Osteopathy During Pregnancy

Individual Assessment and Gentle, Adapted Treatment

Pregnancy produces significant changes throughout the body. As the baby grows, the spine, pelvis, ribcage, abdominal wall, breathing mechanics and circulation must continually adapt.

For some women, these changes are comfortable and manageable. For others, they may contribute to pain, restricted movement, altered breathing or difficulty managing everyday activities.

Mr Gerry Gajadharsingh DO, Osteopath and Diagnostic Consultant in Integrated Medicine, provides individual assessment and gentle osteopathic treatment for women during pregnancy and after childbirth at The Health Equation clinics in London and near Marlborough, Wiltshire.

With nearly 40 years in clinical practice, Gerry adapts every examination and treatment to the individual woman, her stage of pregnancy, medical and obstetric history, comfort and clinical needs.

Extensive Experience in Pregnancy-Related Care

Gerry has worked with pregnant women throughout his clinical career. At one stage, obstetric patients represented approximately 20% of his practice, with regular referrals from experienced obstetricians for women experiencing pregnancy-related pain and musculoskeletal complications.

This experience has developed through close collaboration with conventional maternity and obstetric care. Osteopathic assessment and treatment are provided as a complementary part of a woman’s wider healthcare—not as a replacement for her midwife, GP, obstetrician, physiotherapist or other medical professionals.

Where symptoms fall outside the expected adaptations of pregnancy, Gerry will recommend appropriate maternity or medical assessment. With the patient’s consent, he is also happy to communicate with the clinicians involved in her care.

Common Problems During Pregnancy

Pregnancy-related discomfort can arise from several interacting factors rather than one isolated structure. Women may seek assessment for:

• Lower-back pain
• Pelvic girdle, sacroiliac or pubic-region pain
• Hip, buttock or groin discomfort
• Ribcage and thoracic pain
• Neck, shoulder or upper-back tension
• Coccyx pain
• Pain or difficulty when walking, turning in bed or using stairs
• Postural strain associated with work, sleep or daily activities
• Muscular tension and reduced mobility
• Breathing discomfort or a sense of restricted expansion
• Circulatory discomfort and lower-limb heaviness
• Persistent pain following a previous pregnancy or delivery

Many pregnancy-related symptoms are benign and self-limiting. However, symptoms should not automatically be attributed to pregnancy, and appropriate clinical assessment remains important.

Understanding the Changes of Pregnancy

Pregnancy affects far more than posture. Hormonal, circulatory, respiratory and mechanical adaptations occur together and continue to change throughout each trimester.

As the uterus enlarges, the body must accommodate changes in:

• The position and movement of the spine and pelvis
• Load transfer through the hips and lower limbs
• Ribcage expansion and diaphragm function
• Abdominal-wall tension and pressure management
• Circulation and fluid distribution
• Balance, gait and everyday movement
• Sleep position and physical recovery
• Neural regulation and the physiological response to stress

These adaptations are normal, but they may expose an existing vulnerability or make it more difficult for the body to compensate for a previous injury, joint restriction, respiratory pattern or other functional problem. Osteopathic assessment aims to understand how these factors relate to the individual woman’s symptoms.

A Careful Pregnancy-Specific Assessment

The consultation begins with a detailed discussion of your symptoms, general health, previous pregnancies and relevant obstetric history.

Assessment may include:

• Posture, gait and functional movement
• The lumbar spine, pelvis, sacrum, coccyx and hips
• The thoracic spine, ribcage and breathing mechanics
• Muscles, joints, fascia and load transfer
• Abdominal-wall function and pressure management
• Circulatory, neurological or respiratory examination where indicated
• Review of relevant medical reports, imaging or maternity information

Examination is adapted to your stage of pregnancy and physical comfort. You will not be expected to maintain a position that feels uncomfortable, and findings will be explained before treatment options are discussed.

Osteopathic Manual Treatment During Pregnancy

Treatment is individually selected and modified according to your symptoms, stage of pregnancy, examination findings and personal preferences.

Gerry may draw upon a range of gentle osteopathic approaches, including:

• Soft-tissue and fascial techniques
• Gentle joint articulation and mobilisation
• Treatment of the spine, pelvis, sacrum, ribcage and hips
• Respiratory and diaphragm-focused techniques
• External visceral and pelvic-diaphragm approaches
• Cranial and involuntary-mechanism techniques
• Advice about movement, positioning, pacing and appropriate exercise

Treatment may be provided in side-lying, seated, semi-reclined or another supported position. Your comfort is checked throughout, and techniques are adapted or stopped whenever necessary.

