How To Find a Chiropractor for Pregnancy

by Kmom

Copyright © 2007 Kmom@Vireday.Com. All rights reserved.

This FAQ last updated: June 2007

CONTENTS

 

Introduction

One of the most frequent questions Kmom encounters is about chiropractic care during pregnancy.  Women write and ask how to find a chiropractor that specializes in pregnancy, babies, and children.  They ask questions about the different techniques that can be used to help facilitate a baby turning into a better position for birth or to help resolve some pain they are experiencing during or after pregnancy.  They ask whether they need to have chiropractic care or not, or whether chiropractic care can help them get a VBAC or avoid a cesarean, etc.  They also ask how to resolve some long-standing body issues from previous births. 

All of these are important questions that Kmom answers repeatedly in emails.  To save time, she has compiled answers to the most common questions and put them online here.  She is also working on a more extensive FAQ about chiropractic care, with far more details, research, and women's stories than are in this FAQ.  In addition, she has made space available on this website for guest columnist Dr. Jason Lindekugel, DC, to write about chiropractic safety. 

Kmom hopes that this helps address the most common questions about chiropractic care for pregnancy, and helps women who want it find a chiropractor with special expertise in pregnancy-related issues.   Stay tuned for more writing on this topic.

 

The Purpose of Chiropractic Care During Pregnancy

Many women experience back and pelvic pain in pregnancy.  For some women this is just a passing phenomenon, a little discomfort that goes along with the hormones of pregnancy relaxing the pelvis and helping it expand for the birth.  For other women, however, it is a significant and long-lasting pain that is very debilitating.  Some women find it difficult to turn over in bed, to get dressed in the morning, to walk any distance, or even to sit comfortably for long.  Some women are in constant pain from it; a few even end up in a wheelchair, unable to walk without aid.  

While many doctors will tell women that back and pelvis pain is "normal" in pregnancy and there is nothing that can be done, chiropractors do not believe that significant or long-lasting pain is "normal" at all, and they know from experience that much of it can be helped.  They believe it occurs when the spine or pelvis are out of alignment or the muscles and soft tissues around them are unbalanced. This can present as back pain, pain in the buttocks that radiates down the leg (sciatica), pubic pain in the front of the pelvis, hip pain, tailbone pain, stabbing pains in the abdomen when the mother moves too quickly or sneezes (ligament pain), neck pain, difficulty walking or turning over or lifting one leg, and sometimes shoulder or rib/side pain.  

Chiropractors emphasize that the mother does not have to continue to suffer this kind of pain in pregnancy, and that chiropractic care may help make pregnancy more comfortable.  Many feel it may even help facilitate an easier labor and birth.

Chiropractors believe that chiropractic care can help pregnant women in several different ways:

The most basic component of chiropractic care is to make sure the bony passage around the baby (the pelvis) is as open and well-aligned as possible, creating the largest possible space for the baby to move through.  Many women who have had cesareans have been told that their "sacrum is too prominent" or "too flat," that their pubic arch is "too flat/narrow," that "there is a bone in the way," or simply that their "pelvis is too small/narrow" for a baby to maneuver through.  However, after chiropractic care, many of these cesarean mothers have gone on to give birth to bigger babies than their "stuck" cesarean babies, simply because the pelvic passage is now optimized and the baby has more room.  So maximizing the space through good alignment can actually make a difference for some women.

Chiropractors also place great importance on good nerve function.  They believe that a misaligned spine impedes nerve function.  They believe that poor alignment can not only affect the body physically by causing malpositions and making less room for the baby to get out, but also by causing ineffective, uncoordinated contractions because of poor nerve function.  From his article on "The Safety of Chiropractic Care in Pregnancy," Dr. Jason Lindekugel (D.C.) writes:

Chiropractic manipulation seeks to balance the joints of the body in order to normalize nerve function...In restoring joint function, chiropractors are relieving nerve irritation which in turn relaxes muscles and the ligaments of the pelvis and uterus.  So, proper nerve function is the goal, not just “cracking” joints.  

Finally, chiropractors and midwives have also observed that women who complain about a lot of back/pelvic pain seem to have a higher rate of malpositioned babies, particularly breech babies, asynclitic babies (head tilted to one side), and posterior babies (baby facing towards mom's front instead of towards her back).  Chiropractors believe that this is often caused by a misaligned back and/or pelvis creating tension or "constraint" in the ligaments that support the uterus, which in turn cause the baby to be malpositioned.  And malposition often leads to a high rate of difficult, painful labors.  

