ICPA - Pregnancy Issues

Pregnancy and Spinal Adjustments

More and more women are discovering the many benefits associated with chiropractic care in pregnancy. The most common complaint where women seek chiropractic care in pregnancy is for low back pain. As more women utilize chiropractic care they are noticing additional benefits to chiropractic care in pregnancy.

The International Chiropractic Pediatric Association is involved in several large, collaborative studies to show the efficacy and safety of chiropractic care in pregnancy. Doctors of Chiropractic are participating in advanced educational classes to learn specific chiropractic techniques which facillitate easier, safer deliveries for the mother and baby. One such technique is called the Webster Technique.

To find a Doctor of Chiropractic in your area who works with pregnant mothers and babies, click here.

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Better Birth Outcome:

Chiropractic care of a patient with dystocia: a case report. Alcantara J, Ohm J, Ohm J, JVSR. View Abstract.
This case report provides supporting evidence that chiropractic care may assist in patients with dystocia. We advocate for further research in this field.

The Chiropractic Care of a Gravid Patient with a History of Multiple Caesarean Births and Vertebral Subluxations. Joel Alcantara, BSc, DC Ingrid Hamel, DC JVSR
This case report provides supporting evidence on the effectiveness of chiropractic care in patients with pregnancy-related musculoskeletal complaints, and the possibility for facilitating vaginal birth despite previous Caesareans. We encourage further research into this area of care.

The Webster Technique: Results from a chiropractic practice-based research program. Alcantara, J, Ohm, J "Poster presentation at the ACNM annual meeting in Boston, May 2008. View Abstract
There is a long tradition chiropractic on the care of the pregnant patient. The results of our study demonstrate some measure of effectiveness and safety of the Webster Technique in relieving the consequences of intrauterine constraint (i.e., malposition/malpresentation) in pregnancy. Higher level research designs are needed to make cause and effect inferences. This presentation contributes to the knowledge base that pregnant patients may derive benefits from the Webster Technique. We advocate for continued research in this field.

Effect of pressure applied to the upper thoracic (placebo) versus lumbar areas (osteopathic manipulative treatment) for inhibition of lumbar myalgia during labor. Guthrie RA, Martin RH. J Am Osteopath Assoc. 1982 (Dec); 82 (4): 247-251
In a study of 500 women during labor, 352 experienced pain in the lumbar area during labor, an incidence of 70.4%. Low back pain during was associated with baby presentation. Application of pressure to the lumbar area to inhibit lumbar pain reduced the need for major narcotic pain medication and minor tranquilizing medication.

Back pain during pregnancy and labor Diakow PR, Gadsby TA, Gadsby JB, Gleddie JG, Leprich DJ, Scales AM. J Manipulative Physiol Ther. 1991 (Feb); 14 (2): 116-118
84% of patients receiving spinal manipulative therapy reported relief of back pain during pregnancy. There was significantly less likelihood of back labor when spinal manipulative therapy was administered during pregnancy.

Quality of Life:

Intractable migraine headaches during pregnancy under chiropractic care. Alcantara, J, Cossette, M View Abstract
Chiropractic adjustments characterized as high-velocity, low amplitude thrusts and the Activator Instrument were applied to sites of vertebral subluxations. No reported adverse events were associated with this type of care. Massage, trigger point therapy, increase water intake and change in sleeping posture were adjunctive care. The intensity of her migraine headaches had significantly reduced following the first three visits from pain rating of 8-9/10 to 2/10 on the verbal pain scale and attack frequency improvement from once daily to once every 3 days. This resulted in self-withdrawal and decrease dependence on medication.
This case study provides supporting evidence on the safety and effectiveness of chiropractic care during pregnancy with a chief complaint of migraine headaches.

