Pregnancy

A study published on October 14, 2010 in the Oxford journal, Human Reproduction, shows a link between mothers who took painkillers such as acetaminophen, aspirin and ibuprofen during pregnancy, and an increase in future reproductive problems in their male children. Reuters news in London also published a November 9, 2010 article on this study and stated that women who took a combination of more than one of these drugs during pregnancy had an increased risk of giving birth to sons with undescended testicles.

The study showed that the condition of undescended testicles, known as cryptorchidism, is linked to later creating poor semen quality and a greater risk of testicular cancer in the male’s adult life. The article noted that this could explain the sharp increase over the past few decades in male reproductive disorders.

Lead researcher Henrik Leffers of Rigshospitalet, the national hospital of Denmark, commented, “Women may want to try to reduce their analgesic use during pregnancy. However, as biologists this is not something we can advise women about. So we recommend that pregnant women seek advice from their physician.” According to Leffers’ team, which consisted of researchers from Finland, Denmark and France, more than half of pregnant women in Western countries report taking mild analgesics.

The study was conducted by questioning 834 women in Denmark and 1,463 in Finland about their use of the painkillers during pregnancy. Their male babies were then examined to see if there were any possible reproductive issues related to undescended testicles. Additional study work was done on rats which showed long term effects of the usage of these drugs leading to insufficient supplies of the male hormone testosterone during a critical period of gestation when the male organs are forming.

In the human part of the study, the results showed that women who took more than one of these painkillers simultaneously had a seven-fold increased risk of giving birth to sons with this form of reproductive problem as compared with women who took nothing.

Neal Patel of the Royal Pharmaceutical Society commented in the Reuters article, “This study adds to the body of evidence about the effect of medicines on fetal development. However, due to study limitations, further research is needed to draw firm conclusions about the effect of painkillers on male fertility.”

In summing up the impact that these findings could have on the human population, lead researchers Leffers commented to Reuters, “Although we should be cautious, the use of mild analgesics constitutes by far the largest exposure to endocrine disruptors among pregnant women, and use of these compounds is at present the best suggestion for an exposure that can affect a large proportion of the human population.”

The above headline comes from the August 14, 2007 issue of the Dallas Morning Star. In this article, Special Contributor Kathleen Green, starts off by stating, ” Moms-to-be once resigned themselves to nine months of misery. But, frankly, they’ve had enough.” She continues, ” More women are exploring options and seeking alternatives to ease back pain, headaches, exhaustion and much more. One place many are finding relief is at a chiropractor’s office.”

The article follows several chiropractors and their pregnant patients and views their reasons for choosing chiropractic and their results. One such patient was Teresa Seymour, who started chiropractic treatment during her first pregnancy with her daughter who is now 2 years old. Teresa said, “If there were times when I could feel that I was starting to get sore in the back, I would go to the chiropractor.” During her second pregnancy, she reported, “Just picking up my daughter could knock a hip a little bit the wrong way and kind of pinch a nerve,” she says. “I went to [my chiropractor], and he’d adjust my back and my hips.”

The article interviews Dr. Ken Wilson, a chiropractor who sees a lot of pregnant women in his practice and estimates that about 20 percent of his patients are pregnant. He stated, “My focus has changed more to pregnant moms and kids nowadays. My wife had to go through the constant low back [pain] and headaches and really being uncomfortable all of the time. I wanted to help her personally.”

Chris Burfield, an educational director with Dr. Wilson added, “When spinal bones get pulled out of place, those bones push up against or irritate the nerves. Those nerves will start to send pain signals off to the brain to let the brain know there’s a problem.”

Sara Townsley, a former high school science teacher received chiropractic care two years ago during her first pregnancy. She recalled, “If I do a lot of cleaning, like bathroom cleaning where I’m bending over, when I’m pregnant, that’s usually when I have my sciatica.” She continued, “Ella [her daughter] really sat on my hips, and it helped to have them aligned regularly to relieve some pressure and nerve pinching.”

The article also interviews a medical physician, Dr. Walter Evans, an obstetrician-gynecologist in private practice at Presbyterian Hospital of Dallas. According to the article, Dr. Evans acknowledges a chiropractor’s potential in prenatal care, sometimes referring patients with lower back pain to chiropractors. He states, “I’ve had good luck working with some chiropractors with patients who have low back pain during pregnancy.

A case study appeared on July 22, 2009 in the scientific periodical, The Journal of Pediatric, Maternal & Family Health, documenting the correction of a breech pregnancy and therefore saving a woman from having an unnecessary C-section delivery.

