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Pregnancy and Labour

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"During pregnancy the pelvic joints and ligaments are relaxed and capable of more extensive movements. This relationship renders the locking mechanism of the sacro-ilia joint less restrictive and permits greater rotation. This change allows alterations in the diameter of the pelvis at childbirth. The less the locking mechanism the more the strain of weight-bearing falls on the ligaments leading to occurrence of sacro-iliac strain during or just after pregnancy. After childbirth the ligaments become tight again but in some cases the locking may occur in the position of rotation of the hip bones adopted during pregnancy. This so-called subluxation of the sacro-ilia joint causes pain by the unusual tension which it imposes on the ligaments and the reduction by forcible manipulation may be attempted." Gray's Anatomy, 36th British Edition
Physiological changes
The physiological changes that occur in the mother during pregnancy can be broken down into two categories:
  • Hormonal
  • Biomechanical
The hormonal changes which are truly profound, overlap into the musculoskeletal system and also affect the biomechanics of the spine.
Many of the neurological conditions seen during pregnancy have their origins in the hormonally induced changes in the pregnant woman. 

Hormones of pregnancy
Progesterone and oestrogen are the most important hormones which affect pregnancy. Progesterone creates vast changes which result in an overall decrease in tonality thereby creating a stasis of activity. Some of progesterone's effects are as follows: a decrease in smooth muscle and vascular tone, and an increase in fat storage and temperature. Progesterone also acts with oestrogen to increase development of the breasts for nursing.

Oestrogen creates significant alterations in the connective tissue. This alteration results in an increase in joint mobility. In addition, oestrogen has an important effect on the uterus and its control and function as well as on the growth and regulation of the foetus.

Cortisol, aldosterone, Human Chorionic Gonadotropin (HCG), Human Chorionic Somatomammotrophin (HCS), relaxin and prolactin also play an integral role in the changes during pregnancy.

Biomechanical considerations of pregnancy
n addition to the alteration of supporting structures by the hormones, there is another significant change which occurs in the pregnant woman that alters her biomechanics. This is the large increase in weight gain over a relatively short period of time. The customary weight gain for the pregnant woman varies between 25 to 35 lbs. However, a weight gain of 40+ lbs. is not uncommon. This gain is a result of the weight of the foetus and maternal organs, an increase in the volume of blood and interstitial fluid as well as an increase in protein and fat storage.
Pregnancy and Chiropractic - Anna Hindley/Victoria Jones

There are no known contraindications to chiropractic care throughout pregnancy. Our chiropractors are trained to work with women who are pregnant and we have specialist equipment to ensure there is no pressure on your abdomen during your adjustments.

Sciatic pain is one of the most common symptoms women may experience during pregnancy. The pelvis and lower back are particularly vulnerable to this type of pain due to the ever increasing changes in weight bearing, pelvic alignment and ligament laxity. True sciatic pain is where the sciatic nerve is compressed at some point from its exit at the vertebral levels and may cause radiation into the buttocks and down the leg. However, there are many things that cause similar pain but are not actually true sciatica. This could be from ligaments, joint restrictions or even muscle trigger points; chiropractic is an effective route to managing this pain.  During pregnancy, weight gain and changes in posture place stress on your joints and muscles. Hormonal fluctuations can trigger migraine and loosen the ligaments and muscles connecting to your pelvis. All of this can result in pain.

Chiropractic uses gentle adjustments to relieve pressure on nerves and ease the stress placed on ligaments and joints. Your chiropractor can also advise you in using stretches, improved posture, nutrition, and safe lifting methods to reduce pain.

Chiropractic care has also been shown to significantly reduce labour time for women who had care throughout their pregnancy. In one study, Dr Joan Fallon found that first-time mums averaged a 24% shorter labour, while experienced mothers (those who had given birth before) had a 39% reduction in the average labour time.  In another hospital study that incorporated chiropractic adjustments during the patient’s pregnancy, the results indicated that there was a 50% decrease in the need for painkillers during delivery, attributable to pre-delivery adjustments. 

Chiropractic is a safe, natural way to manage and treat pain during pregnancy. Research shows that chiropractic adjustments can substantially reduce pain in the low back, pelvis, and hips; ease sciatica; relieve stress; and reduce the frequency of headaches.

But chiropractic does more than treat pain, it enables you to maintain optimal wellness in this crucial time. A doctor of chiropractic can help you develop a nutrition and exercise program to improve the health of you and your baby. Plus, studies show that chiropractic adjustments may reduce blood pressure, heart rate, and stress hormones, boost immunity, and more.

References and Related Studies

Alcantara, Joel and Martine Cossette. “Intractable migraine headaches during pregnancy under chiropractic care.” Complementary Therapies in Clinical   Practice. 2009; 15: 192-7.

Howell ER. Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation:two case reports. Journal of Canadian Chiropractic Association 2012; 56 (2):102-111.

Lisi AJ. Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. Journal of Midwifery & Women’s Health 2006;51:e7- e10.

Ogura, Takeshi and Manabu Tashiro, Mehedi,Shoichi Watanuki, Katsuhiko Shibuya, Keiichiro Yamaguchi, Masatoshi Itoh, Hiroshi Fukuda, Kazuhiko Yanai. Cerebral Metabolic Changes in Men After Chiropractic Spinal Manipulation for Neck Pain. Alternative Therapies. 2011, November/December; 17 (6): 12-17.

Sadr S, Pourkiani-Allah-Abad N, Stuber KJ. The treatment experience of patients with   low back pain during pregnancy and their chiropractors: a qualitative study. Chiropractic & Manual Therapies 2012, 20:32. doi:10.1186/2045-709X-20-32.

Teodorczyk-Injeyan JA, McGregor M, Ruegg R, Injeyan HS. Interleukin 2-regulated in    vitro antibody production following a single spinal manipulative treatment in normal subjects. Chiropractic & Osteopathy 2010; 18:26.








REFERENCES:

-Fallon, J. DC. The Effect of Chiropractic Treatment on Pregnancy and Labour: A

Comprehensive Study. Proceedings of the World Federation of Chiropractic, 1991:24-31.

Fallon, J. DC. Chiropractic and Pregnancy; A Partnership of the Future. ICA Review

Nov/Dec 1990. (pg. 39-42)-Frietag, P. Expert testimony of Frietag, P. MD PhD, comparing the results of two neighbouring hospitals, US District Court, Northern Illinois, Eastern Division, No.76C 3777.
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