Pregnancy and Chiropractic

The joys of pregnancy! Whether this is your first baby or your fifth one, there is much to look forward to and prepare for.

Chiropractors have actually cared for pregnant women for many years. Recently, however, with the increased interest in natural birthing, and in an effort to avoid having a C-section, a growing number of mothers have incorporated chiropractic into their prenatal care. To understand how chiropractic care can contribute to a better birth, it is important to look at the mother’s and fetus’s biomechanics throughout pregnancy.

Hormonal and Structural Changes taking place during Pregnancy

A pregnant woman’s body undergoes an amazing amount of changes during pregnancy. As the fetus develops, her musculoskeletal system needs to adjust in accordance in order to accommodate the growing uterus and prepare for the delivery. Chiropractic care is aimed at helping a pregnant woman’s body stay aligned as these changes take place and helps to keep the nervous system functioning at its optimal level.

From pelvic shifts to changes in appetite to breast enlargement and tenderness to back pain, pregnancy can strain every part of the body. These hormonal and structural changes taking place in the body of a pregnant female can lead to pelvic and spinal misalignment and pain in the lower back experienced by a number of women during pregnancy. 

• Changes in Lumbar Spine During Pregnancy

As the pregnancy progresses, there is an increasing weight added to the anterior aspect of the pelvis. In order to distribute weight more evenly throughout the body and maintain stability, the lumbar spine becomes more ‘Lodortic’ (an abnormally increased inward curvature of the spine in the lumbar region). This increase in normal curvature of the spine can lead to sciatica, knee pain and muscle spasm.

The primary cause of lower back pain in a pregnant female is structural adaptation. The changing load distribution taking place due to the growing fetus causes spinal dysfunction. Additionally, pressure on the internal organs such as peritoneum, bladder and rectum are also some of the causes of back pain and muscle spasms.

The normal weight gain of 25-30 pounds during pregnancy may also lead to priformis syndrome (a neuromuscular disorder that occurs when the sciatic nerve is compressed by the priformis muscles located in buttocks) causing low back pain, sciatica pain and leg pain. Sciatica can also be a caused by pelvic instability as the sciatic nerve passes through the priformis muscle.

• Misalignment of Pelvis and Spine and its Consequences on a Pregnant Female

These discomforts are the result of the stresses put on the body by the rapid growth of the baby and the changes the body must undergo to accommodate those adjustments. As her belly becomes bigger, the center of gravity changes. The growth is so quick that it is often difficult for the low back and pelvis to adjust to this change. This causes stress in those areas, resulting in misalignments, which then causes pain and dysfunction.

The misalignment of pelvis and spine may have a far greater impact on the pregnant patient in comparison to her developing baby. These misalignments are called subluxations (partial dislocation) in chiropractic. As the pregnancy progresses more weight is transferred to the front of the abdomen. This constant abdominal pressure may lead to significant pain and dysfunction. This pain is excruciating and is greatly exacerbated by the change in the centre of gravity and weight of the protruding abdomen.

These stresses in a pregnant female may cause partial dislocation in the mother’s spine which may lead to interference in the communication pathway between the brain and the body. These blockages may also induce additional stress on the nervous system of the pregnant female, causing potential impairing of organs and vital systems. It goes without saying that during pregnancy any interference to the nervous system can be detrimental not only to her health but also the wellbeing of the growing baby.

Moreover, due to pelvic subluxations, there can be increased tension on the ligaments that support the uterus. This constant pulling and tugging may cause the uterus to become unbalanced or misaligned (which may also lead to mal-positioning of the fetus) and may even limit the space available in the uterus for the normal development and growth of the developing fetus. This condition is called intrauterine constant.

In order to gain a better understanding of this condition, it is of significant importance to look at the female anatomy and understand the relationship between the positioning of the fetus and pelvic biomechanics. The female pelvis consists of key ligaments that support her uterus. The uterus is connected to the pelvis by three ligaments: the broad ligament, the uterosacral ligaments, and the round ligaments. With the growth of the fetus, their role also becomes increasingly important.

