Why Osteopathic Manipulative Medicine is Helpful During Pregnancy

Physiological Changes During Pregnancy

Hormonal Changes:

• Relaxin: Starts to be released 10^th-12^th week and causes laxity within the SI joints and pubic symphysis.

• Progesterone: Increased levels during pregnancy cause increases in fluid retention.

Hemodynamic Changes:

• Increased Cardiac Output

• Sodium Retention

• Water Retention

• Expansion in blood volume

• Reduction in Systemic Vascular Resistance

• Decrease in Venous and Lymphatic Return

*These changes begin early in pregnancy, reach their peak during second trimester and remain relatively constant until delivery.

Structural Changes:

• Anterior or forward tilting of the pelvis.

• Increased lumbar lordosis – thoracic kyphosis – cervical lordosis – cranio-sacral strains.

• Postural stresses shift from ligamentous and disk-oriented balance TO strenuous muscle-controlled balance and continued distension of the abdomen decreases the muscular capacity to counterbalance.

• Muscles get stretched beyond their capacity to contract efficiently.

All of these physiologic changes put stress on:

1. Transitional levels of the spine: C/T, T/L and L/S junctions.

2. Iliopsoas muscle: very important in lumbar column support, is a prime mover of L/S junction and can strongly influence sacral motion.

3. Sympathetic (T10-L2 innervation to the pelvis) and Parasympathetic Nervous (S2-S4 innervation to pelvic structures through pelvic splanchnic nerve) System

4. Respiratory and Circulatory function: Diaphragm/Rib restriction, Constipation, Edema, Varicosities, Cramps, Back/Pelvis/Hip pain.