Today I am going to talk a little bit about what I do for a living. You may or may not know that I am a Chiropractic Physician, specializing in maternal health and pediatrics. I feel as though this area of specialty is not as well known as the sports medicine area of Chiropractic. So, I thought I would share a little bit about why pregnant women (or women trying to get pregnant) could benefit from chiropractic as well as how it works for a pregnant body.
Why Chiropractic for Pregnancy?
Chiropractic is a valuable tool for a pregnant woman’s growing and changing body to help support it and to ease the pain that comes along with pregnancy. Before we start, a quick anatomy lesson: the spine has 4 natural curves (cervical, thoracic, lumbar and sacral). The cervical and lumbar curves are lordotic or convex toward the front of the body. The thoracic and sacral curves are kyphotic or concave toward the front of the body. See Figure 1 and refer back if necessary.
Now think about adding 6, 7, 8 or more pounds to your belly, in front of the lumbar area. Naturally, the extra weight is going to make that lumbar curve become even more convex, which is going to put more stress on the joints above and below. Mainly, the top of the sacrum will be tilting forward more and the joint between that lumbar and thoracic curve will be stressed because of the changes in the normal curves of the spine.
Not to mention, the abdominal muscles are being stretched and may not be supporting as well as they should be. This is made even worse by relaxin (a hormone that is present as early as conception) which is now loosening the ligaments to create pelvic and expansion of the cervix. All of this, along with the extra weight in front, will throw off balance and you will not be as stable as you used to be (possibly leaving you susceptible to injury). How could you not have back pain with all of that happening to your body?
Of course much of this is based on how well you were able to care for your body before pregnancy. Which brings me to “Why chiropractic?” Well, pre-pregnancy, your maternal health chiropractor can help you prepare your body in terms of nutrition and lifestyle changes, working on the biomechanics (relationship between structure and function) of your body and creating strength and stability. If you are planning on becoming pregnant it’s vital to decrease toxins in your everyday life, get yourself on prenatal vitamins and clean up your diet to boost fertility. A study from Harvard showed an 80% decrease in infertility with the lifestyle changes made by switching to a fertility diet (1). Lastly, when trying to get pregnant, your maternal health chiropractor can help you strengthen your core muscles to prevent joint restrictions. These stretches and exercises will improve balance and stability to carry a child to term and will also prepare your body for labor and delivery of the baby.
If you are already pregnant, chiropractic manipulation will optimize fetal positioning and decreases the chances of intrauterine constraint. This basically means that if the pelvis is not equal in structure and function when comparing the 2 sides, the uterus will not be supported symmetrically, which will then create a constrained environment for the baby to grow in. We have to remember that our bones (spine, pelvis and sacrum in this case) house and protect our organs (most important to this topic: the uterus and ovaries). If the sacrum (see figure 1) is restricted in movement on one side, the pelvic bones, muscles and ligaments that attach to it will also be restricted. This can lead to your baby not being in the optimal position for birth and can cause birth trauma during delivery (2). Continuing balance and strengthening exercises can prevent injury and further prepare you for delivery.
I know most of this sounds scary but remember there are a lot of factors that can prevent any of it from even occurring in the first place.
How does Chiropractic work for a pregnant woman’s body?
So, how does Chiropractic affect the body? Well, many maternal health chiropractors will use the gentle yet effective treatment method known as Webster Technique. This method utilizes a pattern of tight muscles, tight ligaments and restricted joint movement, and the female pelvic anatomy to determine the biomechanical imbalance (or difference in structure and function when comparing both sides).
First, while standing the doctor will place their hands on each hip and check to see which hip is sitting lower. Then you will lie face down on the table with a pregnancy pillow (See Figure 3) or special table that drops out to accommodate the mother’s belly.
Next, the tightness of the lumbar paraspinal muscles (the muscles adjacent to the spine in the low back) are compared on both sides (See Figure 4).
The doctor will then assess to find the lowest lumbar vertebrae that is restricted in rotation to one side (See Figure 1).
Next, the more tender posterior superior iliac spine (PSIS) is determined by applying light pressure (See Figure 5).
Then, the doctor will feel for the tighter sacrotuberous ligament. Usually, all of these findings will be on the same side (See Figure 6).
Lastly, resistance of the muscles that attach to the pelvis are checked on both sides to find which side is tighter, this will usually be on the side opposite to the other findings (See Figure 7).
Now that you have been assessed, the treatment will begin. Let’s say all of the findings were on the left and the muscles that attach to the pelvis are tighter on the right. Since our muscles, ligaments and joints work in concert, this tells us that all the tight muscles and ligaments on the left are slightly pulling the left, upper sacrum forward and downward. Therefore, a counteractive thrust is applied that will correct the motion of the sacrum in relation to the pelvis. A drop table is used to apply this treatment. A drop table is a treatment table in which a portion of the table gently drops out from under when thrusted upon to reduce the amount of force required to correct a specific joint. If the findings of the exam do not follow the common patterns, your doctor will know how to accommodate treatment based on you body and its specific needs. At this time your doctor may address restrictions in your pubic bone and tightness in your psoas muscle (another muscle in the pelvic region).
Next, your doctor will release the tightness in your round ligament. The round ligament originates from the uterus and inserts into the pubic ramus (See Figure 8). In the first trimester, you may not feel much but as your baby grows the ligament is pulled taught. Around the second trimester, the ligament has become tight enough to produce pain. Have you ever stood up quickly and felt a sharp pain on the lower outer part of your belly? It could be your round ligament. While you will not have this problem early on, it is good to massage the ligament all throughout your pregnancy. P.S. most moms love having this area massaged.
If you have aches and pains in any other region, your doctor will have assessed that area and will treat them as well.
I know that was a long one. Thanks for bearing with me and please feel free to contact me if you have any questions at all.
I will be posting a “First Chiropractic Visit for Pregnancy”article very soon to give you a quick look at the process from making the appointment to leaving your first visit
Dr. Neha Shah
Chiropractic Physician | Webster Technique Certified
White Oak Family Wellness
White Oak Family Wellness
405 Illinois Ave #2b
St Charles, IL 60174