If the female pelvis maintains its biomechanical balance during pregnancy, it symmetrically supports the uterus. This allows optional room for the normal movement of the fetus in the uterus and facilitates the growth of the baby. On the contrary, if the female sacrum (which is the major triangular bone in her pelvis) is misaligned, it affects the entire pelvic alignment. Misalignment of the pelvis creates an uneven pulling on the uterine ligaments which is a major reason why some pregnant females feel more sensitivity on one side than the other.

Gross misalignment conditions such as torticollis (a condition in which the head of the fetus tilts to one side. It is also sometimes referred to as a wryneck) create additional stress to the neuromuscular system of the baby and can also impair their nervous system and adversely affect body functions and systems.

Moreover, intrauterine constraint not only impacts the positioning of the fetus but can also impair the future wellbeing and health of the baby. If the pelvis is subluxated, these ligaments can also become torque. When the ligaments are affected, they directly impact the position of the uterus which can result in the baby not being in an optimal position. This type of situation may result in a breech baby or a transverse baby.

The optimal birth position is anterior vertex (rear facing, head down). Constraint in the uterus also contributes to abnormal positioning of fetus. Fetal presentations other than cephalic or positions other than anterior may result in frequent birth complications for the mother and the baby.

• Breech Presentation, Pelvic Imbalance and Child Birth

When a baby presents breech or posterior, it is often the result of an imbalance in the mother’s pelvis forcing the baby to assume a compromised position. Most babies move into delivery position a few weeks prior to birth with the head moving closer to the birth canal. When this fails to happen, the baby’s buttocks and or feet will be positioned to be delivered first. This is referred to as breech presentation.

Even if the baby is vertex, their head may tilt off to one side. This condition is termed as asynclitic. Whilst this condition is not as troublesome as breech, it could still result in a less comfortable, lengthier and more complicated child birth. Under ideal conditions, the neck of the baby should be flexed in forward direction without titling to either side.

Of course the body’s intelligence wants the easiest route for the baby. If the biomechanics of the pregnant female becomes compromised, obstetric interventions are most likely to be implemented and recommended. Every intervention has significant side effects for both the baby and pregnant female. Additionally, such interventions are most often not based on evidence therefore their effectiveness is still questionable.

Pregnancy and Chiropractic

Chiropractic care during pregnancy is rapidly becoming an important part of parental care. Sadly, most women are unaware of the benefits of chiropractic care for themselves and their unborn baby.

The goal of the chiropractor is to correct the subluxations in the pelvis to help balance the uterus and allow the baby to get into a better position. Chiropractic adjustments for a pregnant woman are specific, gentle, and safe.

Some chiropractors are certified in the Webster Technique which is a technique that is used to relieve intrauterine constraint caused by imbalance in the pelvis and the pelvic ligaments. Webster certified chiropractors adjust the pelvis and also feel for and relieve tension in the round ligaments.

The Webster Technique is a specific chiropractic analysis and adjustment that reduces interference to the nerve system, facilitates balance in the pelvic muscles and ligaments, and in turn reduces constraint to the woman’s uterus allowing the baby to get into the best possible position for birth. Reducing this nerve system stress is a key ingredient for normal bodily function.

To cut it short, because of these physiological and biomechanical compensations, practitioner care must be taken to select the specific analysis and adjustment most appropriate for the complex changes during the various stages of pregnancy.

The increased potential for spinal instability in the mother and the resulting subluxations in the woman’s spine throughout pregnancy affect the health and well-being of both her and her baby. This warrants regular chiropractic check- ups in all women throughout pregnancy.

Fortunately, today’s parents are becoming increasingly aware of the importance of the mother’s pelvic biomechanics throughout pregnancy. Giving it due attention will not only result in a more comfortable pregnancy, but will optimize the baby’s developing systems in uterus and contribute toward achieving optimal fetal positioning for a safer and easier birth for both mother and baby.