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New Zealand research suggests that pregnant women may benefit particularly from chiropractic care adding weight to the positive outcomes many women have reported. Results from a pilot study, due to be published in the Journal of Manipulative and Physiological Therapeutics, indicate that chiropractic adjustments of pregnant women appear to relax the pelvic floor muscles at rest .
Commenting on the study, Dr Cassandra Fairest, chiropractor and spokesperson for the New Zealand Chiropractors’ Association says: 'As there were no changes documented when they adjusted the non-pregnant comparison group, this finding in the pregnant women appears to be an effect unique in pregnancy’.
‘This relaxation of the pelvic floor muscles seen after the women were adjusted may mean that chiropractic care could be of benefit to pregnant women, as it may help them have a natural vaginal delivery. Excessive tension and restriction in the pelvic floor may be a contributing factor to the need for some assisted deliveries requiring intervention with forceps or c-section. The primary findings of this study are incredibly encouraging, especially given the fact that quantitatively assessing the effect of spinal adjustment on pelvic floor muscle function has not previously been done.’
The study, funded by the Australian Spinal Research Foundation, was conducted by internationally award winning researcher Dr Heidi Haavik, Director of the Chiropractic Research Centre at the New Zealand College of Chiropractic, Dr Jenny Kruger, midwife and Research Fellow at Auckland University’s Bioengineering Institute and Dr Bernadette Murphy, Professor Faculty of Health Sciences, University of Ontario Institute of Technology.
The study saw participants undergo ultrasound examination, and perform three different manoeuvres – squeezing as hard as they could, bearing down (that pushing which opens up the Hiatus hole in the pelvic floor) and at rest. They studied the women in the control group and the active group, and looked at them pre and post adjustment.
Dr Fairest says: 'The pelvic floor muscles (the Levator Ani muscle complex) are known to have active roles in pregnancy and childbirth, as well as in spinal stabilisation. When the pelvic floor muscles are damaged or stressed over time, health issues like incontinence and vaginal prolapses can occur. We know these are problems with massive emotional, physical, social and financial costs across the world and a significant cause of stress for these women.’
Commenting on her research Dr Heidi Haavik says: 'For a woman in labour, the ability to relax pelvic floor muscles (as well as contract them) to allow the baby to move through the birth canal is incredibly important, especially as the baby crowns. If the woman can’t relax these muscles as the baby moves through, she will tire more quickly and may require intervention to assist with the birthing process. Muscles that cannot relax may also result in a birth requiring intervention. In an ideal situation, strong pelvic floor muscles with an ability to relax would better prepare a mother for a natural, vaginal birth.’
'We were expecting to see changes in the squeezes and pushes, but we saw nothing. But what was really interesting is that the actual (hiatus) hole itself became larger at rest. What it suggests is the muscles that form the pelvic floor rim that support our internal organs and that contract and relax to give birth to a baby, must have relaxed. That alone is extremely exciting. The relaxation of those muscles is so important and assists in being able to give birth naturally.’
Dr Haavik points out that it’s early days in terms of understanding the full impact of this study’s findings and that further research is required. But she explains: 'We do now know that adjusting women during their pregnancy gives them a greater ability to relax the pelvic floor. For pregnant women, this has the potential to give them a greater degree of control over the pelvic floor muscles, which in turn may make vaginal childbirth easier. At this point, we can only speculate on what the impacts could be in terms of reduced need for medical intervention, or increased well-being of mother and child. But it does indeed show us that chiropractic may be of significant benefit to pregnant women. The current findings are from a pilot study and of course further scientific studies are required to validate these initial results.’
1. Pelvic floor functional changes with spinal manipulation in pregnant and non-pregnant women: A pilot study. JMPT 2016. In Press.