By Sharon Kirkey, Postmedia NewsSeptember 21, 2011

Canadian scientists are working on a way to make older human eggs young again — and maybe even slow menopause — experiments that could make it easier for women in their 40s and perhaps beyond to have babies.

The answer may lie in a single vitamin.

 Toronto fertility doctors say their experiments in mice show that co-enzyme Q10 makes older mice produce more and healthier eggs. The doctors are now preparing to test the supplement on women 35 and older undergoing fertility treatments.

The work comes as women are pushing back motherhood ever later in life. Across Canada, pregnancies in women over 35 are increasing, and fertility clinics are seeing more women over 40. “Our mean age for patients first coming to see us is now 37,” said Dr. Robert Casper, medical director of the Toronto Centre for Advanced Reproductive Technology. Five years ago, it was 33.

 Not only do older women find it more difficult to get pregnant, they run an elevated risk of miscarrying or of conceiving embryos with chromosomal abnormalities that cause conditions such as Down syndrome.

A woman is born with all the eggs she will ever have, and by the time she reaches her late 30s, the quality of those eggs begins an irreversible slide. They have less chance of leading to a normal live birth.

 Eggs have 46 chromosomes to begin with, but they undergo a change when a woman ovulates. Each egg discards 23 of its own chromosomes and, if it’s fertilized, takes in 23 from the sperm cell to replace them. But this takes a lot of energy.

The energy in eggs, and essentially in all human cells, is produced by mitochondria, little power packs inside all our cells. But these weaken with age so that they don’t produce as much energy, resulting in a steady decline in tissue and organ function.

“Somebody who is 20 will have eggs with 20-year-old mitochondria in them, and somebody who’s 40 will have 40-year-old mitochondria that will produce less energy,” said Casper, professor in the division of reproductive sciences at the University of Toronto and a senior scientist at the Samuel Lunenfeld Research Institute at Toronto’s Mount Sinai Hospital.

If there isn’t enough energy to separate the chromosomes properly, some get left behind. “They don’t get pulled out,” Casper explains. Extra chromosomes can lead to aneuploidy, an abnormal number of chromosomes, the stringlike structures that carry our genetic material.

“That’s why Down syndrome increases with age — it’s all an energy issue,” Casper said. “It’s not that there is anything wrong with the eggs, it’s just that the batteries have run down.”

Casper’s team has been studying mitochondria for years, trying to understand whether it’s possible to boost energy production in human eggs.  Together with Dr. Andrea Jurisicova, an associate professor in the department of obstetrics and gynecology at the University of Toronto, the researchers originally tried injecting young mitochondria into old mouse eggs, using a preparation made from cord-blood stem cells, which are fetal cells, so that the old eggs would have young, healthy mitochondria.

The technique worked — it improved the quality of the eggs and the embryos. The problem was, the embryos had two different mitochondrial DNA — essentially, two different mothers. When Canada’s Assisted Human Reproduction Act outlawed mitochondrial gene replacement in 2004, Casper’s team abandoned that avenue of research.  Now they’re working on a different tack, using co-enzyme Q10.  Mitochondria need co-enzyme Q10 to make energy. The vitamin is also a powerful anti-oxidant that may prevent mitochondrial DNA damage, Casper said.

Co-enzyme Q10′s production by the body also decreases as we get older, starting around age 25.

“One of the theories about why we get old and die in the first place is that our cells just run out of energy — the mitochondria stop working properly and there’s just not enough energy for cellular function so organs start to fail,” Casper said. “A simple explanation could be that there’s not enough fuel from the co-Q10 around.”

In a pilot study using 52-week old mice — mid-life for a mouse, and the equivalent of 40 to 50 for a human — Casper’s team gave half the group co-enzyme Q10, and the other half a placebo. Next they compared eggs retrieved from both groups of mice with eggs from 10-week old mice.

“What we found was that just treating the mice with co-Q10 we got more eggs when we gave them fertility drugs,” Casper said. The nuclear spindles that pull the chromosomes apart were more like those in young eggs. The litter size was bigger, and the eggs from the vitamin-treated mice had improved mitochondrial function.  Even more surprising, when the researchers examined the mouse ovaries, there were significantly more egg follicles in the old mice treated with the co-Q10 — suggesting, Casper said, “that we actually were able to delay the onset of the equivalent of menopause in the mice.”

The glitch is that the mice were pre-treated for 18 weeks — the equivalent of 10 years or so relative to a human lifespan.

“We might be able to delay menopause, but it might take a decade of pre-treatment,” Casper said.

“The question is: how long do you have to give it, and can there be so much damage already in the mitochondria that it doesn’t make any difference?” Either way, it could take years of women taking the supplement to stave off menopause. “You’d probably have to have it in your cornflakes.”

The more immediate application might be in improving an older woman’s fertility by improving her egg quality.

When word got out about his early research on the Internet, women undergoing fertility treatments began taking co-enzyme Q10. Casper is now trying to recruit women over 35 for a study testing whether taking 600 mg daily of the supplement can lead to a higher number of chromosomally normal eggs.