Chiropractors believe that by relieving any misalignments, they will reduce in-utero constraint, thus helping babies be positioned more advantageously, and therefore helping women have safer, faster, and more effective labors and births.

Summary

The purpose of chiropractic care during pregnancy is to: 

  1. Keep the body well-aligned to make the maximum possible space available for baby to pass through

  2. To optimize nerve function so that contractions can be effective and coordinated

  3. To balance the joints, ligaments, and muscles of the supporting structures for the uterus so baby has the best chance to assume the healthiest  possible position for growing and for being born easily  

In other words,  the purpose of chiropractic care during pregnancy is to help pregnancy, labor, and birth be as smooth and easy as possible for mother and baby.  

 

The Concept of "In-Utero Constraint"

The concept of "in-utero constraint" is an important one in chiropractic care for pregnancy.  Chiropractor Dr. Larry Webster first theorized it.  His observation was that a misalignment or lack of balance in the pelvis can pull on the ligaments that help support the uterus, causing tension or "constraint" on the uterus, and making it uncomfortable for the baby inside to assume the most optimal position for birth.  

He believed that by helping the pelvis align properly, balancing the muscles around the area, and then "releasing" the soft tissues around the uterus (the ligaments, the pelvic diaphragm, etc.), constraint on the uterus could be resolved, and then the baby would be free to move into the best position for an easier and safer birth.  

Dr. Carol Phillips, D.C., describes "in-utero constraint" in her pregnancy book, Hands of Love.  In an excerpt from her book published at http://www.newdawnpublish.com/Excerpts/98.htm, she states:   

First of all, the uterus is not a free-floating home for the baby. It is anchored tightly into the bony pelvis by eight distinct ligaments. Imagine for a moment that the pear-shaped uterus is a hot air balloon; surrounded by a large and majestic mountain range, the balloon would be tethered to the ground to insure that it does not float up and away. Well, evenly spaced ligaments also anchor the uterus to the pelvic floor. If our imaginary balloon handlers were to misjudge where to anchor any particular stake used to secure the ropes in the ground, the balloon would tip---making it difficult, if not impossible, for someone to enter or exit the basket. The same thing could happen to the uterus causing the cervical portion, the cervix, to tip away from the center of the vaginal canal...

Restoring balance to the structural framework and the muscular components of the body will result in a balanced uterus, which can contribute to a comfortable pregnancy and a happy mother/baby couple.

Dr. Jeanne Ohm, president of the International Chiropractic Pediatric Association (ICPA) further describes "in-utero constraint" (see  http://www.icpa4kids.org/why/pregnancy.htm), writing:

As your baby develops, your uterus enlarges to accommodate the rapid growth. So long as the pelvis is in a balanced state, the ligaments connected to the uterus maintain an equalized, supportive suspension for the uterus. If your pelvis is out of balance in any way, these ligaments become torqued and twisted, causing a condition known as constraint to your uterus. This constraint limits the space of the developing baby. Any compromised position for the baby throughout pregnancy will affect his or her optimal development...

If the woman’s uterus is constrained as birth approaches, the baby is prevented from getting into the best possible position for birth. Even if the baby is in the desirable head down position, often times constraint to the uterus affects the baby’s head from moving into the ideal presentation for delivery. The head may be slightly tilted off to one side or even more traumatically, present in the posterior position. Any baby position even slightly off during birth will slow down labor, and add pain to both the mother and baby. Many women have been told that their babies were too big, or labor “just slowed down” when it was really the baby’s presentation interfering with the normal process and progression. Avoidable interventions are implemented turning a natural process into an operative one.

Doctors of Chiropractic work specifically with your pelvis throughout pregnancy restoring a state of balance and creating an environment for an easier, safer delivery.

Some chiropractors believe that severe in-utero constraint can cause other problems for babies as well.  For example, some babies are born with Brachial Plexus Palsy (damage to the nerves that go through the shoulder from the spine to the arm) or torticollis ("wry neck").  Doctors assume that Brachial Plexus Palsy and other similar problems are caused only during a traumatic birth, so they are puzzled when a baby who is born by elective cesarean still has this problem.  The answer may be that because of in-utero constraint, the baby was forced to lie in an uncomfortable position that over the long term, caused nerve damage and problems for the baby.  So in-utero constraint may be the source of problems even when an elective cesarean is planned. 

