Pregnancy

study published in the July/August 2002 issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) shows that a chiropractic technique known as the “Webster Technique” for managing the musculoskeletal causes of intrauterine constraint, is effective in cases of pregnancy with women experiencing breech presentation which can lead to a cesarean section birth.

According to the published study, “Intrauterine constraint is defined as any force external to the developing fetus that obstructs the normal movement of the fetus.” Intrauterine constraint can prevent the developing fetus from moving into the normal head-down position needed for a normal vaginal birth. When this happens this is called a “breech presentation”. This situation plays a critical role in how the mother delivers her baby. According to the statistics published in the article, in the United States 86% of all infants with breech presentation are delivered by cesarean section.

According to the JMPT article, the Webster Technique is a chiropractic technique designed to relieve the musculoskeletal causes of intrauterine constraint. This technique is also known by names such as as Webster’s In-Utero Constraint Technique or Webster’s Breech Turning Technique. The Webster Technique was developed by Dr. Larry Webster in 1978. Dr. Webster was often referred to in the Chiropractic profession as “The Grandfather of Chiropractic Pediatrics.” Additionally, the technique is presently taught in many chiropractic colleges and postgraduate chiropractic education seminars.

The study was done by surveying a large number of doctors of chiropractic who use the technique to see the percentage of results they obtain on real patients. The survey required detailed information to verify the accuracy of the responses. The results showed that 82% of the doctors surveyed reported a high rate of success when using the Webster Technique. The results from the study suggested that it may be beneficial to perform the Webster Technique in the 8th month of pregnancy, if it has been determined that the child is in the breech position. This timing is important because from the 8th month on, a breech presentation is unlikely to spontaneously convert to the normal head down position.

The study concludes by saying, “when successful, the Webster Technique avoids the costs and risks of cesarean section or vaginal trial of breech. In view of these findings, the Webster Technique deserves serious consideration in the management of expectant mothers exhibiting adverse fetal presentation.”

This February 8, 2006 USA Today article starts off with a grave warning to pregnant women, “Women who take a common type of antidepressant during the second half of their pregnancy are about six times more likely to give birth to a baby with a rare but potentially fatal heart and lung condition.”

The problems come from drugs called SSRI antidepressants such as Prozac, Zoloft, and Paxil. The potential problem is a rare but serious situation called PPHN: persistent pulmonary hypertension of the newborn. Normally, the rate of PPHN is one or two per 1000 babies. The recent study shows the rate of this problem to rise to 1 in 100 in women taking these antidepressants late in their pregnancy. PPHN kills up to 20 percent of babies and half the survivors are left with serious abnormalities

The study, prompting the alarms, is published in the February 9, 2006 issue of the New England Journal of Medicine. Lead author on the study, Christina Chambers, Ph.D., M.P.H., of the Departments of Pediatrics and Family and Preventive Medicine at UCSD noted that the risk of incidence of these problems are higher in women taking these antidepressants. She states, “Based on our findings, we estimate that six to twelve mothers per thousand who use an SSRI after 20 weeks’ gestation, are likely to deliver a child with PPHN.”

Dr. Sandra Kweder, deputy director of the office of new drugs at the FDA’s Center for Drug Evaluation and Research commented, “This appears to be a very well-conducted study and we find the results to be very concerning.”

In an unrelated study published in the February 2, 2006 issue of the Archives of Pediatrics & Adolescent Medicine, it was determined that almost one-third of infants born to mothers using SSRI antidepressants at or near term experienced withdrawal symptoms known as neonatal abstinence syndrome, or NAS. In other words these infants are subject to withdrawal symptoms. This syndrome is characterized by high-pitched crying, tremors, and sleep disturbances. The authors of the study also note, “The long-term effects of prolonged exposure to SSRIs, particularly in neonates who develop severe symptoms, have yet to be determined.”

A case study documenting the resolution of bedwetting and improvement of Autism Spectrum Disorder (ASD) appeared in the January 30, 2012 issue of the Journal of Upper Cervical Chiropractic Research.

The authors of the study start off by noting that between 5-6 million children over the age of 6 are affected by bedwetting in the United States. They also report that it is estimated that approximately 1 in 110 children in the United States suffer from ASD and it is found to be more common among boys than in girls.