The rub is that, as soon as the researchers explain the mouse results, none of the women want to be randomized to the placebo group, “especially if they’re 40.”  “They just want to move ahead and get going,” said Casper, who will be discussing his work Thursday — in a talk entitled “Can we rejuvenate old eggs?” — at the annual meeting of the Canadian Fertility and Andrology Society, the body representing Canada’s fertility doctors. As reported by Postmedia Monday, the meeting was originally closed to the media. The board has now decided to open the meeting to reporters.

The Toronto researchers need 50 women for their study; they’re up to 25 so far, after a year-and-a-half of trying.

If the mice experiments hold up in the clinical trials, the implications would be significant, Casper said. “Women could get pregnant easier when they’re older.”

It could also buoy calls for more single-embryo transfers. For years fertility clinics have been putting three, four or more embryos back into women over 40 in the hope that at least one would implant and a baby would result.

“It’s not so much that these women get multiple pregnancies,” Casper said. “Most of them still don’t get pregnant because they don’t have any normal eggs left.

“The only strategy we have right now to try to improve the pregnancy rates in older women is to induce multiple ovulation and get more eggs to work with, so there’s more chance there will be a normal one there.”

“If we could improve the percentage of normal eggs, you wouldn’t have to put back so many embryos.”

The other hope is that, “if we can increase the energy for chromosome separation, then we could eliminate Down syndrome and other chromosomal abnormalities,” said Casper.

Almost one in five births in Canada is to a mother over the age of the 35 — an age when the risks involved with childbirth and pregnancy start to increase. Mothers older than 40 are three times more likely to develop serious pregnancy-related complications such as gestational diabetes and hypertension compared to their younger counterparts, according to a report released last week by the Canadian Institute for Health Information.

skirkey@postmedia.com

Twitter.com/sharon_kirkey

© Copyright (c) Postmedia News

Smoking is such a well-known hazard to the mother that it only follows that it is also harmful to the baby. Yet hundreds of thousands of pregnant women still smoke. Second-hand smoke from smokers who live or work with pregnant women can also affect the foetus. Exposure to smoke can result in spontaneous abortion, preterm births, low-weight full-term babies, deformities and birth defects, and foetal and infant deaths.

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A new review paper by University of Nottingham researchers found that secondhand smoke exposure increased the risk of stillbirth by 23 percent in nonsmoking pregnant women, compared with women who were not exposed to smoke at work or at home. Passive smoking also increased the risk of congenital birth defects by 13 percent. The authors noted that the baby’s father was the source of secondhand smoke exposure in five of the nineteen studies: “These results highlight the importance for smoking prevention and cessation to focus on the father in addition to the mother during the preconception period as well as during pregnancy.” Study author Jo Leonardi-Bee said in a press statement that further research is needed to determine whether paternal smoking affects pregnancy through the sidestream smoke that the mother inhales, or whether the father’s smoking affects his sperm development, or both. Source: http://www.healthland.time.com/2011/03/14/study-secondhand-smoke-increases-riskofstillbirth- birth-defects/

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It’s not healthy to smoke during pregnancy but an estimated 12% to 24% of pregnant women continue to use tobacco, according to national data [PDF]. So if the existing evidence hasn’t convinced them to quit, perhaps this new study will: a researcher from the Loma Linda University School of Medicine reports that fetal exposure to nicotine may be associated with increased blood pressure among children once they grow up.

Granted, the study measured nicotine’s effects on rat fetuses rather than developing humans. But if the association holds up in people, we should be concerned about the hearts of babies born to smoking mothers.

Previous studies in humans has shown that children born to smoking mothers have suffer from damage to their vascular, or blood-vessel system, but it’s impossible to prove the correlation given confounding factors. So DaLiao Xiao, assistant research professor of basic sciences at Loma Linda set out to test the association in rats. In an experiment, he gave 12 pregnant rats a daily dose of intravenous nicotine and 13 different pregnant rats a saline placebo. He then monitored their offspring for up to five months for signs of heart damage or other circulation problems. At five months, the offspring of the rats who were given nicotine had two classic signs of heightened heart risk: increased oxidative stress and hypertension.

While we can’t extrapolate that people react the same way as rats — and we can’t extrapolate that a nicotine injection perfectly mirrors the real-world delivery of nicotine through smoking, nicotine gums or patches — the research does highlight how maternal smoking may lead to poor cardiovascular outcomes for children. Lighting up doesn’t just affect the mother-to-be, but those cigarettes could leave a lasting health legacy on her kids as well.

Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

Read more: http://healthland.time.com/2011/07/21/why-pregnant-women-shouldnt-smoke/#ixzz1XHJtTWZj

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Also:

Honein MA, Paulozzi LJ et al.“Family History, Maternal Smoking and Clubfoot: An Indication of a Gene-Environment Interaction.” American Journal of Epidemiology. 2000; 152(7): 658–665.

Wisborg K, Henriksen TB et al. “Smoking during pregnancy and hospitalization of the child.” Pediatrics (online version). (Oct. 1999); 104(4):e46. www.toyourhealth.com/mpacms/tyh/article.php?id=555.

