Pregnancy : A Chiropractic Perspective
How your pregnancy unfolds, and the decisions you make along the way will stem from the perspective you have of the world around you.
Do you see the world as a place of hostility, where you must fight to stay healthy, that when a problem develops you attack that one problem? Do you see yourself needing to control and regulate how things occur, treating illnesses with medication to make yourself healthy? Your health is dependent on what you do to fight disease? This is a mechanistic perspective and is the medical model of health. You will appreciate all the attention from your doctor and it will likely feel like a well needed safety net.
Or do you see the world vitalistically? You trust your body and Mother Nature instinctively, supporting and encouraging the natural flow of events since they must happen for a reason? You look at your body and existence as a whole, and look to the cause rather than the treatment of symptoms? You recognise that healing comes from within, and you need to support the process?
It is likely that if the first paragraph appeals to you, then a traditional medical approach to pregnancy will make sense to you. Chiropractic is by definition vitalistic, and the contents of this info sheet will be focused on how you can naturally support your body through, and after pregnancy, giving Mother Nature room to breathe.
THE INTERVENTION CHAIN REACTION
Childbirth itself is poorly understood. Prominent medical textbooks(1) state that to better understand when childbirth is not running to plan, doctors need to better understand what ‘normal’ actually is. In practice this means that if labour is not running on schedule, a recommendation is often given to medically intervene, even though there is no clear definition of what that schedule should be. Statistically(2) as soon as one intervention occurs, the risk / chances of the next intervention increases dramatically, often ending in a Cesarean Section. This last step is then often lauded as vital to rescue the mother or child from the complications that occurred during labour, of which many are caused by the interventions themselves. How does the chain reaction start and what can you do to limit the risk?
DUE DATE Estimation
Is notoriously inaccurate(3) when assessed with Ultrasound, only 3% of deliveries are on time. Be relaxed about this and consider perhaps a ‘Birth Month’ Late births are not by definition going to result in a complicated birth. If the doctors try to induce before you are ready without medical reason to do so there is a much higher chance of things not going to plan.
ULTRASOUND
Is considered(4) up to 7 days inaccurate in the first trimester, 14 days in the second, and up to 21 days out in the 3rd. This also means that if the child is considered too big, then this assessment is highly likely inaccurate, and may result in an unnecessary C-section recommendation. Use of the 20 week ultrasound to check for placenta location is also questionable, since most will self-correct prior to labour, and it becomes only significant when still present at birth itself. There have been calls in the last few years to perform zero ultrasounds except for valid medical reasons, and certainly not to take photos.
ARRIVING AT THE HOSPITAL TOO SOON
By arriving too soon in labour at the hospital, the chances are higher that the mother’s stress levels will be higher (more later), the doctors may consider labour is taking too long, and the chances of medical intervention increases(5). So take your time getting there.
INDUCTION
There is no evidence to support breaking the waters will assist in accelerating labour, and may induce complications if the fetus is not correctly in place. Dilation should also be at least 5 cm before such intervention is called for, yet it is often recommended with only 3 cm dilation. Medication to stimulate contraction increases the strength and length of the contractions, but each contraction squeezes the fetus and creates undue stress. This stress may be used to recommend further intervention. The contractions are also far more painful, so the doctors are like to recommend an epidural. the next step…
EPIDURAL
An epidural is an anaesthesia injected into the spine, so now that the mother is numb, there is no pain, but she cannot push properly. She must also now lie on her back for birth. She is likely also much more stressed, and this negatively impacts what is now a medical procedure and cannot be considered a normal birth.. Stress for the mother also stresses the child, and this may be interpreted as a need to do an emergency C-Section. There remains also the question what effect these drugs have on the not yet born child.
MATERNAL POSITION
For the baby to pass through the pelvis, the sacrum MUST tilt and move backwards. If the mother is lying on her back, the sacrum is being pushed forwards, and means the baby cannot get through. There are many other positions, some dependent on the stage of labour, these should all be known and talked through with the midwife and attending doctors. Have a plan and do what feels right.
PUSHING
Your body knows when to push, do not push too early. Leave it as late as feels natural. An epidural takes away this awareness and means the pushing can be at the wrong time. The uterus is a muscular organ and needs full neurological control, and this is particularly where chiropractic can play a significant role to ensure that everything in the pelvic area is moving well and well connected.