In this case a 6 year old boy who was bedwetting was brought to the chiropractor. At age two he was diagnosed with Autism Spectrum Disorder, and exhibited the symptoms of that problem when arriving for care.

The boy’s mother reported that her pregnancy with her son was difficult and she noted that she had taken Levoxyl for hypothyroidism throughout the pregnancy. She also stated that the childs hospital delivery and birth were traumatic resulting in a cesarean section. The boy’s mother reported that as her son was growing up he had multiple falls, and suffered from numerous bouts of ear infections.

A chiropractic examination was performed that included palpation, a postural analysis, leg length tests, bilateral weight analysis, thermography, and neck x-rays. The results of the examination procedures led to the conclusion of the presence of a subluxation at the upper neck, (atlas). Specific chiropractic adjustments were then initiated for correction of the atlas subluxation. Follow up examination procedures were performed during the course of care.

The mother noted that her son had completely stopped wetting his bed after the first visit. As care continued she also reported that she had observed a 70% improvement in his ASD, and noticed that he had performed better in school and displayed greater social skills.

In their conclusion the authors wrote, “This case study explores the possible link between the objective reduction of a vertebral subluxation and the resolution of nocturnal enuresis as well as the subjective improvement in the behavioral patterns of a child diagnosed with Autistic Spectrum Disorder.”

On April 8, 2010, from the New Zealand news outlet Voxy News, comes a report on the preliminary results of a study that shows chiropractic care makes it easier for pregnant women to deliver their babies. The current study is being conducted at the New Zealand College of Chiropractic in Mt. Wellington, New Zealand.

This study looks at how chiropractic care may influence pelvic floor muscle function in healthy women before and after childbirth, and in women suffering from pelvic floor dysfunction. Researcher Dr. Jenny Kruger and research director Dr. Heidi Haavik-Taylor are in charge of the study and are optimistic about the final results.

Dr. Kruger noted, “We are working with a number of pregnant women here in New Zealand and the University of Australia in Sydney, which is also involved in the study, is testing hundreds of women.” She continued, “We are using state of the art 4D ultrasound to visualize the pelvic floor of women, pre and post chiropractic adjustments. We want to see whether spinal adjustments can alter the way the pelvic floor works.”

This new study should add to the body of evidence for the benefits of chiropractic for pregnant women. On their website, the American Pregnancy Association describes chiropractic by saying, “Chiropractic care is health maintenance of the spinal column, discs, related nerves and bone geometry without drugs or surgery. It involves the art and science of adjusting misaligned joints of the body, especially of the spine, which reduces spinal nerve stress and therefore promotes health throughout the body.” The association explained some reasons for seeking chiropractic while pregnant. “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.”

In the April 11, 2011, issue of the scientific periodical, the Journal of Pediatric, Maternal & Family Health, is a documented case study showing chiropractic helping a pregnant woman with a breech presentation pregnancy. A breech presentation is when the fetus is not in the proper head-down position as the delivery date is approaching.

According to the study, a breech presentation is created by “intrauterine constraint” which the authors describe as, “as any force external to the developing fetus that obstructs the normal movement of the fetus.”

The study reports that, in the United States, 86 percent of infants with breech presentation are delivered by cesarean which increases risks to the mother and the baby.

In this case, a 25-year-old woman went to a chiropractic office 31 weeks into her pregnancy. She was referred to the chiropractor by her obstetrician who had recently performed an ultrasound which confirmed the breech position. She was hoping to avoid a c-section birth.

A chiropractic examination was performed using the procedures of the “Webster Technique”. The Webster Technique is a specialized analysis and procedure developed by the late Dr. Larry Webster who was affectionately known as the “grandfather of chiropractic pediatrics”. A determination was made that this woman fit the protocol, and so the chiropractor applied the Webster Technique.

Within four hours of the first Webster Technique adjustment, the woman reported feeling “a lot of movement”. The woman commented that she felt the fetus had shifted from a breech position to the transverse position. After her second chiropractic visit, the woman had a prenatal visit at which the obstetrician confirmed that the fetus had turned to the proper vertex position. The study noted that the woman continued to receive chiropractic adjustments for resolution of low back pain until delivery. She eventually had an uncomplicated vaginal delivery.

