Ep 83: Chiropractic Prenatal Exam Questions

Just as your OB or midwife, doula, pelvic floor PT or other birth support team members will ask questions in their exams, the questions they ask serve a specific purpose and role.  In today’s episode, Dr. Shannon outlines some of the questions she asks during her prenatal chiropractic exam.  Now, not all chiropractors are going to ask the same questions, in the same order or same manner, and not all chiropractors practice the same techniques, but having some insight into the types of questions asked during the exam, and the why behind them can give insight into what to expect with care.  She goes over 7 main questions that she asks all prenatal patients, and although those questions and the answers provided can lead to more questions, this a good starting point for understanding chiropractic care.  Then she discusses several other questions she asks all patients during their exam.  What does your sports history and job duties, daily tasks, and diet have to do with your prenatal chiropractic care…….a lot!  

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• 12:45 (Cont.) Ep 83: Chiropractic Prenatal Exam Questions

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Unknown 0:00

Hello, you are listening to the aligned birth podcast. I am Dr. Shannon. I'm one of the hosts of the show. And today is a fun little solo episode me by myself chatting about a prenatal topic that I wanted to give a little bit more information about. And the focus of today's episode is going to be questions I asked during my chiropractic prenatal exam. I think for those who haven't been to a chiropractor before, you may not, you know, know what to expect with care and that goes outside of what to expect with the adjustment but sometimes, knowing some of the questions that might come up in the exam can give some insight into what to expect with chiropractic care. And I wanted to do this too, because sometimes I'll have moms in the office and they give me a little bit of a look of confusion when we're asking certain questions and it's kind of like the I don't know if they necessarily see all the connective pieces there as to why we're asking certain questions. And so I thought I could go through and share some of those that I asked today. So again, this isn't this is like my personal questions. I'm a prenatal chiropractor in the metro Atlanta area. So these questions may not be what happens in every prenatal office. There may be more than maybe less and I'm not necessarily going to do every single question that I asked but there were a few that I wanted to focus on and wanted to give a little insight into, Okay, where am I going with this question and why I'm asking it and then even how I listened to the response that can give insight into where else we could go to help support this new and growing family. So again, I'm excited to chat today about the questions I asked during my chiropractic prenatal exam. Like I had already said, obviously, these questions might be different for a different chiropractic office to for wherever you go. And this is, you know, specific to the technique that I practice as well because again, I've mentioned before there's over 200 Different chiropractic techniques. So also wanting to put a little disclaimer out that, you know, there's different reasons for mom's wanting to start under care for prenatal and so yes, there's the typical, there's aches and pains, right so that it can be that low back pain, it can be round ligament pain, it can be sciatica type pain, and so those are going to obviously warrant specific questions you know, pain points, where are you feeling it? How, how does it feel describe it, what's the pain scale? When does it happen like these the questions I want to ask are kind of outside of that normal questions that we ask. We have learned in all of our chiropractic education, so but then there's also the fetal mount position that seems to come into the office too. So those are going to be specific questions there. Or even moms coming in. Wanting a different birth experience second time around. And then there's the moms that come in that don't necessarily have any sort of pain points, and it's kind of that wanting that different birth, like maybe they're feeling fine. I hear a lot of times people say I just want to have everything like lined up and aligned and I want to really put my body in the best position possible for giving birth. So again, no, I'm still going to ask specific questions even whether you're coming in with pain or not. And you know, we'll go over that in a minute as far as why I'm asking that to kind of paint this picture of our life experiences. So obviously, one of the first ones and Rachel had talked about this on the show like we talked about sharing your estimated due date and sometimes you're sharing it with friends and family and maybe like work environment or something it can be that can put a lot of pressure on you, especially if you are going past that estimated due date, but I do ask what your estimated due date is because it is important to know and it's important for the OB the midwife to know Okay, do we have a thought process on to when baby's coming? But also, there's a big difference between starting care at 12 weeks versus like 38 weeks or even like pre consecutively versus like right towards the end. There's there's going to be some differences and the differences that are going to occur there is going to be obviously like frequency of care, but also Are you coming in with pain or what's what's bringing you in what's going on? So I do like to start with knowing, okay, what kind of timeframe are we looking at for care plan? I always asked you know, have you been adjusted before have you been under chiropractic