 

Is Chiropractic Care Really Necessary in Pregnancy

Many critics point out that chiropractic can't be absolutely vital to pregnancy and birth.  After all, women have been having babies for thousands of years before chiropractic care came along.  Even now, many women who do not receive chiropractic care somehow manage to give birth just fine without it.  

This is all true. Although chiropractors will tell you that chiropractic care is vital in pregnancy, the bottom line is that many women do just fine without it.  For some women, it becomes more of a "quality of life" issue.  If they are suffering with back or pelvis discomfort and chiropractic care can help alleviate some of that, why not try it?  But then again, if they don't wish to try it, or if their pain is not substantial or resolves on its own, it certainly is not mandatory to go see a chiropractor. 

Yet for a subset of women, chiropractic care may be important in pregnancy.  Significant pain is a sign that something is wrong; ignoring significant pain in other healthcare situations often means ignoring a vital clue that may lead to escalating problems later on.  This is also true in pregnancy.  A little discomfort now and again is common in pregnancy, but significant pain during pregnancy is nature's way of drawing attention to something that needs to be fixed.  It should not be ignored.

Many chiropractors believe that chronic pelvic or back pain indicates an alignment problem that needs addressing, and ignoring this may result in damage during the birth, especially in women who give birth anesthetized by an epidural and with their legs back in stirrups.  But even in natural birth with good mobility, sometimes the body can be injured.  

For example, some women experience temporary or permanent damage to their pelvis (especially the joint in front, the pubic symphysis) during birth, especially births with epidurals.  This is called Symphysis Pubis Dysfunction (SPD), or in its worst state, Diastasis Symphysis Pubis (DSP).  [To read more about SPD and DSP, click here.]  Some of these women end up with their mobility permanently impaired and in long-term pain; a few even end up in wheelchairs.  These women can often benefit greatly from careful chiropractic care but frankly it's more effective if it's fixed before severe damage is done during birth.

Other women find that they have significant tailbone pain after a birth (or even during pregnancy).  Although it is possible to break the tailbone during birth, usually tailbone pain simply means that it has been moved out of place or stressed in some way.  Chiropractic treatment can help alleviate the long-term tailbone pain many women face with sitting and standing up.  

So while all women probably do not need to see a chiropractor, for some women it may be more important.  Again, significant pain during pregnancy is nature's red alert sign that something needs to be fixed.  Therefore, women who are experiencing significant pain during pregnancy are the women that most need to see a chiropractor.  In addition, a few other groups may benefit from routine care as well.  

Who Needs Chiropractic Care Most?

No one has studied which groups of women benefit most from chiropractic care in pregnancy.  Chiropractors would argue that all women should be seen during pregnancy, and perhaps it's true that many women might be helped or made more comfortable during pregnancy.  However, anecdotal reports and logic suggest that the following groups would probably benefit the most from ongoing chiropractic care before and during pregnancy:

  1. Women with significant back/pelvis pain in pregnancy

  2. Women with a history of prior back/pelvis pain before or during pregnancy

  3. Women with postpartum discomfort after a previous birth

  4. Women with a history of car accidents, falls, sports injuries, etc.

  5. Women with a prior cesarean for "big baby" or "too small/mis-shaped pelvis" or a prior "difficult" birth

  6. Women with a history of malpositioned babies (breech or posterior etc.)

  7. Women who are plus-sized before pregnancy

Women who have significant back or pelvis pain in pregnancy that does not resolve with a little time can usually benefit from chiropractic care in pregnancy.  Symptoms such as low back pain, sciatica (shooting pains down the backside and the legs), pain in the pubic area (front of the pelvic), difficulty rolling over in bed or raising one leg at a time, hip pain, a "stuck" feeling in the hip, difficulty walking, upper back pain, etc. all respond well to chiropractic care.   So if you are having discomfort in your back, hips, pubic bone, legs, or pelvis, you might want to consider chiropractic care.  

Women who have had a history of back or pelvic pain in previous pregnancies or before/between pregnancies might also want to consider chiropractic care.  Back or pelvic pain often indicates a spine or pelvis that is out of alignment and treating this proactively may help prevent or lessen problems during pregnancy when the hormones of pregnancy loosen ligaments and tend to worsen any pre-existing back or pelvis issues.  

