The Webster Technique: A Chiropractic Technique To Turn Breech Babies
Approximately 4% of all pregnancies result in a breech presentation. Most babies are in a head down or vertex position by the mothers 34th week of pregnancy. Breech presentation is that where the fetus is in a head up position. Although spontaneous conversion from head up to head down can occur before 34 weeks of gestation, few will do so after 34 weeks. Breech presentation past the 34th week of pregnancy is one of the most common reasons for scheduled c-sections deliveries.
The importance of preventing these subsequent cesarean section deliveries is important considering current statistics. In the US in 1965 when c-section rates were first recorded we were delivering 4.5% of our babies through this surgical intervention. The rate has increased annually. The rates for 2007 are now topping 33%! Nearly 13% of these c-sections are being performed because of the breech presentation. In 1985 the World Health Organization (WHO) proposed 15% as the highest acceptable limit for cesarean section rates. This figure was based on the cesarean section rates of countries with the lowest perinatal mortality rates. The US is falling well short of these limits.
The Webster technique was developed by the late Dr. Larry Webster, D.C. Dr. Webster was the founder of what is today known as the International Chiropractic Pediatric Association (ICPA). Dr. Webster developed the technique that now bears his name in an effort to address what he called “intrauterine constraint”. By reducing the stresses being applied to the mother’s uterus, the baby would be given more room to move into the proper head down position on his own. This approach has proven to be much less traumatic than the obstetric approach, known as external cephalic version, and much more effective as well.
Intrauterine constraint is the result of abnormal forces and stresses being applied to the uterus. Some basic anatomy of the female pelvis is required to understand this concept. The pelvic basin consists of the left and right inominate bones (the large hip bones) and the sacrum (tailbone). The uterus is held in place within the pelvic basin by 2 primary sets of ligaments, the broad ligaments, and the round ligaments. These ligaments connect the uterus to the abdominal wall and the sacrum. When the sacrum is misaligned within the pelvic basin it can pull on these ligaments in an unequal fashion which contributes to distortion in the position of the uterus within the pelvis. This distortion is what causes intrauterine constraint. The uterus can be twisted which reduces the internal space for the developing fetus to move around in. If the fetus can’t move freely during the mother’s 34th week of pregnancy, they may not be able to get into the head down position on their own resulting in the breech presentation.
The Webster technique consists of chiropractic evaluation of the sacrum and it’s alignment within the pelvis. Adjustments are performed to put the sacrum back into the correct alignment. Massage and stretching of the attachment points of the uterine ligaments on the abdominal wall is also performed. This specific combination of adjustments and soft tissue work serve to normalize the tension of the uterine ligaments on the uterus itself and result in the reduction of intrauterine constraint. With normal tension on the uterus and more room within, the fetus can position itself where it already knows it needs to be, head down. The most current published research on the effectiveness of the Webster technique demonstrates an 82% success rate.