Side-sleeping with a pregnancy pillow (or pillow between knees)
After about 20 weeks, side-sleeping is recommended (preferably left side). A pillow between the knees and one supporting the bump dramatically reduces back and hip strain.
Condition
Pregnancy and Postpartum Chiropractic Care in Gaithersburg, MD
Safe, Gentle Care for Back Pain, Pelvic Pain, and Recovery
Pregnancy and postpartum are hard enough — you shouldn't be in pain on top of it.
We provide safe, gentle, evidence-based care for the musculoskeletal patterns that show up during pregnancy and after delivery — alongside your OB or midwife. Schedule today.
The short version
Pregnancy puts the spine, pelvis, and core under months of progressive load that no other condition replicates. 50–80% of pregnant women experience back pain, and a substantial portion deal with pelvic girdle pain, sciatica, round ligament pain, or postpartum recovery issues. The research supports chiropractic, soft tissue therapy, and targeted exercise as safe and effective during pregnancy and after delivery. At Potomac Valley Chiropractic in Gaithersburg, our providers use pregnancy-appropriate techniques (including the Webster Technique) to help you feel better during pregnancy and recover well afterward — alongside your OB or midwife.
Understanding it
What is pregnancy and postpartum care?
Pregnancy reshapes your spine, pelvis, and core. We provide safe, gentle, evidence-based care for back pain, pelvic girdle pain, sciatica, and postpartum recovery — alongside your OB or midwife.
Pregnancy reshapes the body in ways no other condition does. Hormones (especially relaxin) increase ligament laxity. Body weight increases unevenly. The pelvis tilts forward. The spinal curves shift. Core musculature stretches and weakens. The result is a combination of normal physical changes and frequently painful musculoskeletal patterns that show up in predictable places — the lower back, the pelvis (especially the sacroiliac joints and pubic symphysis), the round ligaments, the sciatic nerve, and the upper back and neck.
Postpartum recovery brings its own set of patterns. Postural shifts from carrying and nursing. Weakened core and pelvic floor muscles. Often a diastasis recti (separation of the abdominal muscles). Continued ligament laxity for months after delivery. Sleep deprivation and the physical demands of caring for a newborn.
Pregnancy chiropractic care is a recognized specialty within chiropractic. It uses techniques specifically designed for pregnancy — modified positioning to avoid pressure on the abdomen, lower-force adjustments, and certified techniques like the Webster Technique that focus on the pelvic alignment that supports a healthy pregnancy.
We work alongside your obstetrician or midwife, not in place of them. We don't deliver babies. We don't manage pregnancy-related medical conditions. We focus on what we do well — safely addressing the musculoskeletal patterns that make pregnancy and postpartum harder than they need to be.
- Lower back pain — affects 50–80% of pregnancies
- Pelvic girdle pain (SI joint, pubic symphysis) — common during second and third trimesters
- Sciatica during pregnancy — often from postural and pelvic changes
- Round ligament pain — sharp pulling sensations as the uterus grows
- Postpartum back pain, neck pain, and pelvic recovery
- Diastasis recti rehabilitation
Is this what you're feeling?
Common pregnancy and postpartum symptoms
If any of these sound familiar, you're not alone — and pregnancy and postpartum care usually responds well to the right plan.
Lower back pain — usually worsening in the second and third trimesters
The most common pregnancy musculoskeletal symptom. Often a dull ache that becomes worse with prolonged standing, sitting, or activity.
Sharp pelvic pain — pubic symphysis, SI joints, or hips
Pelvic girdle pain affects up to 1 in 5 pregnancies. Sharp, well-localized pain often with specific aggravating movements (rolling over in bed, standing on one leg).
Radiating leg pain or numbness (sciatica)
Common pattern during the third trimester as postural and pelvic changes compress or irritate the sciatic nerve.
Sharp pulling sensations in the lower abdomen
Round ligament pain — usually short-lived, related to sudden movement or changes in position. Generally normal but can be quite uncomfortable.
Upper back and neck pain
Posture changes during pregnancy and the demands of carrying/nursing postpartum often produce upper back and neck symptoms.
Postpartum back, hip, or pelvic pain that persists past 6 weeks
Many women assume postpartum pain is 'normal' — it's common, but it's also treatable and shouldn't be accepted as permanent.
Difficulty engaging the core after delivery
Often related to diastasis recti, pelvic floor dysfunction, or both — both treatable with appropriate rehab.