Chung KC, Kowalski CP et al. “Maternal cigarette smoking during pregnancy and the risk of having a child with a cleft lip/palate.” Plastic and Reconstructive Surgery. 2000; 105: 485–491. Source:  www.toyourhealth.com/mpacms/tyh/article.php?id=557.mpacms/tyh/article.php?id=557.

Man LX, Chang B. “Maternal cigarette smoking during pregnancy increases the risk of having a child with a congenital digital anomaly.” Plastic & Reconstructive Surgery. (January 2006);117(1): 301–308. Source: www.toyourhealth.com/mpacms/tyh/article.php?id=576

Pregnancy can have a profound effect on a woman’s body. The body changes due to the added weight of a child; which can induce back pain, loose ligaments and a poor center of gravity. Chiropractic care and comfortable, supportive footwear can benefit women in all stages of maternity.

According to the American Chiropractic Association, “During pregnancy, a woman’s center of gravity almost immediately begins to shift forward to the front of her pelvis…. As the baby grows in size, the woman’s weight is projected even farther forward, and the curvature of her lower back is increased, placing extra stress on the spinal disks. In compensation, the normal curvature of the upper spine increases, as well.

During pregnancy, misalignment of the spine and pelvis are common changes that women may experience. This will put stress on the lower back and midsection. Chiropractic manipulation to these areas of the body can help reduce discomfort and prepare women for childbirth. For mothers that are wary about consuming temporary pain-relievers during pregnancy, chiropractic adjustments can provide a solution.

As the baby grows inside the mother’s belly, more weight is added to her body, meaning more pressure on her feet. As a result, the medial longitudinal arches will drop, making the feet look bigger. Dropped or flat arches can be detrimental for other parts of the body. The knees, low back, and spine can become misaligned, inducing stress to these parts of the body.

Aside from receiving routine adjustments, pregnant women with fallen arches can help relieve pain by wearing comfortable and supportive shoes. Tennis shoes with a high medial arch support that can absorb shock help alleviate pain for pregnant women.

High heels are not recommended for pregnant women, as the potential for injury can be heightened when their center of gravity is off balance. According to a BBC News Health article, “High heels alter your posture, shorten your calf muscles and place increased pressure on your back and knees. In pregnancy this places extra pressure on your joints when they are already under strain – which can result in a host of foot, leg and back problems and could increase the likelihood of falls.”

High heels and ill-fitted shoes add stress to the body and disrupt the normal gait pattern even for women who are not pregnant. These types of shoes should be worn in moderation to avoid injury. Having a pair of comfortable shoes handy to slip into can prevent a night out from ending early.

Ill fitted shoes can have a harmful effect on women’s feet. According to Larry Keller, “Nine times more women develop problems from improperly fitting shoes than men, and nine out of 10 women wear shoes too small for their feet.”  Shoes that are too small can be rough on pressure points in the feet, creating calluses or painful bunions. Tight shoes disturb the gait pattern and can have a formidable effect on joints throughout the body.

Properly fitted shoes should leave space (around ½ inch) for the toes to have wiggle room. Women should shop for shoes during the afternoon, as the feet naturally expand during the day. Above all, shoes should be comfortable and supportive.

A chiropractor’s systematic approach and expertise of spinal manipulations provide an option for pain relief. This is especially beneficial for pregnant women seeking pain relief without risking harm to their baby.

Routinely visiting a chiropractor and making simple lifestyle adjustments can help relive pain from pregnancy. It can also help alleviate stress from everyday life. This could be as simple as opting for more supportive footwear. On your next visit with your chiropractor, ask how you can make changes to start living a more stress-free life!

1 American Chiropractic Association. (2011). Chiropractic Advice for Moms-to-Be. http://www.acatoday.org/content_css.cfm?CID=85

2 BBC News Health. (2010). Stiletto warning for pregnant women. http://www.bbc.co.uk/news/10309086

3 Keller, Larry. (2011). How to Stop Tight Shoes From Hurting. http://www.ehow.com/how_7718116_stop-tight-shoes-hurting.html

This was no small study: 59, 334 women served as participants, and results applied to women who consumed carbonated and non-carbonated soft drinks containing artificial sweeteners. Moreover, no relationship was noted between soft drink consumption and increased risk of preterm delivery in women who consumed sugar-sweetened soft drinks (either carbonated or non-carbonated).

American Journal of Clinical Nutrition September 2010 92: 3, p 626-633; First published online June 30, 2010. doi:10.3945/ajcn.2009.28968

[Source: http://www.toyourhealth.com/mpacms/tyh/article.php?id=1408]

Thanks for taking the time to share your stories and opinions!

I really want to add personal success/birth stories of my practice members and would love it if you would be willing to share what your experience was, particularly of receiving chiropractic care with me during your pregnancy. You can either write your story below andemail me at chiropractor@dccnet.com or go to the following link to download the attached .pdf Book 2 Request For Stories and fill it in and mail or scan it then email it back to me. I truly appreciate your response and I want you to know that you can share your story anonymously or I can use your name (full name, initials etc. you decide).