care before? Whether you'd been under care during a previous pregnancy or whether you were under care just under care for a specific reason or a specific event that happened because that also gives me insight into like to see well what did you like about the care what did you not like? Certain adjusting procedures adjusting techniques I never like to force anything on anyone and you know, just looking at okay, what makes this person feel most comfortable with chiropractic care, and then I'd like to see okay, well, did it help you know, with whatever you were seeking care for, for that first experience anyways, you know, what was your experience with it? And then I like to kind of see okay, well, maybe we can have either the same or better experience this time around as well. So, again, what is your estimated due date? I do like to know that. Um, and this is in no particular order. This is just I was jotting down notes and I was like, You know what, this this is what I go through and ask and one can obviously to, depending upon the response is going to dictate, well, what that next question might be, right. So, again, to these questions usually lead to further questions, but it really is pulling the information out of a patient is really harnessing like, what questions am I asking? Am I asking good questions to really pull out the information that I am wanting to hear even if the person is like, I don't know why they would ask this or why they want to know that another one is like Who was your provider? And where are you planning on giving birth? So if we're more of you know, working with an OB we're going to be giving birth in a hospital. I like to know those things. I like to know that practice. I like to know that hospital and that can give you some huge insight into how that practice and how that hospital is approaching care. And that can play a big part too. If you know looking at what mom's desire is for birth and we'll get to that in a minute too. But and then there's a big difference to where if we've got like a home birth midwife. So those are kind of those two extremes, but then you have practices that do have midwives there. So a lot of times I'm listening to these responses from my moms too, and listening to hear for certain statements like what what are we wanting at this birth? How comfortable do we feel what they're provided? Because sometimes I'll have moms say, Well, I'm seeing the I'm at the practice that I've been at since I started getting pelvic exams. You know, since I started my period, I've been with this practice, and it's an actually, you know, OB GYN practice, and I'm staying there. So it's kind of like, oh, this is what I've always known. That can give us some insight into are we feeling 100% comfortable there because you may not be 100% comfortable with that same person that you've been with, and now you're wanting to give birth and it's a little bit different, maybe the words and the statements that they're using are a little bit different. So I do try to listen and tune into some of how, how my mom's are answering the questions that I'm asking. I feel like it's sometimes people tend to come into the office and they tried to like sit a little bit taller, because I feel like they think I'm looking at them and like judging their posture. I just make notes of things and everybody does it that's in this field, even like pelvic floor PTS, we'll look at people and like how they're walking and how they're shifting their weight and it's you know, too if you have like a therapist, friend, you're like, oh my gosh, is she judging me for the statements and words I'm saying? So I never want the that judgment aspect of things to come in. There's no judgment. I'm just using observations and then how best can I help this person? In the office right now? How can I help this mom have the verse that she wants to have? So again, I'm looking at who's your provider and where do you plan on giving birth and there's a lot of different hospitals birthing centers in this metro Atlanta area. And so that can give insight to what we want, you know, are wanting waterbirth like all there's all kinds of options and maybe mom doesn't even know about these words and options. So I'm also listening to the response to say, I wonder if there's some new words and new vocabulary I can give her so she can go Oh, yeah, I do want that or no, I don't. Because sidebar here so with and I share a lot of like my birth story. On the show because my first and my second birth were so different. And it I don't feel you know, shame or anything about my first as far as it being like the emergency C section and I, you know, maybe I could have prepared better but I look at it as that like, I use that experience to then help moms because I had never heard the word doula. And so I think if I had heard the word, maybe I would have researched it more and I think it was more of like,

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the questions that I was hearing from my provider was, you know, well, who all is going to be in the birth room? With you like, Who are you going to allow and your birth? And so I'm thinking, Well, you know, my mom and my husband, but if I didn't know the word doula I couldn't I wouldn't be able to formulate, oh, well, I'm going to have a labor support person. I didn't know that that was an option. So do you see how flipping that question so I guess I jumped ahead. But one of my other questions is are you planning on having a doula I like to mention those words in office because then that can create a whole conversation of what is a doula? You know, and I didn't know that that was an option. So it's not blaming a provider for not trying to expand my vocabulary. But I think using certain words, and I think how we formulate