The patient: “Suzy,” a hard-working occupational therapist, was a patient who originally came to see me many years ago, when in her early twenties. She had since married and was now pregnant. She loved being busy and physically active, both in her work and in her personal lives, and was excited about her upcoming delivery.
Why she came to see me: I received a call from Suzy a week before her “due date.” Her obstetrician was concerned that the “baby had not dropped as expected” and that a Caesarean section may be necessary. Suzy didn’t want to deliver by C-section—she knew that a vaginal birth is generally healthier for both the baby and the mother.
How I evaluated her: Suzy brought in a complete set of her records from her obstetrician that we thoroughly reviewed. Her work up from this doctor was very complete and found no issues with the “pelvimetry” (measurements of the internal dimensions of her pelvis) that might have interfered with a normal delivery. I assessed her pelvic articulations (the joints between her sacrum and her hip bones) and found that her sacrum (the bony structure where the spine connects to the pelvis) was being held in an exaggerated forward-bending, or “nutated,” position.
How we addressed the problem: I provided moist heat to her lower back and sacrum area and carefully adjusted the joints between her hips and sacrum. Given her situation literally days away from delivery, this series of adjustments was particularly challenging. Fortunately, I was able to release the sacrum from its “locked forward” position and told her that I felt confident that labor would proceed successfully.
The patient’s progress: Suzy’s obstetrician assessed her again when she went into labor and assured her that the baby had dropped, and things looked good for a normal delivery. Just before I wrote up this blog post, Suzy came in for some follow up physical medicine, and I saw some pictures of happy baby, mom, dad…and, I believe, a happy obstetrician too!