The Webster Technique
Helping Breech Babies Turn in Preparation for Birth
Last week, Shivone, a new patient called my office and told my assistant, Lacey, that her baby is in the breech position and she was desperate to avoid having a cesarean delivery. The hands-on doctor that I am, as soon as I had a free moment, I called her back to discuss the situation and get the details. Her due date was five weeks away and time was of the essence. She was considering having her Ob/Gyn perform version, the technique where the doctor tries to manually turn the baby in the head-down position in preparation for delivery, but she was hoping there might be another option first.
Media-savvy mom that Shivone is, she went online and did research. She had heard that certain chiropractors who specialize in pregnancy chiropractic care practice a gentle adjustment to the spine and hips called the Webster Technique, which facilitates a baby in the breech position to turn on its own accord. Shivone decided to make an appointment and come to my office for a consultation that same day.
After a series of 3 or 4 visits over the course of the week, Shivone arrived at my office one Monday in tears. “The baby has turned! Her head is down! I just had my OB appointment! OMG! I am so happy. Thank you!!” I gave Shivone a big hug and we smiled at each other from ear to ear. I told her I don’t walk on water, I don’t have a magic wand, and I guarantee nothing. However, I know a thing about spinal biomechanics and pregnancy on top of having a strong belief in the body working beautifully as nature intended it to. So what exactly is the Webster Technique, you ask?
You have seen the Webster Technique — that chiropractic technique to help pregnant mothers with breech babies — featured on The Learning Channel’s hit series “A Baby Story.” You have read about it in Mothering magazine and Midwifery Today. You have seen it on the Internet. You have heard it talked about by birthing professionals. Perhaps potential patients have asked you about it. But what is it?
The Webster Technique, discovered by Dr. Larry Webster, founder of the International Chiropractic Pediatric Association (ICPA), is a specific chiropractic adjustment for pregnant mothers. It is a chiropractic technique designed to relieve the causes of intrauterine constraint.
Formerly known as Webster’s “In-Utero Constraint Technique” or “Webster’s Breech Turning Technique,” the Webster Technique was developed by Dr. Webster in 1978. It has been highly successful in relieving intrauterine constraint and helping to convert breech presentations to cephalic presentation for more than 20 years.
Intrauterine constraint is defined as any forces external to the developing fetus that obstructs the normal movement of the fetus. Intrauterine constraint can prevent the developing fetus from attaining a head down vertex position and achieving a vaginal birth, resulting in cesarean section delivery. Today, nearly 13% of all cesarean deliveries performed are due to breech presentation.
In 1985, the World Health Organization (WHO) proposed 15% as the highest acceptable limit for cesarean section rates. This figure was based on the cesarean section rates of countries with the lowest perinatal mortality rates in the world. In 1991, the figure was adopted as a goal for the year 2000 by the United States Department of Health and Human Services.
Currently, approximately 4.6 % of all singleton pregnancies develop into breech presentation, and the incidence of perinatal mortality with breech presentation is approximately four times that of a vertex presentation. While many infants in breech presentation before 34 weeks will convert spontaneously to a cephalic presentation, few will do so afterward.
Decreasing the number of caesareans for breech presentation has been offered as a strategy to reach the Healthy People 2000 goal of 15% cesarean section rate. The importance of preventing intrauterine constraint and subsequent cesarean section delivery is apparent, considering in the United States approximately 22% of all births were cesarean section deliveries. In Canada the incidence of cesarean section ranges from 15%-22%, depending on the province. The Webster Technique is a chiropractic means of decreasing the number of caesareans for breech presentation.
Performance of the Webster Technique involves analysis of the relationship of the bones of the pelvis, and correction of aberrant biomechanics through the use of a light force chiropractic adjustment of the sacrum (Step 1). It also involves analysis and relief of specific abdominal muscle tension or spasm (Step 2). Both steps are intended to relieve the musculoskeletal causes of intrauterine constraint that may lead to cesarean section delivery.
It is important to stress that the Webster Technique is not to be misconstrued as the practice of obstetrics. The Webster Technique is a specific chiropractic technique intended to relieve a specific musculoskeletal condition, and is well within the chiropractor’s scope of practice. At no time does the chiropractor attempt to change the position of the fetus as is done in external cephalic version (ECV). Untrained individuals should not attempt the Webster Technique. In addition, the Webster Technique should not be confused with other unproven or unsafe “chiropractic breech turning” techniques.
The ICPA, founded by Dr. Webster, maintains the only database of chiropractors certified in the proper performance of the Webster Technique. In addition, the ICPA currently offers the only courses to certify chiropractors in the proper performance of it. Growing awareness of the Webster Technique is demonstrating the increased demand for doctors of chiropractic trained to perform it. Because of its ability to facilitate easier, safer deliveries for both mother and baby, many birth care providers are actively seeking doctors of chiropractic with the skills in this technique.