our questions can help our patients make informed decisions. So I made an informed decision, but I didn't I don't think I had the big picture of what a doula was, you know? As far as making that decision. So that's where I go with some of these questions and some of the words that I like to use and listening to the responses now. If I have a first time pregnant mom it's it's always so fun to hear. Hear them talk and speak about birth but I if this is a second, third, fourth, whatever pregnancy I do usually ask you Is this your first pregnancy now? I will say more than half of the women that have come into my office have experienced a miscarriage or stillbirth. A pregnancy loss, infant loss, the whole the whole gamut there and so this can be a little bit difficult too because I want that I your health care provider in this prenatal aspect of care. I do need to know those things and it can still be difficult but it needs to be acknowledged to and so I do like to express my not my thoughts and feelings on that but I just validate like you had this experience and that was tough. And now you're pregnant again. And this can be tough too. So I like to look at that as have we do we need any other resources or support there around how we are experiencing this pregnancy if something was very traumatic beforehand. So it is a very loaded question like oh, is this your first pregnancy? Well, no. And then there's a lot of other questions that can come from that. And there's also the aspect of okay, well, that first pregnancy was wonderful and great, but the labor and birth itself was very traumatizing. And so now we're coming into this second, third, fourth pregnancy with a little bit more baggage, right. So this is definitely a loaded question and I do I spend a lot of time listening in the office. I know it sounds like I talk a lot on the show, obviously. But it sounds like I'm talking a lot in in this exam, but I just spend a good deal of time listening because I listened to the words that we're saying and how we're saying then because then I'm also in my head I'm writing down notes and I'm saying okay, how best can I support this person? You know, does it sound like we might still need maybe to deal with some of that trauma. Do mental health counseling do we need to deal with this trauma that like we've still got some tightness and maybe pelvic floor PT is what we need? Like all of these things? And again, to it's just mentioning these words, maybe this person has never heard the word pelvic floor PT or knew that that was an option. Or maybe they know that this is an option, but it's just not something that they can mentally, physically, emotionally, financially do right now. So at least just acknowledging those things. But again, two, we talk about that concept of history. And then we talk about those prior pregnancies and birth and this is a lot this is a lot to unpack and a lot to unfold. And this is where sometimes like I said, we can come into okay, this warrants more questions and pushing on a little bit further there. Now, I like I mentioned before, I do like to ask, are you planning on having a doula because sometimes people say no, I don't want that or I don't know what that is, or yes, I'm having what you know, it's it's the words that we choose there. And so whether someone is planning on again to like I said, the order isn't necessarily how I'm asking these questions, because I do end up asking me about this. birth plan but whether someone's planning on having you know, they want this unmedicated least invasive birth as possible, or they you know, are wanting the epidural I have some moms that come in and they're like, you know, this is this is what I want. I just don't want to be induced, but I'm okay with having an epidural. Like I listened to these words and again to I think, okay, how can we best support this person? Um, I, obviously I do love doulas. I've shared a lot in my birth story. And I even just previously in this episode, I shared a little bit of like having known those words. I do really wish I'd had a doula. I'm okay. I'm okay with it. But looking back and I'm like, oh, man, that would have been really cool to experience that. And so that's what I usually like to share. Now. I'm I'm going to pause here for a moment because it sounds like I in this first exam, these thoughts are going in my head as far as how can I best support this person? I don't worry. I try not to word vomit and be like, Oh, here's your first visit. Bla bla bla bla bla bla bla bla, you have this tire homework assignment to do this information overload which is overwhelming because what I tend to try to do is we take it one little step at a time we research one little thing at a time and mentioning something one little thing at a time as we come in for our adjustments. So there is a try to ease into it a bit as well engaging too because some it depends on the person you know, some people aren't overwhelmed and uh, you know what I need to know this, this this right now because this is what I've planned and other ones are like, I would really like to have an unmedicated birth. And then it's kind of like, okay, where where can I meet this person at without obviously, word vomiting and information overloading on them as well. So, yes, I do ask if they're planning on having a doula. I do ask about childbirth education classes. And I like to know what classes you're looking at what you're thinking of, if you're completely open and you have no idea what to look at or where to start. There's lots of different you know, lots of different options there. But then if we are giving birth in a hospital, I do like to know Okay, are you planning on taking that hospital one? Or are you okay with doing maybe an independent one as well? Or maybe