Women who suffered an injury or who experienced postpartum discomfort after a previous birth may also benefit from chiropractic care.  Some women damage their tailbones or pubic symphysis areas during birth, especially in the "stranded beetle" position promoted in many hospitals (semi-sitting, knees pulled strongly back, chin to chest).  If you had a lot of tailbone or pubic pain (or even difficulty walking or sitting) after your last birth, you might want to strongly consider chiropractic care.  

Women who have had a history of car accidents, falls, horseback accidents, or sports injuries also often greatly benefit from chiropractic care in pregnancy.  The forces of these falls and accidents can damage and cause imbalances within the pelvis and spine.  Add in the ligament-relaxing hormones of pregnancy, and many of these women begin to experience pain and significant discomfort in pregnancy.  Women with significant back or pelvic pain in pregnancy and those with a history of accidents or falls may also benefit from regular chiropractic care as a way to prevent fetal malpositions in labor and long difficult births (or cesareans).  

Many women who have had past cesareans for a "too big" baby or a "too small/mis-shapen" pelvis (or a "too flat" pelvis, or a "prominent sacrum," or a "bone sticking out in the way") find that chiropractic care makes a great deal of difference to their next labor and birth.  Many women who have had "CPD" or "FTP" cesareans go on to have a vaginal birth with even bigger babies the next time, once the pelvis has been aligned and balanced.  (See anecdotal stories below.)  Women who have had prior "difficult births" because of the baby's size or position etc. may also find chiropractic care helpful.

Women with a history of malpositioned babies may also benefit strongly from regular chiropractic care in pregnancy.  If you have had a breech baby in the past, aligning the pelvis and releasing the ligaments may help you avoid another.  And although Webster's and Bagnell Techniques are most famous for helping to resolve breech malpresentations, anecdotal reports suggest that it is also very effective for women who have had posterior, transverse, or asynclitic babies (i.e., head-down babies, but with subtle malpositions that can impede a fast easy labor).  Women who have had babies with brow or face presentations may also be helped.

Plus-sized women may also particularly benefit from chiropractic care in pregnancy.  Obesity is a strong mechanical stressor on the body and can cause the body to go out of alignment at times.  In addition, if a heavy person is in an accident or falls, the forces disrupting the body are greater and may cause more misalignment than in a person who is smaller.  Some research shows that heavy women have a higher rate of malpositioned babies; this certainly seems to be borne out in many of the birth stories that are sent to Kmom by other big moms.  By helping to align the body and prevent fetal malpositions, regular chiropractic care may help obese women lower their risk for a cesarean or a difficult birth, or may help them toward a VBAC.  (See anecdotal stories below.)

So while ALL women do not "have" to have chiropractic care in pregnancy, many women do find that it adds to their comfort level during pregnancy and reduces the discomfort level many pregnant women experience.  However,  for some women, chiropractic care in pregnancy may actually make the difference between a cesarean and a normal vaginal birth, prevent birth trauma for them or their babies, and increase their long-term quality of life.  

 

The Webster Technique and the Bagnell Technique

There are two main "techniques" or chiropractic protocols that are used to help relieve pelvic misalignment and imbalances so that a malpositioned baby can turn on its own.  These are:
  1. The Webster Technique
  2. The Bagnell Technique 

In the future, other protocols may be developed too, but as of now these are the two main ones.  The Webster Technique is by far more well-known and there are many chiropractors trained in it.  The Bagnell Technique is relatively new and not very well-known, but some  women find it more helpful.  

The Webster Technique is the technique derived by Dr. Larry Webster.  It places a strong emphasis on looking for and correcting a "posterior" sacrum (where the top of the sacrum is tilted away from the internal organs abnormally), and releasing tension in the round ligament (ligament in the front of the abdomen that connects the pubic symphysis area to the uterus).  

The Bagnell Technique was developed by Dr. Lawrence Bagnell and Dr. Karen Gardner Bagnell.  The principles behind the Bagnell Technique are similar to the Webster Technique----looking for misalignments in the pelvis, releasing and balancing the soft tissues and muscles in the area so the baby can assume the best possible position for birth.  

