By James Dohn, D.C.
I received this call on a late Sunday after noon; "Dr. Dohn, this is Dharma, Sarah’s doula. Sarah is having her baby at home and has been in labor for 20 hours now. She is in a lot of back pain. We realize it is Sunday evening, but she would really like you to consider a house call to see if you can help her." I said, "Sure, I'll be there within 10 minutes"
Because my own daughter was born in a home birth setting 27 years ago, I have an appreciation and knowledge of the pros and cons of natural childbirth. I have also adjusted several mothers at their home births. I know that moms like Sarah, do not want to have any drugs or other unnecessary interventions, if possible, for themselves or their babies. That is why they choose midwives, guardians of the natural process of birth.
As a matter of fact, midwives have been around a lot longer than the AMA, hospitals, law suits and pharmaceuticals. That is because the miracle of birth is a universal God given gift of life that usually happens all by itself. Our bodies do not need manuals or licenses or insurance to know what to do.
However, our bodies do need assistance sometimes in allowing the natural functions to take place. Interruptions in the progress of normal labor should be addressed and fixed as soon as possible to prevent further delay in progress and maternal exhaustion. Midwives and Chiropractors share the same ideological goal of assisting the body to do what it does best in the most proficient manner possible for that individual.
Midwives are the masters of patience; they do not live in the hurry up world of assembly line hospital practices that put time limits on birth; all in an attempt to get the most money for the least amount of time. They are skilled at recognizing the true barriers to labor progress, those that are physical, mental, and emotional. They have accumulated generations of knowledge to avoid dangerous, expensive drugs, trauma-inducing interventions and surgical procedures.
Midwives are licensed and are more than careful in looking for complications that would require modern hospital intervention. Anne Sommers, L.M., Sarah’s midwife, for example, has attended hundreds of home births; and no one has ever died or been crippled. Though complications can happen, when they do, Anne has a responsible, medical intercession plan for handling them. Today, when I arrive at Sarah’s home, I notice that Anne has a complete home birth kit with fetal heart rate monitor (Doppler), resuscitation equipment, oxygen, and other necessary medical instruments. She has a selection of medications to control hemorrhage, there if needed, but only as a last resort.
At Sarah’s home birth, "Natural as possible" is the intention; hence the request for the chiropractor first - for Sarah's back pain.
Sarah, a 27 year old dance teacher and student, is in the process of giving birth to her and her partner Brian’s first child; having done everything in her power to ensure a healthy birth and life for her baby. Brian is a musician and teacher; the room is filled with drums, guitars, saxophones and other various musical instruments. The couple is dedicated to a vegetarian lifestyle and their home beautifully reflects their cultural and spiritual beliefs.
Sarah’s upstairs, one bedroom apartment is busy with birth activity. In the living room sets a large, portable, blue plastic hot tub filled with warm water for an underwater birth. Sarah chooses to labor and possibly give birth in the tub. Her baby has been developing in his Mama's warm, fluid-filled body for nine months now and the welcome to a warm water environment will be comforting to Mama and baby both.
When I walk in to the bedroom, I see Sarah curled up on her bed, next to a beautiful new bassinet filled with blankets and soft toys for the newborn. There is not much room with all the extra furniture for baby. It is 5:40 PM Sunday evening.
Anne tells me that the labor began Sat at 9:30 PM and continued, steadily progressing until about an hour ago when the contractions began to space further apart. The back pain began to build.
According to Anne, Sarah’s labor had reached a plateau where dilation was not progressing. Her cervix remained at 7 cm. for the last few hours. Though Sarah was spending a lot of time in the bathroom, laboring in and out of the tub, changing positions frequently, the baby’s head was in a right occipital position, with a slight acynclitism (head tilted to one side).
This fetal misalignment interfered with the descent of the baby’s head. Sarah could not feel her contractions in the front of her abdomen but only in her back, which is common with this position. Sarah felt like she had a brick pressing against her tailbone.
After I wash my hands I go in to see Sarah. "Hi Sarah. Doesn't look like much fun right now. Tell me exactly where the pain seems focused to you now. And can you change positions to feel better?"
Sarah replies, "Hi Dr. Jim. It hurts right along the low back, all over." (She points to her sacrum, tail bone, and indicate the pain as going to either side equally).
I have examined and worked with Sarah in my office previously so I am familiar with her specifically unique spinal curves and conditions. I have her roll onto her side with a pillow under her head, a pillow between her knees and a pillow to hug. Based on my examination and her description of the pain pattern, I begin a gentle massage of her sacro-iliac joints and of her lumbo sacral fascia. She moans approvingly so I continue and she reports the pain being relieved.
Her contractions are still stopped for now. I then palpate her sacrum and coccyx and feel the fixation of the sacral ligament. I then take a sacral-tuberosity ligament contact. This is gentle, steady thumb pressure superior, posterior and lateral. This is known as Logan Basic Chiropractic Technique and is widely taught at Chiropractic Colleges. The gentle pressure, held for a minute or more, has a relaxing effect on the lumbar spine and the pelvic floor. As I hold this contact I can feel the release and the baby beginning to move.
Anne checks the baby’s heart rate and says it is normal and healthy. Sarah reports the contractions are beginning again. I have Sarah roll over on her other side and take a sacral-tuberous contact on the other side. The baby is very active at this point. I release the contact and Anne takes over to supervise the contractions and measure for cervical dilation. The contractions are regular and progress is being made. Sarah notices that she is feeling the contractions in the front. I need to go home for a time so I assure them that I will return in 90 minutes and leave.
When I return, Anne tells me that Sarah’s contractions continued for an hour after I left and now have diminished - Sarah was again in back pain. I have Sarah get into the side lying position and again take the sacral-tuberosity ligament contact. I hold this contact gently for about one minute on both sides.
I left the bedroom and decided to wait in the living room. Sarah’s labor progressed significantly. Ten minutes later she gave birth to bouncing, happy, healthy baby boy whose Apgar score was 10/10. Everyone is joyously happy.
I was called in by a Licensed Midwife to deal with a laboring mother’s back pain that was successfully treated by the sacral tuberosity ligament adjustment. Wouldn’t it be wonderful if Chiropractors could be present at every birth no matter where they occur?