More and more women are seeking the benefits of chiropractic care in pregnancy. Many birth care providers are becoming aware of the efficacy of care throughout pregnancy and encouraging their patients/clients to find doctors of chiropractic who are interested in caring for pregnant women. As with any specialty group within the population, there are specific types of spinal analysis and adjustment which are adapted to the best care for that population.
The Webster Technique is a specific analysis and adjustment whose appeal, necessity and popularity are increasing in both the professional and public sectors. Discovered by Dr. Larry Webster, this technique was first taught as a sacral adjustment which allowed a baby in a breech presentation to turn to the vertex position. As founder of the International Chiropractic Pediatric Association (ICPA) and Pediatric Instructor at Life College, Dr Webster had the venue to share this technique with many students and doctors of chiropractic. These practitioners brought this technique into their communities and, according to Dr. Webster’s instructions, offered it to mothers who presented with breech presentations in their last tri-mester. Success with this specific adjustment to alleviate “breech presentations” became known by birthing practitioners (primarily midwives) and it became known as the Webster Breech Turning Technique.
When Dr. Anrig was compiling the extensive materials for her textbook, Chiropractic Pediatrics, the name of the technique was revised to the Webster In-Utero-Constraint Technique. This title reflected a more accurate description of the technique, as it identified the physiological relationship between the sacral subluxation and intrauterine constraint.
After Dr Webster’s passing in 1997, the technique continued to be taught by instructors of the ICPA’s 120-hour certification program. With its increased exposure and use, more women experienced the benefits of the technique and more practitioners expressed greater interest in defining the physiological aspects of this particular analysis and adjustment. A look into the physiology of the woman’s pelvis, particularly the suspension ligaments of the uterus and their biomechanical relationship with the sacrum, revealed a deeper understanding of how the administration of this technique could affect the positioning of the developing fetus. In February 2000, the ICPA approved and incorporated a Technique Proficiency class to update and expose doctors to the, now understood, physiology of the technique. The technique, itself, became termed the “Webster Technique.”
This more sophisticated understanding led to an evolution in the technique protocols. Whereas the technique was previously used on women presenting breech in their last trimester only, it is now understood that this specific sacral analysis and adjustment is an asset to the pregnant woman throughout pregnancy as a means of preventing or limiting the potential of intrauterine constraint.
Intrauterine constraint is a condition where fetal movement is restricted, resulting in potential adverse effects to its development throughout pregnancy. Furthermore, limited movement and space in the uterus can lead to malpresentation in various forms: breech, transverse, posterior, as well as ascynclitic presentations. Malpresentation at the time of birth is one of the four leading causes of dystocia (difficult labor). Dystocia is the primary reason for medical intervention. Medical intervention almost always leads to further intervention and, frequently, results in a more traumatic birth for both the mother and baby.
It is a wonderful thing to offer a service and help create an environment that allows a baby to go from breech to vertex. Breech presentations, however, occur in only 4% of the population. Many, many more women experience dystocia in labor, leading to excessive interventions and trauma. When it comes to birth, the obstetric profession readily refers to difficult labor and its cause by admitting that, “Such complications, however, are not determined by birth weight alone, but by a poorly understood relationship between fetal and maternal anatomy and other factors.” In Williams Obstetrics’ chapter on dystocia, the authors also admit that they have a limited understanding of the natural, physiological process of birth.
As doctors of chiropractic, our perspective on physiology offers significant insight into intrauterine constraint, its effects, and the difficult labors it creates. The Webster Technique is a significant analysis and adjustment to be utilized throughout pregnancy for the prevention of dystocia.
The ICPA Technique Committee has put out an official definition of the Webster Technique, and encourages all doctors to remain consistent with this definition when referring to this technique. The term “breech turning” is physiologically, legally and philosophically incorrect. The definition is as follows: “The Webster Technique is a specific chiropractic analysis and adjustment which reduces interference to the nervous system, improves the function of the pelvic muscles and ligaments, which in turn, removes constraint of the woman’s uterus, and allows the baby to get into the best possible position for birth.”
The ICPA Research Department is involved in several large scale studies to demonstrate the efficacy of the Webster Technique for safer, easier births. Members of the ICPA are being invited to participate in these exciting projects.
Since ICPA’s initiation of the Webster Proficiency series in Feb 2000, over 2,000 practitioners have become certified. They are now aware of the physiology behind the technique and the far reaching implications it has on the future of safe and natural birthing. If you are already certified, kudos to you and the women in your community! If you learned the technique years ago, update your knowledge and understanding of its application. Your ability to adequately explain its efficacy to both women and birth care providers establishes your credibility. The way you represent this technique in your community has ramifications for the entire profession. If you do not know this technique, you owe it to the women in your community to become proficient and lead them towards safer, easier births.
It is a true teacher’s dream to see his or her work grow and evolve to be of even greater service and value. When I think back on our founder and teacher, Dr. Larry Webster, I know he would be pleased that his technique is now offering a significant contribution to safer, easier births for all pregnant women.
Dr. Jeanne Ohm has practiced in a family practice with her husband, Dr. Tom, since 1981. They have six children who were all born at home. Dr. Ohm has lectured internationally on the topic Chiropractic Care in Pregnancy and Infancy for many years and is an instructor for the ICPA’s Certification Diplomate Program. Currently, Dr. Ohm is the Executive Coordinator of the International Chiropractic Pediatric Association, the oldest and largest organization of its kind. For additional information about the ICPA or their classes, please visit www.icpa4kids.com or call 610 565-2360.