Osteopathy can play an important role in supporting women

throughout their pregnancy by maximising the mother's ability

to adjust and compensate for the associated changes.
This article introduces osteopathy and discusses how the
profession creates a multi-disciplinary angle of care and
interaction between mainstream and alternative medicine.

OSTEOPATHY AND PREGNANCY

Osteopathy and Pregnancy

Different emphases in pregnancy stages

Osteopathic treatment in the first trimester focuses on the
diapraghm (under the ribcage) for fluid drainage, and the pelvis
as the increasing weight affects the
pelvic ligaments and can contribute
to lower back pain. Osteopaths
also often treat the upper neck to
assist in the reduction of morning
sickness.

Osteopathy as a form of complementary medicine

Osteopathy is a form of complementary medicine, which
encourages the recuperative power of the body through a range
of manual techniques. Emphasis is placed upon assessing
an individual holistically and a diverse range of techniques is
administered, primarily to the musculo-skeletal system, for the
prevention and treatment of disease and dysfunction.
Throughout pregnancy, the body undergoes significant
transformation over a short period of time. The changes involved
are not limited to the muscles, joints, and ligaments, but also the
effects of the additional weight of body fluids on the circulatory
system, the extra demand on the internal organs, as well as the
hormonal and nutritional factors specific to pregnancy.
Osteopathic treatment targets specific areas of the mother
depending on her stage of pregnancy. For example, prior to
conception or early in the pregnancy, an Osteopath aims to
correct any chronic or historical back or pelvic pain, to allow
the body to work efficiently and be in optimal condition to
handle the pregnancy. In addition to back or pelvic problems,
Osteopaths also consider the influence of increased hormone
secretion on arterial and lymphatic flow and also the mechanical
change in lower back biomechanics as a result of the growing
placenta. Similarly, physiotherapy can also be beneficial at this
time especially with exercise prescription, postural training and
rehabilitation of the lower back.

During the second trimester,

emphasis is on the postural
adaptation by the mother. The
lower back curvature flattens
and the muscles compensate
to suppor t the increasing
growth of the baby. The further
increase in fluids challenge the
circulatory system and this is
often reflected by the onset of
sinus congestion. Osteopathic
treatment is often needed to help
the muscles and spine adapt,
while physiotherapy can be useful
in the training of these muscles.
After 30 weeks, the baby begins
to crowd the lower part of the
ribcage and lead to rib pain,
breathlessness and/or indigestion.
The focus of osteopathic treatment
during this last trimester shifts to
combat these symptoms. Treatment goals and techniques promote
fluid movement improving circulation problems like lower leg
cramping, tiredness and varicose veins.
Carpal tunnel can develop, as well as shoulder and upper back
tension from additional breast tissue, all of which can be improved
with osteopathic treatment.

Aid in balance for birth process

The last trimester also signifies the release of hormones that
relax the ligaments, muscles and joints to prepare the body for
childbirth. The ease of the babys descent through the pelvis
requires ligament laxity, hormones, uterine contraction, gravity and
appropriate baby position. If the mother's pelvis is mechanically
unstable or is lacking mobility, it can interfere with the babys
passage through the birth canal. Osteopaths try to resolve
restrictions and improve instability, which may impair the birth
process, helping to restore balance and improve movement of the
pelvis.

Collaborate with specialists offering

multi-disciplinary care

Advice on post-natal exercises and postures to

avoid strain on lower back

Osteopaths collaborate closely with doctors and other specialists,

and can work together to treat various ailments especially in
the management of certain pregnancy related complications.
For example, osteopaths can create a rehabilitation programme
to restore postural stability with a physiotherapist, work with
paediatricians to monitor and resolve some developmental or coordination delays, or assist in reducing any anticipated pregnancy
concerns with an obstetrician. This is where regular and alternative
treatment can compliment each other well.
Concerns that are raised during the course of routine antenatal
care or concerns an Osteopath may have at a consultation can
be discussed between the professionals, and an action plan can
be initiated to appropriately care for the mother. For example,
there are often times when systems within the body become
overwhelmed during the course of a pregnancy. An Osteopath
can modify or choose certain techniques to support and reduce
the strain on systems, such as the circulatory system, to influence
some of the symptoms or processes associated with the various
complications. This ensures that the mother is monitored carefully
between antenatal check-ups and that she receives optimal care
from all professionals involved with her pregnancy.
An Osteopath can also provide tips on making the pregnancy
easier, such as providng safe lifting techniques, comfortable
sleeping positions and exercises and activities to help the body
adjustment uncomplicated and easy.

Osteopathic treatment after delivery is recommended to restore

the normal biomechanics of the back and pelvis. Some mothers
experience back problems after birth, due to weakened ligaments
or the loss of muscular strength from the very hormones that
helped during childbirth. Upper back or neck pain is also common
at this time, from breastfeeding postures or lifting. An osteopath
can provide advice on improving breastfeeding positions, or
advice on better posture during feeding to take the strain off the
upper back. Osteopaths and Physiotherapists can also advise
new mothers on various abdominal and core exercises which dont
put additional strain on the lower back, allowing the mother to be
in a better condition to care for her baby and prevent future back
pain.

Relieve common symptoms that

newborn babies suffer
Newborn babies can also benefit from treatment. Labours which
are either extremely short or very prolonged, when complications
have occurred during the pregnancy, or when deliveries have
needed forceps or ventouse, can put abnormal strains on the baby.
Common symptoms babies suffer from which can be treated
include, but are not limited to, swollen, faces or head asymmetry
that lasts for longer than a few
days, feeding and latching
difficulties, excessive crying,
difficulty settling or disrupted
sleeping, and musculo-skeletal
causes of colic, regurgitation
and Tor ticollis (wr y neck).
Often new mothers like to get
their babies checked out by
an Osteopath for peace of
mind even if no symptoms are
immediately visible.
In summary, osteopathy is a
complementary, gentle and
holistic way of helping the
body cope with the demands
and challenges of pregnancy.
Osteopaths evaluate and
monitor what the body is going through at each stage of pregnancy
and adjust their treatments to support the changing body.
Osteopathy can also help newborn babies who have undergone a
challenging or complicated delivery.
Always remember it is important that you seek advice
from your doctor and obstetrician should you have any
medical complaints or questions regarding your health or
pregnancy. Similarly always consult with your physician
or obstetrician before embarking on a new treatment, diet
or fitness programme. This is especially important when
considering potentially dangerous medical conditions
such as early labour, gestational hypertension and
neonatal infections.

Written by:
Ms Jonine Nash, Osteopath
Member of General Osteopathic Council (GOsC), UK
Masters of Osteopathy
Bachelor of Applied Science (Human Biology)

Matilda International Hospital Outpatient

Department
Tel:
2849 1500 / 2849 1515
Email:
opd@matilda.org
Office Hours: 8:00am 10:00pm (Mon Sun)
* By appointment only

41 Mount Kellett Road, The Peak, Hong Kong

Main line: 2849 0111 Website: www.matilda.org

08/2009

Matilda Medical Centre

Tel:
2537 8500
Email:
mmc.central@matilda.org
Office Hours: 8:30am 6:00pm (Mon Fri)
8:30am 1:00pm (Sat)
* By appointment only

Suite 2601, 26/F, 9 Queens Road Central, Hong Kong

Tel: 2537 8500 Website: www.matilda.org

08/2009