From Dr. Verg Chiropractic, Vancouver, WA and Clackamas, OR
I tell my patients this plainly: all pregnant mamas need to get adjusted. Pregnancy puts a growing load on the pelvis, the low back, the ribs and even the neck and hands, and that load needs continued support all the way to delivery.
At Dr. Verg Chiropractic in Vancouver, WA and Clackamas, OR, we see moms at every stage. Some come in at 14 weeks to “keep everything in place” and prepare for birth. Others come at 30 weeks because the pubic bone hurts so much that rolling over in bed is the hardest part of the day. Some come because the baby is not head down. Here is how I think about pregnancy, what I check, how I adjust, and what we have seen happen for our patients.
Quick Answers
- Is it safe? Pregnancy changes how I adjust. Everything is lighter, and nothing presses on the belly.
- Main technique: a very light drop-table adjustment through the pubic bone, plus gentle work on the hips, sacrum and round ligaments.
- Baby not head down? I never flip the baby. We align the pelvis and release the tight side so the baby has more room, and confirm position with your midwife, OB or an ultrasound.
- How often? Usually twice a week for the first few weeks when you are in pain, then weekly until delivery. For prevention, every two weeks in the second trimester and weekly in the third.
- You don’t need to be in pain to come in. A prenatal evaluation is simply good care for your pregnant body.
What pregnancy does to the pelvis and spine
As the belly grows, the pelvis has to keep moving correctly under a load that changes every week. In my office the most common finding is a pubic bone that has shifted forward on one side, usually with the sacrum pulled to one side and tension in the round ligaments. Moms feel this as stabbing pain at the front of the pelvis, pain in one buttock, pain from the groin down to the inner knee when walking, or a pelvis that feels unstable. (If this sounds familiar, read my article on pelvic instability, the commonly missed cause of low back, pelvic and hip pain.)
One side often gets tighter than the other, especially the quadratus lumborum muscle along the side of the low back. When I balance that side, moms sleep more comfortably at night.
Pregnancy also affects areas people do not expect. I see neck compression that causes tingling and numbness in both hands, worse in the morning and at night. I see shoulder and rib tension, jaw tension and teeth grinding, and numbness along the outer thigh. These are all part of the same body adapting to the baby. Shoulder and upper back tension is common too; see our guide to shoulder pain and chiropractic care.
I also tell moms that exercise is good, but tension after a workout means that exercise is hurting you. Heavy squats and hard core work can over-tighten the pelvic floor and the pelvis. Walking, especially on hills and uneven ground, is the best thing for the baby’s development.
What I check at a prenatal exam
A prenatal exam in my office looks at the whole body, not only the low back. I check:
- The pubic bone and pelvis. Is one side of the pubic bone forward? Is the sacrum deviated? Is one leg shorter by a few millimeters to a centimeter and a half? Are the SI joints restricted or too loose?
- The round ligaments. These run from the uterus down toward the groin. When one side is taut, it can pull on the uterus and make the space for the baby uneven.
- The side muscles of the low back. A spasm in one quadratus lumborum is common, and it often matches the side where mom is most uncomfortable.
- The ribs and upper back. A rib can lock, often after a stretch, and feel like a knot that makes it hard to breathe deeply or sleep.
- The neck, shoulders and hands. Neck compression and tight first ribs can cause tingling in the hands during pregnancy.
- The abdominal wall. I check for separation of the abdominal muscles (diastasis recti).
- Balance and hip motion. Hip range of motion, balance on one leg, and how she walks.
I also ask about prior births, how long labor was, whether earlier babies were head down, and what the midwife or OB has said about the baby’s position.
How I adjust during pregnancy
Pregnancy changes how I adjust. Everything is lighter, and nothing presses on the belly. You can read more on our pregnancy adjustment page.
- Drop-table work on the pubic bone. This is my main pregnancy adjustment. I explain it to moms as basically stepping off a curb: a very light drop where the force goes through the pubic bone, not the belly. Most moms tell me it doesn’t feel like it moves the baby or the belly at all.
- Positioning. When mom can’t lie face down, I work with her seated, standing or lying on her side with a pillow between the thighs. When she can lie face down, I set up the table with a belly pillow or a towel under the abdomen.
- Side-posture adjustments only when she is ready. Early on I usually hold off. When I do use one, I ask if she feels tension in the belly. No tension is a good sign. If she feels it, I add padding or skip it.
- No sudden neck twisting. For the neck I use gentle traction, decompression and nerve glides.
