PREGNANCY &
ANTENATAL CARE
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Pregnancy
This is a very exciting time where the mums body is changing as the baby grows preparing to give birth. At times these changes can be painful and uncomfortable. 75% of pregnant mums suffer from pain in the back or pelvis which is why many women seek chiropractic care throughout their pregnancy journey. Regular chiropractic adjustments during pregnancy may relieve pain and tension creating better birth outcomes and help your body guide the baby into an optimal position for labour. In one study researchers in Switzerland followed 115 pregnant mums for a year who went to see a chiropractor with low back pain. Over half of the patients said that they improved after just one week of chiropractic care and after a month that figure had grown to 70%. By the end of the study about 90% of pregnant mums said their pain was better. Research supports one study reporting that new mums experience on average a 25% reduction in the length of labour time with chiropractic care during pregnancy and that rises to a 31% reduction for mothers who have given birth before. For women in labour, the ability to relax and contract the pelvic floor muscles is really important for helping baby move through the birth canal. In a study conducted in New Zealand, researchers studied pelvic floor muscle function in pregnant women before and after they were adjusted by a chiropractor. What they found was after pregnant women were adjusted their pelvic floor muscles relaxed more . This relaxation of their pelvic floor muscles after they were adjusted may promote a natural vaginal delivery. |
OUR
DOCTORS
Dr Karen Singh
"Becoming a mother has been an incredibly awakening experience to how resilient and dynamic the female body is.
I have also gained an immense appreciation of how much care and support is needed throughout the antenatal & postnatal period.
There is a generalised notion that pregnancy pain and discomfort is normal and there is nothing we can do about it but we are here to help guide & support you through your journey"
It has been reported that approximately 50% of all pregnant women experience back pain during their pregnancy and 50% to 75% of women experience back pain during labour. However, only 21% of pregnant women with back pain seek consultation with a professional. Shaw reports the results of a chiropractic and medical collaborative study indicating that 75% of pregnant patients who received chiropractic care during their pregnancies stated that they found relief from pain.
Biomechanical changes and stress to the neuromusculoskeletal system are present during and immediately after pregnancy. Chiropractic evaluation and treatment during this period may be warranted and considered a safe and effective means of treating common musculoskeletal symptoms that many pregnant patients encounter. The published evidence even suggests that regular chiropractic care may improve the probability of successful natural parturition.
"Becoming a mother has been an incredibly awakening experience to how resilient and dynamic the female body is.
I have also gained an immense appreciation of how much care and support is needed throughout the antenatal & postnatal period.
There is a generalised notion that pregnancy pain and discomfort is normal and there is nothing we can do about it but we are here to help guide & support you through your journey"
It has been reported that approximately 50% of all pregnant women experience back pain during their pregnancy and 50% to 75% of women experience back pain during labour. However, only 21% of pregnant women with back pain seek consultation with a professional. Shaw reports the results of a chiropractic and medical collaborative study indicating that 75% of pregnant patients who received chiropractic care during their pregnancies stated that they found relief from pain.
Biomechanical changes and stress to the neuromusculoskeletal system are present during and immediately after pregnancy. Chiropractic evaluation and treatment during this period may be warranted and considered a safe and effective means of treating common musculoskeletal symptoms that many pregnant patients encounter. The published evidence even suggests that regular chiropractic care may improve the probability of successful natural parturition.
CAUSES
PREGNANCY PAIN
Structural adaptation in the gravid patient is a contributory source of low back pain throughout gestation. Spinal dysfunction related to changing load distributions within the motion segments of the lumbar spine and sacroiliac joints are also a factor in back pain. Traction, pressure or stretch of the adnexa, parietal peritoneum, bladder, urethra, rectum, and pelvic structures can also cause referred pain and secondary muscle spasm. Although the female sacrum has enough depth to enable fetal carriage, the displaced weight gain of 25 to 35 lb greatly increases the stress to the sacroiliac joints. As the fetus develops during gestation, this weight is projected forward and the lumbar lordosis is increased, placing extra stress on the intervertebral discs and facet joints. Through compensation, the sagittal curvature of the remainder of the spinal column increases as well. The lumbar lordosis, designed to absorb some of the axial forces, loses integrity as a static support and may be a source of discogenic injury. In addition, the increase in circulating progesterone, estrogen, and relaxin throughout gestation, especially in the third trimester, brings about pelvic hypermobility and creates a decrease in spinal stabilization. Direct pressure of the fetus on the lumbosacral nerve roots may also be a cause of pain. Physically strenuous work and previous low back pain are factors that may also be associated with an increased risk of developing low back pain and sacroiliac dysfunction during pregnancy. All of these factors contribute to back pain experienced by the pregnant patient, leading some gravid patients to seek chiropractic care.