Adjustments can have a somato-visceral response to reduce blood pressure
www.webmd.com/hypertension-high-blood-pressure/news/20070316/chiropractic-cuts-blood-pressure

Adjustment can reduce anxiety
www.jvsr.com/abstracts/index.asp?id=210

Low Back Pain:

A Clinical Prediction Rule for Classifying Postpartum Subjects With Low Back and Pelvic Girdle Pain Who Demonstrate Short-Term Improvement With Mobilization of the Sacroiliac Joint, Dissertation: University of Pittsburgh, School of Health and Rehabilitation Sciences. Jul 2007. URN etd- 07052007-164019.

Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. www.ncbi.nlm.nih.gov/pubmed/16399602?dopt=Abstract

Sacroiliac subluxation: a common, treatable cause of low-back pain in pregnancy Daly JM, Frame PS, Rapoza PA. Fam Prac Res J 1991;11(2):149-159
A retrospective review of 100 consecutive pregnancies, involving 94 women receiving prenatal care at a rural western New York family practice, was conducted. Back pain was spontaneously reported to the physician by 23 women in 23 pregnancies. Eleven of the 23 women met diagnostic criteria for sacroiliac subluxation. These criteria include absence of lumbar spine and hip pathology, pain in the sacral region, asymmetrical movement of the posterior superior iliac spines upon forward flexion, a positive pelvic compression test and asymmetry of the anterior superior iliac spines. A cohort of 11 women meeting criteria for sacroiliac subluxation was treated with rotational manipulation of the sacroiliac joints. After manipulative therapy, 10 of the 11 women (91%) had relief of pain and no longer exhibited signs of sacroiliac subluxation.

Low back pain during pregnancy. Berg G, Hammar M, Moller-Nielsen J, Linden U, Thorblad J. Obstet Gynecol. 1988 (Jan); 71 (1): 71-75
Of 862 women who answered the questionnaires, about half developed some degree of low back pain. Seventy-nine women who were unable to continue their work because of severe low back pain were referred to an orthopedic surgeon for an orthoneurologic examination. The most common reason for severe low back pain was dysfunction of the sacroiliac joints. Physically strenuous work and previous low back pain were factors associated with an increased risk of developing low back pain and sacroiliac dysfunction during pregnancy.

Back pain during pregnancy: a prospective study. Kristiansson P, Svardsudd K, von Schoultz B. Spine 1996 (Mar 15); 21 (6): 702-709
A cohort of 200 consecutive women attending an antenatal clinic were followed throughout pregnancy with repeated measurements of back pain and possible determinants by questionnaires and physical examinations. Seventy-six percent reported back pain at some time during pregnancy. Sixty-one percent reported onset during the present pregnancy. Back pain during pregnancy is a common complaint. The 30% with the highest pain score reported great difficulties with normal activities. The back pain started early in pregnancy and increased over time. Young women had more pain than older women. Back pain starting during pregnancy may be a special entity and may have another origin than back pain not related to pregnancy.

The prevalence of recalled low back pain during and after pregnancy: a South Australian population survey. Stapleton DB, MacLennan AH, Kristiansson P. Aust N Z J Obstet Gynaecol. 2002 (Nov); 42 (5): 482-485
Thirty-five and a half per cent of women recall having at least moderately severe back pain during pregnancy. Women who reported such back pain were younger, were more likely to report ill health and be unemployed. Increasing parity was not associated with current back pain. The most commonly used treatments were bed rest, pain killing medication, physiotherapy, and chiropractic treatment. Half of those with symptoms were untreated. Sixty-eight per cent of women who experienced moderate or worse low back pain during pregnancy continued to experience recurring low back pain with a self reported reduction in their health.

Additional articles about
chiropractic and pregnancy:

Chiropractic Care in Pregnancy for Safer, Easier Births

Chiropractic and Pregnancy

Pregnancy and Chiropractic

Chiropractic Care During Pregnancy

Chiropractic Care in Pregnancy

Improving Your Pregnancy with Chiropractic Care

Pregnancy

Several Articles on Stork Net

Midwifery and Chiropractic

Birth - What are the Philosophical Options?

Non-Invasive Birth

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