No technique is applied routinely simply because a woman is pregnant. Treatment is guided by the individual clinical assessment and shared decision-making.

High-Velocity Thrust Techniques

As a precautionary principle, Gerry does not use high-velocity thrust techniques during the first trimester of pregnancy.

After the first trimester, a carefully selected and precisely applied high-velocity thrust technique may occasionally be considered where there is a clear clinical indication. This is subject to appropriate assessment, the absence of contraindications and the patient’s informed consent.

These techniques are never used routinely during pregnancy, and gentler alternatives are available whenever they are more appropriate or preferred by the patient.

Breathing, Ribcage Function and Physiological Regulation

Pregnancy naturally changes breathing mechanics as the enlarging uterus influences diaphragm movement and the ribcage adapts to increasing physiological demand.

For some women, an inefficient breathing pattern may contribute to symptoms such as upper-chest tension, breathlessness, light-headedness, tingling, fatigue, disturbed sleep or heightened physiological arousal.

Where clinically appropriate, Gerry may use:

• Observation and assessment of breathing pattern
• Capnometry to measure breathing rate and end-tidal carbon dioxide
• Heart rate variability to explore neural regulation
• Gentle breathing retraining
• Ribcage, thoracic and diaphragm-focused osteopathic treatment
• Relaxation and recovery strategies

The aim is not to override the normal respiratory adaptations of pregnancy, but to identify and address potentially modifiable breathing behaviours that may be contributing to discomfort or reduced physiological resilience.

When Maternity or Medical Assessment Is Needed

Not every pain or symptom during pregnancy is suitable for osteopathic treatment. Some symptoms require assessment by your midwife, maternity unit, GP or emergency services.

Please seek prompt maternity or medical advice if you experience:

• Vaginal bleeding or unexpected fluid loss
• Severe or persistent abdominal pain
• Regular painful contractions or possible premature labour
• Reduced or absent fetal movements
• A severe or persistent headache
• Visual disturbance
• Sudden or marked swelling
• Pain beneath the ribs
• Fever or signs of infection
• Chest pain, unexplained breathlessness or one-sided calf swelling
• Any sudden, severe or rapidly worsening symptom

If Gerry identifies a clinical concern during assessment, treatment will not proceed and appropriate maternity or medical referral will be recommended.

Osteopathic care during pregnancy complements, but does not replace, routine antenatal monitoring or advice from your maternity team.

This safety-netting reflects current NHS pregnancy guidance and RCOG guidance on reduced fetal movements.

Osteopathic Care After Childbirth

The postnatal period brings a further period of physical and physiological adaptation. Recovery may be influenced by pregnancy, the mode of delivery, feeding positions, interrupted sleep and the new physical demands of caring for a baby.

Women may seek assessment for:

• Persistent lower-back or pelvic pain
• Coccyx discomfort
• Ribcage, neck or shoulder tension
• Pain associated with feeding or carrying the baby
• Abdominal-wall weakness or altered pressure management
• Discomfort around a caesarean or other healed scar
• Difficulty returning comfortably to exercise
• Symptoms that began during pregnancy and have not resolved

Assessment and treatment are adapted to the individual woman, her stage of recovery and any obstetric or medical considerations. Where appropriate, Gerry may also recommend pelvic-health physiotherapy, medical review or other specialist care.

Realistic Expectations

Osteopathic care during pregnancy aims to improve comfort, movement and function where clinically appropriate. It does not claim to:

• Turn a breech baby
• Prevent pregnancy complications
• Guarantee a particular type of delivery
• Induce, accelerate or shorten labour
• Replace maternity or obstetric care
• Ensure that pregnancy-related pain will resolve completely

Responses to treatment vary. Gerry will explain what he considers clinically achievable, discuss alternative options and review progress rather than recommending treatment according to a predetermined schedule. If treatment is not helping, the management plan will be reconsidered.

Trusted by Medical Colleagues

“Gerry is a meticulous clinician. He assesses patients in a holistic way that others simply don’t do. Because of this, his results are excellent. He goes the extra mile and leaves no stone unturned. I’m very glad that I met him—and so are my patients.”

Dr Stephanie Goodwin
MBChB, MRCGP, DRCOG, DOccMed, MIPM
Private Physician