It does not have to be either/or. Chiropractic care and pelvic floor physiotherapy can both be helpful during pregnancy, and they are usually helping with different things. Pregnancy-adapted chiropractic care tends to be a better fit for back, hip, pelvis, rib, neck, and movement-related discomfort. Pelvic floor physiotherapy is often the better lead for leaking, pelvic heaviness, prolapse concerns, internal pelvic pain, and other pelvic-floor-specific symptoms. Some patients end up seeing both, where each provider supports a different part of the picture.
If you are pregnant and trying to decide who to see first, this post is for you.
A quick way to think about it
At Tip Top Health near the Mississauga/Oakville border, pregnancy-adapted chiropractic care focuses on how your spine, pelvis, ribs, hips, neck, and movement patterns are handling pregnancy. Pelvic floor physiotherapy focuses on the muscles, nerves, and coordination of the pelvic floor itself, and on internal pelvic symptoms that need that specific training.
Neither replaces the other, and the choice is not about which one is “better.” It is about what is actually bothering you.
When pregnancy chiropractic care may be a fit
I see pregnant patients most often for:
- low back pain or tension that has shown up or gotten worse during pregnancy
- hip discomfort, especially when getting out of bed, out of a car, or turning in bed
- pelvic girdle discomfort or asymmetry through the front or back of the pelvis
- rib and upper back tightness, which often shows up later in pregnancy
- neck strain, often from sleep position, breast changes, or hours at a desk
- tailbone or sit bone discomfort
- general stiffness or a sense that your body is moving differently than it used to
If your main concerns are back, hip, rib, or neck discomfort, pregnancy chiropractic care with Dr. Natalie Lopez may be the right starting point.
Care is adapted for pregnancy: comfortable positioning (side-lying or with bolsters, not flat on your stomach), consent-first explanation of every step, and a pace that respects where you are in your pregnancy.
What chiropractic care is not a fit for is a concern that clearly needs pelvic-floor-specific assessment. If your main issue is leaking, heaviness, internal pelvic pain, or symptoms that may need internal pelvic floor assessment, pelvic floor phsyio should lead.
When pelvic floor physiotherapy may be the better lead
Pelvic floor physiotherapists have specific training for the muscles, nerves, and function of the pelvic floor. Pelvic floor-specific care is often the better first call when your main concern is:
- leaking urine, stool, or gas during pregnancy, with exercise, coughing, or daily movement
- a feeling of pelvic heaviness, dragging, or something “falling” inside the vagina
- prolapse concerns, or a known prolapse you want to manage through pregnancy
- internal pelvic pain, including with intercourse, tampon use, or internal exams
- pelvic-floor-specific recovery questions, including between pregnancies or in early postpartum
I want to be clear about something. Tip Top Health does not provide pelvic floor physiotherapy, and I do not perform internal pelvic floor assessment or treatment. If your concern may need internal assessment or specialized pelvic floor physiotherapy, I am glad to help you think through how to find the right provider.
Tip Top Health offers external pelvic floor rehabilitation at Tip Top Health focused on core coordination, breathing, and muscle retraining — no internal assessment.
How chiropractic care and pelvic floor physiotherapy can work together
For some patients, the question is not “either or.” It is “which one first, and is there a place for both?”
A common pattern: a pregnant patient comes in with back, hip, and rib tension on top of mild leaking with coughing and running. We work on the spine, pelvis, rib, hip, and movement side, and I refer to a pelvic floor physiotherapist for the leaking and pelvic floor coordination. The two providers talk to each other, with your permission, so we are not working at cross purposes.
In other cases, the answer is one or the other. Mostly back, hip, and rib discomfort with no pelvic floor symptoms: chiropractic care may be enough. Mostly leaking, heaviness, or internal pelvic symptoms: pelvic floor-specific care may be the better starting point.
The goal is the right care for what you are actually dealing with.