However, the Bagnell technique has several differences.  It emphasizes alignment of the pubic symphysis, which helps the round ligaments release more easily.  While it looks at the sacrum (like Webster), it is looking for sacral rotation instead of sacral posteriority (a difference in the way the sacrum is misaligned). It also pays close attention to what is going on with the tailbone, the neck, and other ligaments like the sacrotuberous ligament.

This is a summary of the Bagnell Technique at http://www.todayschiropractic.com/archives/jan_feb_04/jf2004_tech.analysis.html :

Both techniques address the breech baby and...neither claims to turn babies, but that is where the similarities end. While Webster’s technique places emphasis on the round ligament, The Bagnell Technique places emphasis on the alignment of the pubic symphysis. In Webster’s technique, sacral posteriority is key, however, The Bagnell Technique has uncovered that sacral rotation plays a much more significant role than posteriority alone. The Bagnell Technique also incorporates the importance of C2, coccyx and the sacrotuberous ligaments....

Misalignment of the Pubis symphysis plays a huge role in our technique. We believe this to be the corner stone of the Bagnell Technique. In fact, this is one of the criteria that sets us apart from the other techniques. Both round ligaments attach into the tissue of the labia majora. Due to this attachment we have found a relationship between the round ligament and the pubic bones. A taut round is always on the side of pubic bone superiority. Unless this superiority is corrected, the round ligament will continue to spasm. We have yet to see an exception to this.

The Bagnell's website further states:

The Bagnell Technique for Breech Presentation was designed with the breech baby in mind, but has also been used very effectively for transverse, oblique and posterior presentations as well. It is a chiropractic technique that focuses on the alignment of the spine and pelvis of the mother to be. It is NOT in any way a medical procedure such as an external version.

Because the Bagnell Technique is a relatively new technique, there are not a lot of chiropractors trained in it yet.  Many are unaware it even exists.  However, the website of the Bagnells ( www.pregnancychiropractic.com ) lists a few doctors that are trained in it.  You can also email them to get further assistance in finding a chiropractor that can help you.  The Bagnells will not sell a copy of their chiropractic protocol to the general public, but your chiropractor can order one online from them at their website.  So even if your chiropractor does not know the Bagnell Technique, with enough turn-around time, they may be able to learn it.  

It should be emphasized that neither the Webster Technique nor the Bagnell Technique actually physically turns the babies.  This is a criticism some doctors level at these techniques, thinking that the chiropractors are actually trying to forcibly turn the baby, like the "external cephalic version" that some doctors do.  This is a complete misperception.

Except to palpate the position of the baby beforehand, the chiropractor never touches the baby during a session.  The emphasis is on evaluating whether the mother has misalignments of her pelvis or tension in her soft tissues that might be keeping the baby from assuming the most optimal position for birth, and then fixing those problems.  The extra room this creates and the release of tension in the tissues allows the baby to turn on its own, without being forced.  Although not every malposition can be avoided, the success rate of the Webster Technique has been documented to be about 80%.  All without forcing anything.  

 

When To See a Chiropractor and How Often

One question that many  women have is when to start seeing a chiropractor and how often they should see one during pregnancy.  But unfortunately, there is no simple answer to this.  The answer totally varies from woman to woman, depending on their unique needs.

Ideally, women would start seeing a chiropractor BETWEEN pregnancies so that any serious issues can be taken care of before the hormones of pregnancy start softening and loosening the ligaments, making it hard to maintain chiropractic adjustments.  The more serious a woman's issues, the smarter it would be to start care BETWEEN pregnancies instead of waiting till after they are pregnant.  

However, many women only start experiencing significant pain once they are already pregnant.  Others may have limits on the amount of chiropractic visits that are covered under their insurance.  So many want to try and maximize the benefit of the visits by timing them carefully, and that may mean limiting them to pregnancy only, or even to the last third of pregnancy only. 

The problem is that no two women's problems are alike, and there is no one prescription that fits all their needs.  The loosening hormones of pregnancy increase as pregnancy increases, so generally speaking it's better to start treatment sooner than later.  However, if you have only a few visits that are covered by insurance or you have limited ability to pay for them out-of-pocket, then you may want to save your visits for the third trimester.  However, if you do this and you have really significant alignment issues, you also run the risk of not getting enough treatment to really fix the problem in time.  So there is no one answer for every woman.  It really depends on the unique circumstances of your particular situation.  

