Thursday, January 18, 2007

The Webster Technique

EoR doesn't want to go back to NOT again, but he was interested enough to follow up on claims in The West Australian regarding chiropracters' amazing ability to resolve breech births.

Also known as the Webster Technique:

The Webster Technique is defined as a specific chiropractic analysis and adjustment that reduces interference to the nerve system and facilitates biomechanical balance in pelvic structures, muscles and ligaments. This has been shown to reduce the effects of intrauterine constraint, allowing the baby to get into the best possible position for birth. Dr. Larry Webster, Founder of the International Chiropractic Pediatric Association discovered this technique as a safe means to restore proper pelvic balance and function for pregnant mothers. In expectant mothers presenting breech, there has been a high reported success rate of the baby turning to the normal vertex position.

There is a study (published in the July/August 2002 issue of the Journal of Manipulative and Physiological Therapeutics) that reports

82% of the doctors surveyed reported a high rate of success when using the Webster Technique.

Many sites reference this study without further details. EoR is suspicious that this is a case of one site copying another (though at least one site claims the success rate as 92%).

The abstract for this single "study" is available at PubMed:

Surveys were mailed to 1047 US and Canadian members of the ICPA. RESULTS: One hundred eighty-seven surveys were returned from 1047 ICPA members, constituting a return rate of 17.86%. Seventy-five responses did not meet the study inclusion criteria and were excluded; 112 surveys (11%) provided the data. Of these 112 surveys, 102 (92%) resulted in resolution of the breech presentation, while 10 (9%) remained unresolved. CONCLUSION: The surveyed doctors reported a high rate of success (82%) in relieving the musculoskeletal causes of intrauterine constraint using the Webster Technique.

A survey may provide some preliminary data for further investigation, but it is not a scientific study of the effectiveness of the technique in relation to other techniques, nor in relation to any control group. There are also other concerns with the data:

  • The survey was retrospective, which means it was subject to recall bias (selective reporting of favorable results).

  • Only 187 chiropractors -- 18% of those surveyed -- returned the questionnaire. Such a low response rate is inherently subject to bias (chiropractors more apt to report cases they believe were successful).

  • In 59 of the cases, the breech presentation was not confirmed by ultrasound, which introduced the potential for medical misdiagnosis.

If the Webster Technique doesn't work, you might like to consider lighting a candle by your toe, visualisation, homeopathy, or talking to your baby.

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