This case involved a 41 year old woman who was 33 weeks pregnant and had confirmation by ultrasound that the baby was in a breech presentation. She came into the chiropractor’s office looking for an alternative to prevent the cesarean procedure which was planned for her 39th week of pregnancy.

The woman did have a history of back pain during her pregnancy. The chiropractic examination showed muscle spasms and tenderness over multiple areas of her spine including her lower back. Her spinal range of motion was also significantly reduced. Numerous other orthopedic tests were positive, and trigger points were detected around her abdomen. It was determined that she had a subluxation of the sacrum and was a good candidate for a technique known as the “Webster In-Utero Constraint Technique”.

According to WikiParenting, “The Webster In-Utero Constraint Technique is a chiropractic procedure used to correct subluxations in the pregnant mothers sacrum and pelvis. The technique was developed the late Dr. Larry Webster, Founder of the International Chiropractic Pediatric Association (ICPA), in 1978. This technique is considered a safe means to restore proper pelvic structure and function for pregnant mothers.” The ICPA defines the procedure by saying, “The Webster Technique is defined as a specific chiropractic analysis and adjustment that reduces interference to the nerve system and facilitates biomechanical balance in pelvic structures, muscles and ligaments. This has been shown to reduce the effects of intrauterine constraint, allowing the baby to get into the best possible position for birth.”

The results of this case study documented that after 5 Webster In-Utero Constraint Technique adjustments were given to the patient over a 1 month period, an ultrasound was performed by the woman’s medical physician. The ultrasound confirmed that the baby had moved into the vertex position resulting in the planned cesarean section being cancelled. The patient had a vaginal delivery of a baby boy weighing 7lbs 8 oz without complications.

“Pregnancy Today” magazine describes themselves as “the journal for parents to be”. On June 13, 2004 they ran a story written by Patti Larson a mother and author, about her experiences while being pregnant and the help she received with Chiropractic care. She began the story by explaining the emotions she and her husband experienced when she found out for sure she was pregnant.

As a woman in her mid-30s having her first baby, she described her concerns and questions by asking, “When will morning sickness start? How long will I be able to work? Will I make it through delivery with little pain and swearing?” She also noted that her diet and sleep habits were good, but although she had great intentions, her exercise regime was less than desirable.

She did however, mention the one thing she saw as a big factor in helping her. “What ultimately saved me from suffering undue tiredness, aches and stress from my ballooning body shape and shifting hormones was chiropractic care.” She continued, “I already made regular visits to my chiropractor prior to pregnancy, so it seemed natural to continue. My chiropractor recommended I continue with weekly visits, adding that I should come in more often if I felt I needed it.”

Dr. Jeff Ptak, her chiropractor in Santa Monica, Calif., explained why chiropractic care made such a positive difference, during her pregnancy. “Chiropractic care addresses the functioning nervous system,” he said. “When the nervous system is not unduly stressed from environmental factors physical, emotional or chemical stress the body will work according to its unique genetic plan. A stressful birth will stress all parties involved and remain until the nervous system stress is cleared. Chiropractic, by allowing the body to handle stress, helps expecting mothers, new mothers and their newborn children handle life with greater ease.”

Leslie Stewart, a certified nurse-midwife also agrees. “Chiropractic care can actually help with labor. Some women who run past their due date have used treatment to help start labor, rather than having a hospital induce them.”

The article author, Patti Larson, noted that she not only continued care through her pregnancy, but also after the birth of her daughter Madeline. She concluded the article by saying, “Madeline received regular adjustments her second week after entering the world. She never had colic, ear infections, colds or any symptoms of sickness throughout her first 12 months of life when children are often most susceptible. Some people cringe when I tell them she sees a chiropractor, yet everyone agrees that she is one of the most alert, active babies they have ever seen. Some say I’m lucky, but I tell them it’s really very simple just stay well adjusted!”

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that treat inflammation, pain, and fever. There are several different types of NSAIDs. Some are available over-the-counter (aspirin, ibuprofen, naproxen sodium, and ketoprofen) and others can only be obtained by prescription. A new study published in the August 16, 2003 British Medical Journal finds that prenatal use of NSAIDs and aspirin increased the risk of miscarriage.