Generally speaking, chiropractors prefer to see women before they become pregnant to start resolving any long-standing misalignment issues.  Once you become pregnant, most chiropractors want to see you on the same approximate schedule that a doctor or midwife sees you, which is about once a month in the first 2 trimesters, bi-weekly in weeks 32-36, and every week after 36 weeks until the baby is born.

Now obviously, that's the ideal schedule.  If a pregnant woman comes in as a new patient and has a lot of major alignment issues going on, most chiropractors are going to want to see her weekly (or more) until her alignment issues are better, and then they will go back to the monthly/biweekly/weekly schedule noted above.  

Other women may not need to be seen even every month.  If the chiropractor finds that there is nothing to adjust, then he/she should send you home and elongate the time between visits.  Some lucky women find that their pain goes away after a couple of chiropractic treatments and then they're done and never need to go back.

On the other hand, some women need to visit more often than weekly. When treatment is first initiated, frequent visits are important to start retraining the body's muscles and ligaments to "remember" the new alignment consistently.  So there may be a flurry of frequent visits in the beginning that slowly space out farther and farther as the woman's body adapts to the new patterns, and then visit frequency comes and goes, depending on the woman's needs. In women with a history of major alignment issues, it's not unusual for the woman to go back to seeing the chiropractor very frequently near the end of pregnancy because the ligaments are so loose by then that it's difficult to maintain any adjustments.   It all depends on the needs of the woman and her comfort levels.  

However, a chiropractor should not force you to buy a pre-packaged bundle of "x" amount of visits for "x" cost.  Some doctors offer this as a way for patients to save money, but the package should be flexible so that if you didn't end up needing "x" amounts of visits, you wouldn't have to have them.  Furthermore, a pre-defined schedule of visits cannot anticipate what your body will need and how it responds to treatment; for some people more frequent visits might be needed, while others may need much less.  A "one size fits all" package is generally the sign of a quack and you should seek out a different chiropractor instead.  

Unfortunately, there are bad chiropractors ("quacks") out there, just as there are quack doctors.  Because of this, some people reject all chiropractors altogether.  But the reasonable response to quack doctors is not to ignore all medical advice and shun all doctors, but instead to find a better, more reputable doctor.  The same goes for chiropractors.  If you find a bad one, don't be afraid to leave and try another one.  Get recommendations from others to help guide you to the more reputable and helpful practitioners.  Keep trying till you find one that seems reasonable and also seems to "get" your particular body needs.  And listen to your instincts; if your intuition is saying that a particular chiropractor is a quack, then listen to that and find a new one.  

Fortunately, most chiropractors are legitimate professionals and are not just out to make a quick buck.  They should evaluate your condition, suggest a plan of care, and then keep re-evaluating your need for visits based on how well you respond to treatments.  Their care plan should be dynamic and changing in response to your own needs and comfort.  

In short, there is no one pattern of visits that you "should" follow.  Ideally, you should try to start chiropractic care between pregnancies, and then in pregnancy see the chiropractor monthly, then bi-weekly, then weekly in the last month.  However, this schedule is not set in stone and should be adjusted to the unique needs of each situation.  

 

How To Find a Chiropractor for Pregnancy

Chiropractors who work with pregnant women and/or know the Webster or Bagnell Techniques can be found in several ways.  There are several chiropractic professional organizations, and they can be a good place to start your search.  These organizations are similar in many ways, but may have differences of opinion on certain philosophies or politics, etc. 

International Chiropractic Association
The International Chiropractic Association (ICA) has a Council on Pediatric Chiropractics. Their definition of "pediatrics" includes in-utero babies, so they treat pregnant women as well as babies and kids.  Many of these ICA members have gone on to become Board Certified in chiropractic pediatrics in a 3-year post-graduate course of over 360 hours.  These chiropractors have "D.I.C.C.P." after their names as well as "D.C." 

Because of their extensive extra training, these chiropractors are probably the most highly qualified at pregnancy and newborn care, but of course no title or coursework guarantees the quality or experience of the chiropractor. However, because of their extra training, this may be the best place to start.  A description of their training may be found at:

The ICA also has a list of members who are trained chiropractors who are interested in and specialize in children, but who may or may not have the further training that a "DICCP" diplomate has. Some of the chiropractors on this list are in the process of working on the DICCP diplomate program but have not finished it yet. Regardless, they may have already had the training on the Webster Technique and may be excellent possibilities as well. This list can be found at: 

In addition, the ICA can be reached at 1 (800) 423-4690 to ask for referrals in person.  Ask for a pediatric chiropractor.  

