Chiropractic Care During Pregnancy: Is It Safe? (Round Rock Moms Ask).

Pregnancy and back pain are almost synonymous. The combination of weight distribution changes, hormonal ligament laxity (thanks, relaxin), postural compensation, and the biomechanical reality of carrying a growing baby means that a significant majority of pregnant women experience low back or pelvic girdle pain at some point.

The frustrating part: many providers simply tell pregnant patients to "take it easy" or suggest Tylenol. These are limited solutions for what can be genuinely disabling pain. Chiropractic care is a well-established, drug-free alternative that most OBs and midwives are comfortable with, and the research supports both its safety and its efficacy for pregnancy-related pain.

The Prevalence of Pregnancy-Related Back Pain

Studies estimate that 50-80% of pregnant women experience low back pain during pregnancy, and a substantial portion of those have pelvic girdle pain, which is pain at or around the sacroiliac joints that can make walking, rolling over in bed, or climbing stairs genuinely difficult.

This is not minor discomfort for many women. Pregnancy-related pelvic girdle pain and low back pain are leading causes of functional disability during pregnancy and one of the more common reasons women take early maternity leave.

Is It Safe?

This is the question every pregnant patient asks first, and the answer is: yes, when performed by a trained chiropractor using appropriate techniques, chiropractic care during pregnancy is safe.

A systematic review published in the Journal of Manipulative and Physiological Therapeutics reviewed the available evidence on chiropractic care for pregnancy-related low back, pelvic girdle pain, or combined pain. The review concluded that chiropractic care appears to be safe during pregnancy and is associated with reduced pain and improved function.¹

A narrative review in the Journal of Chiropractic Medicine similarly concluded that chiropractic care during pregnancy carries a low risk profile when contraindications are properly screened, and noted that adverse events associated with prenatal chiropractic are rare.²

Important contraindications exist and are screened at your initial consultation: placenta previa, placental abruption, ectopic pregnancy, or vaginal bleeding are conditions that require medical management, not chiropractic care.

What Prenatal Chiropractic Actually Involves

Prenatal care looks different from standard chiropractic. We use specialized tables with cutouts or adjustable sections that allow pregnant patients to lie face-down comfortably at any stage of pregnancy. Techniques are modified to avoid prone positioning when appropriate and to avoid any pressure on the abdomen.

The focus is typically on:

• Sacroiliac joint dysfunction: the SI joint is particularly stressed during pregnancy as the pelvis prepares for birth
• Lumbar facet joint restrictions and muscular tension from compensatory postural changes
• Round ligament and hip flexor tension
• Upper thoracic and cervical work for associated neck and upper back pain

The Webster Technique

The Webster Technique is a specific chiropractic protocol developed for use during pregnancy. It addresses sacral alignment and associated ligament tension to optimize pelvic biomechanics during late pregnancy.

Research published in the Journal of Manipulative and Physiological Therapeutics reported on a series of cases where the Webster Technique was used in patients with breech-presenting babies, with a high rate of spontaneous vertex (head-down) conversion following treatment.³ The Webster Technique is not a medical procedure to turn babies. It's a chiropractic technique that addresses pelvic function. Any change in fetal position would be a result of improved pelvic mechanics creating more space for natural fetal movement.

When to Start

Prenatal chiropractic can be beneficial at any trimester. Many patients start in the first trimester to establish a baseline and address early pelvic and lumbar changes before they become symptomatic. Others come in during the second trimester when postural changes become significant, or the third trimester when load and SI joint stress peak.

You don't have to be in pain to benefit. Maintenance care through the second and third trimesters can prevent many of the most common pregnancy-related complaints from developing.

Learn more about our approach on the prenatal and pediatric chiropractic page.

References

1. Weis CA, Pohlman K, Draper C, et al. Chiropractic care for adults with pregnancy-related low back, pelvic girdle pain, or combination pain: a systematic review. Journal of Manipulative and Physiological Therapeutics. 2020;43(7):714-731. PMID: 32900544. DOI: 10.1016/j.jmpt.2020.05.005.
2. Borggren CL. Pregnancy and chiropractic: a narrative review of the literature. Journal of Chiropractic Medicine. 2007;6(2):70-74. PMID: 19674697. DOI: 10.1016/j.jcme.2007.04.004.
3. Pistolese RA. The Webster Technique: a chiropractic technique with obstetric implications. Journal of Manipulative and Physiological Therapeutics. 2002;25(6):E1-9. PMID: 12183701. DOI: 10.1067/mmt.2002.126127.