The Webster Technique

PREGNANCY

Intrauterine constraint is defined as any force external to the developing fetus that obstructs the normal movement of the fetus. Intrauterine constraint has been casually related to a number of structural defects of the peripheral and craniofacial skeleton of the fetus. [Mothers] have described how the forces of intrauterine constraint adversely affect the spine during the prenatal and perinatal periods. Moreover, intrauterine constraint can prevent the developing fetus from attaining a head-down vertex position and achieving a vaginal birth, thereby necessitating a cesarean section delivery.

Nearly 13% of all cesarean deliveries are performed as a result of breech presentation. In the United States, 86% of infants with breech presentation are delivered by cesarean section.

Approximately 3% to 4.6% of all singleton pregnancies result in a breech presentation. The incidence of perinatal mortality with breech presentation is approximately 4 times that of a vertex presentation.

The importance of preventing intrauterine constraint and subsequent cesarean section delivery is apparent, considering current statistics. The United States and Canada have some of the highest rates of obstetric interventions in the world, which boosts the already high cost of obstetric intensive care. In Canada, the incidence of cesarean section ranges from 15% to 22%, depending on the province. In the United States, approximately 22% of all births in 1999 were cesarean section deliveries. Cesarean rates varied from 14.8% in Alaska to 27.3% in Mississippi. This marks the third consecutive increase in cesarean rates in as many years. The US rate for primary cesarean delivery increased for the second consecutive year to 15.5%.Even though the percentage of women beginning prenatal care in the first trimester of pregnancy has increased to 83.2%, the low-birth-weight rate has remained unchanged at 7.6%. In addition, the national rate of vaginal birth after cesarean delivery has fallen 17% since 1996.

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. In 1991, this figure was adopted as a goal for the year 2000 by the United States Department of Health and Human Services. Several reports have cited reducing the number of cesareans for breech presentation as a strategy for reaching the Healthy People 2000 goal of a 15% cesarean section rate, a goal the United States failed to reach and a goal which was again adopted as a Healthy People 2010 goal by the Centers for Disease Control and Prevention (CDC) and the United States Department of Health Resources and Services Administration.

While many fetuses in breech presentation before 34 weeks' gestation will convert spontaneously to a cephalic presentation, few will do so after 34 weeks.Reports of the rates of spontaneous version have varied from 0% to 33%, with an average of approximately 9%. The number of cesarean sections performed due to breech presentation and dystocia has increased, whereas those attributable to fetal distress have not changed significantly, and elective repeat cesarean delivery rates have declined.

Anecdotal reports indicate that the Webster Technique, a chiropractic technique designed to relieve the musculoskeletal causes of intrauterine constraint, has been successful in converting breech presentations to cephalic presentation.

Citation:

Richard A. Pistolese,

The Webster Technique: A chiropractic technique with obstetric implications, Journal of Manipulative and Physiological Therapeutics, Volume 25, Issue 6, 2002, Pages 1-9, ISSN 0161-4754,

https://doi.org/10.1067/mmt.2002.126127.

(https://www.sciencedirect.com/science/article/pii/S0161475402000155)

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