- Soft tissue and mobilization. Round ligament release, sacrotuberous ligament and tailbone work, osteopathic mobilization of the hips and pelvis, and rib mobilization with a gentle “hug” adjustment.
In our office we use the Webster technique, Thompson drop technique, Logan basic technique and pelvic-specific techniques. Each one gives us a gentle way to balance the pelvis, the sacrum and the ligaments that support the uterus, without pressure on the belly. I choose among them based on what I find on the exam that day and how far along mom is. For a wider look at what we do, see our chiropractic back adjustments.
It is important to understand what an adjustment does. We’re not moving bones into place. We’re giving an impulse to the brain so the body moves in a more balanced way, left to right. As the belly grows, that helps the body keep the correct movement pattern. As I tell my patients: none of our adjustments ever made us worse.
When the baby is not head down
What I never do is flip the baby. We align the pelvis, and the baby flips on her own.
There are two reasons why babies don’t turn. One is developmental: the baby is still learning which way is up and down. The second is constriction: tightness, tension or torsion of the uterus. That second one is what I help with. Usually a specific muscle or ligament on one side is in spasm, and it makes the space a little smaller on that side. When we release the round ligament, balance the pubic bone and relax the tight side, the baby has more room.
For the developmental side, I teach moms inversion: a supported upside-down position with pillows, working up to one or two minutes. We’re not turning the baby; we’re helping the baby understand what is up and down. The change in gravity is like an exercise for the baby, and the stretch helps untwist the uterus.
We confirm the baby’s position with the midwife, the OB or an ultrasound. Once the baby is head down, I avoid side-posture adjustments so we don’t encourage a re-flip.
One more thing I tell moms: walking up and down curbs to bring on labor warps the pelvis, and I’m not really for it. Walking on hills, trails and uneven ground in a park is much better.
Home care I give expecting moms
What moms do between visits matters as much as the adjustment. These are the things I give most often:
- A pelvic (SI) belt, not a belly band. The pelvic brace goes around the pubic bone and below. It doesn’t go on the back like a back brace, and it sits well below the belly. I prefer it to a belly band so it doesn’t interfere with the baby’s position. Many moms wear it at night and when sitting in the evening.
- Round ligament self-massage. Each morning, gently pull the skin between the belly button and mid-thigh side to side and up and down. It helps with round ligament cramping.
- Inversion. One to two minutes a day, supported by pillows.
- Walking. Walking is the best thing for the baby’s development. I often recommend 30 minutes three days a week and an hour on the other days, on hills and trails when possible.
- Gentle strength and mobility. Clamshells, pelvic tilts, cat-cow, a side stretch for the low back, resisted trunk rotation, and balancing on one leg while brushing teeth.
- Brace your core before you move. Especially when getting out of bed or lifting a toddler.
- A body pillow. Several of my moms had flare-ups after sleeping without their pregnancy pillow or after a long drive.
- Massage. Prenatal massage is fine. People sometimes say to be careful in early pregnancy, but there is no mechanism for massage to cause a problem.
- A pelvic floor specialist when needed. Hard exercise can make the pelvic floor too tight, so I refer moms who need it.
What we have seen in our office
These examples come from our office, described generally with identifying details left out. Individual results vary.
A baby who turned head down in the third trimester
One mom came in during her third trimester to be well adjusted for birth, and her baby was not head down. Her pubic bone was forward on one side, one hip was limited, and the side muscles of her low back were tight. She had also been working out hard and feeling pelvic tension afterward.
We used light drops on the pubic bone and gentle mobilization of the hips and pelvis, twice a week at first. At home she did inversion, a side stretch, and hill and trail walking, and she eased off the heavy workouts. A few weeks later, an ultrasound confirmed the baby was head down. I believe the tightness on one side was part of what held the baby, and focusing on it helped.
Rib pain and “lightning crotch” pain
Another mom came in during her third trimester with a painful locked rib and poor sleep. She couldn’t lie face down, so we treated her seated, standing and on her side with a pillow, and used a pelvic belt as a rib brace. Her pain went from really bad to a lot better in that first visit, and within a few weeks she rarely felt it.
Later she developed sharp “lightning crotch” pain at the pubic bone. After light drop-table adjustments on the pubic bone, the pain was gone right after the visit, and she could walk comfortably again. Her baby was head down, which her midwife confirmed.
