Pregnancy

From the June 2009 issue of the scientific periodical the Journal of Clinical Chiropractic Pediatrics comes a case study that documents the improvement of pelvic pain in a pregnant woman with chiropractic care. In this case a 28-year-old female, 32 weeks pregnant, came into a chiropractic office with the chief complaint of sharp, stabbing pain starting at the left sacroiliac joint and radiating into her left thigh.

In this case the woman was in her third pregnancy and did not have pain problems with her previous two pregnancies. However, in this pregnancy her pain was so severe that it was affecting her daily life. A chiropractic examination was performed and due to her pregnancy, no x-rays were taken. A diagnosis of pelvic subluxation was made and a plan of correction was determined.

The initial chiropractic care consisted of two visits a week for 4 weeks, one visit a week for 4 weeks and one visit every two weeks for a month. The results documented in this case study showed that the woman felt little or no change during the first week of care. However, during the second week of care she experienced a 50% reduction in her pain.

Unfortunately during the fourth week of care, the woman reported that she had fallen backwards over a chair and felt the pelvic and leg pain return almost immediately with the same intensity as before. However, with an increase in frequency of her adjustments she was feeling 90% improvement by the 6th week. After the 8th week of care, she delivered a health baby boy.

There was no return of her pelvic pain after her delivery. She occasionally experienced some dull lower back pain as her body returned to a normal state, but these episodes were mild and helped with chiropractic. The study noted that 4 months after delivery, the woman remains pain free.

A study published in the January 26, 2012, issue of the Journal of Pediatric, Maternal & Family Health reported that 70 percent of woman with abnormal fetal position pregnancies reported a correction of the fetal position. This study comprised 81 pregnant women with breech pregnancies late in their pregnancy.

The study authors begin by noting that between 25 and 30 percent of all pregnancies are breech (feet first) presentation by the end of the 28th week of pregnancy. However, that number drops dramatically by the 34th week with only about 3-4 percent reaching term with the breech presentation. The risk to the mother and baby is between three to four times higher for a breech birth than for a normal vertex birth delivery.

This study reviewed the results of 24 independent Doctors of Chiropractic who had seen 81 pregnant women who presented for care with a breech presentation. The determination of a breech presentation was made on average at 31.8 weeks of pregnancy. The women’s average age was 32.4 years.

The results of the study showed that by the 36th week, 70 percent of the women in the study had their pregnancy turn to a normal vertex position. A number of the women had used other forms of natural care in conjunction with the chiropractic. These other forms of care included slant board, crawling exercises, hip and pelvic movements and acupuncture. The only consistent care present in this study was the chiropractic care which all the women were receiving.

In their discussion, the authors discussed the overall growing evidence that chiropractic care is helpful for women with breech pregnancies, and noted, “With the continued popularity of chiropractic to address NMS (neuro-musculo-skeletal) complaints in the general population and for pregnancy related complaints in particular, there is now a growing body of literature documenting that pregnant patients may also derive benefits from chiropractic care beyond these NMS complaints.”

A study published in the December 2010 issue of the Journal of Clinical Chiropractic Pediatrics looked at the prevalence and reasons pregnant women sought chiropractic care. The survey study was conducted in Oslo Norway and approved by the Anglo-European College of Chiropractic, in Bournemouth, United Kingdom.

pregnantIn this study, a survey was conducted of the first 100 pregnant women who presented for chiropractic care at a clinic in Oslo. Data for the study was collected over a 16 month period and data from the women was only included during their pregnancy. Pregnant women were only included in this study if they spoke Norwegian and remained under chiropractic care for more than one visit.

The results of the study showed that the median age of pregnant women who came in for chiropractic care was 32.5 years with the youngest being 25 and the oldest being 42. About half of the women (47%) were in their first pregnancy, while the other half (49%) were in their second pregnancy, and only a small number (4%) were in their third. According to the study, 32% of the women had never received any care for any musculoskeletal problems in the health care system regardless of pregnancy status. Additionally, 38% had been to a chiropractor before, either before they were pregnant, or in a previous pregnancy.

The study also showed that 44% of the women had been referred for chiropractic care by a family member or a friend. However, what was interesting is that 48% were referred for chiropractic care by another health care professional. Of this 48%, the referral breakdown showed that 23% received advice from their midwife, 15% from their medical doctor, and 10% from a physiotherapist. One interesting statistic from this study was that almost one-third of the women sought chiropractic care as their first method of care for their problems during pregnancy.

