The chiropractic care of pregnant women: a scoping review of the literature

Abstract

Abstract Background Of the various practitioner-based alternative therapies, chiropractic is highly utilized by pregnant women to address mainly pregnancy related pelvic girdle pain and low back pain. Despite its popularity among pregnant women, no consolidation of the peer-reviewed literature on pregnancy chiropractic care has been performed. To address this deficit, we performed a scoping review to inform chiropractors and other healthcare professionals involved in perinatal care. Methods The literature review was conducted from 1978 to 2022 using PubMed, AMED, EMBASE, CINAHL, MANTIS and Index to Chiropractic Literature. The search terms were chiropractic, chiropractic care, chiropractic manipulation, pregnancy or pregnant or prenatal or antenatal or perinatal or maternal and related words. Inclusion criteria for our review were manuscripts: (1) involving pregnancy care within the scope of practice of chiropractic (i.e., spinal manipulative therapy (SMT) and/or adjunctive therapies) and (2) published in a peer-reviewed journal. Exclusion criteria were: (1) abstracts from conference proceedings, (2) dissertations for a Master or PhD degree, (3) letters to the Editor, (4) chapters in textbooks and (5) non-English language manuscripts. Natural Language Processing and K-means cluster analysis was applied to the eligible manuscripts to identify themes and deficits of the existing literature. Results A total of 127 manuscripts from 733 titles met inclusion criteria for review consisting of three randomized controlled trials, 18 cohort studies, one case control, 49 case reports, 13 case series, one qualitative study, 33 commentaries, 8 systematic reviews, and one best practice recommendations document. Four clusters were identified with manuscripts describing care of pregnant women with complex MSK presentations (Cluster 1), the care of pregnant women with simple MSK presentations (Cluster 2), the use of the Webster Technique (Cluster 3) and papers characterized by advocacy for the chiropractic care of pregnant women (Cluster 4). Conclusions Overall, there is a deficit in the literature on chiropractic pregnancy care. Studies characterizing the practitioner and patient perspective are lacking. We encourage continued research efforts on chiropractic pregnancy care to inform prenatal research, practice, education, and policy.