Chiropractic care is essential for the pregnant mother. Her systems and organs are now providing for two, and their optimal function is critical for the baby’s healthy development. The mother’s spine and pelvis undergo many changes and adaptations to compensate for the growing baby, and the risk of interference to her nerve system is substantially increased. Specific chiropractic care throughout pregnancy works to improve nerve system function, providing greater health potential for both the mother and baby.
Another important reason for care throughout pregnancy is to help establish balance in the mother’s pelvis. Because of a lifetime of stress and trauma to her spine and pelvis, her pelvic opening may be compromised, resulting in a less than optimum passage for the baby. Williams Obstetrics text tells us that, “Any contraction of the pelvic diameters that diminishes the capacity of the pelvis can create dystocia (difficulty) during labor.” They further state that the diameter of the woman’s pelvis is decreased when the sacrum is displaced. Dr. Abraham Towbin, medical researcher on birth, tells us that the bony pelvis may become “deformed” this way, by trauma.
Additionally, these compensations to her spine and pelvis during pregnancy are likely to cause an imbalance to her pelvic muscles and ligaments. The woman’s pelvis supports her growing uterus with specific ligaments. When the pelvic bones are balanced, the uterus is able to enlarge symmetrically with the growing fetus. If the bones of the pelvis are subluxated, this will directly affect the way the uterus will be supported. Unequal ligament support of the uterus will cause torsion to the uterus, reducing the maximum amount of room for the developing fetus. Reduced space for the fetus is called intrauterine constraint.
In some cases, this constraint restricts the fetus’ positions during pregnancy, adversely affecting his/her developing spine and cranium. Additionally, these limitations on the fetus’ movement during pregnancy may prevent him/her from getting into the best possible position for birth. Any birth position other than the ideal vertex, occipital anterior position of the baby may indicate the inhibiting effects of constraint. Such mal-positions lead to longer more painful labors with increased medical interventions in birth. Often c-sections result and both the mother and baby miss the many benefits of a natural vaginal birth.
The Webster Technique, developed by Dr. Larry Webster, founder of the International Chiropractic Pediatric Association (ICPA), is a specific chiropractic analysis and adjustment for pregnant mothers. Working to correct sacral subluxations, this technique balances pelvic muscles and ligaments in the woman’s pelvis, reduces intrauterine constraint and allows the baby to get into the best possible position for birth. For many years, the ICPA has instructed numerous doctors in this technique, and their clinical results show a high success rate in allowing babies in the breech position to go into the normal head down or vertex position.
Dystocia is the obstetric term defined as difficult or prolonged labor. Based on the four physiological causes of dystocia as defined by Williams Obstetrics text, specific chiropractic adjustments address each of these reasons, potentially eliminating the physiological causes of dystocia. This means that the doctor of chiropractic can play a vital role in the prevention of dystocia when the patient is seen throughout pregnancy. Reducing the potential for dystocia lowers the incidence of medical interventions associated with difficult labor and delivery.
The Webster Technique offers the doctor of chiropractic a means of analysis and correction to be used throughout pregnancy to facilitate easier, safer deliveries. As in all techniques during pregnancy, the analysis must be specific and the thrust gentle. The sacral adjustment may be done side posture when the practitioner avoids any torsion to the pelvic and respiratory diaphragms. The adjustment may be done prone with the use of pregnancy pillows for comfort and safety. In either mode, correcting the sacral misalignment is paramount.
Specific sacral analysis is performed on each visit throughout pregnancy to determine the correction needed. Care continues throughout pregnancy to restore and maintain balance in the pelvis. There are no known contraindications to this adjustment throughout pregnancy.
The ICPA offers doctors of chiropractic the opportunity to learn this technique as originally instructed by Dr. Webster and with variations pertinent to the many specific cases that come into your office. Specifically, the ICPA Perinatal Class offers the attendee an understanding of the physiological causes of dystocia and the specific adjustments relevant to its prevention.
It is important that doctors of chiropractic actively embrace the pregnant population into their practices. The potential elimination of dystocia, because of the positive effects the chiropractic adjustment has on birth outcome, is an important service chiropractic offers.
References
1. Cunningham FG, et al, Dystocia Due to Pelvic Contraction, Williams Obstetrics, Nineteenth Ed. 1989.
2. Towbin A, “Dystocia”, Brain Damage in the Newborn and its Neurologic Sequelle, 1998.
3. Netter F. Pelvic Viscera and Perineum. Atlas of Human Anatomy, 1994.
4. Hellstrom B. Sallmander U. Prevention of Spinal Cord Injury in Hyperextension of the Fetal Head. JAMA 1968, 204(12): 1041-4.
5. Anriig C, Plaugher G. Chiropractic Management of In-Utero Constraint. Pediatric Chiropractic, 1998; Chapter 5, page 102.
Jeanne Ohm, DC, has practiced Family Chiropractic since 1981. She is currently Executive Director of the International Chiropractic Pediatric Association and is the instructor on Perinatal Care in their 360-Hour Diplomate program. She can be contacted via their site at: www.icpa4kids.com.