Chiropractic Care During Pregnancy: A Complete Guide

Pregnancy changes everything about your body. That’s not a poetic statement — it’s a biomechanical reality. Over nine months, your centre of gravity shifts forward, your ligaments loosen under the influence of relaxin, your pelvis widens, and your spine adapts to carrying weight it wasn’t carrying before. Most women experience some degree of back pain, pelvic discomfort, or postural strain during pregnancy. A Cochrane review puts it at more than two-thirds of pregnant women experiencing low back pain and almost one-fifth experiencing pelvic pain, with both tending to increase as pregnancy progresses.¹

So it makes sense that pregnant women look for relief. And increasingly, they’re looking at chiropractic care. But the question isn’t just “does it help?” — it’s “is it safe?”, “what does it actually involve?”, and “how do I find someone who knows what they’re doing with a pregnant patient?”

Let’s work through this properly.

Important: This article is general health information, not medical advice. Always consult your midwife, obstetrician, or GP before starting any new treatment during pregnancy. If you’re experiencing severe pain, bleeding, contractions, or any symptoms that concern you, seek immediate medical attention.

Why pregnancy creates so much musculoskeletal pain

To understand why chiropractic care can be relevant during pregnancy, you need to understand what’s actually happening to the body. It’s not just about carrying extra weight — although that’s part of it.

The relaxin factor. From early in pregnancy, your body produces increased levels of the hormone relaxin. Its job is to loosen the ligaments in your pelvis to prepare for birth. The problem is that relaxin doesn’t just target the pelvis — it affects ligaments throughout the body. Your joints become more mobile, which sounds like it should feel good, but actually makes them less stable. Your spine, sacroiliac joints, and pelvis all become more susceptible to misalignment and strain because the structures that normally hold them in place are softer than usual.

Centre of gravity shift. As the baby grows, your centre of gravity moves forward. Your body compensates by increasing the curve in your lower back (lumbar lordosis), which puts more compression on the facet joints of the lumbar spine. Your upper back rounds more to counterbalance. Your neck tilts forward. The whole chain adapts, and every link in that chain is a potential source of discomfort.

Weight distribution. Over the course of pregnancy, the recommended weight gain for a woman who started at a healthy weight is 11.5 to 16 kilograms.² That weight is concentrated in the front of the body, which loads the spine asymmetrically. The muscles of the lower back and pelvis have to work harder to maintain posture, and they fatigue faster.

Pelvic changes. The sacroiliac joints — where your spine meets your pelvis — take an enormous amount of strain during pregnancy. These joints aren’t designed for a lot of movement, but relaxin loosens them, the growing uterus puts pressure on them from the front, and the shifting centre of gravity loads them differently. SI joint pain is one of the most common pregnancy complaints, and it can be genuinely debilitating.

All of this adds up to a body that’s under significant mechanical stress, with reduced joint stability, altered posture, and limited options for pain relief. You can’t take most anti-inflammatory medications during pregnancy. Your exercise options change. You can’t sleep in your usual positions. It’s not surprising that manual therapy becomes an appealing option.

What prenatal chiropractic care actually involves

If you’ve never been to a chiropractor while pregnant, you might picture someone cracking your back while you lie face-down. That’s not how it works. Prenatal chiropractic care is modified significantly from standard chiropractic treatment.

Modified positioning. You won’t be lying flat on your stomach. Prenatal chiropractors use special tables with drop-away sections or cushioning systems that accommodate a pregnant belly. Some use pregnancy pillows or bolsters. Others work with you lying on your side. The point is that there’s no pressure on the abdomen at any stage.

Gentler techniques. The adjustments used during pregnancy tend to be lower-force than standard chiropractic techniques. Many prenatal chiropractors favour drop-piece tables (where a section of the table drops slightly during the adjustment, reducing the force needed), activator instruments (a small spring-loaded device that delivers a precise, low-force impulse), or gentle mobilisation techniques. High-velocity thrusts to the lower back aren’t typically used in late pregnancy.

Pelvic focus. A lot of prenatal chiropractic work centres on the pelvis and sacroiliac joints. This is where most of the mechanical dysfunction occurs during pregnancy, and it’s where treatment can make the most practical difference. Techniques like the Webster Technique (more on that shortly) are specifically designed for pelvic balance during pregnancy.

Soft tissue work. Many prenatal chiropractors incorporate soft tissue techniques — gentle muscle release, trigger point work, and stretching — particularly for the muscles of the lower back, hips, and glutes that are working overtime to stabilise a changing pelvis.

