ACOG Committee on Obstetric Practice Addresses Pain Management – F4CP Responds

On May 17, 2018, The American College of Obstetricians and Gynecologists’ (ACOG) Committee on Obstetric Practice released an important and timely committee opinion addressing postpartum pain management.

The advice of the ACOG Obstetrics Practice Committee is consistent with federal guidelines and recommendations seeking to increase the use of non-pharmacologic approaches to pain management and a minimization and elimination of the use of opioid containing products whenever possible, according the Foundation for Chiropractic Progress (F4CP).

“Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman’s ability to care for herself and her infant,” notes the nation’s OBGYN community. In addition to interfering with the ability of a mother to care for her child, the use of opioids puts infants at risk. In April 2017, the U.S. Food and Drug Administration (FDA) announced labeling revisions advising “breastfeeding is not recommended while using medicines that contain codeine or tramadol because of the potential for serious adverse effects in the infant due to opioid overdose.”

ACOG carefully explores the impact of non-steroidal anti-inflammatory medications (NSAIDS) and codeine (opioid) containing products. Unfortunately, the ACOG opinion statement does not offer any guidance to obstetricians or mothers about available non-pharmacologic approaches to pain management.

For advice and recommendations relative to the non-pharmacologic management of postpartum pain, the Foundation for Chiropractic Progress consulted the clinicians involved in a ground-breaking interprofessional collaboration involving Life University’s Vital Life Health Center (VLHC) and Atlanta Birth Center (ABC) located in downtown/midtown, Atlanta, Georgia.

“As a chiropractor at the Vital Life Health Center I collaborate daily with the midwives and staff of Atlanta Birth Center providing chiropractic care throughout the pregnancy of many ABC clients,” comments Bryna Waters, D.C. “The most gratifying clinical opportunity for me is to adjust a mom-to-be, and see her go onto complete a normal delivery much faster than her progress had been up to that point.”

“Chiropractic is helpful at all stages of a pregnancy. It accrues to a safe and typically expedited labor and delivery,” according to Dr. Waters. The relationship is equally exciting from the perspective of the midwives responsible for the management of the pregnancy, labor and birth process at Atlanta Birth Center. “It is clear to us that our moms and babies benefit from chiropractic care in pregnancy, birth and postpartum. We have seen shorter, easier labor periods, less pushing times, overall increased likelihood of vaginal births and more successfully established breastfeeding relationships when they have the advantage of chiropractic care,” notes ABC Director and midwife, Anjli Hinman.

The interaction and cooperation involving chiropractic care and midwifery care does not stop at the birth of the newborn as chiropractic care is an essential part of the postpartum period for many clients of Atlanta Birth Center. Ms. Hinman stated, “We agree with ACOG that pain and fatigue are amongst the most common problems reported by women in the early postpartum period for many new mothers. We work with our chiropractic colleagues, massage therapists, physical therapists, cranio-sacral therapists, lactation consultants, maternal mental health therapists and our naturopathic care provider to bring as many resources, skills and clinical interventions as possible to our mothers and newborns to avoid the use of medications whenever and wherever possible. It is an approach we find our clients are looking for and interventions that work.”

“If more mothers had access to the range of care services we are able to provide our patients at the Vital Life Health Center and Atlanta Birth Center, the childbirth process (and developmental stages following) would be easier, safer, cheaper and more satisfying for everyone involved,” Dr. Waters offered.

Vital Life Health Center is an Atlanta-based, Life University affiliated collaboration providing chiropractic, functional neurology, and personal injury care. The Vital Life Health Center is a specialty clinic bringing unique assessment competencies and clinical skills together in a patient-centered neurologically-focused care environment.

Atlanta Birth Center is based on the birth center model of care, we believe pregnancy and birth are normal life events and should be women-centered. This model includes prenatal care, mind, body, spirit and social well-being, postpartum support, and much more to women in the Atlanta metro area. This birth center model of care cannot be duplicated by a local area hospital. We invite you to use our community of providers to learn more about the importance of a birth center care.

Foundation for Chiropractic Progress is a not-for-profit organization, providing information and education regarding the value of chiropractic care and its role in drug-free pain management. Visit; call 866-901-F4CP (3427). Social media: FacebookTwitterLinkedInPinterestYouTube.

F4CP Implements National Billboard Advertising

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Foundation for Chiropractic Progress Implements National Billboard Advertising

In honor of National Drug-Free Pain Management Awareness Month in September, the Foundation for Chiropractic Progress, along with six of its Group Member State Associations, are placing billboards throughout the U.S.

The billboards will support the Foundation’s goal to position chiropractic care as a safe, effective and drug-free first-line approach to manage back pain prior to utilization of drugs and surgery.

The placements are expected to reach nearly 8 million consumers.