The study, based on a sample size of 1,055 pregnant women, points to a five times more likely risk of a miscarriage in women who took NSAIDs at the beginning of their pregnancies compared to women who took them later in their pregnancies. According to the study, there is an 80 per cent increase in the chance of a miscarriage in women who took these NSAIDs at any point in their pregnancy. The researchers also found that the risk increased when the drugs were used for longer than one week but these risks were not affected by other factors such as drinking alcohol or coffee.

Researcher De-Kun Li from the Kaiser Foundation Research Institute in Oakland, California where the study was conducted says that there was a “striking contrast” between the effects of acetaminophen and that of NSAIDs in the results of this study.

This new study follows up on a study at the University of Aarhus in Denmark in 2001 in which researchers examined patients’ medical records and the national birth registry. The team found an association between miscarriages after 28 weeks and NSAID usage in the weeks immediately before the miscarriage.

Pharmacologist Andy Gray of Natal University’s Nelson Mandela School of Medicine in South Africa suggests, “Women should avoid non-steroidal anti-inflammatory drugs during pregnancy and not take anything without consulting their doctor.”

On April 2, 2004 the TV station WOAI from San Antonio Texas ran a special during their news program with Chiropractic advice for pregnant women. The feature started by noting, “Studies have found that about half of all expectant mothers will develop low-back pain at some point during their pregnancies.” The article explained this by saying that during pregnancy, a woman’s center of gravity almost immediately begins to shift forward to the front of her pelvis.

Additionally as the baby continues to grow, the pregnant woman’s weight is projected even farther forward, and the curvature of her lower back is therefore increased. This places extra stress on the spinal disks. As a result, the normal curvature of the upper spine increases, as well.

The article notes a series of tips from the American Chiropractic Association, these include:

Try exercising at least three times a week, gently stretching before and after exercise.

Wear flat, sensible shoes.

When picking up children, bend from the knees, not the waist.

Get plenty of rest.

Sleep on your side with a pillow between your knees to take pressure off your lower back.

If you have to sit at a computer for long hours, make your workstation ergonomically correct.

Eat small meals or snacks every four to five hours-rather than the usual three large meals-to help keep nausea or extreme hunger at bay.

The feature also recommends chiropractic care for pregnancy. They conclude, “Before you become pregnant, your doctor of chiropractic can detect any imbalances in the pelvis or elsewhere in your body that could contribute to pregnancy discomfort or possible neuromusculoskeletal problems after childbirth.”

A research article published on February 2, 2010 in the scientific periodical, the Journal of Pediatric, Maternal and Family Health, documented the case study of a pregnant woman whose breech pregnancy was corrected with chiropractic care. This case study involved a 35 year old woman who was pregnant with her third child. She had recently been to her OBGYN for an ultrasound, which showed the male fetus to be in a breech position.

The woman, now in her 31st week of pregnancy, had also been experiencing pain in her pelvis just 2 weeks earlier. Because of this pain she was forced to discontinue her daily exercise regimen which included running three miles per day. She described the pain as more of a pressure in her pelvis as opposed to a pain. In addition, the woman reported that she had gained more weight with this pregnancy than with either of her two previous pregnancies and she was experiencing heartburn and acid reflux.

The woman went for a chiropractic examination after having done some research on the Internet where she found some information about breech pregnancies being helped with specific forms of chiropractic care. Her examination showed some postural irregularities indicating some spinal involvement. In addition, bilateral surface temperature measurements and surface EMG tests also showed asymmetry indicating spinal involvement.

Based upon the chiropractic examination findings care was initiated using the “Webster Technique”, a specific chiropractic technique used in breech pregnancy when certain examination findings are present. The case study noted that the Webster Technique has been shown to have high rates of success, based on a previous survey of 112 chiropractic practitioners who utilized the Webster Technique in their offices. In that survey study 92% of the cases had resolution of breech presentation, and of this 88% resulted in unassisted vaginal births.

In this case, the woman received seven Webster Technique adjustments over the course of a three week period. An ultrasound was performed by the patient’s obstetrician after the patient’s fifth adjustment, showing that the fetus had successfully moved into a normal vertex position. The patient gave birth to the 7 pound 12 ounce boy vaginally after an uncomplicated 12 hour labor five days earlier than the baby’s projected due date and approximately one month after the mother had started chiropractic care.

In the October 8, 2002 issue of the online magazine “The Beacon Journal” at Ohio.com, appears a story with the simple headline, “Adjusting baby”. The story talks about pregnant women’s success in going to chiropractors as part of their care. The article states that many women who go to chiropractors during pregnancy do so for back pain related issues. The misconception is that we treat pain,’ says Dr. Joseph Medina, an Ohio chiropractor. “My job in health care is to find pressure that’s in the spinal column and take it off. When I do that, back pain tends to clear up.”