Exercise and ergonomic advice. This is an underrated part of good prenatal chiropractic care. A chiropractor who works with pregnant patients should be giving you practical advice on sleeping positions, sitting posture, how to get in and out of bed, and appropriate exercises to maintain pelvic stability. If you’re only getting adjusted and sent home without any self-management strategies, you’re missing half the value.

The Webster Technique — what it is and what it isn’t

You’ll see the Webster Technique mentioned a lot in the context of prenatal chiropractic, and there’s a fair amount of confusion about what it actually does.

The Webster Technique is a specific chiropractic analysis and adjustment of the sacrum (the triangular bone at the base of the spine, between the two halves of the pelvis). It was developed by Dr. Larry Webster and is taught by the International Chiropractic Pediatric Association (ICPA). The technique aims to restore proper biomechanical function of the sacrum and pelvis, reducing tension in the surrounding muscles and ligaments.

Here’s where it gets complicated. The Webster Technique has become widely associated with turning breech babies, and you’ll find no shortage of chiropractors marketing it for that purpose. But that framing is misleading.

The technique doesn’t turn the baby. It addresses the mother’s pelvic biomechanics. The theory is that if the pelvis is properly balanced and the ligaments supporting the uterus (particularly the round ligaments) aren’t under asymmetric tension, the baby has more room to move into the optimal head-down position on its own. It’s creating the conditions for the baby to turn, not physically turning the baby.

Does it work? The evidence is thin. What exists is mostly case reports and practitioner surveys. The most-cited paper is a 2002 survey of ICPA members in which the responding chiropractors reported high rates of breech resolution, but only 11% of surveyed members provided usable data, the outcomes were reported by the practitioners themselves, and there was no comparison group.³ We don’t have randomised controlled trials showing that the Webster Technique reduces breech presentation, so there is no reliable evidence that it turns breech babies. A practitioner who tells you the Webster Technique will definitely turn your breech baby is overstating the evidence. One who says it may help optimise pelvic balance, which could create a more favourable environment for the baby to turn, is being more honest.

If your baby is breech, discuss all your options with your obstetrician or midwife. External cephalic version (ECV), performed by an obstetrician, is the evidence-based medical approach for turning breech babies: a Cochrane review of randomised trials found that attempting ECV at term reduces the chance of the baby still being breech at birth and of a caesarean section.⁴ Chiropractic care might complement this, but it shouldn’t replace the conversation with your maternity care provider.

Is chiropractic safe during pregnancy?

This is the question most pregnant women want answered first, and rightfully so.

The short answer is that serious harm appears to be uncommon, but the evidence has gaps. A 2012 review found only a few reported cases of adverse events after spinal manipulation during pregnancy or the postpartum period — mostly after neck manipulation — and none linked specifically to the pregnancy itself, such as premature delivery.⁵ A 2023 review cautioned that adverse events in studies of pregnant patients are reported too inconsistently to estimate the actual level of risk.⁶ Low-force, pregnancy-modified care from a practitioner experienced with pregnant patients is the sensible way to approach it.

All practising chiropractors in Australia must be registered with the Chiropractic Board of Australia through Ahpra, which works to ensure chiropractors are suitably trained, qualified and safe to practise.⁷ However — and this is an important caveat — not all chiropractors have the same level of experience or additional training in prenatal care. Just as you’d look for a physiotherapist with sports injury experience for a sports injury, you should look for a chiropractor with specific prenatal training and experience for pregnancy-related care.

When chiropractic should be avoided or modified during pregnancy:

• If you have vaginal bleeding or placenta previa
• If you have ectopic pregnancy
• If you have toxaemia or pre-eclampsia
• If you’re at risk of premature labour
• If you have any condition your obstetrician or midwife considers a contraindication to manual therapy

Always tell your chiropractor you’re pregnant, even in early pregnancy when it might not be visible. And always let your maternity care provider know you’re seeing a chiropractor. Good practitioners communicate across disciplines — that’s how safe, coordinated care works.

What does the evidence actually say?

Let’s be honest about the state of the research, because this is an area where enthusiasm sometimes outpaces evidence.

