Safety Status:

Trying to Conceive: Limited
Pregnancy: Limited
Postpartum: Limited

What We Know: Chiropractic care involves the treatment of mechanical disorders of the musculoskeletal system, particularly the spine, using manual adjustment techniques to improve alignment, relieve pain, and support overall health.

For individuals trying to conceive, chiropractic care receives a “Limited” classification primarily due to known complications associated with chiropractic manipulation, most noticeably carotid artery dissection (damage of the major blood vessels supplying the brain) with neck adjustments. Research specifically examining chiropractic care and fertility outcomes is limited. 

During pregnancy, chiropractic care receives a “Limited” classification primarily due to the need for specialized techniques and potential contraindications with certain pregnancy complications. The American College of Obstetricians and Gynecologists (ACOG) acknowledges that chiropractic adjustments may help relieve back pain during pregnancy but emphasizes the importance of communication between healthcare providers. Key pregnancy considerations include:

1. Seeking chiropractors with specialized training in prenatal care
2. Using appropriate equipment and positioning (specialized tables with drop-away sections or pregnancy pillows)
3. Employing gentler techniques, particularly as pregnancy progresses
4. Avoiding certain manipulation techniques, especially high-velocity thrusts to the lower back and neck adjustments which can cause life-threatening damage to blood vessels that supply the brain
5. Ensuring provider awareness of any pregnancy complications such as placental abruption, ectopic pregnancy, or preeclampsia, which may contraindicate certain treatments

Appropriate chiropractic care during pregnancy may help manage musculoskeletal discomfort, though high-quality research remains limited.

For postpartum individuals, chiropractic care also receives a “Limited” classification with consideration needed for recovery status. Postpartum-specific considerations include:

1. Awareness of increased joint laxity that persists for several months after delivery due to hormonal influences
2. Modified techniques to accommodate healing perineal tissues or cesarean incision sites
3. Careful evaluation of potential diastasis recti (abdominal separation) that might affect positioning and treatment
4. Attention to biomechanical changes related to nursing positions and infant carrying

For both pregnancy and postpartum periods, certain high-velocity adjustment techniques should be approached with particular caution, and in some cases avoided entirely, in favor of gentler approaches. The International Chiropractic Association recommends individualized assessment and treatment plans that account for the unique physiological changes during reproductive periods.

Before seeking chiropractic care during pregnancy or postpartum, individuals should consult with their primary healthcare provider, particularly if they have high-risk conditions or complications. Coordination between obstetric care providers and chiropractors helps ensure comprehensive, safe care.

Sources: American College of Obstetricians and Gynecologists (ACOG) Patient Resources on Complementary Therapies, Journal of Manipulative and Physiological Therapeutics Systematic Reviews, Journal of the Canadian Chiropractic Association Clinical Recommendations