Since the beginning of osteopathy, gynecology (women's health) has been an elementary part of the osteopathic work. Pregnancy and birth are natural processes, which in certain cases require support. In addition to the support of a gynecologist, a midwife and possibly a doula, osteopathy represents a supplement or extension.
Pregnancy brings physiological and structural changes to the body that affect everyday life (Lavelle 2012). These include weight gain, postural changes, changes in tissue, respiratory function and hormonal balance (Kofler 2003). These adaptations of the body to the new situation may or may not (!) lead to discomfort. Examples of pregnancy-associated complaints are: nausea, vomiting, digestive problems, heartburn, symphysis pain, back pain, sciatica, hip and pelvic pain, bladder dysfunction such as incontinence, headaches and depressive mood (Frawley et al. 2016; Resch 2003).
Gillemont (2003) and Lavelle (2012) mention a variety of applications of osteopathy in pregnancy:
The release of tensions, blockages and adhesions and via these an influence on the uninhibited development of the child.
Preparation of the tissues for the birth process and removal of obstacles in the birth canal for a birth without complaints (shortening of the birth duration, lower risk of birth complications, reduced Caesarean section rate (Lenz 2003)).
Correction of malposition of the baby (if reversible).
Stimulation of blood and lymph flow, e.g., to treat water retention, kidney congestion, and bladder disorders.
Treatment of pain in the head and spine area.
Support of postpartum involution, as well as the treatment of scars (cesarean section, perineal tear or incision).
Improvement of the quality of life.
Study situation: A review (systemic review) published in 2016 by Ruffini et al. summarizes the study results of 24 studies investigating the efficacy of osteopathic treatments in relation to various gynecological complaints. 8 of the studies investigated related to the effect of osteopathic treatments on pregnancy-related factors - quality of life, pain reduction, heart rate variability, and general pregnancy complaints. A positive influence of osteoapthy was found on the following specific target parameters: pain, impairment, and autonomic functions. In addition studies have shown a reduced risk of meconium in the amniotic fluid (an indicator of increased stress in the baby), fewer preterm births, reduced use of forceps, reduced pain and use of medications during labor, lower rates of cesarean section, and perineal tears and incisions. According to the authors, only the effectiveness of back pain in pregnancy has been proven. With regard to other mentioned influences of osteopathy the significance of the studies is not clear (too small number of studies, too small number of subjects, etc.) but with a tendency towards a positive influence. The authors conclude that osteopathy can be used as a useful complement in gynecology and obstetrics.
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I consider pregnancy and birth as natural processes which at some points need special care. Often pregnant women are suggested to be sick, no longer able to perform, no longer usable or the word pregnancy appears as a diagnosis (the determination of an illness). Here I would like to motivate a rethinking and focus on the "natural", the "healthy". At the same time, it is of course important to recognize diseases that occur or persist during pregnancy and to treat them in the best possible way.
Literature:
Frawley, J.; Sundberg, T.; Steel, A.; Sibbritt, D.; Broom, A.; Adams, J. (2015). Therapies Prevalence and characteristics of woman who consult with osteopathic practitioners during pregnancy: a report from the Australian Longitudinal Study on Woman’s health (ALSWH). Journal of Bodywork And Movement 2016 (20), S. 168-172).
Gillemont, B. (2003). Osteopathie in der Schwangerschaft. Deutsche Zeitschrift für Osteopathie 2003 (4). S. 40.
Kendi, L. H.; Buchanan, S.; Brown, K. B.; Rodriguez, M; Cruzer, A. (2015). Pregnancy Research on Osteopathic Manipulation Optimizing Tretment Effects: the PROMOTE study. American Journal of Obstetics & Gynecology 2015 (January), S. 108.e1-108.e9.
Kofler; G. (2003). Osteopathy for Back and Pelvic Pain in Pregnancy. Undergraduate Project for the Diploma of the Wiener Schule für Osteopathie (WSO).
Lavelle, J. M. (2012). Osteopathic Manipulative Treatment in Pregnant Woman. JAOA 112 (6), S. 343-346).
Lenz, D. (2003). Osteopathie in der Schwangerschaft: Profitieren Mutter und Kind? Deutsche Zeitschrift für Osteopathie 2003 (4), S. 9.
Licciardone, J. C.; Buchanan, S.; Kendi, L. H.;King, H. H.; Fulda, K. G.; Stoll, S. T. (2010). Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial. American Journal of Obstetics & Gynecology 2010 (January), S. 43.e1-43.e8.
Mogren, I. M.; Pohjanen, A. I. (2005). Low Back Pain and Pelvic Pain During Pregnancy. Spine 30 (8), S: 983-991.
Resch, K.-H. (2003). Gesundheitsstörungen in der Schwangerschaft: Joker Osteopathie? Deutsche Zeitschrift für Osteopathie 2003 (4), S. 10.
Ruffini, N., D’Alessandro, G., Cardinali, L., Frondaroli, F., Cerritelli, F. (2016). Osteopathic manipulative treatment in gynecology and obstetrics: a systematic review. Complementary Therapies in Medicine 26, S. 72-78.
Photography:
Rebecca Thoma