Hello, my name is Dr. Alex Coleman. I am the owner of Maximized Chiropractic in Bismarck, North Dakota, and today I want to talk to you about something called dystocia, which is basically slow and difficult labor—a labor that you don't want—and kind of how chiropractic and the chiropractic lifestyle can help you have the birth of your dreams.

So first, I want to talk about the state of birth in our country because it's kind of grim, and I think some of the things that we'll talk about today could be part of the solution. None of the stuff that I'm about to talk about is to degrade or bash or speak negatively of the medical profession at all. I think they're doing wonderful things, but I think some of the things that we're doing aren't working, and these stats will kind of show it, and I think there are solutions that can be worked towards to better the birth in our country.

So, the first one, over the last roughly 30 years, C-sections have been rising from about 20% of the time to about over 32% of the time, and it seems to be staying around that 32% of the time. It's not getting any better; it seems to have been getting even worse these last few years. That's roughly like a 50-60% increase in the last 30 years. To me, C-sections are a sign that something failed. The World Health Organization says that the ideal C-section rate is somewhere around 10% of the time. So that's them suggesting that if everything else was perfect, if our systems during pregnancy and birth were ideal, that around 10% of the time, C-sections are unavoidable. So we're at 32%, so that's quite a bit higher.

Inductions have skyrocketed in the last 30 years. We're talking from roughly 10% to, again, over 33%. That represents a 243% increase. That's a very large increase in how many moms are getting induced when they're going into labor. Maternal death rose since 1999. So, one argument for, "Well, we're having more C-sections and more inductions, but that means babies and moms are safer," the reality is that it's not. Maternal death has risen 148% since 1999, so it's going up dramatically. It has gone up dramatically, and this is the scariest stat to me, guys. The United States is ranked 55th in the world. That means there are developing countries that have lower maternal death rates than the United States. So to me, that's very scary. That's concerning.

I did a little research for this and found that Norway is ranked number one. So why is that? Why is a country like Norway so different than the United States? We have the most doctors in the world, we spend the most money on healthcare in the world, we have the most drugs in the world, why does that mean that we're not number one? Why are we not number one because of all those resources? So some of the big differences with countries like Norway, and it seems like the Scandinavian countries kind of have it figured out for the health of moms and babies, and just kind of health and happiness in general. So with birth specifically, these are some of the things that I found. Birth is considered a natural process in Norway. Birth is not a disease that needs to be treated and fixed at every single step of the way. The C-section rate in Norway is about half of what it is in our country. And this was very interesting to me, that they have more midwives than they do OBGYNs. In North Dakota, especially, midwives are very few and far between. There's too much regulation, and they're unfortunately frowned upon, which I very strongly disagree with. So, seeing that there are more midwives than OBGYNs in Norway, that was very interesting and surprising to me, and it just kind of goes along with the fact that they view birth as a natural process.

So, these are some of the things that are going on right now. C-sections are going up, inductions are going up, health is not getting better with babies and with moms. So if that's happening, what can we do about it? I don't claim to have all the answers of how we can fix this. This is a pretty deep problem, but I know that prenatal chiropractic can help, and that's what we're going to talk about today.

So, dystocia, which is a fancy word for labor that slows down, labor that's long, labor that doesn't progress fast enough or at all, is called dystocia. The three main causes of that are broken down into power, passage, and passenger. So those are the three things that we're going to talk about today.

So, power is basically how effective your uterus is contracting and pushing the baby down and out. How much power is your uterus pushing down on the baby? This is obviously the first and one of the most important parts of labor, and this is something that can get missed very often. So, think of your uterus and your brain like these two wires right here. So, you have this connection between your brain and your uterus that is connected through wires. Those wires can get interfered with, they can be slowed down, they can be disrupted, and when that happens, it means that your uterus can be firing less than ideal. Looking at these batteries here, picture this one on the right having perfect connection and power. Your brain is connected to your uterus beautifully, the wires are hooked up and working great, have full power going all the way down. Shifts in our spine and irritation of our nervous system can actually cause that to slow down, so the strength becomes lower, weaker. The uterus becomes less strong. Instead of getting nice, consistent, predictable, rhythmic contractions, we're getting stalling, spasming, quivering, constantly doubling up and tripling up contractions that aren't as effective.

