Many patients choose chiropractic care during their pregnancy for not only decreasing pregnancy-related symptoms such as low back pain but also lessening the pain during labor. A recent, interesting article from JMPT (Journal of Manipulative and Physiological Therapeutics) studied the relationship between chiropractic adjustment and the function of the pelvic floor muscle by measuring the birth canal (in this study, the birth canal refers to the levator hiatal area which is formed by the pelvic floor muscles).
Pelvic floor muscles have important functions such as supporting our organs from descending, controlling bowel movements, and also providing a passageway for the baby. Any damage or dysfunction to the pelvic floor muscles can cause urinary/fecal incontinence, pelvic organ prolapse, and difficulty in vaginal delivery during pregnancy. During this research, two groups (pregnant patients in their second trimester and nonpregnant chiropractic students) were recruited and their pelvic floor muscles function was assessed before and after chiropractic adjustments via ultrasonographic imaging of the levator hiatal area (birth canal). More relaxed pelvic floor muscles will result in a bigger birth canal (levator hiatal area) with better elasticity which will help in a smoother vaginal delivery without damaging the surrounding soft tissue.
To summarize, the pregnant group resulted in a larger birth canal area after receiving chiropractic adjustments, whereas the nonpregnant group showed no significant change. This shows that chiropractic adjustments can help pregnant women relax their pelvic floor muscles to aid their vaginal delivery.
This study also reports a very interesting result from the nonpregnant group. After receiving chiropractic adjustments, the birth canal was measured while subjects were performing the Valsalva maneuver (this mimics a bearing down, defecation position, which increases intra-abdominal pressure to stress the pelvic floor muscles). Their birth canal area was larger than the “normal nonpregnant women” and similar to the second/third trimester pregnant women or elite nulliparous athletes. How can a nonpregnant women have same size of birth canal as pregnant women in their second/third trimester? This is most due to the group of nonpregnant subjects being chiropractic students where they receive chiropractic adjustments regularly. Chiropractic adjustments improve the function of the nervous system, resulting in improved motor control. In my opinion, this implies that chiropractic adjustments will not only help pregnant women but also prepare nonpregnant women to have a healthy pregnancy and possible vaginal delivery in the future by aiding the function of pelvic floor muscles.
Roy Jung, D.C., CCSP®
13751 Lake City Way NE STE 310
Seattle, WA 98125