Causes and risk factors
What drives pregnancy and postpartum musculoskeletal pain
Knowing what's contributing to your pregnancy and postpartum care is the first step toward a plan that actually works.
Progressive load and postural changes during pregnancy
Body weight increases. Center of gravity shifts. The lumbar curve increases. All combine to put more load on the lower back and pelvis.
Relaxin and other hormonal changes
Relaxin increases ligament laxity, especially in the pelvis, to allow delivery. This is necessary — but it also means joints are less stable and more likely to become painful.
Pelvic alignment shifts as the baby grows
Sacroiliac joints and the pubic symphysis become more mobile and can develop dysfunction patterns specific to pregnancy.
Core muscle stretch and abdominal separation (diastasis recti)
The abdominal muscles stretch to accommodate the growing uterus and often separate. Recovery takes targeted rehab.
Postural demands of nursing and carrying a newborn
Postpartum patients spend hours in flexed, side-shifted positions that strain the upper back, neck, and shoulders.
Sleep deprivation and reduced movement
Sleep is foundational to tissue recovery. Combined with the reduced movement many new parents experience, this slows musculoskeletal healing.
Safety first
When pregnancy or postpartum symptoms need urgent care
Most cases respond well to effective care — but a small number of symptoms warrant an emergency-room visit, not a chiropractic appointment. If you have any of the signs below, call 911 or go to your nearest ER.
Vaginal bleeding, fluid leakage, or decreased fetal movement
Pregnancy emergency — contact your OB or midwife immediately, or go to the emergency room.
Severe abdominal pain that's constant or worsening
Different from round ligament pain — needs OB evaluation immediately.
Severe headache, vision changes, or upper abdominal pain (especially after 20 weeks)
Possible preeclampsia — emergency evaluation through your OB or the ER.
Loss of bladder or bowel control
Possible cauda equina syndrome — surgical emergency. Go to the ER immediately.
Severe one-sided abdominal pain with shoulder pain (early pregnancy)
Possible ectopic pregnancy — emergency evaluation needed.
Significant calf swelling with pain
Possible blood clot — pregnancy increases this risk substantially. Emergency evaluation needed.
Fever with pelvic pain postpartum
Possible postpartum infection — contact your OB immediately.
What you can do today
What you can do at home during pregnancy and postpartum
Simple, evidence-based steps you can take today to feel better while we get you in. None of these replace a full evaluation, but they're a smart starting point for most pregnancy and postpartum care flare-ups.
Move every day — gentle, consistent activity
Walking, prenatal yoga, swimming, and prescribed exercises all help. Avoiding all movement actually makes pregnancy musculoskeletal pain worse.
Avoid prolonged static positions
Long stretches of sitting or standing both aggravate pregnancy pain. Change positions every 30 minutes.
Postural awareness when standing, sitting, and lifting
As the bump grows, the temptation is to lean back. Keeping a more neutral posture (and using your legs for lifting) substantially reduces back symptoms.
Hydration and nutrition
Both directly affect tissue health, ligament strength, and recovery. Increased water intake is appropriate during pregnancy.
Pelvic floor and core awareness during pregnancy and postpartum
Pelvic floor activation and gentle core engagement (when appropriate) help both during pregnancy and postpartum recovery. We coordinate with pelvic floor PTs when relevant.
Imaging guidance
Imaging during pregnancy and postpartum
Imaging is a tool, not a default. Your doctor will discuss whether it's appropriate for your specific situation during the exam.
Imaging during pregnancy is deliberately limited. X-rays are avoided unless absolutely necessary because of radiation exposure to the developing baby. MRI is generally considered safe during pregnancy when truly needed, but is still used sparingly.
Most pregnancy musculoskeletal complaints can be accurately assessed and treated through physical examination and history — no imaging needed.
Postpartum imaging follows standard guidelines once you're cleared by your OB.
If a clinical situation arises during pregnancy where imaging might be warranted, we coordinate carefully with your OB or midwife to determine the right approach.
- Pregnancy musculoskeletal care is almost always done without imaging
- X-rays are avoided during pregnancy unless absolutely necessary
- MRI is considered safe when truly needed but is used sparingly during pregnancy
- We coordinate closely with your OB or midwife on any imaging decisions
Your recovery
What recovery looks like
Most patients want a realistic timeline — not a sales pitch. Here's what the research and our 25+ years of clinical experience tell us.
