:: January/February 2006 Volume 5/Number 1

It's Yoga, Baby!
Prenatal & Postpartum Yoga For
Mother & Child

By FELICIA M. TOMASKO

Pregnant women are adapting their yoga practices for nine months, and yoga neophytes are finding yoga, often for the first time, while pregnant.  Doctors and midwives are recommending classes, which are even appearing at medical centers. To no one’s surprise, women in prenatal yoga classes are convinced that yoga is the track to a healthy pregnancy, healthy birthing process and healthy baby.

Why Do Yoga during Pregnancy?

While pregnant women were once told to take it easy during pregnancy, rest and stay in bed, that advice has changed. Resting doesn’t help relieve backache and that is one of the most common complaints during pregnancy because of the increasing burden of additional weight coupled with the abdominal muscles stretching. This affects the ability of the abdominal muscles to perform adequately in their usual role of supporting the low back.

Yoga helps make pregnancy more comfortable and can even help make delivery and subsequent recovery quicker and easier. Nellie, a prenatal yoga student in Santa Barbara raves about yoga: “Once I got pregnant, I had constant low back pain. It was so bad I could hardly walk. But when I do yoga, the pain goes away.”

Although pregnancy can be one of the most joyous times in a woman’s life, it can also be one of the most stressful. Some of the factors inducing stress include a constantly changing body, morning sickness and swollen ankles. More challenging complications can arise over concern about the new baby’s health and anxiety regarding taking on a new burden. Excess stress increases fear and fatigue and can add to complications. Yoga reduces and relieves the negative impact of stress.

Yoga helps to strengthen the muscles of the pelvis and thighs, which help support the weight of the growing baby and are useful pushing muscles during labor.  Asana (postures) are useful for maintaining suppleness in the spine, alleviating physical tension held throughout the back and shoulders as women gain weight in the abdominal and breast areas. Yoga helps normalize blood pressure, which can rise during pregnancy. Regular practice balances weight gain, keeping it from being too rapid or even too slow. And yoga is effective for reducing the ankle, leg and foot swelling many women can experience as a result of increased weight and water volume.

A unique aspect of yoga is the fact that it strengthens both body and mind. Shantell Herndon, director of Love the Belly in Silverlake, California, found that yoga allowed her to listen to her pregnant body. This inspired her to offer yoga at the center. Herndon believes yoga empowers women to critically evaluate medical advice and make informed choices throughout their birth process.

Another advocate of increasing women’s personal power and their physical and mental control during the birthing process is Dr. Tina Navarez, chief of obstetrics in Los Angeles and regional chief of obstetrics in southern California for Kaiser. Dr. Navarez finds that prenatal yoga is beneficial physically and improves mental control along with a woman’s ability to relax during labor. 

The social aspects are important too. Attending prenatal yoga classes offers women an immediate support system. Students mingle with women in early stages of pregnancy as well as those who are ready to deliver. By getting the chance to talk to women who are further along, anxiety about the future can be alleviated. Women can even make bonds that extend beyond the mat. During Gurmukh’s prenatal class at Golden Bridge, partner poses offer women an opportunity to stretch together and learn each other’s names. After class, women exchange phone numbers or sit down to a cup of tea. Liza Janden of Vista, California, reports that women form playgroups with their new babies after meeting in prenatal yoga.

According to Iyengar teacher Anna Delury, yoga can strengthen the flexibility of a practitioner’s body—and mind. It can help a mind become more easily prepared for events impossible to prepare for in advance, says Delury.  In her case, that preparation helped her cope with an emergency Cesarean, rather than the natural childbirth she had expected. 

Exercise and Pregnancy - the Medical Recommendations

The number of people who exercise during pregnancy is alarmingly low. Results from a survey published in November, 2005, by Terry Leet at St. Louis University revealed only a small proportion (about 6%) of pregnant women actually follow recommended guidelines and exercise at least three times each week.

The American College of Obstetricians and Gynecologists (ACOG) suggests that pregnant women who are not experiencing any complications exercise daily. Exercise is beneficial for the cardiovascular systems of both mother and baby, and can reduce the risk of complications, including gestational diabetes and high blood pressure.

Some organizations specifically mention yoga in their exercise recommendations. The Lamaze International’s tips for a healthy pregnancy suggest yoga as a prenatal exercise option. They state that yoga can help support stress reduction, recognizing that yoga is much more than just physical fitness.