My pregnancy chiropractic experience: _____________________________________________________

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Do you want your name published? ___ Yes ____ No.

If yes, please write exactly how you would like your name to be published in the book (i.e. D.M., Donna

M. or full name): ______________________________________________________________________.

Thank you once again for the opportunity to serve you, your family and friends – my life wouldn’t be the same without you!

Yours in health,

Dr. Stacey Rosenberg

 Recent research reported in the Journal of Pediatric, Maternal & Family Health – Chiropractic reveals that chiropractic may play an important role in helping pregnant women with breech presentations deliver normally in such situations.

 The research is the first to report on the use of a hand held instrument to administer a specialized chiropractic technique developed for “In Utero Constraint”, a leading cause of breech presentations.

 ”Every day more clinical research is showing that chiropractic care can play a crucial role during pregnancy, labour and delivery” stated Dr. Drew Rubin, the author of the study. “Research showing that the Webster Technique can affect a breech presentation so that more aggressive interventions such as C-sections can be potentially avoided is growing. This study is the first to use a hand held adjusting instrument to perform Webster’s Technique” added Dr. Rubin.

 Despite widespread education and efforts to curb birthing interventions such as caesarean sections, their use remains high and concern amongst health care advocates is growing. The concern centers around the use of high risk interventions for “convenience” of the doctor or mother without taking into consideration the long term effects of a traumatic birth on the child.

 ”Some expectant mothers are hesitant to undergo chiropractic care for fear it might harm the baby” stated Dr. Matthew McCoy a researcher, public health expert and editor of the journal that published the study. “But the data shows this is simply not the case and chiropractic has been shown to be safe and effective during pregnancy. The findings from Dr. Rubin’s study add further options for the way pregnant women are adjusted” added McCoy.

 As pointed out in the paper, a hand held adjusting instrument was used to perform one part of the adjustment known as Webster’s Technique. The instrument produces a very light impulse that helps “reset” the spinal or pelvic joints. According to chiropractic specialists, distortions of the spine and pelvis either cause or add to the problem of “In Utero Constraint”, possibly causing breech pregnancies. Spinal and pelvic distortions, termed subluxations by chiropractors, result in structural and neurological interference to the spine and nerve system. It is this interference that may affect the birth process and chiropractors correct or reduce this interference, correct the imbalance and allow the fetus to turn in preparation for the birth process.

 ”The goal is for the mother to be checked prior to the time of delivery so that these problems can be corrected beforehand and a difficult labor avoided” remarked Dr. Rubin adding “While these are only three cases, coupled with numerous other case studies and some larger clinical studies, our hope is that is shows health care providers that chiropractors can play a very beneficial role in the management of pregnant patients.”

 All three mothers in this study were managed utilizing the Webster Technique and after 2-4 Webster Technique adjustments, the babies turned from a frank breech position to a vertex, head-down position.

 Dr. Rubin calls for more research on the role of chiropractic care in pregnancy and delivery.

 For more information on Webster technique and chiropractic care in pregnancy, contact Dr. Stacey Rosenberg at Gibsons Chiropractic (604) 886-7080 or your local family chiropractor. To find a listing of Webster Technique certified practitioners in your area, visit www.icpa4kids.com.

Chiropractic Table Modification for Pregnancy

Short answer – yes! Chiropractic techniques need to be modified for comfort and to accommodate the growing belly. Additionally, certain techniques should be avoided so you should see a chiropractor trained in the techniques that address in utero constraint or mal-presentations, who will check for misalignment of the pelvic bones, pubic bones, misalignment of the sacrum and vertebrae, and spasm of the ligaments that support the uterus and help hold the pelvis together (such as Webster Technique or Bagnell Pregnancy Technique).*

How can visiting a Chiropractor be beneficial to a pregnant woman?

Labour Helper Technique

Chiropractic care during pregnancy helps with the typical pregnancy backache, it ensures the pelvis is working and moving properly prior to and during labour. Chiropractic care throughout pregnancy can relieve and even prevent the common discomforts experienced in pregnancy. Specific adjustments eliminate these stresses in your spine, restore balance to your pelvis and result in greater comfort and lifestyle improvements. Chiropractic care throughout pregnancy restores balance to your pelvic muscles and ligaments and therefore leads to safer and easier deliveries for you and your baby. Additionally, the chiropractic adjustment removes interference to the nervous system allowing your uterus to function at its maximum potential. Published studies have indicated that chiropractic care does in fact reduce labour time. According to recent studies, chiropractic care may result in easier pregnancy including increased comfort during the third trimester and delivery, and reduced need for analgesics (pain medication). In one study, women receiving chiropractic care through their first pregnancy had twenty-four per cent shorter labour times [than average] and subjects giving birth for the second or third time reported thirty-nine per cent shorter labour times. In another study, the need for analgesics was reduced by fifty per cent in the patients who received adjustments. In addition, eighty-four per cent of women report relief of back pain during pregnancy with chiropractic care! And because the sacroiliac joints of the pelvis function better, there is significantly less likelihood of back labour (contractions and sharp pain felt in the lower back during labour) and dystocia when receiving chiropractic care through pregnancy. Chiropractic care has also been shown to increase breast milk production and breastfeeding comfort.