not even doing the hospital one and just doing an independent like I do like to mention those options because again, I never really knew of independent childbirth education classes when I was pregnant 1213 years ago, so I think it would have been really beneficial had I taken one that wasn't just the hospital based class, and I speak that to my mom's in in that aspect of like, I do think it would have been beneficial and Rachel and I have done a couple of episodes on the differences between the two and even I did an interview with Tara she's the massage therapist and massage therapist and she is childbirth educator as well and she does independent classes and we even talked about you know, not necessarily having to do those hospital based classes. So also not all childbirth education classes are created equally. And so I do like to ask, well, what does your class cover? Does it go into breastfeeding and breastfeeding support? Because if not, I'm definitely going to mention as we go along and care either having Lactation Support set up in advance or taking a breastfeeding class in advance or at least having that in your mind and say, You know what, I know that this is something I might want to do, but I'm gonna put it on the backburner for now again, it's having those words in your vernacular so that you can make that informed decision and the newborn care I have a lot of you know, with my first time moms, they're like, I want a class on newborn care and so sometimes, some childbirth education classes aren't offering that I you know, does it go over stages of labor? Does it go over pain management, does it go over? labor positions, like a lot of them do, but I think it's good to know and research different options and classes. I'm never just saying, Oh, just take this this class. This one was really good and it covers everything that you need to know. That's not necessarily the case for everybody. So again, to giving options for my expecting families, and then I look to like, you know, is your partner going to take the classes with you? Like that's always really good for them to experience it as well. Not so much so that they can be like a different type of labor support person, but they can help you and like, hey, remember we did this in the class like maybe while you are in labor and contractions, they can help remind us of some of the things that we learned.

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So again, not all childbirth education classes are created equal. Some people want in person somewhat virtual, some are really long and spread out one in summer just an intensive like weekend like there's lots of different options which yes can be overwhelming. But if we break it down piece by piece, it can help to mentally digest all of the information. Another one is what is your birth plan, you know, have we thought of a plan? And again to I listen to the words that are used in describing the birth and then I kind of think of okay, how do you how do you want to feel with this birth what what is ideal to you what, how do you want to be supported, right? And so, again, to it is in how the question is asked, in kind of getting a certain response from someone and saying something that's more in depth. And I want to know a little bit more about what that ideal plan is for you. And then sometimes we'll even ask questions about like, well, I don't have a birth name, but I do want to create one okay, here's information on that as well. So again, too, maybe you don't even know that you can have a birth plan, and that you can say no to certain procedures and things. So again, it's it's helping moms make those informed decisions. Another thing I ask is, you know, is anyone else part of your birth support team now sometimes this has already come up in in the birth plan and those type of things, but I do like to see, you know, do we have are we already established with the mental health therapists do we have a history of anxiety about big life changes and so we've we know that this is another big life change coming up. And so we want to go ahead and get that relationship started again, with our therapists do we have do we have prolapse or anything with our first pregnancy and our first birth and so have we been seeing a pelvic floor PT and using them to help us strengthen, loosen our muscles and prepare for birth prepare the pelvic floor for birth you know, those type of things? And we've talked about our birth support team in general, but I do like to see do we have anybody else? I have some moms that have, you know, their oncologists are part of their birth support team because you know, they're in remission and those type of things. So, birth support teams can look different for everybody. And sometimes, there's a very big team and sometimes there's a little bit smaller team, but I do like to see who all is involved there. Um, and this is where I use the answers from these questions to make those specific care plan recommendations for their birth support, Team recommendations, nutritional recommendations. Sometimes provider feedback, if you know we're really hoping for a specific type of birth, but maybe the hospital that we are looking at birthing at can give a little bit more pushback on certain procedures than is ideal. I'm trying to say this in the most politically correct judicial manner without bashing certain things, since I don't want to bash certain things. But I definitely don't want to give I very careful with using my birth experience in the practice that I was within everything. I never like Swing, swing someone you know, and it's hard and sometimes some of those Facebook groups you hear a lot of negative. Talk about some providers and some of it is warranted. Yes. And there's birth trauma, and then