How to Choose a Teacher

Prenatal yoga is a specialty, and as the practice becomes increasingly popular, it is important to find an experienced teacher. Anna Delury  recommends that students find a teacher who has mentored with an experienced teacher, one who is aware of and sensitive to the unique challenges of pregnancy, even if they have not been pregnant themselves. “Some of the most experienced and skillful prenatal teachers have never been pregnant,” she says. 

Rather than try to attend every prenatal yoga class available, Delury cautions students to remember to reduce stress: “Attending a couple of classes a week with a teacher a woman can really bond with can do wonders. An experienced teacher can also give students a practice to do at home.”

When to Begin

A woman who is already a yoga practitioner can continue throughout pregnancy, modifying as her body changes through the different stages. But it is also appropriate and generally safe (with a person’s individual healthcare provider’s consent) for a neophyte to take to the mat.

Often women do not like to start a practice during their first trimester, since hormonal changes can trigger nausea or morning sickness. The second trimester is the most recommended time to take up a new practice. Gurmukh finds that students often begin attending class their 12th week. Diane Gysbers, prenatal teacher at the Iyengar Institute of Los Angeles,  errs on the side of caution, advising new students to begin during their 14th week. 

To Do and Not to Do

While exercise (including yoga) is critical, yoga teachers caution pregnant women not to overdo it. Gysbers reminds her students to go easier with their practices while pregnant and not cause strain or stress. The needs of a constantly changing body can also vary dramatically throughout pregnancy, making it even more important to be attentive during practice.

A standard yoga practice is not necessarily appropriate during pregnancy. Throughout the nine months, hormonal fluctuations and rapid physical changes create the need for cautions. When considering what not to practice, and also what to include in a practice, Anna Delury points out that overall pregnancy is first and foremost a time of expansion.

This expansion is not limited to the pelvis and abdomen; the mind is also expanding as women prepare for the new baby. Modifying the practice to support expansion from within is vital. This occurs by making space for the abdominal area through poses like badakonasana (soles of the feet together and knees open). Sitting on blanket, bolsters and other supports and practicing side stretches also support internal expansion.

Gurmukh cites a number of important contraindications during pregnancy. She eliminates the breath of fire, a Kundalini yoga mainstay. Additionally, she cautions women not to pull on the bandhas (locks or seals, including mula bandha, or anal lock, and uddyana bandha, or abdominal lock). Consistent with advice of other teachers, Gurumkh eliminates abdominal strengthening movements and reminds students not to exercise to the point of exhaustion or excessively increase their heart rate. Poses lying on the belly are generally avoided.

Jumping is not recommended while pregnant, as it can lead to tightening the abdominal muscles and gripping the uterus. Poses described as push-up backbends are generally avoided, including  bhujanasana (cobra). Expansive backbends, on the other hand, like ustrasana (camel) can be attempted with proper precautions. Twists compressing the abdominal area and uterus are avoided, while expansive twists can be practiced with an experienced teacher. Most often, women are advised not to lie flat on their back after their fifth month as it reduces circulation. Instead they prop themselves up on bolsters or blankets.

Many of us are amazed seeing a seven-month pregnant woman in handstand. While there is disagreement as to invert or not invert during pregnancy, the best answer is that it depends. According to B.K.S. Iyengar, as quoted by Senior Intermediate teacher Delury, if a yoga practitioner already practicing inversions becomes pregnant, then they can continue as long as comfortable, although they often naturally drop away. Inversions are done judiciously, insists Delury, only when appropriate and with an experienced teacher. Women taking up yoga for the first time when pregnant are instructed to avoid strenuous inversions like headstand.

From the Studio to the Hospital

Hospital staff and medical professionals who practice yoga are spearheading the introduction of prenatal yoga in the medical setting. At Kaiser Sunset in Los Angeles, Chief of Obstetrics Dr. Tina Navarez attended yoga classes; the positive experience inspired her to initiate the integration of yoga into every prenatal appointment in the facility’s new group visit program. During the first hour of the group prenatal visits women talk with each other and their healthcare practitioners about current issues and challenges.  The second hour is devoted to a group yoga class with Anusara-trained instructor Jessica Jennings. Kaiser Sunset’s program is a pilot and being considered for other facilities.

Kaiser is not the only Los Angeles medical facility incorporating yoga. Natalie Stawsky teaches prenatal yoga to a completely different population at the downtown California Hospital, where a federal grant offers services to low-income women. Stawsky offers bilingual classes in Spanish and English to women, most of whom have never taken a yoga class before. “The women,” Stawsky says, “become empowered; yoga connects them more consciously with the process of pregnancy and with their baby.”