What common aliments do you see most when working with pregnant women?

The preventative check-ups, typical pregnancy backache, lower ribcage discomfort, pubic bone discomfort, upper back ache from increased breast size, breech presentation, in utero constraint, and delayed maturity (past due date).

At what age can children start seeing a Chiropractor?

My children were both checked within one hour of delivery. And even with their natural, non-invasive, midwife-delivered births, both had small misalignments in the upper neck area. Studies show that infants showed signs of nervous system injury and birth trauma in up to 40% of natural, non-traumatic births. A German physician (M.D.) found upper cervical (neck) misalignments and dysfunction in over 90% of neonates (newborns).

“The birth process and eager hands pulling and twisting can put a great deal of pressure on the spinal nerves and muscles of the infant’s neck (up to eighty pounds in some studies). In a difficult delivery, damage to the delicate tissues of the spine may occur, especially when vacuum extraction or forceps are used. While forceps injuries may be less common today, vacuum extraction can do just as much damage—up to 120 pounds of pressure goes through the baby’s head and neck to literally suck the baby out of the mother (decapitation can occur at 140 pounds of pressure, to give you an idea of the high forces involved).

Changing diapers may also place undue stress on the baby’s mid-back (thoracic spine). Raising the infant’s legs with one hand to place the diaper underneath can cause repetitive stress to these spinal joints. Spinal problems can also occur as a result of the frequent falls suffered by young infants in the first months of life. A fall from a bed, a sudden stop in an automobile, or any significant unsupported movement of the head and neck in an infant can induce excessive movement in the spine causing subluxations. At the other end of the spine, the act of learning to walk, and the number of simple falls encountered in this way, can induce trauma to the lower spinal segments and to the large sacroiliac joints of the pelvis.”*

NB: Adjustments for children and babies are safe and take into account the delicate nature of the pediatric spine. The amount of pressure used to check and adjust a child’s spine is very small, approximately the same as you would use to check a tomato for ripeness.

How could seeing a Chiropractor be beneficial to a child?

Unless a child has an obvious problem, it can be difficult for parents to recognize when a child has spinal subluxations (misalignments causing nerve interference). There are some signs, however, which parents may look for which can be an indicator of an infant with a spinal problem including: the child’s head consistently being tilted to one side; restricted head or neck motion to one side; disturbed sleeping patterns where the child sleeps for only an hour or two at a time; feeding difficulties in the young infant, for example, the infant may have difficulty nursing at the breast on one particular side; and the presence of any of the symptoms of ill-health mentioned previously. Nerve interference from subluxations is implicated in many common childhood health problems such as: sucking dysfunction, colic, irritability, reflux, unexplained crying, recurrent ear infections, frequent colds, headaches, asthma, lack of appetite, poor digestion, constipation , stomach aches, so called ‘growing pains ‘, back aches, bed-wetting , poor general health, and fatigue.*

*(From Natural Pregnancy, Natural Baby – Natural Remedies for Pregnancy, Birth and Post-Partum Discomforts)

[This article was originally posted in the October-November 2008 edition of Coastparents.ca Online Newsletter Parent Profile of Dr. Rosenberg]

Benefits

You don’t need to become a member of an expensive gym to go walking. And except for a good pair of walking shoes, it requires virtually no equipment.

A sedentary lifestyle has debilitating influence on people’s health as they age. Exercise is imperative or as the old saying goes: “if you don’t use it, you lose it!” Walking accomplishes all of the following and more:

• Improves cardiovascular endurance
• Tones muscles of the lower body
• Burns calories:  about 80 if walking 2 miles per hour, and about 107 if walking 4 1/2 miles per hour
• Reduces risk of heart disease

Shoes

The first item of business when beginning your walking program is to select the right pair of shoes. I recommend the following tips: Make sure the shoes you purchase fit properly. The balls of your feet should rest exactly at the point where the toe end of the shoe bends during walking. Avoid high-top shoes that often cover the entire ankle, limiting your foot’s ability to move freely and naturally. Opt instead for shoes that offer your ankle a fuller range of motion. Select shoes with plenty of cushioning in the soles to absorb the impact of your walking. If you suffer from excessive pronation, fallen arches or other biomechanical problems with your feet, consider getting custom-made orthotic supports. Pregnancy can make the arches stretch and drop more from the effects of the hormone Relaxin, as well as from the weight gain and altered biomechanics (the classic ‘pregnancy waddle’) so it is extra important to ensure you are wearing proper, supportive footware when you are exercising while pregnant.

