What Happens at a Prenatal Chiro Appointment

Dr. Sarah Mickeler

Dr. Sarah Mickeler, Chiropractor and Oona’s Founder and CEO, shows us what happens during a prenatal chiropractic appointment.

Hey guys, so I think that there’s a lot of misconceptions about what happens in a chiropractic appointment for prenatal. And admittedly, at Oona, we do things differently than other clinics do. So, I wanted to give you a little primer on what a prenatal chiropractic appointment would look like in our clinic.

So, I have a patient here who is she’s 35 weeks pregnant. She’s a frequent flyer, this is baby number three. And so she’s been my patient for a while now. And I just wanted to give you a little primer on what this might look like.

Okay, so the first thing you’re going to see here is that Whitney is faced down on the table. So, we have this awesome table that opens up in the abdominal region. It will open up as wide as we need it to or as small as we need it to accommodate your growing belly. And I think you would agree, most moms love being in this position.

Whitney has typical low back pain of pregnancy. Most moms are going to come in and say they have some pain in here, their butts are sore, their hips are sore, all of the things are sore. But I’m going to do a whole bunch of soft tissue work, basically in her butt and in her low back area in this position where she is going to feel like $1 million.

Awesome, so, I’m doing a whole bunch of soft tissue work on Whitney’s bum. And most moms will tell me that their butts are really sore. They don’t even know it until I go in here and do the work. And then, they’re like, “Oh my gosh, I didn’t know that that hurts so much.” But the reality is when we’re pregnant, even the act of standing up straight is hard on our butts because we have a belly that’s growing every single day and our center of gravity shifts forward, and we end up coming back like this. And in order to do that, we end up gripping our butts.

So we have lots of things that we talk about in the appointments on how not to do that. But the reality is, it’s going to happen. So Whitney has some upper back pain which is also really common in pregnancy. Many of you will have experienced this and so, there is lots we can do about that. But what I’m doing now is something called, kind of a variant on something called ART. This is just going to help to relax all of the muscles in her upper back. It’s super, relatively gentle, but it feels like it’s actually doing something, which is great.

So this is just to get these muscles up here relaxed. The other thing too is with pregnant posture, everything goes a little bit funky, right? So, our pelvis is tilted under, we end up arching our backs back, and then as we arch our back we end up having to move our head forward. It turns into this really funky mess. So we try to balance everything.

Awesome, so the next thing I’m going to do is something the thumper, which is the best. So most of our patients love thumper. It’s a giant vibrating massager. It looks scary but it’s actually the best. And we’re going to spend a fair bit of time in Whitley’s bum area doing thumper. And so this is really quick relaxation of all of these muscles, it feels great. Most of my patients wish we could spend three or four hours in this position, but unfortunately, we can’t. So we got a couple of minutes and it just, again, helps to relax everything. So we’re going to do her low back, spend some time in here, and then move up.

Okay, so now that we’re done all of that, the next really important part of this treatment is something that we call a drop piece adjustment. So this is the part that tends to freak people out a little bit, but it’s really not scary. And it is kind of the most gentle way that we can get up to adjust the pelvis. So you won’t usually see in our office that we’re twisting people into pretzels in order to do an adjustment. And that is what often differentiates us from other chiropractors. I’m not a huge fan of twisting people because it puts torque on the pelvis when you’re pregnant and I don’t want to be twisting in the uterus. So we do everything in this position, so this table is magical.

And I’m going to press on a lever and you’ll see Whitney’s pelvis is going to pop up here. Like that, okay? And so, what I’m going to do is I’m going to put my hand on her SI joint. Which is this area in the low back that is probably sore. And with two hands, I’m going to give it a push. So it’s a bit of a loud noise, but it’s the table and not her joint. Okay, so that’s it. How did that feel, Whitney?

[Whitney]  It doesn’t feel like anything, really.

I know, it really feels like nothing, which can be disappointing, but it does something. So we’re going to do that three times. For Whitney, I’m actually going to do it three times on both sides. So I’ll come around to the other side and do it over here too.

Great, the other thing we’re going to do is use something called an activator. It’s just a manual adjuster that’s super, super gentle without any popping or cracking.

Okay, so it’s going to sound like I’m stapling her but I’m not. And, so basically, I’m going to get into an area on her spine. All of these things are optional. If someone comes in and says, “I’m really not into that.” No problem, we don’t have to do that, okay? So we’re just going to get in there and do a super gentle adjustment on her lower back. And again, I’m going to do it up here too. So the nice thing about the activator is that it’s super-specific. We can get into whatever spot we want to, which is awesome.

So now we’ve done our soft tissue work, we’ve done our thumper, we’ve done our drop piece adjustment, we’ve done our activator, we’ve done everything on the backside. I’m going to have Whitney flip over and we’re going to do some work on her belly.

So in this position, I’m going to do some soft tissue work on Whitney’s round ligaments. Then also just kind of on all of the soft tissue that is around her belly, right? So at this point in pregnancy, everything is feeling relatively heavy, not the most comfortable. And I want to give her a better walking experience so that when she’s walking around, she’s in a lot less discomfort. And you can say for sure that it actually helps.

So by doing all of these things together the actual treatment can last. So, the soft tissue work on the belly is just me giving a little bit of pressure into those round ligaments. The round ligaments are what hold the uterus up and out of the back of the abdomen, okay?

And you probably will have had some round ligament pain at some point in your pregnancy, very commonly early on, especially in first pregnancies. It’s often the first thing that people feel. They’ll be like, “Oh, I just have some tightness really low down” right? In subsequent pregnancies, absolutely too. It tends to get a little bit better as the uterus pops out of the pelvis and over that pubic bone. And then it tends to rear its head again, sometime after around week 32, 33. It’s also one of these things that if you’ve had it before, you will probably have it again in subsequent pregnancies, and it will probably happen earlier.

So I’m going to do a whole bunch of soft tissue work in here. I’m going to get out some cream, we’re going to rub her belly. I had someone once describe me as a Kung Fu Panda because of the way that this feels, super awesome and yet effective. And the combination of all of this is going to leave Whitney feeling really, really good. We’re also probably going to do a few little exercises with her in the office.

But at this point, I would recommend that Whitney is back again in another two weeks. Typically, from weeks 36 to 41 or whenever this baby makes its appearance, I’ll be seeing her once a week, at that point. It really depends on the patient but that’s so that we can give this baby a fighting chance of having a really beautiful position inside this uterus for a slippery, wet fish birth. And that’s what we want. We want really easy births. Okay, and that’s about it.

If you guys have any questions, by all means, get in touch. We can answer all of them.

Great, thanks.

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