Pregnancy Care
Pregnancy & CHIROPRACTIC CARE
Chiropractic care is an important part of any woman’s pregnancy, allowing a woman to stay comfortable, mobile and healthy during her term. Chiropractic care during pregnancy allows women to carry and deliver their children with more comfort and ease.
During pregnancy, there are several changes that occur in preparation for creating the environment for the developing baby. These may lead to structural and nervous system stress due to:
• hormonal changes resulting in ligament laxity leading to misalignment of joints and pain, commonly in the spine and pelvis
• emotional challenges due to the changing family dynamic and responsibilities
• increased breast and belly size leading to an increased low back curve and postural adaptations
Establishing pelvic balance and alignment is another reason to obtain chiropractic care during pregnancy. When the pelvis is misaligned it may reduce the amount of room available for the developing baby. This restriction is called intrauterine constraint. A misaligned pelvis may also make it difficult for the baby to get into the best possible position for delivery.
The nervous system is the master communication system to all the body systems including the reproductive system. Keeping the spine aligned helps the entire body work more effectively.
Common pregnancy complaints alleviated with chiropractic care
Many common complaints during pregnancy can be managed through chiropractic care. The hormone relaxin begins to influence the body during the second week of gestation, causing the supportive ligaments that hold the joints in good alignment to become lax and misalignments occurs more frequently, resulting in:
- low back pain
- sciatica
- coccyx/tailbone pain
- pubic symphysis pain and dysfunction
- rib pain
- headaches/migraines
Benefits of Chiropractic Care during pregnancy
Besides pain management, additional benefits of chiropractic care during pregnancy may include:
- Maintaining a healthier pregnancy
- Controlling symptoms of nausea
- Reducing the time of labor and delivery (decrease by 24-39%)
- Relieving back, neck or joint pain
- Preventing a potential cesarean section
The Webster Technique
Chiropractic care, and in particular the use of the post graduate studied Webster Technique by members of the International Chiropractic Pediatric Association, is something that all pregnant woman need to strongly consider. The Webster Technique is a specific chiropractic analysis and adjustment. The technique reduces interference to the nervous system and facilitates bio-mechanical balance in the pelvic structures, muscles and ligaments. It has been shown to decrease the effects of intra-uterine constraint, allowing the baby to be in the best position possible for the birthing process.
It is considered normal by some for a baby to present breech until the third trimester. Most birth practitioners are not concerned with breech presentations until a patient is 36 weeks along. Approximately 4% of all pregnancies result in a breech presentation.
Currently, the International Chiropractic Pediatric Association recommends that women receive chiropractic care throughout pregnancy to establish pelvic balance and optimize the room a baby has for development throughout pregnancy. With a balanced pelvis, babies have a greater chance of moving into the correct position for birth, and the crisis and worry associated with breech and posterior presentations may be avoided altogether. Optimal baby positioning at the time of birth also eliminates the potential for dystocia (difficult labor) and therefore results in easier and safer deliveries for both the mother and baby.
Chiropractic care has been shown to be extremely safe for both the mother and her unborn child. Dr. Sarah is experienced in working with pregnant women and adjustments are done with as gently as possible to correct the biomechanical restrictions. Pregnancy pillows, modified positioning and instrument-assisted adjusting (Activator) may be used to allow for the most comfortable and effective adjustments. She will also provide you homecare instructions that are safe to use during pregnancy and compliment any adjustments made to your spine.
The chiropractic wellness lifestyle includes making informed health care choices for you and your family. The International Chiropractic Pediatric Association (ICPA) (http://www.icpa4kids.org) offers numerous articles and research for you on pregnancy, birth and childhood health concerns. If you have any questions, please discuss any of them with us on your next visit to the office.
Prenatal and Pregnancy Massage
Therapeutic massage has been used for centuries to improve overall health, reduce stress, and relieve muscle tension. Pregnant women have often received ambivalent responses from the health community regarding the safety and purpose of massage during pregnancy. Modern investigation and research is proving that prenatal massage therapy can be a very instrumental ingredient in women’s prenatal care and should be given careful consideration.
The benefits of prenatal massage or massage during pregnancy:
Studies indicate that massage therapy performed during pregnancy can reduce anxiety, decrease symptoms of depression, relieve muscle aches and joint pains, and improve labor outcomes and newborn health.
Our south Edmonton massage therapists are experienced in addressing different needs using various techniques of pregnancy massage. One of which is called Swedish Massage, which aims to relax muscle tension and improve lymphatic and blood circulation through mild pressure applied to the muscle groups of the body. Swedish Massage is the recommended prenatal massage method during pregnancy because it addresses many common discomforts associated with the skeletal and circulatory changes brought on by hormone shifts during pregnancy.
Hormone regulation
Studies done in the past 10 years have shown that hormone levels associated with relaxation and stress are significantly altered, leading to mood regulation and improved cardiovascular health, when massage therapy was introduced to women’s prenatal care. Hormones such as norepinephrine and cortisol (“stress hormones”) were reduced and dopamine and serotonin levels (low levels of these hormones are associated with depression) were increased in women who received bi-weekly massages for only five weeks. These changes in hormone levels also led to fewer complications during birth and fewer instances of newborn complications, such as low birth weight. The evidence points strongly to maternal and newborn health benefits when relaxing, therapeutic massage is incorporated into regular prenatal care.
Other potential benefits of prenatal massage:
- Reduced back, joint pain
- Improved circulation
- Reduced edema
- Reduced muscle tension and headaches
- Reduced stress and anxiety
- Improved oxygenation of soft tissues and muscles
- Better sleep
Is prenatal massage safe throughout the entire pregnancy?
