Thursday, December 16, 2010

Don’t schedule that repeat c-section until you read this!

Written on December 9, 2010 at 7:43 am by Birth Sense

I’ve long been a believer in the value of chiropractic treament for the frequent low back pain and sciatica that many women experience during pregnancy.  But a recent question from a reader led me to consider whether chirpopractic might have other benefits during pregnancy. 

A reader emailed me with a question: I have a prominent sacral promontory, and ended up with a c-section for my first birth.  Does this mean an automatic repeat c-section for me?  My doctor and midwife say that chiropractic treatment won’t help; is this true?

To answer the question, I turned to Dr. Dawn Tames, of Sacred Touch Chiropractic.   A chiropractor specializing in pregnancy and pediatric care, Dr. Dawn has posted an article on her website that discusses the benefit of chiropractic treatment, not only for low back pain, but also for dystocia, or difficult labor. 

I spoke with Dr. Dawn, who expressed her conviction that a prominent sacral promontory is not a defect that a woman is born with, but a variation from normal spinal alignment, which can be treated by chiropratic adjustments.  To give you a visual picture of what we’re talking about here, compare the following diagrams:

This is a normal spinal curve.  However, during pregnancy, most women develop what is called lordosis, or “sway back”.  This is shown more clearly in the next diagram.

abnl curve

You can see more clearly in this image the difference between a normal curve of the spine and an abnormal curve.  Notice the prominent sacral promontory–the inside surface of the sacrum which the baby has to navigate past when descending the birth canal.   The exaggerated curve of this spine, or swayback as it’s commonly called, shifts the angle of the birth canal, causing the sacral promontory to protrude further into the birth canal.  Not only can this cause decreased space for the baby to pass through, in extreme conditions it can cause a ”shelf-like” prominence upon which the baby’s head or shoulder can get stuck.  Women with this condition are commonly told that they will need to deliver by c-section.  This is what I learned in my training, and while I’ve always encouraged mothers to try vaginal delivery, because sometimes we are surprised, I’ve believed what I was taught about the slim chances that a woman with a prominent sacral promontory could deliver vaginally.

Dr. Dawn told me that a simple maneuver, which may need to be performed several times during pregnancy, can reposition the sacrum and modify the abnormal curve of the spine.  Even women with scoliosis, she says, can benefit from about 6 months of treatment, greatly improving their chances of normal birth.  

Dr. Dawn and her chiropractor colleagues initiated a research study to document their results.  They collaborated with a group of perinatologists, who are medical doctors specializing in problem pregnancies.  The group shared care of pregnant patients, with the perinatologists managing the prenatal care, and the chiropractors monitoring the spinal alignment of each woman, and making adjustments as needed.  The results were very encouraging–women in the group who received chiropractic care as well as prenatal care had fewer c-sections, fewer problem labors, and fewer misaligned babies.   As the researchers were preparing to submit their results for publication, the perinatologists made an unusual demand.  They wanted the chiropractors to teach the nurses in the perinatology practice to perform the spinal adjustments, so the perinatology practice could bill for the adjustments in addition to prenatal care.  When the chiropractors declined to do this, the perinatologists refused to release their data for study publication.  Dr. Dawn is now in the midst of a new study, which she plans to publish in the near future. 

With the wealth of new information being presented on the topic of treating spinal misalignment for prevention of labor dystocia, and posterior and breech babies,  women now have even more reason not to schedule that repeat c-section, without first looking into what chiropractic treatment can do to help. 

An important point to remember:  chiropractors are not routinely trained in these specialized techniques.  Dr. Dawn took additional specialty training in pregnancy and pediatric care.  To find a chiropractor who is skilled in pregnancy care, check out the International Chiropractic Pediatric Association.

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