From the Mat to the Delivery Room

 “When I was pregnant, I did yoga throughout,” says Shantell Herndon. “I attribute my natural birth to yoga, to my sense of empowerment…my ability to get back into my breath during labor, to breathe and feel myself not tightening, but opening.” The test of yoga’s benefit can come in the delivery room. Empowerment and acceptance validate yoga’s benefits.

Many women actively practice during their labor, including Golden Bridge teacher Anna Getty. “The first four hours of my labor, for each contraction, I went into easy pose (sitting cross-legged), placed my hands in jnana mudra, gazed at my third eye point, and breathed [the chant] sat nam during each contraction….The next four, I walked, still meditating, and then the last few hours practiced [common prenatal poses] cat/cow, squat and spinal flexes.”

Kundalini yoga, such as Gurmukh teaches, is known for its long intense holds for the purpose of strengthening one’s will – an important aspect of a stressless pregnancy and birth. Gurmukh utilizes Kundalini yoga sets and sequences to help women prepare for the actual experience of a contraction. Many sets integrating easy breath and movement in her classes are continued for a minute, three minutes or even five minutes so a woman can experience physical intensity that is not dangerous and prepare the body for the intense, but transient, experience of a contraction. They leave the practice, prepared for the inevitable experience.

Holding a hatha yoga pose also prepares women for labor, as Jennifer Shelmon found after practicing with Liza Janda in Vista, California. “Holding a contraction in one part of my body, while trying to relax the other parts and to breathe through the uncomfortable feeling of holding the pose, that was kind of like labor.”

Breath exercises practiced in prenatal classes can even be lifesaving. Shelle Noble’s ecstatic homebirth became an emergency hospital visit when she hemorrhaged. But she remained calm throughout: “it was all about the breath,” Noble says. “My breath kept me connected and kept me conscious.”

All of these yoga practices will affect women differently and will be implemented differently by each. “Birth is not an intellectual process,” says Gurmukh. “Rather than mimicking another woman’s birth, it is necessary to realize that no birth and no baby are like your own.”

Beyond Delivery

“Prenatal yoga is wonderful,” says Delury, “but postnatal will save the mother.” Although easy to neglect, postpartum or postnatal yoga can support a new mother’s rejuvenation.

It is important to properly recover post-delivery before resuming a full routine. From an Ayurvedic perspective, the first 40 days after pregnancy are vital. Birth is an experience that increases vata, or the body’s air element, particularly due to the empty space left in the abdomen. Excess vata can contribute to postpartum depression and can also exacerbate anxiety, exhaustion, sleeplessness and fatigue.

It is thus important for the new mother to pamper herself with oil massage to calm vata via touch and the skin, and also include foods that are warm, soothing and easy to digest. To enhance rejuvenation, beautiful surroundings, support from family and friends and spending time in a quiet environment are also beneficial.

Ayurvedic recommendations encourage staying home with the new baby for the first 40 days, at least as much as possible. Gurmukh confirms this, and teaches students about the importance of the 40-day postpartum period for relaxation, nesting and bonding with their baby.

Gysbers generally takes postpartum students who have had a vaginal birth after four weeks, and a C-section after six to eight, with their doctor’s permission. But some yoga practices can be integrated right after birth. For example, Stawsky began exercises to engage the muscles of the pelvic floor (Kegels in biomedicine, or ashvini mudra or mula bandha in yoga) and abdominal poses the day after delivery to gently initiate recovery.

The demands of a newborn can be one of the biggest challenges of a postpartum yoga practice. But, women can be assured that it is not necessary to take on a full 60-90 minute practice to receive yoga’s benefits. Even 10 or 20 minutes a day can make a big difference, and a practice can be divided into manageable segments and fit in to an accessible routine, 10 minutes here and there.

Women can also bring their newborn to the studio. Mommy (and Poppa) and Me classes are sprouting up all over; they offer a chance to not only practice with baby nearby, but also socialize and even breastfeed when necessary.

Throughout the cycle of pregnancy, delivery and beyond, women are finding strength, their breath and peace of mind through yoga practice.

Felicia Tomasko is a writer, Ayurvedic practitioner and yoga teacher in Santa Barbara, California. She can be contacted at feliciatomasko@yahoo.com.

 

 

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