Literature reviewPregnancy and chiropractic: a narrative review of the literature
Introduction
Chiropractic care has typically included the care of pregnant patients to assure the patient a comfortable pregnancy and to help facilitate an uncomplicated labor and delivery. The literature describing the rationale for characteristics of care for this group of patients is sparse but growing. A few conducted studies support the care of pregnant patients, but the paucity of definitive literature has resulted in a lack of consensus in approaches to chiropractic care within the profession. This article provides a narrative review of the use of chiropractic care for women during pregnancy and labor in an attempt to summarize the chiropractor's role in the comanagement of the pregnant patient.
Section snippets
Methods
A search of relevant articles published in the English language was conducted using a PubMed (1987-2006) search. Medical subject headings used were the terms pregnancy and chiropractic. Key phrases searched were low back pain in pregnancy and Webster Technique. Bibliographies of all pertinent articles, after reviewing the current research articles obtained through this search, were then searched for additional references in older or non-indexed literature, and to obtain further articles and
Discussion
It has been reported that approximately 50% of all pregnant women experience back pain during their pregnancy and 50% to 75% of women experience back pain during labor.1., 2., 3. However, only 21% of pregnant women with back pain seek consultation with their medical physicians.2., 4. According to the 2005 Job Analysis of Chiropractic, surveyed chiropractors reported that they rarely treat pregnant women.5 However, of the pregnant population that the respondents did encounter in their practices,
Conclusion
Although chiropractic care typically includes the care of pregnant patients, the research literature is sparse. Biomechanical changes and stress to the neuromusculoskeletal system are present during and immediately after pregnancy. Chiropractic evaluation and treatment during this period may be warranted and considered a safe and effective means of treating common musculoskeletal symptoms that many pregnant patients encounter. The published evidence even suggests that regular chiropractic care
Acknowledgment
The author would like to express gratitude to Michael Wiles, DC, for his guidance, support, inspiration, and critical review throughout the process of publication of this review; and to Jim Hulbert, PhD, for his assistance in editorial counsel.
References (33)
Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series
J Midwifery Women's Health
(2006)- et al.
Chiropractic care, including craniosacral therapy, during pregnancy: a static-group comparison of obstetric interventions during labor and delivery
J Manipulative Physiol Ther
(1995) - et al.
Back pain during pregnancy and labor
J Manipulative Physiol Ther
(1991) - et al.
Low back pain in pregnancy
Obstet Gynecol
(1988) - et al.
Low back pain in pregnancy
Spine
(1987) - et al.
- et al.
Complementary and alternative medicine for low-back pain in pregnancy: a cross-sectional survey
J Altern Complement Med
(2005) Patient page: for your health: chiropractic advice for moms-to-be
J Am Chiropr Assoc
(2003)- J.M. Fallon. Textbook on chiropractic & pregnancy. Arlington, VA: International Chiropractic Association; 1994: 52,...
The female patient: enhancing and broadening the chiropractic encounter with pregnant and postpartum patients
J Am Chiropr Assoc
(2003)
When to adjust: chiropractic and pregnancy
J Am Chiropr Assoc
Chiropractic and pregnancy: a partnership for the future
ICA Int Rev Chiropr
Osteopathic manipulative treatment in prenatal care: a retrospective case control design study
J Am Osteopath Assoc
Osteopathy's contribution to prenatal care
J Am Osteopath Assoc
Obstetrical practice
J Am Osteopath Assoc
The value of routine manipulation in pregnancy
J Am Osteopath Assoc
Cited by (15)
Best-Practice Recommendations for Chiropractic Care for Pregnant and Postpartum Patients: Results of a Consensus Process
2022, Journal of Manipulative and Physiological TherapeuticsCitation Excerpt :Mild and transient side effects have been reported after lumbar spine SMT and, although rare, serious adverse events have been reported following cervical SMT in a few case reports.70,71 If red flags are identified during pregnancy and early postpartum, clinicians should fully discuss the risks of SMT in each of the spinal regions they are considering adjusting.70,72 A thorough history and physical examination may help to identify potential red flags such as prothrombotic and extreme joint laxity.70
Biofield and manipulative therapies for emotional wellbeing and fertility
2022, Fertility, Pregnancy, and WellnessChiropractic Management of Pregnancy-Related Lumbopelvic Pain: A Case Study
2016, Journal of Chiropractic MedicineCitation Excerpt :Although complementary and alternative medicine (CAM) has gained popularity among pregnant women, efficacy studies are still in the “infancy” days.14–16 Studies suggest that spinal manipulation therapy (SMT) may be an effective and safe intervention in PR LPP.17–19 A recent randomized chiropractic clinical trial18 reported on the combination of multimodal and obstetric management in PR LPP.
The use of validated outcome measures in the chiropractic care of pregnant patients: A systematic review of the literature
2015, Complementary Therapies in Clinical PracticeRelationship between complementary and alternative medicine use and incidence of adverse birth outcomes: An examination of a nationally representative sample of 1835 Australian women
2014, MidwiferyCitation Excerpt :Despite the claims made by CAM practitioners, there is limited clinical evidence for the effectiveness of CAM in pregnancy (Phillips and Meyer, 1995; Mantle, 1997; Parsons et al., 1999; Simpson et al., 2001; Halberstein et al., 2007; Beddoe et al., 2009; Drobbin and Welsh, 2009; Ensiyeh and Sakineh, 2009; Furber et al., 2009; Reis, 2011; Adams et al., 2012), and non-CAM clinicians have outlined concerns regarding the safety of some CAM use by pregnant women (Gaffney and Smith, 2004; Adams, 2011; Adams et al., 2011a, 2011b). A number of these safety concerns are supported by available research (Tiran, 1996; Borrelli et al., 2005; Mills and Bone, 2005; Narendran et al., 2005; Borggren, 2007; Dugoua et al., 2008; Smith and Cochrane, 2009; Bornhoft and Mattheissen, 2012). Given the prevalence of CAM use by pregnant women, the potential safety issues, and the debate surrounding the integration of these medicines in maternity care, rigorous research identifying potential effects of CAM use on women׳s birth outcomes is required (Adams, 2011).
Breech repositioning unresponsive to webster technique: Coexistence of oligohydramnios
2013, Journal of Chiropractic MedicineCitation Excerpt :Approximately 3% to 5% of all pregnancies reach full term presenting with breech presentation.1-6 The Webster technique is a chiropractic procedure that is believed to relieve the musculoskeletal cause of intrauterine constraint, with the goal of repositioning breech presentation to cephalic presentation.7-9 The Webster technique is thought to promote cephalic presentation by treating sacroiliac joint dysfunction with sacral manipulation and lower abdominal tenderness, nodules, or adhesions with light effleurage therapy.7,10