So ideally, during labor, a contraction would beautifully push a baby slowly down and out, and when that signal is working really well, it happens really well. And when the signal is not getting to your uterus very well, it means less than optimal signal. You can also kind of think of it like a Wi-Fi signal, or like a cell signal. If you're out in the middle of nowhere in North Dakota, and somebody calls you on your phone and you only hear every third word, you're not going to get a good idea of what's happening in the conversation. But if that signal is very strong, you know exactly what's going on. If the signal from your brain to your uterus is very strong, your uterus knows exactly what to do. It contracts in the right spots, it pushes down effectively. If the signals from point A to point B are weak and interfered with, then the power of those contractions are going to be weak, leading to dystocia.

One of the second causes of dystocia is passage. So, passage is essentially the birth canal. What is the shape of the birth canal? How open is it? How wide is it? And is this something that is ideal or not ideal? I have a few models for you to kind of see this. The picture is hard to kind of show you. Here's a pelvis. You can see this opening right here. I probably couldn't birth like this. I think it would hurt a lot. But here's a little baby. This baby can go down and out. So, this little opening here, this is a circle, nice and round. This is what a birth canal should look like. There are many different versions of pelvic shapes in women. This is not how they all look, but it's a similar story. They all have an opening here. Some are more ideal for birth than others, but this is just kind of a rough example of what it looks like. So, our pelvis normally moves, so it walks side to side. And you can really easily here see when I twist this pelvis, watch how that birth canal shifts from being nice and open to not nice and open. This is much harder for a baby to come out of. You can see how much of my head that you can see through this now. When I twist, you can see much less. So, this twisting is passage. If your pelvis is stuck and twisted and not opening as well as it should, it is very hard for a baby to come out. It's very easy to see how a chiropractor can help this, making sure that a pelvis is aligned properly and that opening is as wide as possible. That's huge. That is a very, very easy thing that most chiropractors know how to do, making sure that a mom's pelvis is open and beautiful and optimal. This should be a part of every single mom's care during pregnancy.

Passenger is the last one. Passenger is essentially, where's the baby positioned? Birth is not just a mom pushing a baby out. Birth is not just a uterus contracting and squeezing a baby out. The baby actually has a lot to do with this, and how they're positioned is a big part of it. When they're positioned… So, ideally, we have… this is a whole bunch of different options, not all the options… LOP here, left occiput posterior. That's when the head is down and the back of the baby is kind of positioned towards the left side of the mom. That is the ideal position. Now, babies can come out in most of these positions, minus the breech ones. In the US, babies aren't traditionally delivered breech, but the ones that are head down are ideal. You can see some of these can be really tough, like look at the ones on the bottom here, where the face is presenting. That is not good for the baby. It's very hard for a baby to come out. So, there's an ideal position that baby needs to be in when the baby's coming down. The reason it's ideal to be in one of these positions is the baby has things called primitive reflexes. Now, these reflexes are basically ways to help the baby push themselves out of the birth canal. When the spine starts to come down and gets pushed against this little pubic bone right here, their legs kick, and they actually push themselves out. When their head and neck start to turn, their arms help that, and there's reflexes that help them spiral down the birth canal and out. And if the baby's in the wrong position, like you've heard of maybe occiput posterior, or sunny-side up, those positions… When the baby's in that position, they don't help coming down. It's essentially dead weight, and labor is much harder when the uterus is the only thing pushing the baby down. When the baby's helping, because they're in the right position, labor is much easier. So, making sure that the pelvis is in the right position will dramatically help make sure the baby's in the right position.