A case study appearing in the August 6, 2008 issue of the scientific periodical, the Journal of Vertebral Subluxation Research, documented the case of a 23 year old woman with a history of infertility, who was helped with chiropractic. In this case the young woman, who had been on birth control for six years, was also suffering from absence of a menstrual period, low back pain and progressively worsening numbness in both of her legs.

When presenting for chiropractic care, this patient had been trying to get pregnant for over a year. Her history revealed that as a young girl she had never had a period. In response her medical doctor placed her on birth control which she remained on for 6 years. She saw her gynecologist one month prior to the initiation of chiropractic care. Her pelvic ultrasound was normal as was all the patient’s blood work.

Examination determined the presence of subluxations. Chiropractic care was initiated at a rate of 3 visits per week. After 2 weeks of care the patient reported that her back pain had been alleviated. However, at that time she was still suffering from numbness and tingling in her legs, feet, and hips. Further medical tests revealed nothing.

After 3 and a half months of chiropractic care, the patient started having her period. When this happened she also experienced relief from her leg and feet issues. After 4 and a half months of care, she reported that she had 3 positive over-the-counter pregnancy tests and was going for a urine analysis and ultrasound for confirmation. The results of the urine test was positive for pregnancy and the ultrasound performed by her midwife confirmed the implantation site in her uterus. As a result, the patient cancelled her appointment with a fertility specialist.

In this case the patient did not receive any other type of care while receiving chiropractic.

The above is the actual headline from the August 7, 2007 Milford Daily News in Massachusetts. This article addresses the benefits of chiropractic care in pregnancy. The article starts by following the story of one chiropractic patient, Amanda Giampaoli-Martinez, who was receiving chiropractic care throughout her pregnancy. The story notes that when Amanda was ready to give birth she called her chiropractor Dr. Maryam Ahsan, to be present at the birth.

It was not two minutes after the birth of Amanda’s new baby girl, Arianna, that she was checked by Dr. Maryam. New mother Amanda recalled the activity by stating, “Dr. Maryam was driving when I called her and asked if she could come to the hospital. She just turned her car around.” Giampaoli-Martinez continued, “When I was having bad pain, (Dr. Ahsan) put me on my side and adjusted me while I was on the table.” Ms. Giampaoli-Martinez was pleased with her results and noted, “I went three times a week, and after a month my back pain was gone. I was also having shooting leg pain and the hip alignment helped to take that away.”

The article explains that the International Chiropractic Pediatric Association teaches a technique named after the associations late founder Dr. Larry Webster, called the Webster Technique. The article explains that the Webster Technique decreases intrauterine constraint, resulting in a quicker, less difficult delivery. This technique became prominent after it was discovered that certain adjustments had a high success rate in reversing the position of breech babies.

Dr. Jeanne Ohm, executive director of the International Chiropractic Pediatric Association, explained the procedure, “There is no deep tissue massage with this technique. It’s a really light force,” she said. “Chiropractors will check the woman’s sacrum (pelvis bone) and press on different areas to restore balance. They (patients) turn her on her back and check her belly and a round ligament for tightness.” Dr. Ohm continued, “There are no known contraindications or complications to the adjustments. No one’s ever called back to report a problem, and I would definitely be the first to know. Osteopathic studies have shown the adjustments reduce labor time and fight dystocia (abnormal or overly long childbirth).”

The article also interviewed Dr. David Bilstrom, a board certified physical medicine and rehabilitation specialist, and director of Oasis Center for Health in Hinsdale. He feels that most medical doctors are unfamiliar with chiropractic care. He states, “Chiropractic care tends to be quite safe. In the right hands, I would feel very comfortable seeing the treatment done.”

A November 7, 2001 report on a study conducted by the International Chiropractic Pediatric Association showed that a chiropractic technique known as the “Webster Breech Turning Technique” was statistically very successful in resolving breech pregnancies without medical procedures. A Breech pregnancy is when the baby is not properly positioned in the mother’s womb near the date for delivery. If the baby is not positioned head-first, the delivery may be difficult or even dangerous for both the mother and child.