Getting Started

Walking just 12 minutes every other day can offer important health benefits. Walking 20 minutes every other day is even better. In order to increase your longevity, try to eventually work up to 30 minutes, five days per week. The following tips should help you get started safely and smoothly:

• Move your arms freely, in coordination with the opposite leg.
• Don’t stoop your head or look down as you walk. This will challenge the normal forward curve of your neck, which, in turn, will cause you to carry your weight improperly.
• Don’t carry weights or dumbbells while walking. They’re better used as a separate part of your exercise regimen. If you do carry weights while walking, be sure that they are light enough that they do not interfere with the “rhythm” of your arms and legs; in order to counterbalance the body, when your right arm moves forward, the left leg should be moving forward, etc.
• Expect a little soreness in the thighs and calves for the first week or two. If you experience more than minor soreness, check with your Doctor of Chiropractic.
• Walk briskly, with “purpose.” Simply “sauntering,” while relaxing and enjoyable, is not an effective form of cardiovascular exercise.

Keep in mind that, if you have not previously been physically active, you should consult your doctor before beginning a new exercise program. Begin slowly with a walk of perhaps half of a mile at a pace that does not cause discomfort. Continue this for about two weeks, then start to increase the pace and length of time walking. Eventually – depending on your age – you can build your “target” heart rate/pulse to either 120 beats per minute or, if younger, as many as 140 beats per minute. For the average adult, a heart rate of 120 beats per minute would require walking at about 2 miles per hour, while a heart rate of 140 beats per minute would require a pace of 4 ½ miles per hour. Click here for more pregnancy exercise tips.

Surfaces

Some walking surfaces are better than others on your musculoskeletal system. Walking on a cushioned or rubberized track is ideal, because the cushioning of this type of track absorbs most of the impact of your walking. Many recreation centers offer this type of track free of charge.

Grass is another good surface, but watch out for hidden dips or holes in the ground. Walking on a surface with no give, such as concrete or a mall floor, is not your best choice, because this type of surface will not absorb much of the impact your body will experience. If you do choose to walk on such a surface, be extra careful to select highly cushioned shoes.

Strollers

Strollers are great for giving your back a break from carrying your little one – when you use them properly. As you walk behind the stroller, your elbows should be slightly bent, back straight. Imagine a fishing line pulling you up from your sternal notch (the bump on the upper part of your breastbone). This will make your chest come up and your shoulders come down with your chin tucked in. Ideally, your stroller should have adjustable handles so that you, your spouse and other caregivers can easily raise or lower the handles to waist level – the optimal position for ergonomic ease. In case you’ve inherited a stroller with fixed handles that are too low for your comfort, check your favourite baby supply store for handle extenders.

Now that you’ve nailed the stroller walk, don’t blow it by bending over to transfer baby in and out. Instead of hunching your back, kneel on one knee to get down to baby’s level, and then straighten your legs to stand up. When you need to free up your arms, front carriers or slings come in handy. As with everything else, just be sure not to overdo as this can cause neck and shoulder strain.

Hydration

Drink 8-10 eight-ounce glasses of water a day to help keep the kidneys active, dilute and remove toxins from the body, and replace lost fluids. (Coffee, tea, soft drinks and alcohol are diuretics (dehydrators) – don’t substitute them for water,  especially when you are pregnant). If you perspire during walking, you may need to drink even more.

Pain and Injury

While you may experience pain or injury in a particular area, such as a knee or a hip, the root of the problem may lie somewhere else. Injuries of this nature are not regional, or isolated, but often systemic. A problem in the foot or ankle can create an imbalance in every step, leading to discomfort or injury that moves to the knees, hips, low back, or elsewhere. If you suffer from pain beyond typical muscle soreness, your Doctor of Chiropractic can diagnose and treat your pain or injury and get you back into the swing of your walking routine.

Your Doctor of Chiropractic can also help customize a wellness program that is right for you and has the expertise to help keep you in the mainstream of life.

Your Nervous System

A person’s spine is made of twenty-four moveable bones called vertebrae, plus the sacrum (tailbone), pelvis, and skull. From the brain, nerve impulses travel down the spinal cord, branch out into nerves, and exit between the vertebrae. When the vertebrae become misaligned or unable to move properly – a condition called vertebral subluxation – it irritates and interferes with the nerves. The message from the brain is slowed down and the life-energy carried by the nerve is unable to reach the organs and tissues at one hundred percent of its potential. A Doctor of Chiropractic aligns the vertebrae and pelvis through gentle adjustments to the spine, thereby relieving the pressure on the nerves and allowing one hundred percent of the nerve energy to reach the tissues it serves.

Chiropractic is a medical system based on the premise that disease and disorders are caused by nerve interference which is caused by a misalignment of the bones, especially in the spine. Specific chiropractic care throughout pregnancy works to enhance nervous system function providing greater health potential for both the mother and baby. It also removes interference to your nervous system allowing your uterus to work at its maximum potential. Chiropractors offer a conservative approach to treatment of pregnant women, without the use of any drug interventions. The aim is to alleviate the stresses and strains of pregnancy and to improve comfort for both mother and baby. [3, 4, 6]

Chiropractic care prior to conception promotes a more regular menstrual cycle and optimum uterine function. It prepares the body to be strong, flexible and as balanced as possible to carry the pregnancy. As your baby grows, your musculoskeletal system must also adjust accordingly to accommodate the growing uterus and prepare for delivery. [5] And adjusting women through pregnancy and labour is one of the most rewarding parts of our jobs as chiropractors, because a healthier pregnancy means an easier labour and delivery – a much better transition for the next generation into this world! [2]

