Maternal Care - Added
RECOMMENDATION - Added
A woman’s body experiences numerous biomechanical adaptations and physiological changes during pregnancy. These changes may have an adverse affect on her neuro-musculo-skeletal system.
Because of these physiological and biomechanical compensations, practitioner care must be taken to select the specific analysis and adjustment most appropriate for the complex changes during the various stages of pregnancy.
The increased potential for spinal instability in the mother and the resulting subluxations in the woman’s spine throughout pregnancy affect the health and well-being of both her and her baby. This warrants regular chiropractic check ups in all women throughout pregnancy.
Patient education pertinent to chiropractic care in pregnancy is encouraged.
Rating: Established Evidence: E,L
Commentary - Added
The doctor of chiropractic plays an essential role in both the mother and baby’s musculoskeletal and nerve system care throughout pregnancy and in preparation for birth.
Varney’s Midwifery text states:
“The potential for damage in pregnancy and the postpartum period to a woman’s neuro-musculo-skeletal structure is great. Shifts in the center of gravity forward and slightly up destabilize her posture and realign the carriage of weights and forces through her joints, predisposing nerves, muscles, bones, and connective tissues to damage. Increased levels of relaxin and elastin further aggravate this situation.” 1
Gait compensations and increased biomechanical loads lead to further strain on spinal segments and their supporting structures.
Female sacroiliac joints tend to be flatter, with a wider retroarticular space and longer interosseous ligaments, all promoting greater mobility.2 As hormonal changes affect supporting musculature and ligament laxity, there is an increase in spinal and sacroiliac articulations compensation and mobility. If a motion segment is compensating for a lack of mobility at an adjacent level, then these segments may become more hypermobile. 3,4
_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision