had 24 per cent shorter labour times and subjects giving birth for the second or third time reported 39 per cent shorter labour times. In another study, the need for analgesics was reduced by 50 per cent in the patients who had received adjustments. In addition, 84 per cent of women report relief of back pain during pregnancy with chiropractic care!6,7,8 And because the sacroiliac joints of the pelvis function better, there is significantly less likelihood of back labour (contractions and sharp pain felt in the lower back/ sacral area during labour) when receiv- ing chiropractic care during pregnancy.9 Chiropractic care has helped new moth- ers become more comfortable breastfeed- ing (posture-wise) as well as to produce more milk.10 MODIfyING CHIROpRACTIC fOR pREGNANCy As a pregnancy advances, some chiro- practic techniques need to be modi- fied for the patient’s comfort and safety. In particular, you should avoid having her lying prone unless you have a table with a drop-away thoraco-lumbar piece, a tilt-up pelvic piece with a roll under her shoulders and/or special pregnancy pillows to accommodate her growing belly (Figure 1). You should be trained in pregnancy-specific techniques, such as Webster or Bagnell techniques, that address uterine constraint (foetal mal- presentations). Sacro Occipital Tech- niques (SOT) blocks work well, espe- cially in a supine position, and I also use an activator extensively. Checking the alignment of the sacrum, pelvic bones, pubic bones, ligaments that support the uterus (e.g., the round ligament), and supporting muscles such as the gluteals, piriformis, thigh adductors and lumbar paraspinals is essential. Additionally, many women will have upper thoracic subluxations from the increasing mass of the breasts in preparation for lactation, lower rib dysfunction from stretching to accommodate the growing belly, as well as cervical subluxations from the shift in the centre of gravity. Ensure that you don’t have the mother lying on her back too long, even with the knees bent (I use a Dutchman’s roll or yoga bolster under the knees for comfort) as lying on the back can put a great deal of pressure on the lumbar spine due to increased lordo- sis. Lying on the back in the second and www.canadianchiropractor.ca third trimester can also cause changes in blood pressure. For some women, it can cause a drop in blood pressure that can make them feel very dizzy; for oth- ers, it can cause an unwanted increase in Figure 1 blood pressure. After checking all of the above, the only side-lying technique that I use in the latest stage of pregnancy is a labour starter or helper. Once mother is ready CANADIAN CHIROPRACTOR | FEBRUARY 2009 • 33
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