Safe Chiropractic Care for Each Trimester of Pregnancy

Chiropractors use the Webster Technique to treat expecting mothers during each trimester of pregnancy to prepare the mother’s body to handle the stresses of pregnancy and to allow for an easier labor and delivery.

Before we start detailing the type of care provided during each trimester of pregnancy, could you please explain what the Webster Technique is and how it is unique to prenatal care?

Dr. Gregg Rubinstein: Well, that’s a really good question. And most of the moms who seek out our care have usually been recommended by a doula, midwife, or maybe an OB-GYN. So, they’re coming in specifically for the Webster Technique. The Webster Technique is a specific type of technique, a chiropractic analysis, and it includes some diversified adjustments. And the goal of that adjustment is to reduce the effects of sacral subluxation or sacroiliac joint dysfunction. And I’ll do a little better job defining that in a minute. And in doing so, it improves what’s called the neural biomechanical function in the pelvis.

And to kind of make that into more plain English and not doctor talk, but that’s the official definition put out by the ICPA and really what it is, is a system of analyzing the bony alignment of the sacrum, which is the triangular wedge that the entire spine is balanced on, the lumbar spine, which are the five lower lumbar vertebrae, the sacroiliac joint and the pelvic girdle, which includes the pubic symphysis and all those bones in conjunction with the ligaments that kind of stabilize the uterus, which is particularly the round ligament, and then the uterosacral ligament and the broad ligament.

Now, all these structures kind of do this dance to kind of support the uterus floating inside the mom. And then what can happen is some of these ligaments can become tight. They can start to pull, and then that can put the pelvis out of balance, change the alignment in the pelvis, which sometimes can slow down delivery or cause pain and discomfort for the mom. So, with the Webster Technique, we’re able to provide gentle chiropractic care, which helps realign the sacrum, the pelvis, and balance the ligament tensions to make the mom a lot more comfortable during her pregnancy, and in many cases, there’s a lot of research supporting that it actually improves delivery outcomes and can actually prevent the need for other interventions, such as epidurals and Pitocin and C-sections. So, it’s a real important part and a lot of moms are using it to just get relief during pregnancy because they can’t take medications when they’re having all the discomfort of things associated with pregnancy and the weight gain and the center of gravity shifting anterior.

So, it’s a real important technique and it’s been gaining traction for years and is becoming more and more popular and a much bigger part of my practice now.

What are some reasons why women should start to see a chiropractor early on in their pregnancy, in their first trimester?

Dr. Gregg Rubinstein: Well, chiropractic care in pregnancy is vital to the normal physiological function of both the mother and the baby throughout the pregnancy. So, more women and birth providers are discovering the benefits associated with chiropractic care in pregnancy and recognize the expertise through this Webster Certification. So, I became certified in it and what it is, it’s really about just keeping the spine and nerve system healthy, especially in the beginning.

The first trimester, there’s not a ton going on. The body’s getting ready and the baby’s growing, but usually there’s not a significant amount of weight gain and things like that. So, we’re just kind of working to maintain good alignment, good spinal health, and really just make sure that they maintain all the flexibility of the joints, because all that is going to come into play much later in the second and third trimester. But in the beginning, some of them will start to have some discomfort. Some of the new moms, a lot of them have questions and a lot of them have just done their research and know that if you take care all the way through pregnancy, it’s not like this rush at the end to try and do all kinds of work. So, it’s just keeping the body consistently healthy and prepared and preparing the mother’s body to handle the bigger stresses that are coming down the pike.

What issues start to present themselves in the second trimester of pregnancy that a chiropractor can help with?

Dr. Gregg Rubinstein: Well, typically, as we said before, in the second trimester, more symptoms can start to arise as the expecting mom gains more weight, her center of gravity is going to move anterior as the belly extends, which will start to stress the lower back and pelvis. And then you’ll start to see changes in the way they walk and they’re going to have to change the way they sleep. And then that can cause issues because now, “Oh, I can’t sleep on my stomach. I was a stomach sleeper.” We hear things of that nature. So those things really start to change in trimester two. Also towards the latter part of that, the body’s going to start to secrete that hormone relaxin, which really sets up all the things that we need to do in the third trimester. And things change a little bit.

Up until the second trimester, you can still use some of the traditional techniques. The side posture adjustments are okay to do up until about week 30. There are applied in the same manner that they would be in most non-pregnant people, so to speak. But it’s really a beginning, where at that point, once we cross from two to three, that’s where things start to change.

