CHIROPRACTIC CONSIDERATIONS DURING PREGNANCY
by Anna Maynard

Chiropractic concentrates on the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system in order to improve its function and maintain general health. Chiropractic acknowledges the close relationship between different parts of the body and the nervous system and that all parts of the body need to get their signals via the nervous system to work effectively.

Mechanical stresses start during pregnancy and may be accentuated by along or difficult labour. During pregnancy the body changes rapidally and it is important to try and maximise the function of the body systems during this time. The development of the foetus starts in the first few weeks thus an awareness of the stresses and strains placed on the body is important from the very early stages.

In the first trimester the foetus is well cushioned within the mothers bony pelvis and within the foetal membranes abd amniotic fluid. At this time the hormonal balance begins to change allowing the mother's ligaments to become more flexible in preparation for the enlarging foetus and eventually the birth.

As the pregnancy progresses and the baby enlarges the amount of available space decreases and the baby has less room to move around. the stresses throughout the bany and materal spine increase. Low back pain during pregnancy is common and can often be related to misalignment of the mother's pelvis, which is already under increased strain from the increased abdominal weight. Pelvic and lower back misalignment can present in many different ways including pain around the base of the spine (coccyx) in the small of the back, at the front around the pubic bone or as "sciatica".

Many of the ligaments that support and surround the developing foetus attach to the mothers pelvis and spine, thus any compromise in function to these areas can cause different, imbalanced tensions on the ligamentous structures. This can decrease the amount of space available in the womb and many hinder the baby achieving the optimal foetal position prior to birth. Chiropractic treatment during pregnancy can treat the cause of the back pain and address the alignment of the pelvis thereby maximising the amount of space the baby has in the abdoment and enhancing the pelvic outlet thereby preparing for the birth itself.

Some pregnant women do not suffer with back pain but nevertheless benefit from maximising function of the spine and pelvis, balancing the ligaments and muscles and preparing for birth through gentle treatment, advice and exercises. Preparing for birth can produce its own anxieties and recognising these tensions whether mechanical or otherwise should allow pregnancy to be a positive experience.

Relaxation techniques offer many benefits to both mother and baby. Finding time to relax at particularly stressful times should

allow fear and anxiety to decrease
allow blood flow to the womb and the baby to be maximised
maximise the baby's oxygen and nutrients through the increased blood supply minimise the affect of stress hormones both on the mother and the baby

Becoming aware of the demands placed upon your body during pregnancy will improve your well-being and preparation for the arrival of your baby. Achieving comfortable positions at work and at home is very important and will help reduce possible mechanical irritation. Here's some to try -

Standing
Standing with one foot diagonally in front of the other opens the pelvic outlet, maximising the available space.

When standing still for a long period, eg ironing or washing-up, standing with one foot on a block or a step will minimise strain through the lower back

Lying
Lying on the left side encourages the baby into the optimal foetus position and reduces low back and pelvic strain

Putting a pillow in-between your knees prevents any twisting in your back whilst lying on your side.

Sitting
A lways try to sit with your knees lower than your hips, again maximising the area in the abdomen for the foetus to lie in

Kneeling
Kneeling on all fours in the 'cat' position will take weight off the spine and pelvis and isa comfortable resting position.

Anna Maynard works from the Godalming Chiroractic Clinic. Her work and that of her colleague Tone Tellefsen focuses on care of the pregnant woman and child, working to ensure a better health and positive outlook during pregnancy and the early years.