It has also been reported that there may be a relationship between back pain throughout pregnancy and a longer duration of the labour and delivery process. A retrospective review of statistics reported that primigravida women who seek chiropractic care throughout gestation have, on average, a 25% shorter labour time whereas multiparous women who seek chiropractic care throughout their pregnancy have, on average, 31% shorter labour times. An increasing number of practitioners and obstetricians are realizing the benefits of manual therapy for their pregnant patients and inclusion of chiropractic care during patient's pregnancies and labours is becoming more widely accepted.
It has also been reported that there may be a relationship between back pain throughout pregnancy and a longer duration of the labour and delivery process. A retrospective review of statistics reported that primigravida women who seek chiropractic care throughout gestation have, on average, a 25% shorter labour time whereas multiparous women who seek chiropractic care throughout their pregnancy have, on average, 31% shorter labour times. An increasing number of practitioners and obstetricians are realizing the benefits of manual therapy for their pregnant patients and inclusion of chiropractic care during patient's pregnancies and labours is becoming more widely accepted.
BREECH BABY
We understand anatomy and fetal position and perform Webster Technique!
Can Chiropractors Turn Breech Babies? No, your chiropractor won’t turn your breech baby. However, that’s not saying chiropractic care doesn’t help. On the contrary, it does. Your chiropractor can use certain techniques to encourage the baby to position itself right. Our specialists help pregnant women by applying the famous Webster Technique. This method aims to resolve what Dr. Webster called intrauterine constraint. The method is all about minimising the pressure on the mother’s uterus. It seeks to correct pelvic misalignment. It also strives to re-establish the connection between the mother’s birthing organs and the brain. Overall, the Webster Technique is less about flipping breech babies and more about empowering them to present properly. Your chiropractor tries to relax the ligaments and joints of your pelvis. Doing this creates a more functional environment for the fetus. In the end, you’ll have a bit more room so your baby can turn with ease. |
Fetal descent is impacted by the maternal pelvis. The maternal pelvis is a bony structure and it forces the baby to make several movements in order for it to fit through and to delivery vaginally safely.
Typically, the baby is going to be head down and entering the canal at this angle. Sometimes, the baby cannot turn head down (cephalic). A breech position may be caused by an imbalance (asymmetry) in the mother’s pelvis or soft tissues. In other words, a tension or a twist in the lower uterine segment may be a “soft tissue” issue. This is not the woman’s fault as we simply live in an era where a slight twist in the pelvis is common. Some causes of this may be:
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MECHANISMS
OF PAIN
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Mechanisms of Pain
Low back pain is often described as an inevitable complication of pregnancy. Fascial constraint and spinal pelvic subluxation may be the cause of low back pain in pregnancy. As the growing uterus expands, it pulls the sacral base anterior, causing an anterior tilt of the pelvis and flexion of the hips. This orientation of the pelvis causes an increase in the lumbar lordosis, which increases the activity of the iliopsoas muscles. The piriformis muscle remains in a contracted state to maintain the external rotation of the legs, which compensates for a lack of balance as the centre of gravity shifts as the pregnancy progresses. However, gentle myofascial relaxation of the piriformis and iliopsoas can greatly aide in the reduction of pain and tension. Also, improving the strength of the transverse abdominus muscle is thought to prevent some of the typical postural alterations that are seen in the third trimester that come with anterior pelvic tilt. Anterior translation of the cervical spine and extension of the occiput on the atlas can occur and be related to muscle spasms and suboccipital headaches to compensate for the laxity experienced as gestation progresses. Release of these spasms can be quite beneficial in alleviating continuous cephalgia. Also, exaggerated thoracic kyphosis, anterior translation of the head, and the increased weight of the breast tissue may cause cervicothoracic pain, thoracic outlet syndrome symptoms, or myofascial pain syndromes. The hormone relaxin is found circulating in greater quantities in a woman in her third trimester. In addition, a specific chiropractic