This chiropractic technique was created by the late Dr. Larry Webster, who was affectionately known as “The grandfather of chiropractic pediatrics.” The study entailed surveying members of the International Chiropractic Pediatric Association, Inc (ICPA – www.icpa4kids.com) throughout the United States and Canada. The survey noted that there were a reported 112 cases of breech recorded by the chiropractors. Of these, the results were 102 positive resolutions. This means that in 102 of 112 cases the baby turned properly after the chiropractic procedure was performed. This represents a success rate of almost 92%!

The conclusions of this study clearly stated, “When successful, the Webster Technique avoids the costs and/or risks of either, ECV, cesarean section or vaginal trial of breech. In view of these findings the Webster Technique deserves serious consideration in the health care management of expectant mothers exhibiting adverse fetal presentation.”

The January 27, 2001 British Medical Journal published the results of a new study that showed that exercise during pregnancy may increase birth weight. The study done at Case Western Reserve University in Cleveland, Ohio, followed 46 women who were not exercising by their eighth week of pregnancy.

These women were divided into two groups. One group was placed on a mild exercise regime while the other was not. The results showed that women who exercised gave birth to babies who were significantly heavier and longer than those babies born to women who did not exercise.

In a related article also in the British Medical Journal, was the results of another study that showed that larger babies are smarter and develop into children who perform better in school than smaller babies. The study considered a birth weight of 5.5 pounds to be normal. The lead author of the study, Dr. Marcus Richard of Britain’s Medical Research Council states, “It seems clear that birth weight has an influence on cognitive function.” He did go on to state, “Birth weight is only one of the numerous factors that influence cognitive function.”

The study did say that in follow ups of the effects of birth weight on intelligence, the effects were most noticeable under the age of 26. By the age of 43 there were no noticeable effects.

Numerous articles and reports have been in the press recently on chiropractic care for pregnant women. One such news story appeared April 16, 2003 on the NBC TV affiliate from Providence, Rhode Island. The news report by Health Check 10 Reporter Barbara Morse, started by featuring one woman Lee Ann, who recalled having severe pain during her pregnancy by saying, “Pelvic pain, mostly the bone. It felt like something was digging in to my bone. The doctors told me there was nothing they could do.”

Lee Ann then learned that chiropractic care was available at the medical facility, Women and Infants’ Hospital. At this facility, she sought the services of Dr. Ron Tyszkowski, a chiropractor at Women and Infants’ Hospital. “Chiropractic is an option for them and the doctors that are on staff at Women and Infants’ use specific safe techniques for pregnant women that are gentle, natural and do a really effective job of controlling those symptoms,” Dr. Tyszkowski said.

The story also highlighted another chiropractic success story of a woman named Lucia. She recalled, “Where I was living during the pregnancy, I had two flights of stairs I had to go up all the time. It got to the point I could barely carry my son up the stairs.” She described the outcome of the chiropractic care by saying, “I probably couldn’t have gotten through it without it.”

On their website, www.icpa4kids.com, the International Chiropractic Pediatric Association (ICPA) has many articles on chiropractic care during pregnancy. The articles state that a growing number of pregnant women are turning to holistic therapies, including chiropractic. Researchers at Robert Wood Johnson Medical School pooled data on 463 women who had recently given birth. In total, 31.3% of subjects used at least one type of complementary care during their pregnancies. Specifically, 5.2% visited a chiropractor; 2.8% had acupuncture or acupressure and 2.8% took vitamin supplements. 5.8% tried alternative techniques (biofeedback, meditation, yoga, tai chi, mental healing, imagery, Reiki, therapeutic touch, dance, reflex, art and aroma therapies); 24.2% used natural therapies (teas, herbs, oils and foods used for medicinal purposes). According to another study reported on the ICPA website, 82 certified nurse-midwives in North Carolina were surveyed about chiropractic care. The results showed that 57.3% of midwives participating in this survey recommending chiropractic to their patients.

ICPA Board member, Dr. Jeanne Ohm, sums up the benefits by saying, “Chiropractic care is essential for the pregnant mother. Her systems and organs are now providing for two and their optimal function is critical for the baby’s healthy development. The mother’s spine and pelvis undergoes many changes and adaptations to compensate for the growing baby and the risk of interference to her nervous system is increased. Specific chiropractic care throughout pregnancy works with enhancing nervous system function providing greater health potential for both the mother and baby.”