During the second part, there still can be some discomfort and pain as the ligaments loosen up and you’re changing the way you sleep, you’re changing the way you walk, you’re changing the way you just about do everything and the body’s changing as well. So, it’s so important to maintain good alignment during the second trimester, really also just in preparation for the third.

The third and final trimester can be the most uncomfortable for women as the baby grows. What type of chiropractic treatments are performed during this phase of pregnancy?

Dr. Gregg Rubinstein: Well, lucky for us chiropractors, it doesn’t really change. The Webster Technique is very consistent. And as long as you keep doing your analysis and your analysis isn’t changing, and the listings aren’t changing, the treatment itself, the Webster is really more of a repetition than anything new that happens in the third trimester.

However, during the third trimester, again, as we said before, much more of that hormone relaxin is secreted. The ligaments can become a little more lax, but that’s by design. So that loosens up the pelvic girdle and allows a little more spread through the sacroiliac joints. And will actually ease and give more spread so it’s easier for the baby to pass through the birth canal. But remember, there’s a lot more weight and the baby is much more anterior, which really puts a lot more strain on those ligaments that we were talking about before, particularly the round ligament. Moms can feel a lot of round ligament pain, and that can be on the pubic symphysis or even up underneath the rib cage. They can feel discomfort there.

And the great thing about chiropractic is one, it works with the body and two, it’s really safe, gentle, and effective, and there’s no side effects. These moms want to take aspirin or Advil or something to deal with the pain. And they really can’t because, or shouldn’t anyway, because when you take those medications, you share the bloodstream with the baby. Any chemicals or things that you take in that aren’t necessarily good for you are going to have an effect on the baby. It might not be a huge effect, but again, you want to stack the deck in your favor.

A lot of the moms that we work want to raise natural, healthy, drug-free kids. And that’s really what’s so important during that third trimester. The technique is the same, but we just do maybe a little bit more of it. And it’s just a little more pointed, and there are a few things that you can’t do in trimester three, like the side posture traditional adjustments, those need to stop a little earlier primarily because of the ligament laxity.

Could you summarize how chiropractic care throughout pregnancy prepares the baby and the mother for a smoother and safer labor and delivery?

Dr. Gregg Rubinstein: It’s really interesting because Dr. Larry Webster, the founder of the ICPA, and also the founder of the Webster Technique, was an instructor at Life College and he developed the Webster Technique in response to his daughter, Lucinda’s birth. Dr. Webster was present along the arduous birth and along the birth he actually was doing some adjusting and he felt that chiropractic could have a bigger impact in labor with a more specific approach to the pelvis. So, after his personal experience, he strove to really develop an adjustment for laboring women to ease the birth. And he felt that there’s got to be a more specific way of addressing the subluxations throughout the pregnancy that would be safer for the mother. So, shortly after, he was caring for a family member whose mother was pregnant and also presenting breech. And then he started to apply this newly discovered approach in hopes for an easier delivery like his daughter had. And he saw that when he was treating her once per week for several weeks, they noticed that the baby turned vertex in time for delivery. And then he started teaching the technique to a lot of other chiropractors and they reported similar things, “Oh, the baby wasn’t in optimal position, we applied the Webster Technique.” And then for a little while, they called it like a Webster Breech Turning Technique, but we really found that it’s not appropriate to call it that. So, he really kind of redefined it and called it the Webster In-Utero Constraint Technique but now it’s really been just kind of named the Webster Technique and left alone, because we don’t want to imply that the technique can always be used to turn the baby.

It’s really about relaxing the ligaments, aligning the pelvic girdle in the mother and just kind of assisting her and hoping that mother nature does her best when this technique is applied correctly. Also, we always employ the help of an OB if anything doesn’t look right. And a lot of them are very interested in how chiropractic affects the biomechanics of the pelvis now. And a lot of OB-GYNs are encouraging their patients to seek chiropractic care during pregnancy.

So, it’s really been a very exciting time and as long as you’re doing the right things throughout the pregnancy, it’s stacking the deck in your favor. There’s no guarantee, some of my moms still end up having C-sections for various reasons, but the majority of the births go pretty smooth and we hear all these wonderful stories. A lot of times after birth, the moms come in with these beautiful babies and we get to see who we were working with all along. It’s really just a wonderful time for the mother and for us when we get to meet the baby. So, it’s really just a beautiful, beautiful thing to be part of this and working with a lot of the moms and that’s how it all came about.

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