In addition to being aware of the available research, textbook writings and the chiropractor’s clinical experience supporting the importance of chiropractic care in pregnancy for safer and easier births, it is important that the doctor of chiropractic understand the physiological causes of dystocia in labor and the potential the chiropractic adjustment has in reducing the causes of dystocia. Dystocia is abnormal function in labor and the number one cause for invasive intervention that results in trauma and subluxation in the mother and infant.
In Williams Obstetrics, the authors define dystocia as “Abnormal Labor.” They further emphasize, “Dystocia is very complex, and although its definition - abnormal progress in labor seems simple, there is no consensus as to what ‘abnormal progress’ means. Thus, it seems prudent to attempt a better understanding of normal labor in order to determine departures from normal.” 26
Williams Obstetrics defines the causes of dystocia to be:
Abnormalities of the expulsive forces— either uterine forces insufficiently strong or inappropriately coordinated to efface and dilate the cervix (uterine dysfunction), or inadequate voluntary muscle effort during the second stage of labor. (Power)
Abnormalities of the maternal bony pelvis– that is pelvic contraction (Passage)
Abnormalities of presentation, position, or development of the fetus (presented in chapter 19) (Passenger)
Abnormalities of the soft tissue of the reproductive tract that form an obstacle to fetal descent.27
When examined from a structural perspective, each of these causes may be prevented with specific chiropractic analysis and adjustment of the pregnant woman’s spine throughout pregnancy. In other words, each cause of dystocia is addressed with specific, regular chiropractic care throughout pregnancy.
Correlating the causes of dystocia with the corrective accomplishments of the chiropractic adjustment is as follows:
Uterine dysfunction may very well be caused by a decrease in nerve innervation to the uterus which normally initiates strong contractions and maintains adequate muscle function throughout labor. Specific segmental care throughout pregnancy restores adequate nerve supply and therefore normal function to the uterus.
Pelvic contraction is defined as misalignment of the pelvic bones caused by physical trauma to the woman. Specific chiropractic adjustments offer the potential for pelvic realignment reducing pelvic contraction.
Abnormalities of presentation, position or development are known to be caused by intrauterine constraint. Preliminary studies with the Webster technique are demonstrating the efficacy of reducing intrauterine constraint to the woman’s uterus.
Preliminary, clinical findings are showing reduction in fibroids and migration of placenta attachment to more desirable positions while the patient is under chiropractic care.
_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision