Prenatal chiropractic care, through a pregnancy that changes weekly

Back and pelvic pain are common during pregnancy. When we see pregnant patients at our Clarksville office, we use pregnancy pillows for positioning, modify our technique and generally use less force. Before any of that, a new or changing symptom deserves a proper look, because not every ache in pregnancy is an ordinary one and some need your OB or midwife, or emergency care, instead.

What changes in your body during pregnancy?

As the weeks go by, three changes can contribute to aches and pains: the load you carry, your posture, and the tissues that support the pelvis. They don't explain every symptom.

Load and posture. As the uterus grows, your balance and posture change, and the extra load can strain your back.

Ligament laxity. Pregnancy hormones can loosen the ligaments that support the pelvis. Pelvic girdle pain can be felt over the pubic joint at the front or at the back of the pelvis, and it can make walking, stairs or turning over in bed hard. An exam helps tell it apart from other causes.

Where the pain travels. Pain in the buttock or leg may be referred from nearby joints or muscles, or it may involve a nerve (our sciatica guide goes into that), and where it hurts doesn't tell you which. Being pregnant doesn't rule out a neurological or other medical problem, either, so it's worth letting your OB or midwife know about new symptoms before you choose a treatment.

Round ligament pain can cause a brief, sharp pain low in the belly. Belly pain that's persistent, severe or worrying in some other way shouldn't be put down to ligaments, and the NHS lists the common causes and the warning signs to know.

Which pregnancy symptoms need medical care right away?

Some symptoms overlap with problems that need immediate medical attention. If you have any of the symptoms below, contact your OB or midwife immediately, and if you can't reach them, get emergency care. Please don't wait for an appointment with us.

• Pain, swelling, warmth or redness in one calf or thigh. These can be warning signs of a blood clot and need medical assessment.
• Severe or persistent headache, changes in your vision, sudden swelling of the face or hands, or pain under the ribs on the right side. These can indicate preeclampsia, usually after twenty weeks.
• Regular tightening or cramping before thirty-seven weeks, any vaginal bleeding, or fluid loss.
• A reduction or change in the baby's movements.
• Fever with back pain, or back or flank pain with burning on urination, which can point to an infection, not a mechanical problem.
• Severe or persistent abdominal pain.

Call 911 for chest pain, trouble breathing, fainting, or severe pain or bleeding when you need emergency help. The CDC's urgent maternal warning signs and the NHS guide to pain in pregnancy explain why these changes need prompt action.

How we adapt prenatal chiropractic care

We regularly treat pregnant patients. None of our doctors holds a separate prenatal chiropractic certification or specialty license, and neither "prenatal chiropractor" nor "pregnancy chiropractor" is a credential. What changes when you're pregnant is the setup and the force:

• Positioning. We use pregnancy pillows so you can lie comfortably, with both mom and baby properly supported, and we adapt the setup to you.
• Modified technique and less force. We change how we adjust, and we generally use less force during pregnancy.

Your first visit is a history and an exam. We'll want to know what hurts, when it started, what makes it better or worse, how far along you are, and what your OB or midwife has already said about it.

Part of our exam is working out whether back or pelvic pain looks musculoskeletal or needs a medical evaluation instead, and until then we don't assume it's a muscle-and-joint problem.

What about labor, delivery and the baby's position?

Those are questions for your obstetric team, and we leave them there. Our part is back and pelvic pain that turns out to be musculoskeletal. We make no claim that chiropractic care shortens labor, reduces the need for pain relief during delivery, changes the baby's position or improves birth outcomes.

How safe is prenatal chiropractic care, and what are the other options?

A realistic look at safety. Temporary soreness can happen. Serious problems from spinal manipulation have been reported rarely in pregnant patients, but research on it in pregnancy is limited, and what we have can't put an exact figure on the risk. Any treatment and positioning we suggest is something to talk over with your OB or midwife as well as with us. Our page on chiropractic safety during pregnancy goes further into it.

Other options, and what each offers. Your OB or midwife can assess pregnancy-related causes and point you to the right referrals. A physical therapist with pregnancy or pelvic-health experience can help with an individualized movement and exercise plan. Depending on the findings, activity and sleep-position changes, a support belt or suitable exercises may help. ACOG's page on back-pain self-care in pregnancy and RCOG's on how pelvic girdle pain is treated cover those options. The right mix depends on your pregnancy and your symptoms.

If a new symptom turns out to belong with your OB or midwife, we'll say so and point you there. If we are not able to help you with your problem or are unable to reduce your pain levels, we will make sure to give you a recommendation to another experienced provider. If you can't tell whether the ache is in your pelvis or your low back, sorting that out is what the exam at a first visit is for.