Structural Care for Pregnancy

My wife is amazing. No questions, no debates. While there are a plethora of reasons why I say this, I am currently referring specifically to her giving birth to both of our wonderful children. I will avoid straying too far down memory lane, but I want to take a minute to discuss my wife’s experience with pregnancy. For our first child, our daughter, my wife had an uneventful (relatively speaking) pregnancy. She had a lot of the norms – nausea, fatigue, etc, but on the whole things marched along pretty smoothly.

For our son, pregnancy marched along fairly smoothly until we found out that at 38 weeks our son was in the breech position. We had a conversation with our OB that included her telling us that my wife would need a cesarean section, and me informing the OB that before we just agreed to that, there was some structural chiropractic work that I wanted to do with my wife. While the OB agreed, she clearly didn’t understand the purpose or even the goal. For the next week my wife and I employed a rigorous structural correction plan. I addressed shifts in the bony structures and spent a lot of time working on the soft tissues as well. The goal of the structural care was focused on allowing my wife’s pelvis to achieve a normal position which would remove a secondary condition known as intrauterine constraint, and allow our son to achieve the normal position for delivery. At our follow-up appointment ultrasound confirmed that our son was no longer breech, and could be delivered without a cesarean section, which for us was terrific news.

Now let me make a few quick, but essential, points here. First, I did not, do not, will not ever treat to turn a breech baby. There is a medical maneuver for that called an External Cephalic Version (ECV). It is where a medical doctor attempts to turn the baby manually into a head down position.(1) The goal of structural care is to create normal structure which facilitates normal function. Second, I am in no way criticizing or disparaging any woman who has had, or will have, a cesarean section. The procedure can be a life saving intervention for the mother, for the baby, or for both. For my wife, she wanted to avoid a cesarean section if possible and was happy to be able to do that.

So now that you have our backstory, let me dive further into why structural chiropractic care during pregnancy is so effective.

Ultimately the main reason we chose to utilize structural chiropractic care for my wife’s scenario is that the Webster Technique has been shown to be much more successful than ECV. With structural chiropractic care demonstrating an 82% effective rate in research (2) and ECV showing less than a 56% success rate in 2016 according to statistics from the CDC. Additionally, there are some drawbacks to ECV which made my wife uncomfortable. While the risk associated with ECV is small, 1 in 286 results in the need for emergency delivery, typically via cesarean section. Other complications such as cord prolapse, vaginal bleeding, and water breaking are infrequent, but associated with the maneuver. (3)

Using structural care during pregnancy is not just for a breech presentation of the baby either. Common complaints like low back pain and sciatica are also associated with the structural shifts that naturally occur during pregnancy. The mechanism of structural shifts is pretty simple. In basic terms the fetus grows in the woman’s uterus it expands, which in turn pushes and strains everything in that area. These shifts result in changes to normal movements – think of things like the late pregnancy “waddle”. All of this is occurring while the woman is carrying the additional weight of pregnancy. This is why structural focused care during pregnancy can be so helpful – it helps to compensate for the inevitable changes of pregnancy. Research also supports that chiropractic care is very safe during pregnancy. (4) In fact evidence exists which shows that getting manipulative therapy during pregnancy is associated with improved labor and delivery outcomes. (5) This indicates that structural care can be beneficial during pregnancy even without a secondary complaint.

At Align Chiropractic, we have specialized equipment to help pregnant women – tables with drop away abdominal pieces, tables that raise and lower to make getting on and off the table easier, gentle adjusting equipment for women that do not want or cannot physically handle manual adjustments, soft tissue tools used to address tight ligaments and muscles. If you have questions, I would be happy to sit down and have a consultation with you. As always, at our office a consultation is a conversation, not a commitment.

1. https://www.acog.org/Patients/FAQs/If-Your-Baby-Is-Breech

2. https://www.ncbi.nlm.nih.gov/pubmed/12183701

3. https://evidencebasedbirth.com/what-is-the-evidence-for-using-an-external-cephalic-version-to-turn-a-breech-baby/

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647084/

5. King H.H., Tettambel M.A., Lockwood M.D., Johnson K.H., Arsenault D.A., Quist R. Osteopathic manipulative treatment in prenatal care: a retrospective case control design study. J Am Osteopath Assoc. 2003;103(12):577–582.