When looking at the reasons why the women sought chiropractic care, the researchers found that for 90% of the women, the main reason they came for care was pelvic pain. Researchers also noted that 60% of the women also suffered from back pain. Additionally 29% of the women had neck pain, 15% suffered from headaches and 2% had migraines.

The study also looked at how long the women waited with their pain before deciding to start chiropractic care. The results showed that the longer they waited, the greater the number of problems they experienced and therefore an increased amount of care was needed to help them. One of the patients expressed their feelings about waiting too long and their quote was included in the study. This patient said, “Why didn’t anyone refer me here earlier? It is just by chance I ended up here in this office. Had I known what I now know, I would have come much earlier.”

A review of previous studies on the effectiveness of chiropractic for pregnant women with lower back pain was published in the July 2008 edition of the Journal of Manipulative and Physiological Therapeutics (JMPT). This study looked at previously published works on this subject to review the body of evidence for the effectiveness of chiropractic care.

The JMPT report starts off by noting that between 50% and 80% of pregnant women suffer from low back pain (LBP) during their pregnancy. They noted that a review of previous work showed that from 68% to 85% of pregnant women with back pain during pregnancy do not look for any care for their lower back pain. The authors theorize that this is because most pregnant women consider back pain to be a normal part of the pregnancy.

In reviewing all the scientific literature on the subject of chiropractic for low back pain in pregnancy, the authors of the JMPT review narrowed their selection down to 6 studies that met their specific criteria. The results of the various studies showed a high percentage of pregnant women did get relief from their lower back pain through chiropractic.

In one reviewed study 84% of the 25 subjects reported relief of their lower back pain. In a larger study of 103 patients who received chiropractic care during their pregnancy, all of the women reported greater than 50% decrease in back pain on a questionnaire. In yet another case series where 120 pregnant women with LBP underwent an average of 15 chiropractic treatments, the results showed that 25% had complete remission of their back pain, 50% reported feeling very well, 15% were feeling better, and 10% noted no change in condition.

Interestingly, none of the studies reviewed for the JMPT report indicated any adverse effects or evidence of harm to either the pregnant woman or unborn child from the chiropractic care. The authors of the JMPT report noted that there was a need for more comprehensive studies involving control groups, but they did note that all studies they included reported positive results for the subject under chiropractic care. They noted in their conclusion, “Results from the 6 included studies showed that chiropractic care is associated with improved outcome in pregnancy-related LBP.”

A documented case study showing chiropractic care helping a breech pregnancy was published on April 7, 2008, in the scientific periodical, the Journal of Vertebral Subluxation Research (JVSR). In this case, a 28 year old woman returned to the chiropractor in her 34th week of pregnancy. She had previously been receiving chiropractic care for headaches and sacroiliac pain.

In week 34 of her pregnancy, the woman’s nurse midwife recommended that she return for chiropractic care after it was discovered that the presentation of her current pregnancy was breech. She had previously carried her first pregnancy in a breech presentation until 37 weeks until seeking chiropractic care.

This study notes that approximately 3%-5% of term pregnancies in the United States result in a breech presentation, while 80%-100% of those breech presenting fetus? are delivered by cesarean section. Breech presentation is when a fetus is set up for the birth with the buttocks or feet rather toward the birth canal rather than the normal head first, known as the “cephalic presentation”.

Upon chiropractic examination, the breech presentation was confirmed and the chiropractic analysis and procedure known as the “Webster Technique” was utilized to determine intrauterine constraint and initiate correction.

Two days after receiving chiropractic care using the Webster Technique, the woman returned to her nurse midwife for her follow up visit. That examination showed that the fetus had turned to a normal presentation. In the conclusion of this case report, the chiropractor, Dr. John Cameron Thomas noted, “The importance of preventing intrauterine constraint and cesarean section deliveries is apparent. For women who desire to deliver vaginally, there are options that can be performed before having a scheduled cesarean section.”

The March 5, 2005 issue of the British Medical Journal reports on a study that shows that mothers who smoke in late pregnancy risk having children with lower intelligence. The research found that young men whose mothers smoked 20 or more cigarettes a day had IQs that were on average 6.2 points below those of sons of non-smokers.

The study noted that the more the mother smoked, the more it affected IQ of the offspring when they grew to an adult. Additionally, the study noted that there was no real difference in socio-economic levels related to the loss of IQ and smoking during late pregnancy.