Most pregnancy musculoskeletal patterns respond well to appropriate effective care during pregnancy and improve substantially after delivery. Many women experience meaningful relief within just a few visits — especially for pelvic girdle pain, lower back pain, and sciatica patterns.
Postpartum recovery happens over months, not weeks. Core, pelvic floor, and overall musculoskeletal function gradually rebuild over 6–12 months postpartum with appropriate care and exercise. Patients who address postpartum musculoskeletal issues early generally have substantially better long-term outcomes than those who wait.
Phase 1
First trimester (weeks 1–12)
Musculoskeletal symptoms are usually mild. Foundation work — posture, gentle movement, hydration. Round ligament pain may start.
Phase 2
Second trimester (weeks 13–27)
Pelvic girdle pain and lower back pain often start. This is when chiropractic care, soft tissue work, and targeted exercise produce the biggest results.
Phase 3
Third trimester (weeks 28–40)
Symptoms typically peak. Frequent care, gentle pelvic alignment work (Webster Technique when appropriate), and posture support help substantially.
Phase 4
Postpartum (weeks 0–12)
Recovery phase. Once cleared by your OB, we work on postpartum back and hip pain, core re-engagement, posture from nursing/carrying, and beginning of pelvic floor and core rehab.
Phase 5
Postpartum (months 3–12+)
Progressive return to full strength and function. Many women come back for ongoing care through this period to address diastasis recti, postural patterns, and overall recovery.
Our approach
How we help pregnant and postpartum patients
Every patient starts with a personalized exam and a plain-language explanation of what we found. From there, we build a plan around your symptoms, your goals, and the activities you want to get back to.
How we care for pregnant and postpartum patients — gentle, modified, evidence-based
Pregnancy chiropractic care isn't 'regular chiropractic with a smaller table.' It's a different approach that respects what's happening in your body during pregnancy and after delivery.
All adjustments during pregnancy are modified — positioning to avoid pressure on the abdomen, lower-force techniques, and specialized prenatal tables that accommodate the growing bump. Pregnancy-trained providers know exactly which adjustments are appropriate at each stage.
The Webster Technique is a specific chiropractic approach for pregnant patients that focuses on pelvic alignment, soft tissue work, and ligament balance. It's safe, gentle, and well-suited to pregnancy. Many of our prenatal patients ask for it specifically.
Soft tissue work during pregnancy addresses the muscles and ligaments that take the most strain — the lumbar paraspinals, glutes, piriformis, and round ligaments. We use techniques that are appropriate for pregnant patients.
Prenatal therapeutic exercise focuses on safe core work (no traditional crunches), pelvic floor awareness, hip strength, and postural endurance. These exercises both reduce pregnancy symptoms and prepare your body for delivery and recovery.
Postpartum care begins (with your OB's clearance, usually around 6 weeks) with gentle work on the lower back, hips, and upper body. Core and pelvic floor rehab follow as you recover. We coordinate with pelvic floor PTs when more focused pelvic floor work is needed.
Through it all, we work alongside your OB or midwife. We never replace medical care — we add a musculoskeletal layer to a team that's looking after your overall pregnancy.
Treatment options
Pregnancy and postpartum care options
Most patients get better faster when treatments are combined — instead of trying one approach at a time and hoping for the best.
Chiropractic care
Pregnancy-modified adjustments and Webster Technique work to address pelvic alignment, lower back pain, and sciatica safely during pregnancy.
Learn more →Soft tissue therapy
Pregnancy-appropriate soft tissue work for the lumbar paraspinals, glutes, hip muscles, and round ligaments.
Learn more →Therapeutic exercise
Prenatal and postpartum exercise — safe core work, pelvic floor coordination, hip strength, and postural endurance.
Learn more →Physical therapy / rehab
Structured rehab for postpartum recovery — diastasis recti, core re-engagement, return to exercise, and pelvic stability work.
Learn more →Cupping therapy
Useful adjunct for postpartum patients dealing with chronic upper back and neck tension from carrying and nursing.
Learn more →What the research says
What the research says about pregnancy and postpartum care
Verified national and peer-reviewed data on pregnancy and postpartum care — so you understand what you're dealing with and why the plan we recommend actually works.
>60%
Of pregnant women experience low back pain, per ACOG — making it one of the most common pregnancy-related musculoskeletal complaints. Strengthening abdominal and back muscles is the primary modifiable risk factor.