The evidence for chiropractic care during pregnancy is promising but not definitive. A 2008 systematic review found six studies of chiropractic care for pregnancy-related low back pain; all reported improvement, but none had randomisation or a control group, so the authors could not make a definitive statement about whether the care itself was responsible.⁸ A 2009 study in the Journal of Manipulative and Physiological Therapeutics followed 115 women with pregnancy-related lumbopelvic pain treated by a chiropractor and physiotherapist team: of the 78 with end-of-treatment data, 73% rated their improvement as “excellent” or “good”, and 67% had a clinically significant improvement in pain. The authors noted that without a control group they could not separate the effect of treatment from natural recovery.⁹ A 2020 systematic review rated the evidence for chiropractic care in pregnancy-related low back pain as inconclusive but favourable, and for spinal manipulation as inconclusive.¹⁰ The Cochrane review found low-quality evidence that a multi-modal approach (manual therapy, exercise and education) reduced pain and disability.¹

However, many of these studies are small, lack control groups, or rely on self-reported outcomes. We don’t have the same depth of randomised controlled trial evidence that exists for, say, exercise during pregnancy — and even there, the Cochrane review rated much of the evidence as low quality.¹ That doesn’t mean chiropractic doesn’t work — absence of evidence isn’t evidence of absence — but it means we should be measured in our claims.

What we can say with reasonable confidence is:

• Pregnant women receiving chiropractic care commonly report less pain, although the studies lack control groups⁸⁹
• Published reports of serious adverse events after spinal manipulation in pregnancy are few, though reporting is inconsistent⁵⁶
• Patients in observational studies tend to rate their improvement well⁹
• A combination of manual therapy, exercise and education has some (low-quality) evidence behind it, and exercise on its own is one of the better-studied options¹

What we can’t say definitively is that chiropractic care reduces labour time, prevents complications, or improves birth outcomes. Some chiropractors make these claims, but the evidence to support them is anecdotal or based on very small studies.

When prenatal chiropractic care works best

Based on the available evidence and clinical experience, chiropractic care during pregnancy tends to be most helpful for:

Low back pain. This is the most common reason pregnant women seek chiropractic care, and it’s where the evidence is strongest — though a 2020 systematic review still rated it as inconclusive.¹⁰ The combination of spinal adjustments, pelvic work, and exercise advice can meaningfully reduce pregnancy-related low back pain for many women.

Sacroiliac joint dysfunction. That deep, one-sided pain in your lower back or buttock that gets worse when you walk, climb stairs, or roll over in bed. Some women find targeted chiropractic work helpful here, particularly when combined with stabilisation exercises and support belt recommendations, although trial evidence for chiropractic care in pregnancy-related pelvic girdle pain is limited.¹⁰

Round ligament pain. That sharp, grabbing pain in the lower abdomen or groin that catches you when you move suddenly. This is a normal part of pregnancy. Some women report that chiropractic care focused on pelvic balance eases it, but this hasn’t been tested in trials.

Pubic symphysis pain (SPD). Pain at the front of the pelvis where the two halves meet. This can be intensely uncomfortable, especially in the third trimester. Gentle chiropractic work to the pelvis, combined with activity modification advice, can help manage this.

General postural discomfort. The mid-back stiffness, neck tension, and shoulder tightness that come from a changing centre of gravity and the general physical demands of growing a human being.

When it doesn’t help — and what to do instead

Chiropractic care isn’t a universal solution for every pregnancy discomfort. There are situations where other approaches are more appropriate.

Severe pelvic girdle pain that’s limiting mobility. If you can barely walk, chiropractic care alone may not be enough. You may need a referral to a women’s health physiotherapist who can provide a structured rehabilitation programme, prescribe appropriate supports, and potentially coordinate with your maternity care team.

Sciatica that includes nerve symptoms. If you have numbness, tingling, or weakness in your leg alongside back pain, that needs proper assessment. While chiropractic care can help with some cases of pregnancy-related sciatica, true nerve compression needs to be diagnosed and managed carefully.

Pain that doesn’t respond. If you’ve had four to six chiropractic visits with no improvement, it’s not the right approach for your particular issue. A good chiropractor will recognise this and refer you to another provider rather than continuing to treat something that isn’t responding.

High-risk pregnancies. If your pregnancy is medically complex, your care should be led by your obstetrician and midwife. Chiropractic may still be appropriate, but only with explicit clearance from your medical team and open communication between all providers.

How to find a prenatal chiropractor in Australia

Not all chiropractors are equally equipped to work with pregnant patients. Here’s what to look for:

Additional training. Ask whether the chiropractor has completed postgraduate training in prenatal or paediatric chiropractic care. Certification from the ICPA (International Chiropractic Pediatric Association) or similar organisations indicates specialised training, including the Webster Technique.

Appropriate equipment. A chiropractor who regularly sees pregnant patients should have pregnancy-specific equipment — drop-piece tables, pregnancy pillows, or specialised cushion systems. If they ask you to lie flat on your stomach during your third trimester, find someone else.