Additionally, the article highlights that more women are going to chiropractors for a procedure known as the Webster technique. This technique is specifically intended to help women who have a breech pregnancy when the baby should be positioned with the head downward. Dr. Jeanne Ohm, a chiropractor from Philadelphia and executive coordinator and instructor for the International Chiropractic Pediatric Association, described the Webster technique this way: “It’s a specific chiropractic adjustment that removes interferences of the nervous system, balances out pelvic muscles and ligaments, which in turn removes constraint to the woman’s uterus and allows the baby to get into the best possible position for birth.”

The article ended with a response from the patient who originally went to the chiropractor for the pain she was experiencing. Her comments about her results were, “In the morning, my back would hurt so bad it would be hard to walk,” she stated. “Now it’s not bad at all. I really think it’s helping.”

From the January 16, 2012, issue of the Journal of Pediatric, Maternal & Family Health is a case study that documents the successful outcome of a case of breech pregnancy with chiropractic care. Breech presentation is when the fetus in positioned for delivery feet-first, instead of the correct “vertex” head-first position.

In this case study, a 33-year-old woman was 8 months pregnant with her second child. Her first birth was normal with no problems reported. The woman had been seeing a midwife during the pregnancy who determined that the child was breech late in the woman’s pregnancy. The woman was directed to see a chiropractor who works with pregnant women.

A chiropractic examination was performed with thermal scans and surface EMG scans showing asymmetry in the lower spine. It was determined that muscle spasm and subluxations were present. Chiropractic care was initiated using a specific technique known as Webster technique, along with specific adjustments to correct the subluxations present.

The results of this case documented that after the ninth adjustment the baby was in the normal vertex position. Shortly after this, the mother was able to deliver her baby normally without any complications.

This case study also reported on seven previously published cases in which there was a documented resolution of breech pregnancy using chiropractic care. Additionally, the report noted a retrospective study of 104 pregnant women all being helped under chiropractic care.

In their conclusion, the study authors summed up this case with advice by saying, “When a pregnant mother with a breeched infant is faced with a course of action that could impact her and her childs life forever, all options must be explored. The traditional medical routes are effective, yet come along with some very serious risks that must be considered. Although more research needs to be done on the Webster Technique and chiropractic care during pregnancy, they are both extremely safe and effective ways to alter fetal position to allow for the best delivery possible.”

Two news stories chronicled chiropractic helping pregnant women during their times of physical change. One of the stories appeared on the website of the St. Louis Post-Dispatch on July 2, 2007 and followed a second time mother who was suffering from lower back pain caused by her pregnancy. The second story was from the May 22, 2007 Asheville Citizen-Times and reported on a four time mother who had been under chiropractic care regularly to help prevent problems and make the experience healthier.

The St. Louis story followed the plight of Tykita Bethley who was suffering from what she referred to as usual aches and pains during her first pregnancy four years ago. She stated, “My back hurt, and then once I had my daughter, it hurt even more, especially on the right side.” Then during her second pregnancy she added, “My back hurt like crazy then, too, but I had accepted my back pain for the longest time.”

Tykita went to the Pregnancy Clinic at Barnes-Jewish Hospital, a facility that is set up to help study the effect of chiropractic care and exercise on pregnant women. She started care at week 27 and continued throughout the remainder of her pregnancy. She received stretching exercises and chiropractic adjustments. The result was that she became nearly pain free. I can’t tell you,” Tykita stated, “I feel so much better.

In the second story out of Asheville, NC, Wendi Lonabaugh is an ongoing chiropractic patient who was under care to prevent the problems she had with previous pregnancies. She noted that chiropractic made a difference and unlike her previous pregnancies, she did not have any sciatic pain this time, she commented, “It makes sense when you think about it.

The Asheville Citizen-Times also reported that according to the N.C. Chiropractic Association, more than 25 million people visited chiropractors last year. They noted that the number of people receiving chiropractic services has doubled in the past 20 years, and they estimate that the number will double again by 2010.

The article also reported on cyclist Patricia Pinner, who uses chiropractic to help improve her performance. The article reports that Pinner estimates that 90 percent of the women on the Asheville Women’s Cycling team see a chiropractor. “The whole keeping your spine in alignment is necessary for total health,” she said. “When you are trying to compete, total health needs to be as good as it can be.”