Best timing on mobilization treatment during pregnancy
I’m often asked when is the best time for women to receive treatment during their pregnancy. As with most types of care, it depends on the situation. If a woman is symptomatic, ie has sciatica, low back soreness, pubic symphysis pain, etc, the answer is as soon as possible.
If she does not have symptoms, and is physically comfortable, she can wait a bit.
What exactly does mobilization treatment do?
The joints of the low back and pelvis are the most frequently treated areas during pregnancy. The large bones (ileum) of the pelvis, the sacrum and the low back are experiencing the load of extra weight as the pregnancy progresses. The hormonal changes in the body create laxity in the ligaments throughout the entire body. Ligaments hold bone to bone. With a woman gaining 30-50 pounds in 41 weeks, the ligaments are challenged.
For example, in the sacroiliac joints (between the large hip bone and the sacrum, where the dimples are on a woman’s back side) the ligaments on the front and back of the pelvis are anchoring the extra weight gain.
Mobilization treatment ensures that the sacroiliac joints are flexible for the birth. This is very important for comfort, and creates a smoother and faster delivery.
What if I don't have any physical pain?
If there are no symptoms, I recommend being checked at least 6 weeks prior to the due date. This will allow enough time to correct any slight imbalances, flexibility issues, and muscle tightness that might impede labor. Remember, having proper mobility will ensure a smoother labor process
If there is a history of injury to the pelvis or low back, getting checked sooner is a good idea, even if there are no symptoms. For example, if you had a car accident 5 years ago, or fell onto your sacrum 7 years ago, it’s a good idea to check pelvic mobility earlier rather than later.
Old injuries can flare up and be uncomfortable in pregnancy. Even without symptoms, they can create patterns of tightness that might hinder the birthing process.
If you decide to seek out a chiropractor, be sure to find someone with a prenatal expertise. Prenatal care is not part of the curriculum of study in all chiropractic colleges. You will want to find someone who has expertise in treatment protocols that are appropriate for pregnancy.
In my practice, I do gentle mobilization, using low to non-force techniques.
I also add in cranial work, and my own hands on soft tissue massage.
Whenever possible, I teach partners and spouses how to do soft tissue massage at home, customized to the issues we are addressing during treatment.
If the baby is in a breech position, posterior, or transverse, I highly recommend being treated by 32-33 weeks of pregnancy. This will allow enough time to encourage baby to turn without running into a stressful time frame. I also highly recommend seeking out an acupuncturist to help with this. The two modalities should be done in tandem. There will also be things you can do at home to encourage turning. (See breech article)
Pubic Symphysis Pain
There can be varying degrees of pain at the pubic symphysis during pregnancy. They can be mild to severe. Many women experience no symptoms.
The pubic symphysis is at the center front of the pelvis. The pain tends to happen when a woman is walking, turning over in bed, getting in and out of the car, or doing any motion when her legs are ‘scissored’, ligament laxity in general coupled by pregnancy hormones.
The reason for this can range from previous injury, rapid weight gain, short physical stature, strain from a certain position (ie slipping sideways), etc.
The symphysis is where the two bones in front of the pelvis meet. Between them is cartilage, and overlying them in the front and back are strong ligaments. When these ligaments stretch too much, she will experience pain.
The pubic symphysis itself can become misaligned. This will happen when there is significant rotation in the back of the pelvis, nor not enough stability at the symphysis itself. This type of misalignment is usually easily corrected. One or two treatments will usually be all that’s needed. If there is significant instability, usually from injury or rapid weight gain on a short statured woman, it may require stabilizing the symphysis until after the birth. Often a pregnancy support belt or kinesiotape will offer enough stability to bring the pain level down.
Post partum care
It is an excellent idea to have your pelvis checked after the birth. You will want to make sure you have proper mobility for the healing process. I recommend getting checked once you have rested and recuperated. This may be a month or two after the birth. If there are symptoms in the low back, pelvis, pubic symphysis or elsewhere, get checked as soon as you can.
I hope this helps answer some of your questions re: treatment both during the pregnancy, and post partum period.
If you have any specific questions, I am happy to answer those as well.
Please see my website for email and phone contact information.
Blessings on your journey!