Nutrition is a cornerstone of our education and plays a role in our management of patients. An important aspect of optimal health for patients has to do with nutrition. Fertility of both the man and the woman is affected by suboptimal nutrition with a common cause of infertility (even in Sweden) being a deficiency in both vitamins and minerals.
The nutritional status of the mother to be plays a critical role in how the developing fetus is programmed to develop. This concept is called epigenesis and it relates to how the prenatal environment can predispose the fetus to conditions later in life. Nutritional needs change during pregnancy and optimal fetal health depends on maintaining adequate levels of vitamins and minerals.
The vast majority of pregnant women experience low back pain or pelvic pain. It is the most common cause of sick leave in the Scandinavian countries. Despite this, care givers seldom examine women to determine the cause of pain and disability, nor do they refer the patient for care. It is assumed that this is a natural part of the pregnancy which is relieved with birth. Most of the pain syndromes experienced during pregnancy can be diagnosed and effectively treated allowing women to function normally without pain at home and at work. Because the uterus is suspended from the pelvic girdle, problems with the pelvis may affect the developing fetus. Pelvic obliquity affects fetal positioning. The risk for intervention increases dramatically when the fetus is unable to position itself optimally prior to delivery. Intervention increases risk for harm to both the mother and infant, and is a common cause of pain and torticollis in the infant.
Considering the enormous changes to the body, particularly the increase in size and change in biomechanics, it is not surprising that many women experience pain. The posture changes dramatically to compensate for the enlarging abdomen and breasts. The low back is a pivotal point which takes on a large part of the load as center of gravity shifts. The mechanics of the body change, so there is stress on the upper back and neck as well.
Chiropractors are specialists in biomechanical health, how the joints function optimally and how muscles accommodate to changes in joint functioning. The pregnant patient undergoes a series of changes not only in the pelvic girdle and low back, but also in the functioning of the legs and feet, the ribcage and even head positioning. The hormonal changes affect the ligaments, the tissue holding the joints together, adding to the risk for instability to an already overloaded system.
An important aspect of care for the pregnant patient is having an understanding of the biomechanical changes that occur as well as what is optimal positioning for the fetus and how deviations from this affect both the mother and the developing fetus. Special skills are required for safe treatment of the pregnant patient and the developing fetus. Techniques are gentle but effectivly restore normal function to affected joints, muscles and ligaments.