Chiropractic care during Pregnancy: Power, Passage and Passenger

A phrase we often hear is, “I want a natural birth,” which is usually followed by the question, can chiropractic care help during my pregnancy?  The quick and short answer is YES, but let us take some time to explain why it can be helpful but is extremely safe for you and your baby. 

Chiropractic care during pregnancy emphasizes the innate power of the body and uses gentle, safe, non-invasive adjustments to improve the structure and function of the spine and nervous system. In our office, we employ special tables and pregnancy pillows suited for growing bellies to make sure mom is always comfortable.

Power, Passage & Passenger

Chiropractic is an important approach in supporting a healthy pregnancy and a natural birth, by ensuring the pelvis is in good alignment and supporting proper nerve function to the uterus and baby (2). One aspect that is especially critical is dystocia in labour. William Obstetrics defines dystocia as: “Difficult labour that is characterized by abnormally slow progress (3).” It describes dystocia as being related to three aspects of birth: power, passage and passenger.

# 1 – Power 

Power has to do with the ability of the cervix to dilate and the uterus to contract. Abnormalities of the expulsive forces can lead to hyper/hypotonic contractions or other irregular contractions causing ineffective dilation of the cervix. Power can also relate to inadequate muscle effort or poor pushing in the second stage of labour (1,3). 

If the spine is subluxated or out of alignment, this can cause stress on the nervous system and shift the body into the fight or flight response. This can cause the uterus to work less efficiently, similar to if a mom is perceiving danger in her environment.

Subluxations can also inhibit coordinated muscle contraction needed from the core and pelvic muscles in the second stage of labour (2). For example, this can be where women end up stuck during labour…The mother at the hospital has been dilated to 3 cm’s for hours and the nurse says, “You are not progressing, if things don’t get going then you will need some extra help.” These words create fear in most women and send their bodies into the stress response possibly inhibiting the progression of labour. 

# 2 – Passage

Passage has to do with the alignment of the pelvis. Pelvic misalignments from physical trauma, like a fall or an accident or due to chronic postural strain, can obstruct the birth passage. William’s Obstetrics states: “Abnormalities of the bony pelvis can create a contracted pelvis. Any contraction of the pelvic diameters, that diminish the capacity of the pelvis, can create dystocia (3).” This means that a misaligned pelvis can make birth more difficult. Chiropractors address pelvic and sacral misalignments (subluxations) to bring the pelvis back into balance. This also allows the baby room to move into an ideal birthing position which is most often head down and occiput anterior (1).

# 3 – Passenger

Passenger refers to the baby and its ability to exit. Abnormalities of presentation, position or fetal development can be caused by biomechanical restraint. When the pelvis is out of alignment this puts tension on the muscles and connective tissues like the round ligament, broad ligament and utero-sacral ligaments because they connect and stabilize the uterus within the pelvis. This tension can cause movement constraint, decreasing the likelihood of baby assuming the ideal birth position (1,2). This is where Chiropractic care throughout pregnancy can help promote ideal positioning of mom’s pelvis and create an environment for a safer and easier birth.

What about the webster technique? 

The Webster technique, which has sometimes been incorrectly labelled as the ‘breech turning technique,’ has nothing to do with turning breech babies. It is a technique used throughout pregnancy, as a specific analysis and adjustment, to correct the effects of neuromuscular imbalance within the pelvis. It uses gentle adjustments to the sacrum and soft tissue release on the round ligament to help improve the function of the pelvis and take tension off the uterus (1). 

By balancing the nervous system through specific and gentle adjustments, it gives the birthing person the best chance at having a safe, healthy and natural birth. 

A recent paper by Alcantara et al. looking at women under chiropractic care who did have breech presentations reported that all studied in the review had favourable changes in fetal positioning while undergoing Chiropractic care during pregnancy (4). Another more recent study presented at the 2018 ACC research conference, used the ICPA’s practice-based research network to determine the quality of life of pregnant women under Chiropractic care pre and post-partum. They found statistically significant differences in physical function, depression, satisfaction and pain interference in women under Chiropractic (5).

Both Dr. Sarah and Dr. Thom have completed over 200+ additional training hours in the care of pregnant women and children. They are both certified in Webster technique and completed the Certification by the Academy Council of Chiropractic Pediatrics (CACCP) with the International Chiropractic Pediatric Association (ICPA). They also are DNS Pediatric 1 certified, trained through BIRTHFIT and have personal experience with pregnancy and birth while Dr Sarah carried and birthed their two children at home. (Read more about her experience here: 1, 2 & 3)

References 

  1. Ohm J. ICPA Module: Perinatal Care with Webster Certification. 2019 Oct 29-30; Toronto, ON.
  2. Anrig C, Plaugher G. Pediatric Chiropractic. Philadelphia: Lippincott Williams and Wilkins; 2013.
  3. Cunningham F, Leveno K, Bloom S, Spong C, Dashe J, Hoffman B, Casey B, Sheffield J. Williams Obstetrics (24thEdition). United States: McGraw Hill; 2014.
  4. Alcantara J, Martingano S, Keeler V, Schuster L, Ohm J. Resolution of breech presentations following adjustment of subluxations utilizing the webster technique: a case series. J Pediatr Matern & Fam Health – Chiropr 2011; 4: 132-138.
  5. Edwards J, Alcantara J, Union A. The quality of life of pregnant patients under chiropractic care: a retrospective file review. (Abstract from 2018 ACC Research Agenda Conference) J Chiropr Educ 2018 Mar; 32(1): 50-81.