How to decide where to start
A simple split:
Start with pregnancy chiropractic care if your main concern is back, hip, rib, neck, or pelvic girdle discomfort, movement pain when turning in bed, walking, or sitting, or a general sense of stiffness through your spine and pelvis.
Start with pelvic floor-specific care if your main concern is leaking, pelvic heaviness or a prolapse concern, internal pelvic pain, or pelvic-floor-specific recovery questions.
If you are unsure, a short conversation helps. I can assess what is going on, explain whether pregnancy-adapted chiropractic care fits, and tell you honestly if pelvic floor physiotherapy is the better starting point. You can also read more about the pregnancy care and postpartum rehabilitation support at Tip Top Health and external pelvic floor rehabilitation approach when pelvic-floor-specific support is the right fit.
What a pregnancy chiropractic visit at Tip Top Health looks like
If you have never been to a chiropractor while pregnant, it is reasonable to feel cautious. Here is what a typical first visit looks like in our clinic.
I start by asking about your symptoms, what trimester you are in, your health history, what your prenatal provider has said, and how you are feeling about being here. The assessment may look at how you move, how your spine, pelvis, ribs, hips, and neck feel, where the muscles are loading, and what daily movements are hard right now. Treatment may include gentle, pregnancy-adapted chiropractic care, soft tissue work, mobility support, and simple home guidance when appropriate. I explain what I am doing before I do it, and you can stop or pause at any point.
You can also read more about what to expect at your first visit at Tip Top Health.
Questions worth asking yourself before you book
- What symptom am I most trying to address right now?
- Is this mostly movement, joint, or muscle discomfort, or is it pelvic-floor-specific?
- Have I been advised by my midwife, OB, or family doctor to avoid certain movements or positions?
- Do I need coordination with my prenatal provider, my pelvic floor physiotherapist, or another clinician?
Closing
After your baby arrives, postpartum chiropractic care and rehabilitation can help with core recovery, back pain, and returning to movement.
If you are pregnant and unsure whether chiropractic care is the right place to start, I can assess what you are dealing with and explain whether pregnancy-adapted chiropractic care, pelvic floor physiotherapy, or coordinated care makes the most sense. You can book a visit with me, Dr. Natalie Lopez, or start with a free 15-minute consultation if you would rather talk it through first.
Frequently asked questions
Can I see a chiropractor and a pelvic floor physiotherapist at the same time during pregnancy?
Yes. Many pregnant patients see both, with each provider focused on a different part of the picture. Coordination between providers is welcome and can make the care more effective.
How do I know whether to start with a chiropractor or a pelvic floor physiotherapist?
A simple rule of thumb: if your main concern is movement, joint, or muscle discomfort (back, hip, rib, neck, pelvis), start with a chiropractor. If your main concern is leaking, heaviness, prolapse, or internal pelvic pain, start with pelvic floor-specific care. If you are unsure, a short consultation can help you decide.
Is chiropractic care safe during pregnancy?
Pregnancy-adapted chiropractic care is a safe option for back, hip, pelvis, rib, and neck discomfort. Your chiropractor should ask about your pregnancy history, adapt positioning, and explain every step before it happens. If your prenatal provider has given you specific guidance, share it at your first visit.
Does Tip Top Health do internal pelvic floor work?
No. Tip Top Health does not provide pelvic floor physiotherapy or internal pelvic floor work. Pelvic floor rehabilitation at Tip Top is external and movement-based. For internal pelvic floor assessment or treatment, you would see a pelvic floor physiotherapist, and I am glad to help you think through that next step.
Will chiropractic care help with leaking or pelvic heaviness?
Not directly. Leaking, heaviness, and prolapse concerns are usually best led by pelvic floor-specific care. Chiropractic care may still help with the back, hip, or rib tension that often travels with those symptoms.
What does a pregnancy chiropractic appointment feel like?
Care is adapted to your stage of pregnancy and your comfort. You are usually positioned side-lying or supported with a pregnancy pillow, and I explain each step before it happens. The visit moves at a pace that respects how you are feeling that day.