sometimes there's other aspects to it. So it's just kind of using that lens with how we are talking about other care providers. But knowing too that hey, maybe there is another office that might be a little bit better fit for you and the birth plan that you have. So we're using that to help you make informed decisions and to help you curate that birth experience as close as possible to what you want. So that's where I go with some of those prenatal specific questions. There are questions that I asked all new patients though, and whether they are pregnant or not. And so this is definitely it's this is where sometimes I'll get the looks of like, Oh, I didn't know we were going to go into that today or it does make a little bit of sense, but sometimes they'll be like, Well, I don't know. I hear this a lot. I don't know if this is connected or I don't know if you need to know this or I don't know if this is related to anything that we're talking about. And usually when someone says that, yes, yes, it probably is related. I'm part of your you know, the health care team and so, no body system in our body works alone, everything is physiologically connected. And so, something may seem to not be connected, but it can it can very well be so I do like to ask the sports history. Growing up, not just for slips, falls, traumas, accidents. So that's another thing I asked about growing up like those major ones, but it's good to know do we have a history of little repetitive micro traumas? Because a lot of times those can cause subluxations and nervous system impact. It's just not as memorable as if you were in a traumatic car accident or if you did have a horseback riding injury or something along those lines where you're like, oh, yeah, this makes sense because my low back pain started, instead of well, I played basketball for 10 years. I never had an injury. Could that be where some of my low back pain comes from? You know, it's it's good to try to start to connect the dots and I think that's what I like to do and that it's like a puzzle, you know, and we're trying to put all the little pieces together to help complete it and to make some help make some things make sense. So again, sports history growing up Car Accident history, obviously, that's a big one current exercise. So what do we do? What do we like to do? What can we not do now? Because we're pregnant. If there's aches and pains, or what are we doing because movement is so key, and we've even talked about prenatal movement, and other episodes as well. What are your job duties and daily tasks? Now, a lot of times I know, you know, if we've had, we have previous children, and I know some of those repetitive tasks that we're doing, which is a lot of bending and lifting and holding a kid on one hit. That's a lot in the office. It's like, oh, my hips hurt so bad. And it's when we go back and say okay, well how are we holding? Holding our two year old we're pregnant with this new baby. Um, so those job duties and daily tasks and then just the diet that you're eating supplements, nutritional aspects of things, medications that we're taking, like all of that. I ask all of those things, and this again, is not complete. There's a whole review of organ systems that I asked you to review of systems and we're touching on all parts of the body because again, just looking to see you know, what's their digestive history? Do we have a history of IBS? Like all of those things? I do ask in my exam for all new patients, but like I said, Sometimes my penal patients get a little look of confusion when I'm asking that sports history growing up, especially if it was like Well, no, I mean, I didn't have any injuries. It didn't have any accidents. I felt fine. It's, you know, depending upon your age, it's taken you your 27 years to get to where you are 3038 years of life experiences getting you to where your body is today and what it's feeling today. And so, those little repetitive tasks too, and not to bash like childhood sports. So sometimes I feel like I'm saying, Oh, we shouldn't be doing anything. No, I want you to move all I just want is a little bit of awareness there to say, Oh, wow. Maybe there's some things that if I want to stay this active and healthy, well, what can I do to help my body heal and stay active and healthy, right? So it's not a bashing as far as like oh my gosh, you did you know, too many sports as a kid or those type of things. It's just connecting the dots and bringing awareness to some of those things and to like, Well, why you know, do I have aches and pains during pregnancy? Where is this coming from? And sometimes we connect with that and sometimes we it's all part and so, again, these are not these are just ones that that came to mind that I wanted to mention that I thought we'd give some insight into what maybe you can expect with your chiropractic prenatal exam, because again, to get this person you're coming in, you want to have a baby and it's it's an amazing and crazy experience. But it's also led up to this point. So how have our life experiences kind of led up to this point and maybe digging deeper part of their help and helping them kind of in a bring awareness to how they got to where they are today. So I hope you learned a little bit of something in the show today. And as always, we're so so thankful that listen, share this show episode all the previous ones that we have with friends and family who are expecting as well. We love ratings, reviews, feedback, feel free to give us a follow on Instagram,

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at alligned underscore birth. We're trying to constantly post things and spread knowledge and awareness and again, thank you so so much for tuning in today.

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