Butte, MT
February 2019 – April 2019
Montana W/L N/O Train Depot #1 F/S

Great Falls, MT
February 2019 – April 2019
6th Sw E/L 35′ S/O Rr Trax F/S #2

Helena, MT
February 2019 – April 2019
Euclid S/L @ Glendale #1 F/E

Kalispell, MT
February 2019 – April 2019
US 2 E W/L 250′ N/O Tri-Cty Wrckng #1 f/S

Billings, MT
February 2019 – April 2019
Main St E/L .3 MI N/O Wicks #2 F/S

Bozeman, MT
February 2019 – April 2019
US 85 E/L 500′ N/O Laura Louise LN

Missoula, MT
February 2019 – April 2019
South Ave @ Stephens #1 F/W

Orlando, Florida
August 6 – September 2, 2018
SR 528 NS 100ft W/O Sand Lake Rd
Facing South West

Los Angeles, California
September 3 – 30, 2018

Facing South

Des Moines, Iowa
September 3 – 30, 2018
SE 14TH ST WS  100ft N/O PARK AV
Facing North

Detroit, Michigan
September 3 – 30, 2018
Facing West

Nashville, Tennessee
September 3 – 30, 2018
S/S I-40E @ 906 2ND AV S
Facing North East
Austin, Texas
September 3 – 30, 2018 
I-35 S W/S 1000ft S/O LOOP 4
Facing South
Minot, North Dakota
November 1, 2018 – November 30, 2018

1500 South Broadway (US Highway 83)
Facing Northbound traffic

Mandan, North Dakota
November 1, 2018 – November 30, 2018

Corner of Century & Centennial Road
Facing Westbound traffic

Fargo, North Dakota
November 1, 2018 – November 30, 2018

4301 Main Avenue
Facing Eastbound traffic

Grand Forks, North Dakota
October 15, 2018  – November 15, 2018

DeMers W/O 20th
Facing Westbound traffic

Jamestown, North Dakota
October 15, 2018  – November 15, 2018

10th St SE Between 9th & 10th Ave
Facing Westbound traffic

For more information or to view each billboard placement design, email Marketing Director

Too high a price

Too high a price

Why, months before our “Drug-Free Pain Management Awareness” campaign in September, are we choosing to bring up the opioid epidemic? To answer this question, we point to a Centers for Disease Control and Prevention (CDC) release about the toll it took in 2016, when more people died from drug overdoses in a single year than in the Vietnam and Iraq wars combined.

It is no surprise that the CDC says synthetic and classic opioids today account for six of every 10 drug overdose deaths, given that another CDC study found that one out of every four Americans prescribed long-term opioid painkillers struggle with addiction. It’s a national tragedy that deserves our continuous attention.

As doctors of chiropractic join with other healthcare providers to explore the intricacies of chronic pain and the combination of treatment options, beginning with drug-free, non-invasive chiropractic care, a myriad of pain-related issues continue to surface. Deserving careful consideration are the risks of over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen.

  • Managing the pain with NSAIDs and acetaminophen is like constantly replacing the tires on your car instead of getting the alignment that’s causing them to wear out in the first place. It is far better managed through the first-line option of spinal manipulation – eight out of 10 who seek chiropractic care for pain say they experience significant relief – and, if needed, subsequent physical therapies and medical procedures to address the cause of the pain. Yet 70 percent of new neck and back pain sufferers say they relied on NSAIDs such as Advil, aspirin and Aleve and 45 percent took acetaminophens, such as Tylenol in the first year, according to the 2017 Gallup-Palmer College of Chiropractic annual report.
  • A U.S. experiment recently reported in Journal of the American Medical Association (JAMA) found that NSAIDs and acetaminophen are better at easing the intensity of chronic pain in the back, knees and hips than prescribed opioid painkillers, but they still come with risks. While NSAIDs are not addictive, they can cause internal bleeding and kidney damage. There is also a well-established link between their use and heart hazards, according to Harvard Health Publications. Acetaminophen is generally considered safer, said the Mayo Clinic, but taking more than the recommended dose or mixing it with alcohol increases the risk of kidney damage or liver failure. These risks increase with age and additional health issues.
  • If you must take NSAIDs or acetaminophen, take the lowest recommended dose and only increase it if necessary for pain, recommended Harvard Health Publications. Make sure you’re monitored for possible side effects, and stop taking them when your pain subsides to the point where you can find comfort with hot baths or cold packs. Remember, too, that you have options in treating your pain. Stay as active as possible and watch what you eat. Talk to your team of health providers, including your doctor of chiropractic, about what treatments are available.

If there is one common thread in all of this, it’s that we’re paying too high a price for the hope of stopping the pain. Maybe by raising consciousness now and during our “Drug-Free Pain Management Awareness” campaign in September, we can make a difference.

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