adjustment called the Webster Technique has been reported by chiropractors who use it to correct potential musculoskeletal causes of intrauterine constraint. Intrauterine constraint is defined as any force external to the developing fetus that obstructs the normal movement of the fetus. The technique is focused particularly on women in the eighth month of pregnancy with breech presentation. To evaluate the Webster Technique, surveys were mailed to chiropractors of the International Chiropractic Paediatric Association, an organization that offers training in this specialized technique, and 82% of responding doctors reported using this technique. The doctors reported that they found favourable results in relieving the constraints that may be contributory to the malposition of the fetus, and 92% of cases resulted in resolution of the breech position. These results are especially meaningful because 3% to 4.6% of all pregnancies result in a breech position. If uncorrected, many of these presentations require caesarean delivery. The highest acceptable limit, described by the World Health Organization in 1985, for caesarean delivery rates in the United States was 15%, and in the year 1999, 22% of deliveries were performed by caesarean delivery, and 13% of these were due to breech presentation. The increase in rates of caesarean delivery should be of concern to those providing care to the pregnant patient, especially because chiropractic has been associated with a reduction of the number of caesarean deliveries. Although some fetuses in the breech position will convert before 34 weeks of gestation, data indicate that only about 9% will do so spontaneously. The chiropractor's role in breech presentation is to balance the pelvis and corresponding muscles and ligaments to remove the constraint to the patient's uterus to allow the fetus to assume the correct presenting position. At no time does the chiropractor attempt to change the position of the fetus, as is done with external cephalic version; the chiropractor only attempts to correct a potential cause of intrauterine constraint. Evidence also exists that women who exercise during pregnancy have more energy, fewer mood swings, are able to manage stress more effectively, and achieve more restful sleep compared with sedentary pregnant women. Women who exercise gain 21% less weight throughout gestation; enjoy shorter, easier labours (decreased by an average of 2 hours); experience fewer medical interventions (24% fewer caesarean deliveries and 14% reduction in use of forceps); experience less fetal distress; and enjoy a faster recovery. With their training, chiropractors can also help the pregnant patient manage an exercise routine compatible for her changing body throughout pregnancy. The chiropractic adjustment can be beneficial and, with proper patient positioning for comfort and relaxation, only the slightest force need be applied to safely and successfully correct misalignment and fixation in the spine and pelvis of the pregnant chiropractic patient. Results from a pilot study in the Journal of Manipulative and Physiological Therapeutics, indicate that chiropractic adjustments of pregnant women appear to relax the pelvic floor muscles at rest. This relaxation of the pelvic floor muscles seen after the women were adjusted may mean that chiropractic care could be of benefit to pregnant women, as it may help them have a natural vaginal delivery. Excessive tension and restriction in the pelvic floor may be a contributing factor to the need for some assisted deliveries requiring intervention with forceps or c-section. The primary findings of this study are incredibly encouraging, especially given the fact that quantitatively assessing the effect of spinal adjustment on pelvic floor muscle function has not previously been done. The pelvic floor muscles (the Levator Ani muscle complex) are known to have active roles in pregnancy and childbirth, as well as in spinal stabilisation. When the pelvic floor muscles are damaged or stressed over time, health issues like incontinence and vaginal prolapses can occur. We know these are problems with massive emotional, physical, social and financial costs across the world and a significant cause of stress for these women. For a woman in labour, the ability to relax pelvic floor muscles (as well as contract them) to allow the baby to move through the birth canal is incredibly important, especially as the baby crowns. If the woman can’t relax these muscles as the baby moves through, she will tire more quickly and may require intervention to assist with the birthing process. Muscles that cannot relax may also result in a birth requiring intervention. In an ideal situation, strong pelvic floor muscles with an ability to relax would better prepare a mother for a natural, vaginal birth. |
