Have you ever read one of those magazine articles that try to tell you your body shape compared to food or cutlery? You’re an apple. You’re a spoon. You know what would be useful? A quiz about the shape of your uterus.
Wait. Actually, nevermind.
But the shape of your uterus really is crucial, especially when it comes time to have a baby. And even more important (at least to a chiropractor) is the way that the position of your bones and the tension on the muscles and ligaments are affecting that shape. And more important than that is the effect of the shape of the uterus when it comes to baby positioning.
Breech Is Not a Four-Letter Word! (There Are 6.)
Baby positioning is a major concern for obstetricians and midwives. Typically, babies are born in a head-down position, meaning that little noggin makes it’s exit before all else. However, sometimes, baby is not able to get head-down. This can be for a variety of reasons like uterine malformation, twin births, or a misaligned pelvis. But the most important thing to remember that if it’s safe and physically possible the baby wants to be head down. Gravity will cause the heaviest part if the baby – the head – to move to the bottom, all other things equal.
So what are the traditional approaches to managing a breech pregnancy? Most OBs will schedule you for a cesarean section as soon as they find out the baby is breech. From there, it is often up to the mom to explore her options if she wants to encourage her baby to flip so that she can deliver vaginally. Now, there are some midwives and OBs that will deliver a breech baby vaginally, but they are few and far between (despite that fact that it is possible and by some arguments safer to deliver breech babies vaginally, there is a general fear of malpractice suits). More typically, the medical route includes an external cephalic version. This involves manually turning the baby through mom’s tummy and hoping they stay head down long enough to go to term. This is not always the case, though, and a team is always ready to do an emergency C-section. As you can imagine, it’s not an especially enjoyable experience, but it is an option to be put on the table.
Alternatively, some mom’s will try less conventional methods. Spinning Babies is a website with a ton of information on encouraging proper fetal positioning. Inversions are often helpful and relatively gentle, using gravity to your advantage. Moxibuxtion and acupuncture is another favorite that can be beneficial.
But where does chiropractic fit into this equation? I’m glad you asked.
Ladies, Meet Your Sacrums
I want to say this loud and clear: Chiropractors do NOT flip breech babies. The only people qualified to work with fetal positioning or to comment on the position of a baby in utero are OBs and midwives. All a chiropractor does is make sure that mom’s pelvic biomechanics and nervous system are fully functioning. That’s a job that is big enough, if you ask me.
You see, the body is a very well-connected thing. Which is great, but also presents a host of problems when one area isn’t working properly – because more often than not, it affects other parts, too. Let’s start with the sacrum. It’s a big triangle bone at the bottom of the spine that connects both sides of the pelvis. It rocks back and forth normally when you walk. However, sometimes, due to rotation while sitting, a fall, or a host of other issues, that sacrum can get wedged in a twisted position. This affects several things:
1. The sacral plexus is a group of nerves that innervate the organs in the pelvis and lower extremities. These nerves are compromised by the inflammation that results from the microtears and irritation caused by misaligned joints. And nerves do not like being compressed. Initially they will become hypersensitive and increase the messages they are sending (be it pain signals, muscle tension, etc.) and, eventually – if left long enough – they will go quiet (as in decreased signals to the muscles and organs they control).
2. There are muscles that attach to the sacrum that are pulled longer than they would be normally. On the opposite side, they may be more contracted. Both states result in weakened muscles that can’t function to their full potential.
3. There are ligaments that run from the sacrum to the uterus. These ligaments, like the muscles attached to the sacrum, go taut on one side and slack on the other. This pulls unevenly on the uterus, which in turn pulls unevenly on the round ligaments at the front part of the uterus that run to the internal portion of the abdominal wall.
And that’s just in an everyday case. In pregnancy, women are more susceptible to the this rotation of the sacrum due to the fact the many of the hormones produced in pregnancy are in charge of relaxing the joints of the pelvis so that they can expand to accommodate a growing baby. Because of this hypermobility, mom’s joints are more affected by even small changes in positioning or missteps, putting the sacrum in a compromised position more often.
The Webster Technique
Enter Larry Webster. Dr. Webster was a chiropractor with a special fondness for working with moms and kids. He was a pediatrics professor at Life University (my alma mater!) and founded the Internation Chiropractic Pediatric Association. He also developed a technique for correcting that misaligned sacral positioning that was occurring in so many women, especially in those with babies in breech position.
I’ll say it again, as it bears repeating: Chiropractors DO NOT flip breech babies. Dr. Webster’s technique involves a gentle correction of the rotation of the sacrum, and then some soft tissue work to release the round ligament at the front of the pelvis. By making these two corrections, mom’s pelvic biomechanics are better able to normalize, inflammation in the pelvis is reduced, and the sensitive and crucial nerves in the area are allowed to go back to having their normal (and very important) conversations. Your little baby is never touched, and what they choose to do with the help of gravity and a little more wiggle room is entirely up to them (and their innate intelligence!)
Where can I find a doctor that does Webster Technique?
Most chiropractors have a basic understanding of the Technique, but for someone that has special certification and knows some of the nuances of getting a stubborn sacrum to stay where it belongs, look on the ICPA website for a doctor that is Webster Technique certified (like Dr. Pam!) in your area!