By Florence Bowen, DOMP

Prenatal Osteopathic Care

From the moment you discover you are pregnant, the amount of information and advice, warranted or not, is overwhelming. You equip yourself with the best baby gear, collect books, attend hypnobirthing class, prenatal pilates and attempt to prepare as best as you can for the arrival of your families newest addition. All the while, your body is shifting in ways that are totally new and foreign to you. The maternal changes that occur on a structural, anatomical and physiological level are BIG! I like to refer to pregnancy and the postnatal period as “maternalescence.” Consider this, your body has not undergone such drastic shifts, hormonally and physically since you were a teenager. These rapid changes, often result in common symptoms reported by women during pregnancy.

What is Happening Underneath it All?

With pregnancy comes a surge of the hormones estrogen, progesterone, human chorionic gonadotropin (hCG), prolactin, and relaxin. Relaxin has a rapid relaxing effect, promoting more elasticity within the ligaments, tendons, muscles and smooth muscles of the uterus (Kumar & Magon, 2012). This allows for more pliability in the body and enables the pelvis to widen and open for labour and delivery. This loosening of the joints of the body, is necessary for delivery, however, it often results in pelvic discomfort, hip pain and low back aches during pregnancy.

The curves of the spine and position of the pelvis adapt as pregnancy progresses. With pregnancy, the pelvic bowl rolls forward, increasing the small of your low back, the rib cage widens and opens, and the mid-back flattens (Stone, 1999). Again, this can contribute to discomfort in the lower rib area, back aches, and shoulder tension.

During the fourth month of pregnancy the uterus is too large for the pelvis alone and it migrates upward towards to abdomen. The enlarged uterus forces the abdominal organs and the contents of the abdominal space to reposition. The uterus enlarges so greatly that it compresses the stomach upwards; the bladder, blood vessels, and colon downwards; and the intestines, inferior vena cava, and abdominal aorta backwards. For further perspective, during the last trimester of pregnancy, the growth of the uterus forces the thoracic diaphragm to elevate approximately 4cm (Varney, 2004).

Many of the discomforts experienced during pregnancy are the result of the abdominal organs being displaced and compressed by the uterus. These discomforts include heartburn, increased urinary frequency, constipation, hemorrhoids, lower leg edema, supine hypotensive syndrome, and shortness of breath (Varney, 2004). The discomforts experienced during pregnancy are symptoms which Osteopathic Manual Practitioners can help to relieve and manage during pregnancy.

What is Osteopathy?

Osteopathy is a natural form of medicine which views the body as one interdependent and continuous system. Theoretically, osteopathy aims to restore normality and function throughout the entire body by determining the cause of imbalance and discomfort. The treatment itself involves subtle, intuitive manual manipulation of the bone and soft tissue within the bodies’ limitations. An Osteopath will use a light tactile pressure to find increased musculoskeletal tone and work to release any tensions with a very slight palpation. The approach is subtle and safe during pregnancy.

How Can Osteopathy Help?

1. Relief of Aches and Pains

With pregnancy comes many changes which often result in compensation or adaptation of the entire body. Meaning that when you have an enlarged uterus, the rest of the body has to expand, rotate, twist, broaden to make space! This leads to new tension in the joints, new stretch and compression of the muscles, the fascia, ligaments and tendons. Using a hands on approach, osteopathic manual therapy will address the position and mobility of the bones of the pelvis, spine, peripheral arms, legs, ribcage, cranium and the organs of the body. Osteopathic treatment assures that structures are free to move in all directions which will reduce perceived tightness and discomfort. The treatment of the viscera aims to remove any tension in the ligaments of the viscera, as well as remove any adhesions between the different organs. Adhesion refers to ‘stickiness’ between the organs which often results from the squishing together of the the organs from the enlarged uterus. Osteopathic treatment of the organs, specifically the organs in relationship to the uterus can help manage symptoms such a shortness of breath, heart burn, constipation and nausea.

2. Prepare for Birth and Delivery

Osteopathic treatment can be super beneficial for assuring that the bones of the pelvis, sacrum and tailbone are all in ideal position for labour and delivery. Likewise, the ability to address the organs, including the uterus and the surrounding intestines are useful tools when trying to “flip” or orient the baby head down for delivery!

3. Labour Induction

Craniosacral therapy is regularly incorporated in Osteopathic treatment, it involves a very subtle palpation of the bones and skull. It functions to balance the central nervous system, reduce tension and stress in the body. Balancing the sympathetic and parasympathetic nervous system can be super beneficial for those dealing with an overdue baby. More specifically, treatment of the cranium and sacrum can help induction of labour as it kick starts your parasympathetic nervous system.

When to See an Osteopath During Pregnancy?

Once you are beyond the fatigue of the first trimester, it is often the perfect time to seek out treatment. There are no strict guidelines. It is a subtle approach to tending to your needs as you progress through your pregnancy and prepare for labour and delivery.

Interested in giving osteopathy a go? Click here to book online now.

References

Kumar, P., Magon, N. Hormones in pregnancy. (2012). Nigerian Medical Journal. 53(4), 179-183.

Stone, C. Science in the art of osteopathy. Cheltenham, UK.: Stanley Thornes

Varney, H., Kreibs, J, M., & Gegor, C, L. (2004). Varney’s Midwifery. Sudbury, MA: Jones & Barlett