Simply put, dystocia means “difficult labor.” The term is a Latin interpretation of Greek root words, dys- meaning “difficult” and -tocia meaning “birth.” Dystocia can be defined as “stalled labor” as well. Labor usually involves a sequence of normal physiological developments that prep the mother and fetus for the “crowning event” of delivery. Any event that can stall delivery or cause it to become difficult, is often labeled as dystocia.
There are 3 primary reasons, or causes, for dystocia to occur that are outlined in Williams Obstetrics. Although the causes of dystocia are defined, it is a very complex condition that can be highly subjective, especially in ascertaining a diagnosis. Williams Obstetrics implores that it would be more “prudent to attempt a better understanding of normal labor in order to determine departures from normal.”
The 3 causes of dystocia are (1) abnormalities of the expulsive forces, (2) abnormalities of the maternal bony pelvis and (3) abnormalities of fetal development, position and/or presentation. These causes can be abbreviated into a shorthand interpretation of “Power (1), Passage (2) and Passenger (3).” Let’s further investigate each cause.
Abnormalities of the expulsive forces:
Insufficient uterine contractions, incoordination of cervical dilation or inadequate muscle volition during the second stage of labor are all examples of abnormalities in the expulsive forces. The “Power” behind the labor is stalled or has become difficult.
The uterus is a muscle. And like all muscles, the function of that muscle is dependent on nerve innervation. If there is a disruption to the nerves that innervate the uterine muscle, its function can become insufficient. A vertebral subluxation can disrupt nerve function. This insufficiency can have a secondary effect on cervical dilation. Without proper uterine contraction and strength, the timing of the normal labor process can falter. This often stops cervical dilation.
The cascade of these ill-effects can deplete the energy reserves of the pregnant mother, making it more difficult for her to contract voluntarily along with the lacking involuntary uterus muscle.
Abnormalities of the maternal bony pelvis:
A contracted pelvis can lead to structural abnormalities of the mother’s pelvis. A contracted pelvis can reduce the diameter of the pelvic outlet. The diameter is further decreased in size with a misalignment of the sacrum.
A displaced or misaligned sacrum can effect the overall pelvic alignment and diameter of the pelvic outlet. The “Passage” way that the baby travels becomes abnormal.
Abnormalities of fetal development, position and/or presentation:
Imbalances in the pelvic region create increased tension on the surrounding muscles and ligaments that attach to the sacrum, uterus and other important structures of the female reproductive area.
This abnormal internal environmental setting can effect how the growing fetus is able to position itself in the womb. The fetus will position itself in a place of least resistance, away from any indication of muscle or ligament constraint.
The two major ligaments involved in this constraint is the round and uterosacral ligaments. What is unique about these ligaments is that they also contain muscle fibers. The Round ligament attaches from the anterior uterus to the pubic bone and the uterosacral ligament attaches from the posterior uterus to the sacrum.
With the added restriction in the inferior areas of the uterus and pelvis due to any abnormal bony pelvic biomechanics, the fetus, or the “Passenger”, has a harder time finding the normal head-down position. This leads to a higher prevalence of breech positions.
If there is a misalignment of the sacrum and/or pelvis, this can put added tension on the muscles and ligaments that attach to those bones, especially the round and uterosacral ligaments.
Role of Chiropractic
Looking at the reasons collectively, they are all centered around some type of “abnormality” in structure and/or function. Abnormality is a “deviation from the normal.” What is considered normal in the case of labor? Healthy labor. All we want to do as Chiropractors is to promote healthy labor.
In Chiropractic, there is a wide array of techniques and approaches to adjusting vertebral subluxations and correcting misalignments catered to unique populations, such as pregnant women, children and adults.
One technique, in particular, has shown to have a great positive influence on pregnant women. That is the Webster technique. The Webster technique concentrates on the sacral misalignment and subsequent pelvic biomechanics and female ligamentous integrity.
The aim of the Webster technique is to reduce the aberrant sacral misalignment. The result of this correction helps improve the Nerve and biomechanical function of the pelvis overall. Nerve system stress is reduced to enhance muscle function, pelvic balance is optimized and normal tone is restored to the ligaments.
The Webster technique is a specific Chiropractic analysis and correction. The purpose of the correction is to reduce the effects of a sacral misalignment. In so doing, nerve and biomechanical function in the pelvis are improved.
Chiropractic care does not aim to treat the effects of these dystocia causes. The intention of Chiropractic is to aid the body naturally. A vertebral subluxation can contribute to each one of the 3 causes in a negative way. By reducing the presence of a vertebral subluxation, the body has a better chance to operate at a greater potential and closer to its normal functional capability.
Jarek Esarco, DC, CACCP is a pediatric, family wellness and upper cervical specific Chiropractor. He is an active member of the International Chiropractic Pediatric Association (ICPA). Dr. Jarek has postgraduate certification in Pediatric Chiropractic through the ICPA. Dr. Jarek also has postgraduate certification in the HIO Specific Brain Stem technique through The TIC Institute. Dr. Jarek is happily married to his wife Regina. They live in Youngstown, Ohio with their daughter Ruby.