Dr. Stacey and Udo Rosenberg Pregnancy Photo

As you gain weight, especially in the abdomen, this exerts a downward, forward pull on the lower spine. This extra weight combined with changes in your gait and centre of gravity can set the stage for backache and neck pain. Additionally, as labour approaches, your body secretes a hormone called Relaxin, which loosens ligaments. This may exaggerate the effects of an existing spinal or pelvis problem. [3, 11] The positioning of the baby and its movement as well as expansion of the lower part of the ribcage to accommodate your growing baby can also cause discomfort in the ribs and upper portion of the lower back. Additionally, your increasing breast size in preparation for lactation can create upper back subluxations. [3, 4, 8, 10, 11, 12, 18, 19, 20, 21, 22, 24]

An imbalance in the spine and pelvis is likely to cause an imbalance in the pelvic muscles and ligaments which support the uterus. The uterus is suspended by eight ligaments and a node caused the perineal body. The uterus is connected to the pelvis by ligaments: the broad ligament, the uterosacral ligaments, and the round ligaments. Like a hot air balloon tethered to the ground, these ligaments work to keep the uterus in the proper place in the pelvis and allow support as the uterus grows to accommodate the growing baby. [12] Some of these ligaments attach directly to the pelvis and sacrum, some attach to the labia and are affected by the alignment of the pubic bones. [10, 11, 12, 13]

These suspensory ligaments must all function properly without tension or spasm for the uterus to be suspended properly and itself be without spasm. If the bones of the pelvis are out of alignment or subluxated, this will directly affect the way the uterus will be supported. Unequal ligament support will torque the uterus reducing the amount of room for the developing baby. When the ligaments are affected, they directly affect the position of the uterus which can result in the baby not being in an optimal position. This type of situation may result in a breech baby or a transverse (sideways) baby. This is called intrauterine constraint. This constraint restricts the baby’s positioning during pregnancy adversely affecting his/her developing spine and cranium. Additionally, these limitations on baby’s movement during pregnancy may prevent him/her from getting into the best possible position for the birth (ideal is vertex, occiput anterior). [3, 7, 9, 11, 12, 13]

Any position other than the ideal, including occiput posterior, breech, transverse, oblique or “sunny side up” (face up) lies, lead to longer, more painful labours with increased medical interventions. Any baby position even slightly off during birth will slow down labour, and add pain to both mother and baby. Many women have been told that their baby’s were too big of labour just slowed down when it was really the baby’s presentation interfering with the normal process and progression. Often interventions and c-sections are resorted to and both mother and baby miss the many benefits of a natural, vaginal birth. And because they are so common, many people forget that a c-section is major abdominal surgery and has risks to the mother and baby. [3, 14, 16, 17]

Specific gentle, chiropractic techniques address intrauterine constraint, with the greatest success rates at turning breech (or other less than optimum lies) babies being had if begun at 30 weeks gestation. After 35 weeks, it becomes more difficult to turn the baby due to a lack of room for the baby to make the move. The two most common techniques that address intrauterine constraint are Webster or Bagnell Chiropractic Techniques. [11, 17, 18]

Chiropractic Hip Capsule/Glut Muscle Release Technique - Elbow contact

According to recent studies, chiropractic care may result in easier pregnancy, including increased comfort during the third trimester and delivery and reduced need for analgesics. In one study, women receiving chiropractic care through their first pregnancy had twenty-four per cent shorter labour times and subjects giving birth for the second or third time reported thirty-nine per cent shorter labour times. In another study, the need for analgesics was reduced by fifty per cent in the patients who had received adjustments. In addition, eighty-four per cent of women report relief of back pain during pregnancy with chiropractic care! And because the sacroiliac joints of the pelvis function better, there is significantly less likelihood of back labour (contractions and sharp pain felt in the lower back/sacral area during labour) when receiving chiropractic care during pregnancy. Chiropractic care has helped new mothers become more comfortable breastfeeding (posture-wise) as well as to produce more milk. [8, 10, 12, 18, 19, 20, 21, 22]

Doctors of chiropractic specifically work with your pelvis, including the muscles and ligaments, throughout pregnancy restoring a state balance and thereby creating an environment for an easier safer birth. Gentle chiropractic adjustments during pregnancy can help relieve many of the physical discomforts caused by the shift in gravity and softening of the ligaments to accommodate your growing belly and in preparation for childbirth. Simply put, chiropractic care may keep your pelvis, spine and supporting muscles more flexible, resulting in an easier pregnancy and thereby alleviating the resulting aches and pains in the lower back, hips, sacroiliac joints, and lower ribs. As discomforts shift to the mid-back and neck during the post-partum period from breastfeeding and carrying a newborn, chiropractic care can also help keep you moving and improve your posture as the ligaments slowly tighten back into place. [3, 4, 10, 11, 12, 18, 19, 20, 21, 22]