Experience. Ask how many pregnant patients they see. A chiropractor who treats one pregnant woman a year is different from one who sees several every week. Volume of experience matters for developing the clinical judgement needed to adapt treatment throughout different stages of pregnancy.

Communication with your maternity care team. A good prenatal chiropractor will ask about your obstetric history, your current pregnancy status, and who your midwife or obstetrician is. They should be willing to communicate with your other providers if needed. If they treat your pregnancy care as entirely separate from your medical care, that’s a concern.

Realistic expectations. Be wary of any chiropractor who guarantees outcomes — shorter labour, easier birth, baby turning from breech. A good practitioner will explain what they can realistically help with, what the evidence supports, and what falls outside their scope.

Timing: when to start and how often to go

There’s no single right time to start chiropractic care during pregnancy. Some women begin in the first trimester, particularly if they have pre-existing spinal issues. Others don’t feel the need until the second or third trimester when the mechanical changes become more pronounced.

A reasonable approach:

First trimester: If you’re experiencing pain or have a history of back issues, starting early makes sense. Visits might be fortnightly or as needed. Many women feel relatively well during the first trimester and don’t need much intervention.

Second trimester: This is when many women first notice pregnancy-related back or pelvic pain. Starting care at this point gives you time to establish a baseline and build a management plan before the third trimester, when the mechanical demands increase significantly.

Third trimester: If pelvic balance and comfort are priorities, more regular visits (weekly or fortnightly) can help manage the increasing physical load. This is also when Webster Technique work is typically done if pelvic balance or foetal positioning is a consideration.

How often: This varies, but most prenatal patients see their chiropractor every one to four weeks, depending on symptoms. There’s no evidence supporting a fixed schedule — it should be driven by how you’re feeling and what your body needs.

Common misconceptions

“Chiropractic adjustments can cause miscarriage.” A review of reported adverse events after spinal manipulation in pregnancy and the postpartum period did not identify any pregnancy-specific harms such as premature delivery, and miscarriage was not among the reported cases.⁵ Most miscarriages happen in the first trimester and are usually due to a chromosomal abnormality in the developing baby.¹¹

“You shouldn’t have your back cracked during pregnancy.” The word “cracked” makes it sound violent, but chiropractic adjustments during pregnancy are modified to be gentle. Many techniques used in prenatal care don’t produce any audible sound at all. The adjustments are not being applied with the same force used on a non-pregnant patient.

“Chiropractors can turn breech babies.” As discussed above, this overstates what the Webster Technique does. Chiropractors optimise pelvic biomechanics. The baby may or may not turn as a result. It’s an important distinction.

“You need to see a chiropractor throughout your entire pregnancy.” Some women benefit from regular care throughout pregnancy. Others only need a few visits during a particularly uncomfortable period. There’s no obligation to commit to ongoing care if you don’t need it.

“Chiropractic replaces your obstetrician or midwife.” Absolutely not. Chiropractic care is complementary to your primary maternity care. It doesn’t replace prenatal check-ups, ultrasounds, blood tests, or the medical management of your pregnancy.

After the baby arrives

Pregnancy doesn’t end at delivery, at least not for your spine. The postpartum period brings its own set of physical challenges — feeding positions that strain your neck and upper back, carrying a baby on one hip, sleep deprivation that makes everything hurt more, and a body that’s still recovering from the hormonal and structural changes of pregnancy.

Many women find that a few postnatal chiropractic visits help them transition back to their pre-pregnancy biomechanics. This is especially relevant if you had a difficult delivery, if you’re breastfeeding in positions that strain your upper back, or if you developed pelvic issues during pregnancy that haven’t fully resolved.

Just remember that your body is still recovering from pregnancy and birth, and treatment should be adjusted accordingly.

The bottom line

Chiropractic care during pregnancy is a legitimate option for managing the very real musculoskeletal discomfort that most pregnant women experience. It’s generally safe when performed by a qualified practitioner with prenatal experience, and many women report meaningful relief from low back and pelvic pain.

But it’s not magic, and it’s not a replacement for your primary maternity care. The best outcomes come from working with a chiropractor who communicates with your other providers, sets realistic expectations, adapts their technique to your changing body, and recognises the limits of what chiropractic care can achieve.

Your body is doing something extraordinary during pregnancy. Getting some help managing the mechanical side-effects of that process isn’t indulgent — it’s practical. Just make sure the help you’re getting is evidence-informed, appropriately skilled, and honest about what it can and can’t do.

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