So that's the Webster Technique. This Webster Technique is the gold standard of chiropractic care during pregnancy. If you're seeing a chiropractor who does not know the Webster Technique, is not certified and proficient in the Webster Technique, you're in the wrong place. You absolutely need to be seeing a Webster-proficient chiropractor, not just one that took the seminar, one who has specialized in pregnancy for a very long time. The Webster Technique is essentially a way to evaluate your pelvis and see where your pelvis is. So here's a different model. When we use the Webster Technique, we are looking at the alignment of bones back here, your sacrum, these bones called your ilium, all the ligaments that connect them. Here, we have a whole bunch of these little white ligaments that connect, and your pelvic floor, and then even these nerves at the very top that connect everything down here. The Webster Technique addresses every single one of those structures and makes sure that they're perfectly balanced and perfectly even. And then when we find out where you are, we can give some gentle, corrective adjustments that will help to make sure your pelvis is balanced. That is not a one-time thing, unfortunately. Getting adjusted one time does basically nothing in the long term. And the moms that experience these benefits are the ones that see prenatal chiropractors continually through pregnancy, not just one or two times.

A huge part of how chiropractic can help these… this power, passage, and passenger… how chiropractic can help labor be easier, is this concept right here. Our nervous system has two main branches. We have a stress mode, and we have a calm mode. Stress mode, the fancy word is sympathetic. That is the fight-or-flight response. This is what happens when our body thinks we're in danger. So for a second, I want you to put yourself in the shoes of a wild animal. Say you're a wild deer in Africa, roaming through the prairies, eating grass, and just happen to be pregnant. You lay down, and your body says, "Hey, it's time for this little baby deer to come out." Halfway through labor, a tiger walks up to you. If you're that deer, what do you think is going to happen? Is labor going to speed up, or is labor going to slow down? If a tiger walks up to you and you're in labor, you're for sure going to shut that down right away, like that. You're going to get up, and you're going to run away from that thing because the only thing that matters in that moment is you surviving. For that deer, if you birth your little baby, that tiger is going to eat you, unfortunately. So, we are wired just like these wild animals. We're wired to survive during dangerous times. So, if we are in labor and our body is in this fight-or-flight mode, our body thinks that there's a tiger trying to eat us, and the natural things inside of us, like hormones, our nervous system, and contractions, slow down because your body thinks that it shouldn't have this baby because you're under attack.

The opposite of this is the parasympathetic mode. So, parasympathetic is where we rest, where we digest. This is where babies are born. This is one of the reasons why I see moms all the time that are laboring at home, they get to the hospital, and all of a sudden they're poked and they're prodded, and they're asked questions, and the lights are bright, and they're changing gowns, and they're being hyper-stimulated. That triggers a stress response, and that stress means, "Hey baby, slow down, you shouldn't come out because this is a dangerous world out here." So, parasympathetic is where you should be most of the time during pregnancy, and especially during labor. And there are specific spots in our body, mostly our upper… the upper part of our neck, that controls these parasympathetics. When that part of our nervous system is working really well, it's kind of like we hook a brake pedal up in our body, and we slow down. So ideally, you would be living in a calm, slowed down state all the time. Regular chiropractic adjustments help to stimulate the part of our parasympathetics that allow us to stay calm.

So what does all this mean? If we're able to hook up the power to your uterus, if we're able to make the passage ideal and beautiful and optimal to come out, and we're making the passenger in the perfect position, what does that mean? So for first-time moms, that means that, on average, chiropractic research has shown that first-time moms, the length of their labor goes from… most labors are average around 14 hours for the first time. We bring that down to about 9 hours. Second or more moms, the average labor length is about 9 hours. With chiropractic care, it's about 5 hours. We found that pain meds are reduced by about 50%. C-section rates are massively decreased. In my office, it's less than 10% total C-sections, which is a much lower number than the 33% that is average in Bismarck. We have a 300% increase in proper positioning. So this is an important one too. This goes back to the passenger, the position of the baby, how much the baby can help coming out. No chiropractor's job is to turn your baby. It's a very common misconception that we are turning babies. We don't do that. That is practicing obstetrics. Our job is to create the optimal environment for your baby.

I use this analogy all the time, so if you've seen me, you've heard this next analogy, but this is a very good one to understand. Picture you are somewhere down in the ocean. Say you're in Mexico on the beach, and you're on a babymoon. You're about to have a baby in a few months, so you want to go to the beach and chill and relax for a bit. And you see a bunch of kids down the beach off on this cliff, and they're jumping off this cliff down into the water. It looks super fun, so you follow them over to the cliff, and you're like, "Sweet! I'm going to try this, I'm going to jump into the ocean." And when you get up to the top of the cliff, you look down in the water and you see this huge great white shark swimming in the water. You're not going to jump in the water, obviously, because you knew that if you jumped in the water something would go wrong. That shark would probably eat you. Even if you're a fast swimmer, it's probably going to get you. So, you're just going to say, "You know what? I'm going to stay up here where it's safe. And maybe later, if that shark leaves, then I'll try. But right now, things are not looking good."