Source: ACOG Committee Opinion 804 — Physical Activity and Exercise During Pregnancy and the Postpartum Period (2020)
~20%
Point prevalence of pelvic girdle pain (PGP) in pregnant women, per the European Guidelines. PGP is distinct from low back pain — it presents over the sacroiliac joints or pubic symphysis and is driven by load transfer changes, not disc pathology.
Source: Vleeming et al., European Spine Journal — European Guidelines for the diagnosis and treatment of pelvic girdle pain (2008)
60% → 32.6%
Prevalence of diastasis recti abdominis at 6 weeks postpartum (60%) and at 12 months postpartum (32.6%). About one in three women still have measurable DRA a year after birth — which is why postpartum rehab matters well beyond the 6-week check.
Source: Sperstad et al., Br J Sports Med — Diastasis recti abdominis during pregnancy and 12 months after childbirth (2016)
Exercise reduces pregnancy LBP
A Cochrane systematic review found land-based exercise during pregnancy significantly reduces low back pain and disability — with no increased risk of adverse pregnancy outcomes when supervised appropriately.
~25% persist at 6 months postpartum
Of women with significant pregnancy-related lumbopelvic pain continue to report symptoms at 6 months postpartum without targeted rehab — and roughly 10% still have pain at 1 year. Early postpartum care meaningfully changes this trajectory.
Source: Wu et al., European Spine Journal — Pregnancy-related pelvic girdle pain: terminology, clinical presentation, prevalence (2004)
Manual therapy + exercise safe
Pregnancy-modified chiropractic and manual therapy (side-lying, prone-cushion, Webster Technique) combined with exercise is recommended in the APTA Pelvic Health and ACOG guidelines as a safe, effective option for pregnancy-related musculoskeletal pain.
Source: Clinton et al., JOSPT — Pelvic Girdle Pain in the Antepartum Population: Physical Therapy Clinical Practice Guidelines (2017)
Pregnancy and postpartum
Pregnancy-specific safety notes
All of our pregnancy care is provided by chiropractors trained in modified prenatal techniques. Pregnant patients are positioned to avoid abdominal pressure (often side-lying or on a special pregnancy table), and we use modified, lower-force techniques throughout.
Chiropractic care, including the Webster Technique, is considered safe during pregnancy by major chiropractic organizations and is supported by the available research. We always coordinate with your OB or midwife if you have specific concerns or pregnancy complications.
We avoid certain techniques and positions that aren't appropriate during pregnancy. We're careful about what we do — and that's the right approach.
If you have any of the following, talk to your OB before starting care: placenta previa, vasa previa, preterm labor, severe preeclampsia, ectopic pregnancy, or any condition where your OB has restricted your activity.
- Pregnancy-trained providers using modified prenatal techniques
- Side-lying or prenatal table positioning — no pressure on the abdomen
- Lower-force, gentler adjustments throughout pregnancy
- Webster Technique certification for pelvic alignment work
- Coordination with your OB or midwife as needed
- We never replace medical pregnancy care — we add a musculoskeletal layer
Real patients, real results
What patients say about our pregnancy and postpartum care
Verified word-for-word reviews from our Google Business Profile. We're rated 5.0 stars across 189 reviews.
★★★★★
“I've been seeing Dr. Theodore for about 4 years and the care has been a game-changer. He and his staff take the time to listen, explain everything clearly, and tailor each adjustment to what I need that day. My neck/shoulder pain has improved dramatically, and I always leave feeling better than when I walked in.”
★★★★★
“I could finally sleep through the night after only one visit! At 72, I've received massage, acupuncture and treatment from other places but have never had such immediate results. Your comfort and pain relief is their goal.”
★★★★★
“Excellent and very friendly practice. Dr. Spiro takes his time to understand your individual needs and focus on resolving your issue. He is patient, kind and loves what he does. The office tries its best to get you in quickly and they also don't pressure you into making multiple, recurrent appointments. I recommend his practice to all of my friends and family.”
FAQ
Common questions about pregnancy and postpartum care
Quick, plain-language answers about pregnancy and postpartum care care, what to expect, insurance, and how we help patients in Gaithersburg and Montgomery County.
Is chiropractic care safe during pregnancy?+
When done by a pregnancy-trained provider using modified techniques, yes. Major chiropractic organizations consider pregnancy chiropractic care safe, and the available research supports it. We use specialized positioning (side-lying or prenatal tables), lower-force adjustments, and pregnancy-specific techniques. We always coordinate with your OB or midwife if you have any concerns or pregnancy complications.