Pregnancy chiropractic table modification

Choose a doctor of chiropractic who is experienced in treating pregnant women (you may need to call a few offices in your area to determine this if your primary care giver is unsure). Your chiropractor should be trained in gentle, pregnancy-specific, short-lever, minimal rotation techniques that address intrauterine constraint or foetal mal-positions (e.g. they should be Webster or Bagnell Technique certified) and be able to modify their technique for your comfort (e.g. a table with a drop-away thoraco-lumbar piece, a tilt-up pelvis piece or special pregnancy pillows to accommodate your growing belly). [11, 17, 23, 24]

As your pregnancy advances, some chiropractic techniques will need to be modified for your comfort. Your Chiropractor is aware of this and will make the necessary changes. In particular, special pregnancy pillows and/or tables with drop-away or tilt–up pelvic pieces are used to accommodate your growing belly and breasts. As little force as possible should be used to adjust a pregnant woman due to the Relaxin loosening all the ligaments in the body. In fact, very little force is necessary to accomplish the adjustment for the very same reason! In my opinion, side-lying twisting-type of manual adjustments and long lever lumbar or pelvic manipulation techniques should be avoided in the second and third trimester. Your chiropractor will check for misalignment of the pelvic bones (including the pubis), misalignment of the sacrum and vertebrae, and spasm of the ligaments that support the uterus and help hold the pelvis together. [11, 17, 23, 24]

[1] Foti T, Davids J et al. “A Biomechanical Analysis of Gait During Pregnancy.” The Journal of Bone and Joint Surgery. (2000) Vol 82: 625-632

[2] Collins M. “Pregnancy and Chiropractic.” www.planetchiropractic.com.

[3] Ohm J. “Chiropractic Care in Pregnancy for Safer, Easier Births.” ICPA Newsletter. May/June 2001.

[4] Bagnell KG. “How To Explain Chiropractic Care to the Mother-to-be.” Handout. www.pregnancychiropractic.com

[5] Beingessner M. (2008) Getting Ready for Baby: A Practical Five-Step Guide to Help You Prepare for Labour, Birth and For Life as a Family. Heartlights Publishing: Calgary AB.

[6] www.isischiropractic.co.uk/chiropractic_pregnancy.html

[7] Cunningham FG et al. (1989) ”Dystocia Due to Pelvic Contraction.” Williams Obstetrics, 19th edition.

[8] Alcantara J, Ohm J, Ohm J. “Chiropractic Care of a Patient with Dystocia and Pelvic Subluxation.” Journal of Pediatric, Maternal and Family Health. 2009: (Winter, Issue 1), p1-5.

[9] Towbin A. “Dystocia.” Brain Damage in the Newborn and its Neurologic Sequelle. 1998.

[10] Daly JM, Frame PS, Rapoza PA. “Sacroiliac Subluxation: A Common Treatable Cause of Low Back Pain in Pregnancy.” Fam Prac Res Journal. (1991) 11(2): 149-159.

[11] Bagnell K. (2005). Pre-Natal Chiropractic Care. Instantpublisher.com.

[12] Walters S. “Chiropractic Brings Better Birth Outcomes.” http://www.naturalnews.com/025669.html.

[13] Netter F. (1994) “Pelvic Viscera and Perineum.” Atlas of Human Anatomy.

[14] Gaskin IM. (2003). Ina May’s Guide to Childbirth. Bantam Books: USA.

[15] Hikel K. “The Real Risks for Caesareans: An Expert Interview With Pamela K. Spry, BSN, MS, PhD” www.medscape.com.

[16] Almeida ECS, Nogueira AA et al. “Caesarean Section as a Cause of Chronic Pelvic Pain.” International Journal of Gynaecology. (2002) Vol 79: 101-104.

[17] Ohm, J. “Webster Technique Defined.” ICPA Newsletter.

[18] www.cmaj.ca/content/full/176/4/455; www.icpa4kids.org; www.isischiropractic.co.uk/chiropractic_pregnancy.html.

[19] Berg G, Hammer M et al. “Lower Back Pain During Pregnancy and Labour.” Obstetrics and Gynaecology. (1988) 71: 701-775.

[20] Diakow P, Gladsby T et al. “Back Pain During Pregnancy and Labour.” Journal of Manipulative and Physiological Therapeutics. (1991) 14: 116-118.

[21] Fallon J. “The Effect of Chiropractic Treatment on Pregnancy and Labour: A Comprehensive Study.” Proceedings of the World Federation of Chiropractic. (1991) 24-31.

[22] Wang SM, Dezinno P et al. “Low back pain during pregnancy: prevalence, risk factors, and outcomes.” Obstet Gynecol July 2004;104(1):65-70. Source: www.toyourhealth.com/mpacms/tyh/article.php?id=573

[23] You can find a list of Webster certified practitioners on www.icpa4kids.org.

[24] Rosenberg S. (2008) Natural Pregnancy, Natural Baby – Natural Remedies for Pregnancy, Birth and Post-Partum Discomforts. USA: Xlibris Corp.

[Versions of this article were printed in the Winter 2008 ICPA Pathways Magazine; and January and March 2009 Canadian Chiropractor Magazines]