Dystocia is defined as “slow or difficult labor or delivery.” In contrast, eutocia is defined as “normal labor.” We present the chiropractic care of a 26-yr-old nulliparous female during a home birth delivery with problems of dystocia. The patient’s labor began with strong contractions at 4-5 minute intervals. Twelve hours into labor, cervical dilation was at 4-5 cm with her contraction frequency and duration characterized as inconsistent. With the patient exhausted and twenty two hours into labor, her cervix had dilated to 7cm but her contraction frequency and duration diminished “significantly.” The midwives attempt various homeopathic remedies and patient positioning resulting in decrease fetal heart tones. At 23 hours labor, the midwives determine that the fetus is asynclitic on left possible due to one or both limbs being tucked under the chin, neck area or possible cord entanglement. The midwives suggest an inversion technique with the patient on her chest flat on the floor and her pelvis raised in a caudal incline to improve fetal positioning. The fetal heart tone improved but the uterine contractions were still “weak” and fetal positioning unchanged. In consultation with the attending midwives, the chiropractor utilizes the Webster Technique and adjusts the patient for a left sacral posterior rotation. Furthermore, he alleviates the “tension” in the patient’s right psoas with pregnancy psoas release technique. During the sustained ligament contact in accordance with Webster protocol, the fetus is felt and reported by the mother to move. The midwives report significant improvement in labor progression since time of chiropractic adjustment. The patient’s contractions become stronger and more frequent and following cessation of the “all fours position”, the fetal heart tones stabilize. Twenty eight hours into labor, the fetus is determined to be asynclitic again. The midwives attempt various positioning, more homeopathic remedies and perform surgical rupture of membranes and suggest another adjustment. At 34 hours of labor, the attending chiropractor performs the psoas release and ½ hour later, the patient is at complete cervical dilation. The labor progresses rapidly and mother begins pushing. The baby is born vaginally at home one hour after her Webster Technique care.
This case report provides supporting evidence that chiropractic care may assist in patients with dystocia. We advocate for further research in this field.
Joel Alcantara, DC 1, Justin Ohm, DC 2 and Jeanne Ohm, DC 3
- Research Director, International Chiropractic Pediatric Association, Media, PA and Private Practice of Chiropractic, San Jose, CA USA
- Private Practice of Chiropractic, Media, PA
- Executive Director, International Chiropractic Pediatric Association, Media, PA and Private Practice of Chiropractic, Media, PA
This study was funded by the International Chiropractic Pediatric Association, Media, PA, USA
Journal of Pediatric, Maternal & Family Health - Chiropractic ~ Volume 2009 ~ Issue 1 ~ Pages 1-5. Abstract