Adjusting to Pregnancy: Chiropractic for the Pregnant Woman

regnancy is a time of extraordinary change for a

woman’s body. Tremendous stresses are placed

on the musculoskeletal system. These biochemical

and structural changes frequently create back and

neck pain--in a prospective Swedish study, 61% of

women reported back pain at some point during the

Unfortunately, many women may think that this kind

of discomfort is just something they have to “put up

with” during pregnancy. Only about 1 in 3 women

report these symptoms to their doctors or other prenatal

care providers, and only about 25% of providers

Awareness is growing, however, that chiropractic offers

a gentle, noninvasive option for relief of pregnancy-

related back and neck pain. Researchers at

Robert Wood Johnson Medical School in 2002 found

that more than 5% of pregnant women had sought out

chiropractic care—by far the most commonly used

North Carolina nurse-midwives surveyed recommended

“We don’t really deal with medication or surgery,

which are the primary other options for pain relief out

there and options that doctors don’t recommend during

pregnancy,” says Greg Plaugher, DC, now in private

practice in Alameda, California, formerly an instructor

in pediatrics at Palmer West, and an editor of

Indeed, William Sears, MD, and Martha Sears, RN,

during pregnancy. In the chapter titled, “The Ninth

Month,” they write: “…as your baby descends into

your pelvic cavity, you may experience sharp, stabbing

pains at the base of your spine or in the middle

of your pelvic bone. This creates uncomfortable

twinges or ‘pins and needles’ in the cervix itself. Pain

can radiate down your back or thighs. The increased

pelvic aches and pains are likely due to the relaxation

and stretching of your pelvic ligaments in preparation

for labor. These discomforts can be dealt with by

changing positions. A chiropractor experienced in

working on pregnant people may be able to help with

pelvic adjustments to help balance the hips and pelvis.

It is our personal theory that chiropractic care in

pregnancy can help to avoid or relieve back pain and

also prepare your back and pelvic structures for the

stresses of labor and delivery.”

Although there are plenty of anecdotal reports of chiropractic

care relieving the aches and pains of pregnancy,

the data to back up these reports are still lacking.

But a recent retrospective case series published in

and effectiveness of chiropractic care during pregnancy.

Anthony Lisi, DC, who serves as staff DC for

the VA Connecticut Healthcare System, associate

professor of clinical sciences at the University of

Bridgeport College of Chiropractic, and associate

clinical faculty at the Palmer Center for Chiropractic

Research, followed 17 pregnant women with lowback

pain who underwent chiropractic treatment, including

spinal manipulation. In 16 of the 17 cases, the

women experienced significant improvement in their

pain within an average of about 5 days (approximately

2 visits). None of the women experienced any

adverse events.

Adjustments

Chiropractic adjustment is usually different during

pregnancy, says Mary Malott, DC, a practitioner in

Galveston, Texas. Dr. Malott estimates she sees between

25 and 50 pregnant patients per year. “The

ligaments are more lax, so the adjustments are easier

and gentler, like [the ones] you do with children. In

the low back, a lot of times the adjustment will take

place with just gentle stretching. In the mid-back,

where pregnant patients also have a lot of pain due to

increased breast size, we will often use instruments,

especially the Activator method.”

No matter what the method, as pregnancy progresses,

the doctor of chiropractic will have to make some

adjustments. “You can usually use regular tables to

adjust until the end of the first trimester, but later on,

it’s important to have high-low tables that separate to

allow the abdomen to protrude,” Dr. Plaugher says.

“You’ll have to adapt, but it really isn’t more difficult

P

Pregnancy

than adjusting a large man would be.” Randy Ferrance,

DC, MD, hospitalist in internal medicine/

pediatrics at Riverside Tappahanock Hospital in

Virginia, points out that body pillows also exist that

are made specifically for use with pregnant patients.

There is some evidence that chiropractic can be helpful

when it comes to the discomforts of back labor. A

was significantly less likelihood of back labor in a

woman who had had chiropractic care, a particularly

painful type of labor in which the woman feels most

References

1996 Mar 15;21(6):702-709.

4. Allaire AD, Moos MK, Wells SR Complementary and alternative medicine in pregnancy: a survey of North

6. Diakow PR, Gadsby TA, Gadsby JB, Gleddie JG, Leprich DJ, Scales AM. Back pain during pregnancy and