OMM Benefits Pregnant, Antepartum Women and Newborns

For about 15 years, Dr. Hugh Ettlinger would drive a weekend each month to Massachusetts, to the home of Dr. Anne Wales. Here, Dr. Wales, a leading figure in the field of osteopathic medicine for decades, would mentor Dr. Ettlinger and other young osteopaths on the “laying on of hands” to treat the structural problems of pregnant and antepartum women and newborns.

She looked upon this as her “professional hobby,” says Dr. Ettlinger. Perhaps as importantly, she taught him the importance of providing such a service at little or no cost.

“She said I would treat the mother through nine months of pregnancy and then I would treat the mother and baby through three months after delivery for a one-time fee of $40, and I would become rich with all the experience. Giving back is part of what you do. This is something I have never forgotten.”

For more than 20 years, Dr. Ettlinger and his teams of Osteopathic Manipulative Medicine (OMM) residents have been performing these types of services at SBH. For newborns it’s performed at no cost, as a service to the community. According to a 2010 article in the New York Daily News, “Before babies at St. Barnabas Hospital bounce home, they receive a rare hands on treatment in search for signs of strain from birth and the physical causes of colic, poor feeding and other newborn problems …probing the tiny muscles, ligaments, tendons and connective tissue of newborns for tightness and alignment problems.”

As Dr. Ettlinger explains, “These babies often look fine, but don’t feel good because of colic or constipation or sucking or feeding issues, which may affect their feeding and growth. There are problems with babies that don’t show up for a while. You see babies that seem to be doing fine to everyone who is examining them, but we find problems that we can help with and manage. Osteopathic manipulation very gently releases strain produced during labor and delivery, and allows their bodies to align correctly.”

Now, with the opening of the SBH Health and Wellness Center and the new children’s and women’s health centers there, Dr. Ettlinger and his team will devote one morning a week to working with newborns who have left the hospital as well as women who have pain during pregnancy or after they give birth. “These women face a lot of challenges,” he says. “They gain 30 pounds in a short period of time. But it’s not just that they gain weight, their weight comes forward which causes postural changes. This really sets them up for lower back pain.

Pregnancy is also a fluid issue. This is what causes compression of the nerves, which can create swelling in the legs, carpal tunnel, and a number of problems that we can really help with.

“Working with body structure, we try to keep them as optimized as best as possible so they can withstand the rigors of pregnancy. And that will tie into working with them after delivery when we can take care of some of the things that occurred during labor in order to put them in a position where they can regain their normal posture.”

The arrangement will allow women who come to the new centers for OB care during or after pregnancy to consult with Dr. Ettlinger. “After taking a medical history, we can do an osteopathic structural exam to check for areas of muscle spasm, changes in their postural curve and strains in their joints, and provide hands-on treatment. If you start getting back pain at the end of your first trimester, chances are it is going to get worse before it gets better. We usually follow them semi-regularly in the first couple of trimesters and more often later on as the challenges get greater.”

He stresses that OMM treatments, which are customized and generally last 20 to 30 minutes, are very different from the kinds of treatments performed by a chiropractor or massage therapist. “Our treatments are very gentle and subtle,” he says. “We tend to utilize the patient’s own internal forces. I am much less inclined to force an issue with a tissue, and more inclined to evaluate the tissue and see how it responds as I work with it and find ways to engage the patient’s physiology.”

What does it look like? “It’s not something you see because it is happening internally.” OMM, says Dr. Ettlinger, can often make the delivery itself easier. “The mobility of the pelvis and spine has everything to do with how the women’s pelvis can change shape to make it easier for the baby to pass through. We can help facilitate normal, healthy, smooth deliveries. And, hopefully, we can reduce the rate of complications.”

Like his mentor, Dr. Ettlinger has taught generations of residents the importance of giving back to the community. Softspoken and introspective, he has also generated a bit of a cult following among young osteopathic students from around the country.

Writes one osteopathic student in a chapter newsletter, “During Dr. Ettlinger’s visit as our chapter’s visiting clinician he said something that I have never forgotten.

He brought his hands out in front of him and stretched them out wide past his shoulders and explained, ‘This is how much there is to know about Osteopathy.’ Then he brought his hands back together until there was less than an inch between them and said, ‘This is how much I understand.’ As a first-year osteopathic medical student, I thought if Dr. Ettlinger understands only a small portion of all there is to know about Osteopathy, then I truly have my work cut out for me.”