Erik Mortensen, researcher and one of the authors from Copenhagen University Hospital, Indiana University, commented, “Our results reveal significant long term effects of maternal smoking during pregnancy on mental development. Maternal smoking during pregnancy was associated with lower adult intelligence and there appeared to be a dose-response relationship between maternal smoking and offspring intelligence.”

The study noted that the reason for this finding was not totally understood, but the authors did say an adverse effect on the central nervous system and brain may be a factor: “It seems justified to assume that part of the effect of maternal smoking on offspring cognitive development is a direct result of the effect of substances in cigarette smoke on the fetal central nervous system.

From the March 11, 2008, issue of the the scientific periodical, the Journal of Vertebral Subluxation Research (JVSR), comes a case study involving a pregnant women who was suffering from back pain and therefore sought out chiropractic care. This was her third pregnancy and the previous two pregnancies resulted in cesarean births. The 29 year old woman was hoping to deliver this baby vaginally.

In this case, the woman started chiropractic care in her 34th week of pregnancy because of suffering from back pain. She reported having experienced on and off lower back pain throughout her pregnancy. She had also had similar problems in the third trimester of her previous pregnancy.

A chiropractic examination was performed and the determination of subluxations was made. Care was initiated focusing mainly on the lower spine. On the patient’s 4th visit, she reported that her low back pain had improved significantly and she was “getting around better” than before the care.

In the 40th week of her pregnancy, the woman went into labor. She labored 12 hours at home with her husband before going to the hospital. Although she reported that the medical staff was extremely anxious, given her previous birth history, she delivered a healthy baby girl, naturally and without the use of medications or a Caesarean surgical procedure, as had been the case in her prior births.

The study authors, Joel Alcantara, BSc, DC and Ingrid Hamel, DC, FICPA, concluded, “This case report described the successful chiropractic management of a patient with pregnancy-related low back pain and possibly facilitated a successful vaginal birth despite two previous Caesareans.”

In the Medical Tribune June 24, 1999 is an article reporting that New York Researchers have found that women who smoke during pregnancy may increase the chance of their children having certain behavioral disorders. For years there has been a well-established connection between low birth-weight and mothers who smoke. But this new evidence shows the longer term effects of smoking during pregnancy.

The New York study examined 50 people whose mothers smoked 10 or more cigarettes per day during pregnancy and compared them to 97 whose mothers did not smoke. The research showed that sons of smoking mothers were four times more likely to develop a conduct disorder and or behavioral disorders marked by excessive disobedience, aggression and antisocial behavior. Daughters were five times more likely to be drug dependant teenagers.

Previous research also linked smoking mothers to attention-deficit hyperactivity disorder (ADHD). A 1996 study of 140 boys with ADHD showed 22 percent of the boys with ADHD had mothers who smoked compared with only 8% of those who whose mother didn’t smoke.

In the Medical Tribune June 24, 1999 is an article reporting that New York Researchers have found that women who smoke during pregnancy may increase the chance of their children having certain behavioral disorders. For years there has been a well-established connection between low birth-weight and mothers who smoke. But this new evidence shows the longer term effects of smoking during pregnancy.

The New York study examined 50 people whose mothers smoked 10 or more cigarettes per day during pregnancy and compared them to 97 whose mothers did not smoke. The research showed that sons of smoking mothers were four times more likely to develop a conduct disorder and or behavioral disorders marked by excessive disobedience, aggression and antisocial behavior. Daughters were five times more likely to be drug dependant teenagers.

Previous research also linked smoking mothers to attention-deficit hyperactivity disorder (ADHD). A 1996 study of 140 boys with ADHD showed 22 percent of the boys with ADHD had mothers who smoked compared with only 8% of those who whose mother didn’t smoke.

Reuters Health news service ran an article dated Feb 10, 2000, that stated that researchers now know how drinking alcohol during pregnancy can affect the brain of a fetus. This study also published in the February 11, 2000 issue of the Journal of Science, was conducted at Washington University School of Medicine in St. Louis Missouri.

One of the authors, Dr. John Olney, stated that “Its a mechanism that involves interfering with basic transmitter of the systems in the brain, which literally drives the brains nerve cells to commit suicide.” The shocking part of the report was that it was reported that just one episode of getting drunk during the third trimester of pregnancy would be enough to damage the brain of a fetus.