Pregnancy

Accompanying Your Patient on the Journey of Pregnancy

Pregnancy, to rephrase a popular quotation, is a journey, not a destination. From
conception to ultimately nurturing her child, a woman is subject to the delicate balance of neurologic function, cascading hormones, available building materials and cellular integrity that results in the development of a new member of the human race. Where does the
chiropractor play a role on this momentous journey?

The miracle of having a child can be supported by chiropractors from so many different
avenues that, whatever your specialty, you and any number of your colleagues can
collaborate to become an invaluable support team for the individual, couple or family that desires to take this journey.

From preconception, the tenets of good chiropractic care are of paramount importance. Helping your patient understand that they need to have a healthy, organically clean diet, reduce their stress, get plenty of rest, hydrate, exercise appropriately, may seem cliché, but it cannot be emphasized enough. Preparing the body for this journey will prevent many problems along the way.

Regular chiropractic care will set the stage for the important timing of events required to successfully conceive. The chiropractic adjustment and its profound effect on structural and neurologic function will affect everything from the master endocrine gland (influenced by the rhythm of the cranial bone movement and the tone of the autonomic nervous system) to the vascular system which will transport those hormones to the target organs. The chiropractic adjustment restores structural integrity which in turn supports the integrated activity of the brain, cranial, spinal and accessory nerves that guide the target organs
function and supports the individual cells that must successfully receive those hormones by transporting them across intact receptor sites of the cell membrane.

Your patients body cannot miss a beat during this event, if success is in her sights. You, her chiropractor, are there to adjust her as well as support, motivate and guide her away from the pitfalls that might prevent her from reaching her goal.

A patient will present with a chief complaint that may include infertility, multiple miscarriages, failure to progress in labor, inability to breastfeed or post partum depression. Often times, an in depth exploration of a patients history gives us information about what she has already been through (including traumas, ergonomics, surgeries, illnesses, and other stressors). Gentle exploration of her complaints and her history can help us differentiate the potential dysfunction in any of the numerous systems that must act synchronously to be successful during this process.

Interviewing the father with the same curiosity that you interview the mother may reveal important aspects of his preparation for fatherhood that have ill prepared his own body to reproduce, and although this article is mainly addressing the female reproductive system, be aware that many of the same myriad of interfering factors may exist and will need to be addressed to improve the overall outcome of their endeavors.

Most reproductive complaints may be multifaceted in their origin. Exploration may reveal a spectrum of activities interfering with normal function:

Nutritional excesses and insufficiencies:

Based on ingestion of over processed, low quality, low nutrient density
calories as well as the inadequate intake or inability to absorb and utilize nutrients
present in her past and current diets, the patient may not have developed healthy
reproductive tissue, may not be able to synthesize adequate hormones or, may not have a healthy neurologic or vascular system to support and distribute circulating hormones and nutrients. Failure to ingest specific nutrients, like folic acid, during the pre partum period, for example, can result in neural tube defects in the developing embryo.
As you interview your patient, you should collect a complete dietary history (quality, quantity, frequency, bowel and bladder habits and any other symptoms that occur that could be associated with her dietary intake).
It is also important to gather information about psychological and environmental stressors they may have interfered with her normal development during the
formative years, allergies and indicators of atopic diseases she may have, the onset and characteristics of her menses, and any history of previous attempts at conception and gestation, a full description of her pregnancy, labor and delivery and post partum
experiences, successes as well as failures.

Stress:

The emotional states of pregnant women affect the course of their pregnancies, their deliveries and the behavior and development of their infants into adulthood.
Stress has a profound effect on the brain, often resulting in an overactive sympathetic nervous system. This aberrant brain activity and resultant stress hormones produced by the adrenal glands can inhibit or imbalance the cascade of hormones
necessary to conceive and maintain a pregnancy, as well as initiate and complete labor, stimulate milk production and release for breastfeeding and whose imbalance may
contribute to, along with nutritional factors, post partum depression ).
Chiropractors are healthcare providers who are reported to be good listeners. Sometimes simply unburdening ones soul of worry has been known to allow nature to take its course. Many of us have experienced the young couple who after the emotional and financial strain of many years of attempting to conceive, adopt and joyously
welcome a new member into their family. Within weeks or months they conceive
naturally having taken their focus from the stress of conception and fully immersing themselves in the joy (and associated happy hormones) of parenting their adopted child. It is not always so simple, though, and we although we can listen, we can also provide the resource of networking individuals with mental health care providers or supervised support groups who might additionally join their team and help them make it to the finish line.

Neurology:

Integration of afferent information entering the central nervous system, the plastic connections that develop over time that initiate the actions driven by efficient efferent communication back to the tissues of the body are critical to the maintenance of the pregnant and postpartum patient.
Any interruption in flow of information to the reproductive organs can be as disruptive as an interruption in the flow or levels of hormones critical to conception and the maintenance of the pregnancy. Chronic bombardment of aberrant stimuli to the central nervous system may result in overstimulation of the sympathetic nervous system and disruption of the hypothalamic-pituitary-adrenal axis or it may drive the immune system towards chronic inflammation.
The chiropractic adjustment and the chiropractors understanding of
neurology and appropriate rehabilitative protocols will be important contributions to the maintenance of the health and well being of the pregnant patient and her unborn child.

