
Establishing pelvic balance and alignment is another reason to obtain chiropractic care during pregnancy. When the pelvis is misaligned it may reduce the amount of room available for the developing baby. This restriction is called intrauterine constraint. A misaligned pelvis may also make it difficult for the baby to get into the best possible position for delivery. This can affect the mother’s ability to have a natural, non-invasive birth. Breech and posterior positions can interfere with the natural ease of labor and lead to interventions such as c-sections.
The nervous system is the master communication system to all the body systems including the reproductive system. Keeping the spine aligned helps the entire body work more effectively.
What are the benefits of chiropractic care during pregnancy?
Chiropractic care during pregnancy can provide benefits for women who are pregnant.
Potential benefits of chiropractic care during pregnancy include:
- Maintaining a healthier pregnancy
- Controlling symptoms of nausea
- Reducing the time of labor and delivery
- Relieving back, neck or joint pain
- Prevent a potential cesarean delivery
What about chiropractic care and breech deliveries?
The late Larry Webster, D.C., Founder of the International Chiropractic Pediatric Association(ICPA), developed a specific chiropractic analysis and adjustment which enables chiropractors to establish balance in the pregnant woman’s pelvis and reduce undue stress to her uterus and supporting ligaments. This balanced state in the pelvis has been clinically shown to allow for optimal fetal positioning. The technique is known as the Webster Technique.
It is considered normal by some for a baby to present breech until the third trimester. Most birth practitioners are not concerned with breech presentations until a patient is 37 weeks along. Approximately 4% of all pregnancies result in a breech presentation.
The Journal of Manipulative and Physiological Therapeutics reported in the July/August 2002 issue an 82% success rate of babies turning vertex when doctors of chiropractic used the Webster Technique. Further, the results from the study suggest that it may be beneficial to perform the Webster Technique as soon as the 8th month of pregnancy when a woman has a breech presentation.
Currently, the International Chiropractic Pediatric Association (ICPA) recommends that women receive chiropractic care throughout pregnancy to establish pelvic balance and optimize the room a baby has for development throughout pregnancy. With a balanced pelvis, babies have a greater chance of moving into the correct position for birth, and the crisis and worry associated with breech and posterior presentations may be avoided altogether. Optimal baby positioning at the time of birth also eliminates the potential for dystocia (difficult labor) and therefore results in easier and safer deliveries for both the mother and baby.
Chiropractors and pregnancy: Talk to Your Health Care Provider
As more women are seeking the benefits of chiropractic care throughout pregnancy, more health care providers are seeking trained doctors of chiropractic in their communities to refer their pregnant patients to. Discuss these options with your health care provider. If they are not yet familiar with chiropractic care in pregnancy, ask them to find out more about its many benefits. Most importantly, seek options that support your body’s natural abilities to function and find a team of providers who are respectful of your choices.
What Can You Do?
The ACA (American Chiropractic Association) recommend the following tips for pregnant women:’
- Exercise
- Safe exercise during pregnancy can help strengthen your muscles and prevent discomfort. Try exercising at least three times a week, gently stretching before and after exercise. If you weren’t active before your pregnancy, check with your doctor before starting or continuing any exercise.
- Walking, swimming, and stationary cycling are relatively safe cardiovascular exercises for pregnant women because they do not require jerking or bouncing movements. Jogging can be safe for women who were avid runners before becoming pregnant-if done carefully and under a doctor’s supervision.
- Be sure to exercise in an area with secure footing to minimize the likelihood of falls. Your heart rate should not exceed 140 beats per minute during exercise. Strenuous activity should last no more than 15 minutes at a time.
- Stop your exercise routine immediately if you notice any unusual symptoms, such as vaginal bleeding, dizziness, nausea, weakness, blurred vision, increased swelling, or heart palpitations.
- Health and Safety
- Wear flat, sensible shoes. High or chunky heels can exacerbate postural imbalances and make you less steady on your feet, especially as your pregnancy progresses.
- When picking up children, bend from the knees, not the waist. And never turn your head when you lift. Avoid picking up heavy objects, if possible.
- Get plenty of rest. Pamper yourself and ask for help if you need it. Take a nap if you’re tired, or lie down and elevate your feet for a few moments when you need a break.
- Pregnancy Ergonomics: Your Bed and Desk
- Sleep on your side with a pillow between your knees to take pressure off your lower back. Full-length “body pillows” or “pregnancy wedges” may be helpful. Lying on your left side allows unobstructed blood flow and helps your kidneys flush waste from your body.
- If you have to sit at a computer for long hours, make your workstation ergonomically correct. Position the computer monitor so the top of the screen is at or below your eye level, and place your feet on a small footrest to take pressure off your legs and feet. Take periodic breaks every 30 minutes with a quick walk around the office.
- Nutrition
- Eat small meals or snacks every four to five hours-rather than the usual three large meals-to help keep nausea or extreme hunger at bay. Snack on crackers or yogurt-bland foods high in carbohydrates and protein. Keep saltines in your desk drawer or purse to help stave off waves of “morning sickness.”
- Supplementing with at least 400 micrograms of folic acid a day before and during pregnancy has been shown to decrease the risk of neural tube birth defects, such as spina bifida. Check with your doctor before taking any vitamin or herbal supplement to make sure it’s safety for you and the baby.
How Can Your Maitland Chiropractic Physician Help?
Before you become pregnant, your doctor of chiropractic can detect any imbalances in the pelvis or elsewhere in your body that could contribute to pregnancy discomfort or possible neuro-musculo-skeletal problems after childbirth.
Many pregnant women have found that chiropractic adjustments provide relief from the increased low-back pain brought on by pregnancy. Chiropractic manipulation is safe for the pregnant woman and her baby and can be especially attractive to those who are trying to avoid medications in treating their back pain. Doctors of chiropractic can also offer nutrition, ergonomic, and exercise advice to help a woman enjoy a healthy pregnancy.
Chiropractic care can also help after childbirth. In the eight weeks following labor and delivery, the ligaments that loosened during pregnancy begin to tighten up again. Ideally, joint problems brought on during pregnancy from improper lifting or reaching should be treated before the ligaments return to their pre-pregnancy state-to prevent muscle tension, headaches, rib discomfort, and shoulder problems.
References
- 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.
- International Chiropractic Pediatric Association
- Journal of Manipulative and Physiological Therapeutics, Volume 25, July/August 2002.