Women can begin massage therapy at any point in their pregnancy – during the first, second, or third trimester.
Incorporating Massage Into Your Prenatal Care
The benefits of massage can improve overall prenatal health for many pregnant women. Along with the guidance and advice of a prenatal care provider, massage therapy can be incorporated into routine prenatal care as an emotional and physical health supplement proven to improve pregnancy outcome, and maternal health.
Pregnancy & ACUPUNCTURE
Acupuncture and pelvic pain in pregnancy
Elden et al 2005 published a randomised single blind controlled trial involving 386 pregnant women in the British Medical Journal (BMJ).
Summary
The objective was to compare the efficacy of standard treatment for pelvic pain (a pelvic belt, patient education and home exercisers- for abdominal and gluteal muscles) to standard treatment plus acupuncture or standard treatment plus physiotherapy stabilising exercisers (for the deep lumbopelvic muscles).
The study time frame consisted of one week which was used to establish a baseline, followed by six weeks of treatment. The acupuncture treatment was given twice a week and the stabilising exercisers sessions one hour per week (with patients then doing these exercisers several times a day on a daily basis). Follow up was carried out one week after treatment finished.
Three physiotherapists gave standard treatment, two medical acupuncturists delivered the acupuncture treatment and two physiotherapists gave the stabilising exercisers.
Pain was measured by a visual analogue scale and by an independent examiner before and after treatment.
Conclusion
Acupuncture was superior to stabilising exercisers in the management of pelvic girdle pain in pregnancy. With acupuncture the treatment of choice for patients with one sided sacroiliac pain, one sided sacroiliac pain combined with symphysis pubis pain and double sided sacroiliac pain.
Acupuncture and morning sickness
Smith et al in 2002 published two articles from their research on nausea and vomiting in pregnancy. The first looked at the effectiveness of acupuncture and the second at the safety of acupuncture treatment in early pregnancy.
Summary
The objective was to compare; traditional acupuncture treatment, acupuncture at Neiguan P-6 only, sham acupuncture and no acupuncture treatment for nausea and vomiting. 593 women who were less than 14 weeks pregnant were randomised into 4 groups and received treatment weekly.
The acupuncture group, in which points were chosen according to a traditional acupuncture diagnosis, received two 20 minute acupuncture treatments in the first week followed by one weekly treatment for the next four weeks. The sham acupuncture group were needled at points close to but not on acupuncture points. Both the acupuncture group and the sham acupuncture group received their treatment from the same acupuncturist.
The outcomes of treatment were measured in terms of nausea, dry retching, vomiting and health status.
When compared to the women who received no treatment; the traditional acupuncture group reported less nausea throughout the study and less dry retching from the second week The Neiguan P-6 acupuncture group reported less nausea from the second week and less dry retching from the third week. The sham acupuncture group reported less nausea and dry retching from the third week.
So while all three acupuncture groups reported improvement with nausea and dry retching, it was the traditional acupuncture group that had the fastest response. Patients receiving traditional acupuncture also reported improvement in five aspects of general health status (vitality, social function, physical function, mental health and emotional role function) compared to improvement in two aspects with the Neiguan P-6 and Sham acupuncture groups. In the no treatment group there was improvement in only one aspect.
Although there were no differences in vomiting found in any of the treatment groups the authors speculated that more frequent treatments might have produced greater benefits.
In assessing the safety of acupuncture in early pregnancy data was collected on perinatal outcome, congenital abnormalities, pregnancy complications and the newborn. No differences were found between study groups in the incidence of these outcomes suggesting that there are no serious adverse effects from the use of acupuncture treatment in early pregnancy.
Conclusion
Acupuncture is a safe and effective treatment for women who experience nausea and dry retching in early pregnancy.
Prebirth acupuncture
Prebirth acupuncture has an interesting history with several studies examining the effect of acupuncture used prior to labour.
Summary
Research on the use of acupuncture to prepare women for labour first appeared in 1974 with a study by Kubista and Kucera[8]. Their research concluded that acupuncture once a week from 37 weeks gestation using the acupuncture points Zusanli ST-36, Yanglingquan GB-34, Jiaoxin KID-8, and Shenmai BL-62 was successful in reducing the mean labour time of the women treated.
They calculated the labour time in two ways, the first being as being the time between a cervical dilation of 3-4 cm and the delivery time. In the acupuncture group the labour time was 4 hours and 57 minutes (control group 5 hours and 54 minutes). The second as the mean subjective time of labour, taken from the onset of regular 10 – 15 minute contractions until delivery, the acupuncture group had a labour time of 6 hours and 36 minutes (control 8 hours and 2 minutes).
In 1987 Lyrendas et all[9] basing its study on the work of Kubista and Kucera contradicted their research, concluding that acupuncture lengthened the delivery time. They calculated the average lengths of the latent and active phase and the second stage of labour. In their study the acupuncture group had a total mean delivery time, calculated as time of admission to the delivery ward until delivery, as 8 hours and 30 minutes (control group time of 7 hours and 40 minutes).
In 1998 Tempfer[10] used the acupuncture points Bai Hui DU-20 , Shen Men HT-7, and Nei Guan PC -6 from 36 weeks gestation. This study concluded that acupuncture treatment had positive effect on the duration of labour by shortening the first stage of labour, defined as the time interval between 3 cm cervical dilatation and complete dilation. The acupuncture group had a median duration of 196 minutes compared to the control group time of 321 minutes, (acupuncture group 3 hours and 26 minutes compared to the control group 5 hours and 35 minutes).