pelvic floor muscles

The benefit of chiropractic care and physical medicine have been fairly well documented, both in previous posts to this blog and in the literature. While we have discussed in detail the ways in which chiropractic care can alleviate the aches and pains that result form the physical and hormonal changes of pregnancy, we have not yet fully delved into the positive effects chiropractic care has on the labour and delivery as well as the postnatal phase.

Anatomy of the Pelvic Floor

In order to appreciate how chiropractic care is beneficial to labour and delivery, it is advantageous to review the anatomy of the pelvic floor and how it relates to pregnancy, labour, and the postnatal period.

Pelvic floor muscles (PFM) are a large group of deep and superficial muscles that support pelvic organs, assist in urinary and fecal continence, aid in sexual performance, act as a venous and lymphatic pump, and are critical to the stabilization of pelvic and spinal joints.  The PFM also work with the abdominal core muscles and pulmonary diaphragm to control intra-abdominal pressure and to support the spine and pelvis during movement.

There are three layers of muscle carry out all of these functions: the superficial perineal layer, the deep urogenital diaphragm layer, and the pelvic diaphragm. The image below shows the intricate, basket weave structure of the pelvic floor and helps to illuminate how critical each muscle is to proper function.

pelvic floor muscles

 

Aside from their critical pre/perinatal roles, the PFM are intimately involved in the second stage (push stage) of labour and help to bring baby into the world. If a delivery is particularly difficult and especially if it requires instrument intervention, dysfunction of the PFM can occur. This dysfunction presents as urinary incontinence, fecal incontinence, pelvic pain, and/or pelvic organ prolapse. Research shows that the social and economic burden of PFM dysfunction is enormous.

Chiropractic Care and Pelvic Floor Dysfunction

Research has shown us that manipulation of the sacroiliac (SI) joints and lumbar spine aid in the activation of the transverse and oblique abdominal muscles. Not only are PFMs directly connected and correlated to the SI joints, they are also co-activated with the abdominal core muscles. Because of this, a recent research study aimed to show that chiropractic adjustments of the SI joint and lumbar spine positively affect the function of PFM and, by default, labour and the postnatal period.

Dietz, et al., concluded that women with increased pelvic organ and PFM mobility were correlated to a decrease in delivery times and an increase in uncomplicated births.  Thus, if lumbar and pelvic adjustments are able to alter PFM, adjustments may be beneficial to an uncomplicated second stage of labour. In the recent study by Haavik, et al., the researchers used 3D and 4D ultrasonography to determine if spinal and SI adjustments alter the pelvic floor function in pregnant women. The findings showed that lumbopelvic adjustments do, in fact, appear to relax PFM in pregnant women and, therefore, can benefit vaginal delivery.

Pairing preinatal chiropractic care with care from an internal pelvic floor specialist may help to further reduce complicated labour and decrease the risk of postnatal complications. For more information, please contact us.