Moms to be – whether first time or not – are under a lot of pressure to make all the right decisions for both them and their babies. There is a lot of information out there, and it can be very hard to sort through. My goal for today is to give you the most up to date information about the safety of chiropractic care during pregnancy, so that you are empowered to make the right decision for you.
To start – what are some reasons that a pregnant woman may seek chiropractic care? Both low back pain and pelvic girdle pain are common during pregnancy due to the wide range of changes to the body, even if a woman has never experienced this type of pain before. Carpal tunnel and mid back pain also become more common throughout pregnancy, and may be debilitating.
The prevalence of low back pain during pregnancy is up to 90%, with 75% of women reporting that their pain continued at least 6 months postpartum. A smaller percentage even report still experiencing this pain 2-3 years later. It may be severe enough to interrupt activities of daily living, including sleep and caring for children. Although this pain may be common, that does not mean that it is normal and must just be accepted as a part of pregnancy. Although the exact cause of pregnancy related low back and pelvic girdle pain are not known, it is thought to be a combination of hormonal changes, biomechanical changes due to increased weight and changes in weight distribution, and changes in abdominal musculature to accommodate the fetus.
Although more research is needed, chiropractic care including adjustments and exercise may be beneficial for relief of low back and pelvic girdle pain related to pregnancy. Chiropractic care has also been found effective in treating other conditions that pregnant women may present with, such as neck pain or headaches.
Regarding safety of chiropractic care for these conditions, a new systematic review and update of the literature was published this year (2021). The group looked at 21 quality studies (including systematic reviews, randomized controlled trials, cohort studies and a case study) of pregnant or postpartum patients receiving chiropractic care, and any reported adverse events (from significant to minor). These studies were all published 2011 and later, as studies before that were included in the previous systematic review published in 2015. All of this literature except for the one case study presented only mild and transient events. The case study that was included did demonstrate a serious event after neck manipulation. The previous systematic review demonstrated 4 adverse events after neck manipulation, and 2 adverse events after low back manipulation.
Based on this evidence, the authors determined that adverse events following manipulation in the pregnant and post-partum population are rare. More research still needs to be done, which is common with this population.
When it comes down to it, you as the patient always makes a decision on the type of treatment that you want to receive. Although chiropractic care is generally safe for the pregnant and post-partum population, you should always discuss any questions and concerns with your chiropractor. They will be able to let you know of any contraindications you may have, or suggest alternate treatment options at that time.
Even if you are not interested in chiropractic adjustments, I encourage you to reach out to a chiropractor or other health care professional if you are experiencing pain related to your pregnancy. Although it may be common, it is not something that you should have to live with.
Resources:
Weis, C. A., Stuber, K., Murnaghan, K., & Wynd, S. (2021). Adverse events from spinal manipulations in the pregnant and postpartum periods: a systematic review and update. The journal of the Canadian Chiropractic Association, 65(1), 32–49.
Stuber, K. J., Wynd, S., & Weis, C. A. (2012). Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature. Chiropractic & manual therapies, 20(1), 1-7.
Dr. Brenna Byer D.C. 