Our editor joined in conversation with Dr. Jenny Stofer, a holistic Chiropractor in Los Angeles, specializing in comprehensive support for women’s health, including the full spectrum of fertility, pregnancy, postpartum and pediatrics. Dr. Stofer shared why she believes postpartum pelvic therapy is necessary for all women, no matter what type of labor they experienced. She also revealed that some women shockingly suffer for decades from pelvic issues after childbirth—and holistic advice for how you can avoid them.
LHM
What are the benefits of chiropractic care during pregnancy?
JS
Prenatal chiropractic care is most commonly sought for issues such as low back pain, sciatica, symphysis pubis dysfunction (a.k.a. lightning crotch), and upper back pain—all of which can be caused by misalignment of the spine. The hormone relaxin loosens the ligaments, in order to make room for your growing baby and assists with labor, which makes it very common to experience misalignment during pregnancy. Chiropractic alignment can also help turn the baby into the optimal head-down position. This is called the Webster Technique and is a successful, non-invasive protocol used to allow breech position babies to turn by optimizing the space and mobility of the mother’s pelvis. Another advantage of consistent chiropractic tune-up as your body changes throughout the trimesters sets you up for a quicker labor, and helps in postpartum healing. It helps mamas feel more connected to their bodies throughout every stage of pregnancy. As chiropractic adjustments help regulate the nervous system through the spinal cord, women feel more relaxed as the benefits of healing touch are deeply restorative. “Mothering the mother” is a huge part of this care as mamas need to be seen and heard while they navigate the challenges during all stages of their pregnancy and postpartum healing.
LHM
At what point should women seek chiropractic care during pregnancy?
JS
Ideally, a woman should be seen throughout her entire pregnancy. There is a surprising amount of relaxin hormone at the beginning of pregnancy, and the growth process dynamically changes week to week. During the second trimester, we taper down a bit, to every other week or so, since there are less changes occurring. Though, if you have discomfort or pain, it is best to address the issue right away as it usually becomes more severe as you and your baby grow. It can be more challenging to resolve pain issues if addressed late in pregnancy. That said, if you are going to pick a certain window, the last trimester is typically the most helpful since at that point, simply standing can feel like a workout. Most insurance plans cover several visits per year, and usually even some portion of out-of-network care.
LHM
How can a woman properly plan for postpartum care?
JS
It’s great to have a plan—or a readily-available list of care providers who can possibly do home visits as needed. This list should include a chiropractor, pelvic floor PT, a doula, a lactation consultant, a therapist, and a massage therapist, to name a few. The postpartum period requires so much support and care to help a woman heal and care for herself, and it’s much easier to make a plan for who to call beforehand, rather than trying to figure it out with a sweet newborn in your arms. In most cases, you don’t need to wait until your 6-8 week OB check-up to receive care if something urgent crops up. Pain or discomfort beyond the norm of postpartum healing can go unrecognized or ignored for the first few weeks or mislabeled as “normal”—but in fact isn’t. It’s important to find a practitioner who specializes in the postpartum period, as they know how to best help mama with an appropriately gentle healing session. It truly takes a village, and when we prepare for the postpartum period as much as the birth, we feel supported and are set up for success.
LHM
If a woman were to experience a healthy pregnancy and relatively easy labor, could she still benefit from postpartum pelvic care?
JS
Absolutely. 90% of vaginal births result with some amount of scar tissue. Taking care of our pelvis postpartum can help speed up the healing process and avoid aches and pains down the road when our baby is much heavier and harder on the body—especially when there is an underlying issue. The beautiful way our pelvis accommodates birthing a baby results in an amazing amount of movement, and getting checked postpartum is a lot like scheduling rehab or therapy after a surgery. Why should postpartum women not take care of themselves the same way? In regards to our womb, scar tissue can lead to other issues such as possible difficulties with subsequent pregnancies, incontinence, painful periods, ovulation, and more. Getting manual therapy to your pelvic floor can greatly help you feel more comfort and function in your postpartum body. Mercier Therapy is something I recommend and provide, that brings blood flow and mobility to the womb to heal tight tissue and scar tissue. It helps women reconnect with their pelvis after giving birth, and is especially helpful after a Cesarean birth, as there is quite a bit of scar tissue at the site of the scar and layers beneath that can tug on other tissues. Pelvic floor PT differs as it includes external and internal work and covers more complicated issues like prolapse, incontinence, and other issues. So many women don’t even know that these modalities are available, and that postpartum discomfort that lasts months and months is anything but “normal”. Our bodies deserve better!
LHM
What problems can arise if pelvic care is unaddressed during the postpartum window?
JS
If a woman needs care, the sooner, the better—but it’s never too late. If we can tune into our bodies and our intuition about what we are feeling and what needs attention, that’s usually enough. A woman’s intuition is powerful. Sometimes it’s not urgent and what we need most postpartum is to rest. It sounds simple, but rest seems to be very elusive in our culture, and unfortunately that’s especially true after birth. But the more rest we get, the quicker we heal. Many other cultures acknowledge this need to heal during the fourth trimester and have strict rules about not leaving the house and everyone feeding and taking care of the new mother. The better we can cope with the postpartum hormonal roller coaster and tune into our baby’s needs, the better things go. Sometimes in the postpartum period, women are unfamiliar with their own needs—all the focus is on the baby, or there may have been some birth trauma, or they might be dealing with postpartum depression—which makes it hard to know to ask for help, especially when isolated. This is where our village kicks in, it is how we feel seen and heard as our people can help us reflect how we are doing. And since it can be difficult for new moms to see they have a need, a partner, or a person close to the mama, should keep a list of resources and know how to reach out as well.
LHM
So it’s never too late to address those issues?
JS
Never. There are women who go for decades, denying their body care, and just dealing with their issues by simply adapting to them. It’s so powerful to witness someone’s chronic pain disappearing—to see them realize they could actually feel that much better. There’s an awareness that develops, and we learn that if we take care of ourselves, we are exponentially better at taking care of the people in our lives. And, we teach our children self-care by showing them that we know it’s important to take care of ourselves.
LHM
How can a new mom find time for her own self-care, amongst the pressures of caring for her new baby, especially during a global pandemic?
JS
This is such a hard time to be postpartum. It’s hard even without a pandemic. Though we are living in a state of chaos, experiencing a lot of emotions, including fear and loss, there is still some joy. I’m finding that even in this strange human condition, it is amazing to witness right now that there are still strong mamas digging deep and birthing these amazing babies. There is still newborn bliss, even though it’s a strange beginning. What we need right now—and always—is an extra layer of help and protection for these mamas. We need to mother these mothers and offer help, however we can right now. Limiting exposure to uncontrolled news, social media and anything that we know are triggers to experiencing more intense feelings can also help. Finding joy in small rituals, like a lactation tea, relaxing essential oils, neck and foot rubs, soaking in magnesium baths, really any bathroom time alone! Whatever be her pleasure, and we shouldn’t wait for her to ask, just provide the time for her to connect with herself as a newborn mother.