Endocrinology:

Subluxation can result in an excess of hormone release (nociception resulting in increased activity of the sympathetic nervous system which will involve the function of the adrenal glands) as well as potentially in the decrease of hormone release (cranial subluxation and its influence on pituitary function).
As we addressed earlier, the hormones of stress can interfere with the normal endocrine balance required to conceive and maintain a successful, full term pregnancy. Other problems in her history could contribute to endocrine imbalance or dysfunction (inflammation, auto immune diseases, tumors, surgeries, diabetes, hypertension,
hyperthyroid or hypothyroid (including Hashimotos Disease) and any prescribed
pharmaceuticals including birth control pills and other synthetic hormones.
The health of the endocrine system that produces the hormones and the
receptivity and health of the reproductive target organs are influenced by everything from nutrition to neurology (and everything in between!). Reproductive health, for
example is influenced in development by exposure to medications during fetal development. Faulty egg development in a woman may be the result of her mothers utilization of medications during her own pregnancy. This initial disruption will result in inability to fertilize the egg or inability to develop a viable embryo.

Lifestyle choices:

The choices to smoke tobacco, use recreational drugs, drink alcohol and or excessive caffeine, play extreme sports activity, overwork, overeat, never exercise, never sleep, must all be explored with your patients because any one or combination of lifestyle choices may interfere with their ultimate objective.

Genetics:

If genetics are identified as the particular cause, it is sometimes immediately assumed to be the least possible problem to influence. The caveat that chromosomal irregularity constitutes a limitation of matter is only true in as much as the human body is given everything it needs to optimize function despite the limitation of matter. If we assume the limitation is there, it will remain there.
Our responsibility is to explore those limitations. When we do, we are often surprised by the bodys response. For example, as we discussed previously, stress
triggers a sequence of events that can disrupt homeostasis. If a person with genetic limitations experiences stress, they too suffer the consequences. If stress were reduced in this persons life, how much of their perceived limitation is associated with stress and how much was their true genetic limitation?
If a womans genetic limitation affects absorption or utilization of nutrients, for example, we can provide more of those nutrients in the form of whole foods, herbs and supplements. Or, if we assume that subluxation may be present and if we optimize their neurologic integrity through chiropractic care and specific exercises to maximize function and neuromusculoskeletal integrity, their overall ability to conceive or carry to a pregnancy to term may be positively influenced.
For example, around six percent of women in the United States are affected by PCOS, also known as Polycystic Ovarian Syndrome. Women with PCOS experience a variety of symptoms, including irregular menstruation, facial and body hair, hair loss, weight gain in the upper body, acne, and cysts on the ovaries. Patients with PCOS do not demonstrate uniform symptoms that interfere with becoming pregnant. Some womens eggs do not develop with the normal number of chromosomes, some women have well developed eggs but their follicular development is irregular resulting in longer cycles and irregular release of eggs. Some women with PCOS have successfully
fertilized an egg but have been unable to produce enough progesterone to maintain the pregnancy and the conceptus is lost in the trimester.
About one third of the women who have been diagnosed with PCOS will also have insulin resistance. Insulin resistance is a condition in which the body does not
correctly process insulin. As a result, the patient often demonstrates increased levels of glucose in the blood. This can lead to diabetes and a variety of other problems. This
increased amount of insulin is thought to lead to an increased production of androgens, or male hormones. These hormones are often responsible for many of the symptoms of PCOS, including facial and body hair, hair loss, and weight gain.
Numerous patients have presented to the chiropractic office with the
diagnosis of PCOS and infertility. Some of these patients had not and were not
currently receiving any treatment at all. Others were utilizing pharmaceutical aides like Metformin (or Glucophage) and Clomid. Metformin impacts the way that insulin regulates glucose, and it also helps to cause a decrease in the production of testosterone. Clomid promotes follicular hyper development resulting in multiple eggs being released at one time increasing the opportunity to fertilize and implant the conceptus.
In many of these cases, the addition of one or a combination of weight loss, adjustments, dietary changes, nutritional and herbal supplementation and stress
reduction appear to have helped them successfully conceive and carry a pregnancy to term.

For the patient who experiences a disruption in normal physiology due to any of the reason outlined above, the importance of the service, we as chiropractors can offer our patients, is paramount in their attainment of reproductive health. The detection of subluxation and the chiropractic adjustment help lay the foundation upon which all other building blocks can then be added.

Chiropractors often develop their own academic pursuits and their chiropractic practices around specific specialties. Pediatrics, neurology, and nutrition to name only a few. The coordinated effort of individuals who comprehend the different components of the whole picture (chiropractors, naturopaths, midwives, lactation consultants, nutritionists,
homeopaths, acupuncturists, osteopaths) can support their patients in restoring or for the first time, creating a level of homeostasis that can result in a natural and successful pregnancy. Expanding our vision to include an understanding of these additional components will enhance our ability to optimally support our patients.

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