If you compare that to your body when you're pregnant, your baby is just like you on the top of that cliff. It looks down into the pelvic environment, it looks down into the birth canal, and it says, "Hey, is this good or is this bad? If it's good, I'm going to drop down there and nuzzle in, just beautifully and perfectly, with my head down." If the environment doesn't look good… Maybe it's too small, maybe my cord is too short, maybe the cord is wrapped around my neck… If that's happening, I'm not going to drop down because I know that's not an ideal spot. My job as a chiropractor is not to push you off the cliff into the shark-infested waters. My job is to take the shark and lure it away and go tell them to bother somebody else down the beach. So with you that means making your pelvis so enticing that your baby looks down and says, "Great, I love it! That's exactly where I want to be. I'm going to drop down." In the few cases of moms who have stayed in a bad position even after getting adjusted regularly… this is only a handful… they tend to have short cords or cords wrapped around the neck. So those are instances where the baby knew more than we did. They shouldn't drop down because if a baby drops down and the cord's wrapped around their neck, maybe something bad would have happened. We will never know. So, in the chiropractic case, we are never moving babies down into the birth canal. We are helping them and encouraging them by making the pelvic environment as beautiful as possible.

So, the last thing that we've seen, both in our office and globally with chiropractic research, we found that pregnancy pain in general… Now, this is not just during labor, but during pregnancy in general… is reduced by 75%. So, look at these six stats. These are crazy! Look at the savings in emotional stress for you as a mom, how much pain, medications, C-sections, and pregnancy is reduced. And look at how much time is saved for you having to be in labor. I know you don't want to be in labor for 14-plus hours. This is crazy to me. This is wonderful to me. This is showing me that every single mom should be seeing a prenatal chiropractor during pregnancy. It's cool stuff.

So, who should see a prenatal chiropractor? These first four are very obvious. If you're in pain, if you're having pain, if something's bothering you, if you're having constant morning sickness and can't sleep because you can't get comfortable, you for sure should be seeing a prenatal chiropractor. If your baby's in the wrong spot, if your baby's vertex… or sorry, if your baby's transverse or breech or occiput posterior, that is a great reason to see a prenatal chiropractor. We can help make sure the pelvis is as balanced and as neutral as possible, and hopefully, it will help baby to drop down on their own. Moms who are wanting a VBAC, this is another great example. Moms that are wanting… that maybe had a C-section the first time and didn't like the recovery, didn't like the experience, and are going to do everything that they can to have a successful vaginal delivery afterwards. This is a great time to make sure that every single possible thing that can be done is done, granted your OB says you are a safe candidate for a VBAC. Moms who are wanting a more natural birth, moms that are wanting less interventions during delivery. It's pretty ideal to make sure that every little detail is checked at that point. But honestly, I think that every single mom should be at least checked because it's pretty darn rare. I don't really know that I remember a single mom that I've seen where their pelvis from the beginning was balanced and neutral. It's pretty rare. I see moms come to me a lot after they've been seeing me for a while, but it's extremely rare for a mom to not need their pelvis adjusted during pregnancy. It's a pretty stressful time.

So, this is your cue to start. If you watched all the way to the end of this webinar, you were obviously interested. Maybe you're pregnant right now, maybe you're planning on getting pregnant. I would encourage you to go over some of this stuff with a prenatal chiropractor. There are a few ways on the screen here to get ahold of us. If you are not in Bismarck watching this, go to icpa4kids.org and search for a prenatal chiropractor on this website. Find one that has the letters "CACCP" after their name. If they don't have those letters after their name, that means that, at most, they're dipping their toes into the pediatric and prenatal world. The CACCP doctors are the ones that have devoted their lives to this topic and would love to help you if you're not in Bismarck. But until then, I'm glad you guys listened to this. Thank you. Have a good rest of the day.