Is chiropractic care safe during pregnancy?

What does the evidence say about chiropractic care during pregnancy?

1. In a prospective cohort of 115 pregnant patients with low back or pelvic pain receiving chiropractic care, improvement climbed from 52% at one week to 85% at three months and 88% at one year, with significant pain-score reductions at every follow-up. 1
2. A critical review of the literature found only a handful of reported adverse events tied to spinal manipulation during pregnancy and postpartum, mostly serious complications like fracture, stroke, or epidural hematoma linked specifically to cervical (neck) manipulation rather than lower-back techniques. 2
3. The same review flags pregnancy-specific factors clinicians should weigh before manipulation, including a higher clotting risk (prothrombotic state) and increased joint laxity from the hormone relaxin, and recommends an informed-consent conversation about neurovascular risk for higher-risk patients. 2
4. In interviews, chiropractors who care for pregnant patients described specific safety modifications: avoiding electrical stimulation modalities, some avoiding manipulation altogether in the first trimester, and adapting positioning with pregnancy pillows as pregnancy progresses. 3
5. A 2018 quality-of-life study of 343 pregnant patients under chiropractic care found significant improvements in fatigue, pain interference, and sleep disturbance, but the authors note that prior systematic reviews rate the overall evidence for chiropractic in pregnancy as only low-to-moderate quality, with a randomized trial still needed. 4

Is chiropractic care safe in each trimester?

• First trimester. Some chiropractors choose to avoid spinal manipulation in the first trimester as an extra precaution, even though the reviewed case reports of harm are rare and not specific to early pregnancy.
• Second trimester. As the pregnancy hormone relaxin loosens ligaments, chiropractors typically adjust technique and force, and the tables and positioning are modified with pillows or side-lying setups as the belly grows.
• Third trimester. This is when many chiropractors who work with pregnant patients use the Webster technique, aimed at pelvic balance, which some practitioners associate with breech babies turning, though this specific claim has not been tested in a randomized trial.