International Chiropractic Pediatric Association

The International Chiropractic Pediatric Association (ICPA, found at www.icpa4kids.com and www.icpa4kids.org ) has a list of chiropractors who specialize in working with kids and pregnant mothers, or who have completed a training course in Webster's Technique. 

You can find a pediatric chiropractor with the ICPA at:

However, this is not a complete list of all the chiropractors who are certified in the Webster Technique.  The chiropractors on this list are ones who have paid to be put on this referral list.  There may well be other chiropractors in your area who have been trained in the Webster Technique but did not sign up to be put on this list.  You can call the ICPA and ask if there are others in your area trained in the Webster Technique.

The ICPA is expanding its training program to also create a certification in pediatric chiropractics, but it is not clear just how the ICPA's training differs from the ICA's training.  

According to an ICPA member, the ICPA has created a tiered level of training. The first level is "Webster-Certified," which means 12 hours of extra class time, specializing in the Webster Technique for pregnancy.  It is often the starting point for more advanced training.  The second level is Pediatric Certification; there are two sub-types of this.  The older program participants have the initials F.I.C.P.A after their names, and underwent 120 hours of continuing education. The newer participants undergo an expanded program of 180 hours and have the initials,  C.A.C.C.P., after their names.  The third level of training is the Pediatric Diplomate, which is the highest level of training and requires 360 hours of continuing education.  These chiropractors will have the initials D.A.C.C.P. after their names.  

The certification and diplomate programs are described at:  

The Bagnell Technique

Another relatively new technique for facilitating good fetal position is the Bagnell Technique. It is similar to the Webster Technique in that both believe that many fetal malpositions are caused by a misaligned pelvis pulling on the ligaments that support the uterus. Both emphasize getting the pelvis aligned and releasing the soft tissues around the area in order to release "constraint" and thereby enable the baby to turn. The techniques differ in the type of problem they look for and the protocol used. 

As noted above, the Webster Technique looks for a "posterior" sacrum (one that is tilted back) and round ligament tightness, whereas the Bagnell Technique looks for sacral rotation (turned to one side or another), pubic symphysis problems, or issues with the tailbone, the neck, or the sacrotuberous ligaments. Because the Bagnell Technique is a much newer protocol than the Webster Technique, there are not that many chiropractors trained in it yet. Their website lists some at http://www.pregnancychiropractic.com/find_doctor.php ) and you can email them to see if there are others in your area who are in the process of training.  In addition, your own chiropractor can buy the Bagnell Technique protocol from the www.pregnancychiropractic.com website and learn about it that way.  (This is what Kmom's chiropractor did for her fourth pregnancy.)  

Other Possible Sources

Not everyone who is certified in Webster's Technique is going to be on the ICA or ICPA lists, but they are good first places to start looking.  If you can't find anyone in your area from these lists, it doesn't mean there is no one to help you. Keep looking; many women who initially think there is no one in their area who can help them do eventually find help.  It just may not be from the above sources.

If you cannot find a Webster- or Bagnell-trained chiropractor, you may also want to consider a chiropractor who just has extensive experience with pregnant women. Although the Webster/Bagnell Techniques are probably the most effective at aligning the pelvis and relieving in-utero constraint, even basic chiropractic care may help enough for baby to re-position itself more optimally and/or make birth easier.  It's certainly may be worth a try to consider regular chiropractic care if there truly is no one trained in Webster or Bagnell techniques available.  But if you have a choice, someone trained in these techniques may be preferable.  

To find a good pregnancy chiropractor, try calling your local homebirth midwives, childbirth educators, and doulas. Often they are familiar with the healthcare professionals in the area that offer pregnancy-related services and can recommend a good pregnancy-experienced chiropractor to you.  

Another good way to find a good pregnancy chiropractor is to "cold-call" all the chiros in your area. Ask them:

When you searching for a chiropractor, talk to them on the phone for a bit and get an idea of how experienced they are and whether they "click" with you. If they sound good, consider trying them for one visit to see how things go.   Some chiropractors will do a free consultation so you can visit their practice and check them out.  Talk to the staff about how many pregnant women the doctor usually sees.  Ask for referrals from other patients.  Call the midwives in your area and see if they have any experience with this chiropractor.

