On November 5, 2018, the Journal of Pediatric, Maternal & Family Health published the results of a case study documenting the successful vaginal birth of twins in a woman undergoing chiropractic care, who had previously had a cesarean birth.
When a woman has had a cesarean birth, the two options for subsequent births include a planned second cesarean birth, or a “VBAC”, which is a vaginal birth after caesarean. The authors of the study acknowledge that there are risks and benefits for both these directions. Cesarean births are more commonly recommended by medical professionals in this case but there are no clear evidence favoring one procedure over the other. In the case of twin births, cesareans are far more common.
Many women desire to have vaginal births after cesarean due to vaginal birth enhancing the health and well-being of the mother and baby, promotion of maternal infant connection and easing the transition to motherhood.
In this case, a 34-year-old woman presented herself for chiropractic care in her 16th week of a pregnancy of twin girls. Her primary complaint was that she was suffering with intermittent left sacroiliac pain, as well as left posterior hip and left buttock pain which had been present for the past three weeks. Overall, the woman rated her pain as a 6 out of 10, with 10 being the worst. Some activities made the pain more pronounced while rest seemed to improve her pain.
A chiropractic examination was performed and revealed postural imbalance as shown using bilateral weight scales. Additionally, visible postural abnormalities were noted in inspection including head tilt, a high shoulder and an increase in the mid back curvature. Spinal palpation noted multiple areas of restriction and positional concerns throughout the woman’s spine. From the examination, it was determined that subluxations were present in her spine.
The patient consented to a course of chiropractic care at the rate of 2 visits per week for an initial period of 8 weeks. This was followed by a weekly visit for the remainder of her pregnancy. After the third visit, the woman reported that she was not having any pain. She commented, “This is the first time in a long while that I haven’t felt the pain every day.” During the remainder of her care she reported only occasional discomfort which eventually disappeared altogether.
At 35 weeks and 5 days, the woman successfully delivered her twin girls vaginally. The babies were born 20 minutes apart and weighed 4 lbs., 13oz. and 4 lbs., 3oz. After being checked out in the neonatal intensive care they were returned to their mother who was told that her new daughters were healthy babies.
In a review of available literature on the subject, the study authors noted that there was not a lot of prior material available. “Despite the limited number of published cases in the care of patients with successful VBAC and/or twin pregnancies, we are of the opinion that literature does not truly reflect what occurs in chiropractic practice.” Submitting this case study for publication was partially to increase the database of cases of vaginal birth after cesarean, (VBAC). The authors concluded, “This case report provides supporting evidence on the benefits of chiropractic care for the pregnant woman with the desire for VBAC.”