EPISIOTOMY
The Cochrane Collaboration(6) since 2006 advises against this as it is successfully possible to do Perineal massage to achieve sufficient birth canal opening. Waiting until 10cm dilation before pushing, should avoid the (so called) need for this surgery.
CESAREAN SECTION
There are emergency reasons for doing one, this not the topic here. But elective C-Sections are increasing dramatically(7), and the significant downsides are perhaps not clear enough. Firstly it is major abdominal surgery for the mother, and increases the possibility of her death during childbirth, and also results in a much longer recovery period after giving birth. For the child there are major advances in research(8) showing that a C-Section born child will have a much higher risk of neurological deficits, respiratory problems, and digestive tract disorder which are linked with long term auto-immune disorders. We strongly advise against elective C-sections.
AVOIDING THE CHAIN REACTION
We could also say: how to ensure the doctor doesn’t get in the way of Mother Nature. There are three aspects to a natural delivery:
POWER: can the mother develop and control and push at the right time with the right force to make it all happen
PASSAGE: is the pelvis aligned and mobile enough to allow the child to pass through
PASSENGER: has the child developed properly, with the best presentation and position for birth
HOW CHIROPRACTIC FITS IN
The uterus is a muscular tube, and all muscles require nerve supply. The autonomic supply is from T10-L1, and S2-4. Dysfunction of these vertebra or the iliosacral joints can interfere with normal nerve flow at these levels.
The uterus is suspended with various ligaments, two of which are connected to the inside of the sacrum at the S2 level. If the sacrum is twisted or locked, then an imbalance in the ligaments could occur with potential rotational stress to the uterus and therefore the foetus itself. Chiropractors are specifically trained to identify these spinal dysfunctions and correct them. The benefit is there for anyone who receives chiropractic care, that the nervous system has the best chance of functioning free of interference, and enhances the work of Mother Nature.
The two Round Ligaments run forward from the uterus and attach to the pubis. If a sacral dysfunction exists, these ligaments are often adversely strained and may contribute to the incorrect presentation or position of the foetus. This interconnectedness is part of a chiropractor’s treatment handbook.
Chiropractic is based on the principle that there is an intelligence that gives us life, an intelligence that acts by way of the nervous system. This intelligence, or Mother Nature is respected and supported by the work of your chiropractor. Working mechanistically against this force results in many stresses, side effects and in the case of childbirth, perhaps a higher chance of medical intervention and risk when not necessary.
CHIROPRACTIC RECOMMENDATIONS
For all pregnant mothers we recommend one visit per week for the entire pregnancy, also in the absence of symptoms. A primary benefit is to keep the nervous system at ease. A build-up of stress will have an effect on the developing child, and the importance of remaining at ease with the wonders of pregnancy cannot be understated. There are no known contraindication to chiropractic at any stage of pregnancy, in comparison to the often unknown risks associated with medication of all types. We encourage both parents to be involved in the pregnancy, in terms of care beforehand, understanding birth options, and being part of the plan going into labour itself. Create your birth plan with your birth team, and importantly: trust Mother Nature.
EXTRA TIPS
Don’t cut the umbilical cord until the placenta comes out, it’s back up oxygen for your child, and constitutes 8% of the blood of your newborn child(9). Don’t clean your child straight away or do the measurements, it can surely wait a bit. This immediate medical attention is a huge psychological stress for your child, far more vital is time immediately on your tummy for at least an hour. A newborn should start to suckle on average after about 20 minutes. If you think Vitamin K is necessary, please oral not injection. And lastly, vaccinations are an epidemic, and we believe you should understand how the immune system really works before potentially exposing your child to unnecessary risks too early. works before you agree to any. Please attend our Immune System health talk, and pick up our info sheet on how to strengthen your immune system naturally.
REFERENCES
Williams Obstetrics
Friedman’s Curve and Failure to Progress: A Leading Cause of Unplanned C-sections, August 28, 2013, Rebecca Dekker
Henci Goer, Obstetric Myths vs. Research Realities, Bergin & Garvey 1994
Midwifery Today, Issue 50, Summer 1999
Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women with "No Indicated Risk“ Birth: Issues in Perinatal Care May 2009.
Episiotomy for vaginal birth Carroli G, Mignini L 21 Cochrane Collaboration. January 2009
www.childbirthconnection.org/article.asp?ck=10456
Time to consider the risks of caesarean delivery for long term child health Bluster, J., Liu, J., BMJ 2015; 350
The Placenta: essential resuscitation equipment. August 26, 2010 www.midwifethinking.com