regularly before getting pregnant. Brisk walking, swimming, and riding a stationary bicycle are good choices. Keep it moderate (30 minutes per day), particularly if you weren’t exer- cising before. • Ensure weight training is done under proper guidance. • Measure your heart rate at peak activ- ity to be sure you are not exceeding 140 beats per minute. • Avoid overheating: drink plenty of water, and don’t exercise in hot, humid conditions. • Do lots of Kegel exercises (before and after the birth) to tighten the muscles around your vagina and anus. From Day 1 after the birth, try to do Kegels every time you feed your baby so it is easier to remember. To isolate these muscles, imagine you are trying to stop yourself from passing urine. Hold the contraction of these muscles for as long as you are able, remembering to breathe, and then relax. Repeat the ex- ercise up to 10 repetitions each time, two to three times a day. It will take time to establish yourself as a chiropractic-pregnancy expert . . . Persistence and patience are crucial! • Avoid activities that put you at high risk for injury, such as horseback rid- ing or downhill skiing. • Avoid sports in which you could get hit in the abdomen (for example, soft- ball). • Especially after the third month, avoid exercises that require you to lie flat on your back for an extended period of time since this can reduce your heart rate, lower your blood pressure, cause dizziness, and may reduce blood flow to baby. • Never scuba dive because it can cause dangerous gas bubbles in the baby’s circulatory system. • Before starting any new exercise rou- tine, always check with your health- care provider. • Stop exercising immediately and con- sult your midwife or doctor if any of the following symptoms occur during or after exercise: 24 • CANADIAN CHIROPRACTOR | APRIL 2009 ❍ bleeding ❍ cramping ❍ faintness and/or dizziness ❍ elevated blood pressure ❍ severe joint pain BUILDING A PrEGNANCy PrACTICE Establishing clear lines of communica- tion with the midwives, doulas, pre- natal educators, and medical profes- sionals involved in the care of pregnant women in your community is impera- tive. Of course, this is easiest when you have the appropriate pregnancy-specific training, or when you are expecting your own baby! It is a good idea to send each a brief letter explaining who you are, what you do, and a summary of current chiropractic care in pregnancy research or a few carefully chosen articles. (The ICPA website is a great resource if you don’t know where to start!). And, in our clinic, we follow up with a phone call to each health practitioner involved in pregnancy care a week or two later, to see if they have any questions. We also give a small Christmas gift basket to each radiology, medical, midwifery and massage therapy clinic in our area to keep our centre on the radar! Sending a brief letter or report to your expectant parents’ other care- givers, just like a specialist, is also a wonderful marketing tool that serves to educate the other practitioner as to what chiropractic care can do for their patients, and keeps you in their field of vision. For an example, visit the Cana- dian Chiropractic Association website (www.ccachiro.org) to learn more about the letters on the CCA’s “Building DC- MD Relationships” CDs. Avoid use of overly technical terminology, such as names of orthopedic tests and chiro- practic-specific language, as many really do not understand and may discount your reports as gibberish. Writing and submitting articles to your local publications, such as news- papers, as well as sending each health practitioner a copy of your in-house newsletter, also helps to establish your role as a pregnancy-care expert. Giving them a subscription to the ICPA’s Path- ways magazine can also be useful. We have pregnancy-specific “New Patient Intake Forms,” as well as a note on our regular new patient intake forms that indicates they should ask for a pregnancy form if they are expecting. In my multidisciplinary clinic, we also offer other pregnancy-specific services such as pregnancy massage, pre-natal yoga, homeopathy, and Hypnobirth- ing™ courses. It will take time to es- tablish yourself as the chiropractic- pregnancy expert in your community, so work to open the lines of communi- cation and then be prepared to receive the professional referrals. Persistence and patience is crucial! THE PrEGNANCy-PErfECT OffICE Several things make your office more comfortable and inviting, and help make expectant parents more likely to refer their friends and family to be checked. Having a family-friendly waiting area and adjust- ing rooms, with toys and books for older children in the family, as well as baby toys for the after-pregnancy care, helps. Post- ers stressing the importance of chiroprac- tic care in pregnancy, infancy and child- hood are up on our walls. We always have healthy snacks, water and stickers handy. We have a lending library with many pregnancy and chiro- practic, nutrition, breastfeeding and nat- ural health-care books, magazines and other information resources available to borrow. We also keep a binder of current research articles; have lots of handouts and brochures; and maintain informa- tion on available community resources such as pre-natal yoga and other exercise classes, bellies-and-babies groups and parent-tot groups. We strive to make the waiting area comfortable for breastfeeding by dis- playing a breastfeeding-friendly sticker on the window, having comfy chairs and extra pillows, and making a private room available if required. Also, we give the mom-to-be a small baby gift – worth around $20 or so – after the 35th week of pregnancy. This will include a few things for baby: for example, a onesie, natural skin-care products and a small toy; something for mom (usually healthy chocolate), information on post-natal re- covery and information on chiropractic care for infants and children. We also make sure she has our after-hours con- tact information in case she needs an ad- justment during labour. We also empha- size the importance of the post-delivery checkup to help her body heal more quickly and to start baby off right! • www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor April 2009: Page 24