What is the Webster Technique?+
The Webster Technique is a specific chiropractic approach for pregnant patients that focuses on pelvic alignment, soft tissue work, and ligament balance. It's designed to be safe and gentle, and is widely used during pregnancy to address pelvic-related back pain, sciatica, and discomfort. Our certified providers use it as part of comprehensive prenatal care.
When can I start postpartum chiropractic care?+
Typically after your 6-week postpartum visit and clearance from your OB or midwife. Some patients start earlier with gentle work on the upper back and neck (which doesn't require the same clearance), but lower body and core work usually waits for medical clearance.
Can chiropractic care help with diastasis recti?+
Yes — combined with appropriate rehab. The progressive core work that addresses diastasis recti is part of what we do. For severe diastasis recti or significant pelvic floor dysfunction, we often co-manage with pelvic floor physical therapists who specialize in that work.
Will care help my baby be in a better position for delivery?+
The Webster Technique is sometimes used to help with pelvic balance during pregnancy. While we never make specific claims about delivery outcomes, many of our patients use prenatal care as part of their preparation for delivery and report feeling more comfortable in late pregnancy.
Do I need a referral from my OB?+
No referral required. Many patients let their OB know they're starting chiropractic care, and we're happy to coordinate or provide documentation if your OB asks. We work alongside OBs and midwives regularly.
I'm breastfeeding — does that affect care?+
Not significantly for chiropractic work. The continued effects of pregnancy hormones (especially relaxin) can persist while breastfeeding, which we account for in our techniques. Many nursing patients also benefit from upper back and neck work to address the postural demands of nursing.
Related conditions
Related conditions during pregnancy and postpartum
Related conditions our patients often deal with at the same time.
Back Pain
Lower back pain is the most common pregnancy musculoskeletal complaint — many of the same care principles apply, with pregnancy-specific modifications.
Learn more →Sciatica
Pregnancy sciatica is common and responds well to pregnancy-modified care.
Learn more →Hip Pain
Hip pain during pregnancy is often related to pelvic girdle pain and SI joint dysfunction.
Learn more →Neck Pain
Postural demands of pregnancy and postpartum often produce neck pain that responds well to care.
Learn more →Posture and Desk Pain
Many postpartum patients deal with desk-work patterns layered on top of nursing posture demands.
Learn more →Pregnancy and postpartum are hard enough — you shouldn't be in pain on top of it.
Safe, gentle, evidence-based care alongside your OB or midwife. Schedule today.
https://www.potomacvalleychiro.com/conditions/pregnancy-and-postpartum-care
Sources
- 1. ACOG Committee Opinion 804 — Physical Activity and Exercise During Pregnancy and the Postpartum Period (2020). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period Accessed July 2026.
- 2. Vleeming et al., European Spine Journal — European Guidelines for the diagnosis and treatment of pelvic girdle pain (2008). https://pubmed.ncbi.nlm.nih.gov/18259783/ Accessed July 2026.
- 3. Sperstad et al., Br J Sports Med — Diastasis recti abdominis during pregnancy and 12 months after childbirth (2016). https://pubmed.ncbi.nlm.nih.gov/27324871/ Accessed July 2026.
- 4. Liddle & Pennick, Cochrane Database of Systematic Reviews — Interventions for preventing and treating low-back and pelvic pain during pregnancy (2015). https://pubmed.ncbi.nlm.nih.gov/26422811/ Accessed July 2026.
- 5. Wu et al., European Spine Journal — Pregnancy-related pelvic girdle pain: terminology, clinical presentation, prevalence (2004). https://pubmed.ncbi.nlm.nih.gov/15045170/ Accessed July 2026.
- 6. Clinton et al., JOSPT — Pelvic Girdle Pain in the Antepartum Population: Physical Therapy Clinical Practice Guidelines (2017). https://www.orthopt.org/uploads/content_files/files/Pelvic%20Girdle%20Pain%20in%20the%20Antepartum%20Population_%20Physical%20T...pdf Accessed July 2026.
Medical disclaimer: This page is for educational and informational purposes only. It is not medical advice and does not replace a personalized evaluation from a licensed healthcare provider. If you're dealing with severe, worsening, or red-flag symptoms, please call 911 or go to your nearest emergency room. Schedule a personalized exam with Potomac Valley Chiropractic to get a plan built specifically for your situation.