Dr. Still s Birth Plan. Cheryl Hammes, D.O.

Size: px

Start display at page:

Download "Dr. Still s Birth Plan. Cheryl Hammes, D.O."

Ezra Golden
5 years ago
Views:

1 Dr. Still s Birth Plan Cheryl Hammes, D.O. hammes@ohio.edu

2 Presenter Disclosure Dr. Hammes has no conflict of interest to disclose Dr. Hammes has no financial or scientific disclosures Dr. Hammes has no off-label disclosures.

3 Learning Objectives Review Dr. Still s birth philosophy Discuss PROMOTE study Introduce other professions structural treatments to aide pregnancy and delivery Review studies comparing c-section rates

4 A.T. Still The first duty of the Obstetrician is to carefully examine the bones of the pelvis and spine of the mother, to ascertain if they are normal in shape and position. Philosophy of Osteopathy, 1899 Osteopathic Research and Practice, 1910

5 A.T. Still Explorations and treatments by the osteopath who is worthy of the title DO should deliver 999 children out of 1000 with no instruments but his hands; Philosophy and mechanical principles of osteopathy. 1892, p 210

6 Relax all the nerves: pelvis/pubes Relax all the nerves of the pelvis at the pubes. A.T. Still

7 Support the diaphragms

8 PROMOTE Study Printed American Journal of Obstetrics & Gynecology; January 2015 N=400 Years enrolled Statistically significant: OMT was effective in mitigating the progression of back pain and deterioration of back related functioning

9 PROMOTE OMT Sequence Sitting Thoracic springing Supine Cervical soft tissue Thoracic inlet release Lateral Recumbent Scapulothoracic MFR Lumbosacral soft tissue Supine Abdominal diaphragm redoming Pelvis AP Pelvic diaphragm unwinding Sacroiliac articulation Frogleg Ilial Rotations muscle energy Pubic decompression CV4

10 Seated forward leaning T-Spine Springing

11 Cervical Soft Tissue

12 Suboccipital Release

13 Thoracic Inlet Myofascial Release

14 Lateral Recumbent Scalpulothoracic MFR

15 Lateral Recumbent Lumbosacral Soft Tissue

16 Supine Diaphragm Release

17 AP Pelvic Unwinding

18 SI Articulation

19 Frogleg Sacral Articulation

20 Innominate Muscle Energy

21 Pubic Decompression

22 PROMOTE

23 A.T. Still Explorations and treatments by the osteopath who is worthy of the title DO should deliver 999 children out of 1000 with no instruments but his hands; Philosophy and mechanical principles of osteopathy. 1892, p 210

24 OMT Decrease C-Section Rates? Not proven yet! Osteopathic manipulative treatment in prenatal care: a retrospective case control design study JAOA, 2003 N=321 4 cities Significantly less for meconium stained amniotic fluid & preterm labor

25 Childbirth Education and Obstetric Interventions Among Low-Risk Canadian Women: Is There a Connection? N=624 Older, more educated, primiparous most likely to attend classes Refer to Table 3 for the C-section rates I note /

26 C-Section Rates Higher C-Section Rate OBGYN 32% No childbirth education class attended 49.2% Previous c-section 90 % Lower C-Section Rate CNM/CM 9.9% Attended childbirth education class 30.2% VBAC 10%

27 Birth Education Class Trend has decreased in the last decade: Why?

28 Birth Education Class Attendance There s no time! Internet education Phone a friend instead Epidural = No pain

29 Birth Education/Osteopathy The body is a unit Mind/Body/Spirit Education can ease anxiety about delivery

30 Examine the bones: pelvis/spine How can we help the mothers birth process? Let s look at other methods

31 Examine the bones: pelvis/spine Chiropractic Webster Technique for helping to turn Breech babies The great tool they have is a cool table! Purelymotherhood.com

32 Examine the bones: pelvis/spine Chiropractic Webster Technique Prone Low force adjustment to sacrum and ilium Muscle release technique for piriformis and gluteus Ligamentous release of sacrotuberous ligaments Supine Adjust pubic rami and hips Muscle release for psoas Adjust tight round ligament(s)

33 Examine the bones: pelvis/spine OMT Lab today we will address many of the same as Webster Sacrum Piriformis Pubic rami Psoas Round ligament And more!

34 Self Regulation/Healing/Health Spinning Babies Gail Tully CPM 2002 launched website Multiple publications Midwifery today for CPD Breech

35 Self Regulation/Healing/Health Spinning Babies Sidelying Release Occiput Posterior

36 Self Regulation/Healing/Health Guided Imagery Mind/Body Belly Mapping For Ideal Fetal Position

37 Back to our Osteopathic Roots A.T. Still The first duty of the Obstetrician is to carefully examine the bones of the pelvis and spine of the mother, to ascertain if they are normal in shape and position.

38 A.T. Still Osteopathy walks hand in hand with Nature s laws A student of midwifery can only learn a few general principles before he gets into the field of experience Philosophy & Principles of Osteopathy 312

39 Tying it all together Educate your patients Structure/Function Relationship Nature s principles Pregnancy/delivery is natural not a disease Partner with your patients Empower supportive family members

40 OMM Lab Preview Common Pregnancy Complaints Areas of treatment Carpal Tunnel: cervicothoracic junction/ lymphatics, carpal tunnel release, forearm Constipation: Rib raising, sacrum, pelvis, pelvic diaphragm Extremity edema: lymphatics, diaphragms, knee-chest Low back pain: sacrum, pelvis, pubic decompression, diaphragms, lumbosacral articulation Nausea/Emesis: OA/Cranial, thoracics, sea bands (acupressure) GERD: OA/Cranial, thoracics, abdominal diaphragm Round ligament pain: SCS, sacrum, pelvis

41 References Hensel KL, Buchanan S, Brown SK, et al. Pregnancy research on osteopathic manipulation optimizing treatment effects: the PROMOTE study. Am J Obstet Gynecol 2015;212:108.e1-9. King, Tettambel, Lockwood, Johnson, Arsenault, Quist. Osteopathic manipulative treatment in prenatal care: a retrospective case control design. J Am Osteopath Assoc Dec 2003; 103 (12): Stoll, Hall. Childbirth Education and Obstetric interventions among low-risk Canadian Women: is there a connection? J Perinat Educ Fall, 21 (4) Barber, Lundsberg, Belanger, Pettker, Funai, Illuzzi. Contributing indications to the Rising Cesarean Delivery Rate. Obstet Gynecol 2011 Jul; 118 (1): Spinningbabies.com Hastings, McCallister, Curtis, Valant & Yao. Efficacy of Osteopathic Manipulative Treatment for Management of Postpartum Pain. J Am Osteopath Assoc. 2016; 116 (8):

OMT for the Pregnant Patient

OMT for the Pregnant Patient Presented by: Kristie Petree, DO Assistant Professor of Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine Georgia Campus Philadelphia College of Osteopathic