Pubic bone pain that made it hard to roll over in bed
A mom around 30 weeks had stabbing pain at the front of the pelvis and in one buttock. Walking, standing and rolling over in bed made it worse, and she wasn’t sleeping. Her pubic bone and sacrum were out of balance. We used a very gentle drop on the pubic bone with work on the hips and pelvis, plus an SI belt and a body pillow. A few weeks later she told me: “I really haven’t had much pain around the pelvis, only two hot spots.”
After a car accident during pregnancy
We have cared for several moms who were hurt in car accidents while pregnant (see also our page on car accident chiropractic care and our article Pregnancy and Car Accidents). One came to us with neck, low back and hip pain. With light pregnancy adjustments, a pelvic brace and massage, by mid-pregnancy she rated herself 95% better and was back to full work. In her third trimester she was still about 90% better and could take a long road trip without pain.
Another mom, injured in her third trimester, struggled to lift her toddler. With gentle adjustments, no pressure on the belly and no neck twisting, she was moving better and carrying her toddler more easily a few weeks before her due date.
Tingling hands early in pregnancy
A mom in her first trimester came in to keep everything in place for birth, and to address tingling in both hands at night and in the morning. Her neck and upper ribs were compressed. With rib adjustments, nerve flossing, gentle neck decompression and a night wrist brace, her numbness steadily improved over the following weeks.
How often, and care after the baby arrives
When a mom comes in with pain, I usually see her twice a week for the first few weeks, then weekly until delivery. For moms who come in early for prevention, visits can be every two weeks in the second trimester and weekly in the third. In the home stretch, some moms come twice a week.
Weekly care prevents a lot of issues and helps the body adjust to the pregnancy and then to the recovery after. Being uncomfortable and sleeping badly is not something you just have to accept because you are pregnant.
Care doesn’t stop at delivery. After a vaginal birth I like to see mom about two weeks later. After birth we check for pelvic instability, separation of the abdominal muscles, and neck and shoulder tension from feeding and carrying the baby. We teach core bracing and use light-force and drop-table techniques. One postpartum mom with mild abdominal separation told us at her next visit that the area hadn’t hurt since. We are also happy to see the baby.
Pelvic and hip pain can also continue after birth; our article on hip pain and non-surgical chiropractic relief explains what we look for.
Frequently Asked Questions
Is chiropractic care safe during pregnancy?
In my office, pregnancy changes how I adjust. Everything is lighter, and nothing presses on the belly. My main adjustment is a very light drop-table adjustment through the pubic bone, and most moms tell me it doesn’t feel like it moves the baby or the belly at all. For the neck I use gentle traction, decompression and nerve glides instead of sudden twisting.
Can a chiropractor help turn a breech baby?
I never flip the baby. We align the pelvis, release a tight round ligament or muscle on one side, and balance the pubic bone so the baby has more room, and the baby flips on her own. I also teach supported inversion with pillows. We confirm the baby’s position with the midwife, the OB or an ultrasound.
What is the Webster technique?
The Webster technique is one of the gentle methods we use, along with the Thompson drop technique, the Logan basic technique and pelvic-specific techniques. Each one helps balance the pelvis, the sacrum and the ligaments that support the uterus without pressure on the belly. I choose among them based on the exam that day and how far along mom is.
How often should I see a chiropractor while pregnant?
If you come in with pain, I usually see you twice a week for the first few weeks, then weekly until delivery. For prevention, visits can be every two weeks in the second trimester and weekly in the third, and some moms come twice a week in the home stretch.
Should I wear a belly band or a pelvic belt?
I prefer a pelvic (SI) belt to a belly band. It goes around the pubic bone and below, well below the belly, so it doesn’t interfere with the baby’s position. Many moms wear it at night and when sitting in the evening.
Schedule a prenatal evaluation
You don’t need to be in pain to come in. Having your spine and pelvis evaluated during pregnancy is simply good care for your pregnant body, the same way you see your midwife or OB for checkups. If you are pregnant, whether you feel great, are uncomfortable, or your baby is not head down yet, call our Vancouver, WA or Clackamas, OR office to schedule a prenatal evaluation. Dr. Verg Chiropractic offers a free consultation for new patients at both locations:
- Vancouver, WA — 109 SE 101st Ave — (360) 203-6000
- Portland / Clackamas, OR — 10001 SE Sunnyside Rd #120 — (503) 386-9819
More articles from Dr. Verg are in our Research Corner.
This article is for general educational purposes and does not replace an individualized medical evaluation. Case examples describe individual patients with identifying details left out; results vary. Please consult Dr. Verg, your midwife, your OB or another qualified healthcare provider about your pregnancy.