Keep your "quackometer" on alert and don't be afraid to try a different chiropractor if one doesn't seem "right" to you, if the treatment seems unreasonable or ineffective to you, or if they seem too profit-driven.   If one chiropractor doesn't work well for you, it doesn't mean that none will.  Sometimes it's just a matter of finding the one that "clicks" with you and your needs.  

Many women who initially think that there is no chiropractic help available to them find help with a deeper and more detailed search. Keep digging, don't be afraid to drive a ways, and don't be afraid to try more than one in search of a chiropractor that truly "clicks" with your needs. 

 

Kmom's Story

Kmom's search for a chiropractor who could help her back/pubic symphysis pain and who could help promote a better fetal position was long and involved.  At the time, there were no lists from the ICA or the ICPA to check, and the local chiros she had consulted did not even know about the Webster Technique.

Kmom saw several different chiros or osteopaths (D.O.s) over the years, looking for some help.  The first chiro (a sports specialist available through the local family doctor's office) was size-phobic, never physically evaluated her back or pelvis, told her that she wasn't getting enough exercise and that was the problem, and gave her some special exercises to do for the muscles in the area.  They didn't help.  She then gave up the idea of chiro care for several years.

In her third pregnancy, Kmom stepped up the effort to find some help.  None of the doctors or midwives or childbirth educators she saw knew of anyone who knew the Webster Technique.  She eventually saw an osteopath who had never heard of the Webster Technique, said her back was fine, and was basically no help.  

Then Kmom's prenatal yoga teacher mentioned a chiropractor who used a less forceful "Network" technique for adjustments and who specialized in sacrum pain.  Kmom decided that this was better than nothing.  She saw this chiro; the treatments did not really help much BUT he happened to know of a young chiro in the area who was in the process of getting her DICCP diplomate from the ICA, so he referred Kmom to her.  

Luckily for Kmom, this chiro had *just* learned the Webster Technique at a recent class session and was able to help Kmom out.  The baby turned from posterior to anterior within an hour of the adjustment, the first time it had been anterior the entire pregnancy.  Kmom's back and pubic symphysis pain improved greatly too.  Kmom went on to have a few more adjustments to keep things aligned and then her baby was born (vaginally, for the first time in 3 pregnancies) two weeks later.  

In another pregnancy, Kmom tried an ICPA-trained chiro who was located much closer to her home.  She was perfectly nice and competent, but she didn't "get" Kmom's body or needs and was not able to give her much relief.  In fact, Kmom sometimes felt worse after seeing this chiro.  So even though this chiropractor knew the Webster Technique, was very well-trained and knowledgeable, and was certified through the ICPA, she wasn't the right chiropractor for Kmom.  At another point, she also tried a different osteopath, one with more "classical" manipulation training, and did not find those results as effective either.  Kmom eventually went back to the original chiropractor and her trainees, realizing that a longer drive was well worth the trouble to get better results. These chiropractors also ordered the Bagnell Technique protocol to learn more about that, and found that Kmom tended to respond to that protocol best.

This shows the importance of searching for the practitioner who is right for you. The first  chiros Kmom tried were not able to help her; neither were the osteopaths she saw.  Had the ICA or ICPA lists been available then, her original pregnancy chiro would not have been listed because she was still in the process of training.  An ICPA-trained chiro that Kmom tried later looked great on paper but was not effective for Kmom, for whatever reason.  And the chiros Kmom sees regularly now are not listed on "the lists," because neither of them is a DICCP diplomate----BUT they have been trained by a DICCP diplomate and so are familiar (and well-trained!) in the techniques needed.  

So there are no easy or quick answers to searching for a good chiropractor for pregnancy.  If at first you don't find a "Webster Technique" or "Bagnell Technique" chiropractor, keep trying.  If the chiro or osteopath you try at first doesn't seem able to help you or you don't get good results with them, be willing to try others.  Good and bad chiros are all over out there; lists can be a good place to start your search but ultimately they don't tell you much about the quality of the chiros themselves.  Nothing substitutes for actually trying something and keeping the search up till you find one that really "clicks" with your needs.  

 

Copyright © 2007 Kmom@Vireday.com. All rights reserved. No portion of this work may be reproduced or sold, either by itself or as part of a larger work, without the express written permission of the author; this restriction covers all publication media, electrical, chemical, mechanical or other such as may arise over time.

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