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Ask the Provider,

Diane Larson, APRN, CNM, CNP

Stellis Health

 

Using Prenatal Yoga to Promote Healthy Pregnancy and Birth

 

Question: I am pregnant with my first baby and want to stay healthy. I have heard a lot about prenatal yoga. How would prenatal yoga benefit me?

 

Answer: Yoga is an excellent exercise for pregnant women to help build strength and flexibility while improving concentration and willpower. The word yoga means, “to unite” or bring the mind and body into synchrony through breathing, postures and meditation.  Studies have shown that practicing yoga in pregnancy is safe and provides numerous benefits to pregnant women and their babies.

 

Prenatal Yoga focuses on improving the flexibility and endurance of the muscle groups needed for childbirth, while reducing specific pain issues common in pregnancy such as pelvic pain and low back pain. Yoga is more than a physical exercise, though. One of the most beneficial effects of yoga is an overall feeling of well-being. As a woman learns to focus her breathing she improves her ability to consciously relax and keep calm. This results in decreased stress, anxiety and depression, and improves sleep. Regular yoga practice improves a woman’s ability to resist the urge to tighten up with pain, which is extremely important during labor. Meditation is a component of yoga that is sometimes left out of classes which focus on the postures, however it is an integral part of yoga and has special benefits for pregnant women. Prenatal yoga classes usually include breathing exercises, a guided imagery sequence or a progressive relaxation sequence which gives women skills that can be used during labor to reduce pain and improve satisfaction and a sense of confidence during birth.

 

Taking a prenatal yoga class during pregnancy gives women a chance to meet other pregnant women in a supportive environment. Sharing their pregnancy experience in this way can give women an emotional boost. Many prenatal yoga classes incorporate postpartum students with special exercises for the postpartum body as well, so women may meet other moms who have recently delivered, and they can learn from each other and share their experiences while bonding in the comfortable setting of a yoga class. Many prenatal/postpartum yoga classes provide opportunities for participants to introduce themselves, give their due date, and share any physical challenges they are experiencing at that time. It can be very reassuring to pregnant women to see that other moms are feeling similar discomforts to their own.

 

Prenatal yoga with a trained prenatal yoga instructor is also very safe and most women can participate safely because modifications are made specifically for the pregnant body. However, certain pregnancy complications are not compatible with yoga practice.  If a woman has high blood pressure, heart disease, lung disease, back problems, a history of preterm labor, incompetent cervix, poor fetal growth, persistent bleeding or severe pain, prenatal yoga is not a good choice for her.

 

Some of the symptoms of the first trimester of pregnancy such as lightheadedness, nausea, and headaches make exercise seem less than fun, but once a woman is feeling well enough to be active, prenatal yoga can be very refreshing. In the first trimester, women must remember to drink plenty of fluids throughout the day and during the yoga class.
Women in this trimester should avoid certain yoga poses such as inversions, full body twists, or complete forward folds. The instructor will suggest modifications or alternative poses which are safe during pregnancy. 

 

 In the second trimester, most women feel pretty good. However, if they are experiencing frequent heart palpitations, significant shortness of breath, severe back pain that doesn’t resolve with stretching, problems walking or fainting, they should see their midwife or doctor, and should avoid yoga if it causes any unusual symptoms until they have clearance from their health care provider.  Prenatal yoga instructors will have modifications for safe yoga practice in the second trimester including either a chair or space near the wall for each student for balancing since the woman’s center of gravity will be different due to their growing abdomen.   Instructors will also offer a chair when appropriate for seated pose modifications. Instructors will have bolsters and pillows available for pose modifications. Women should not do supine postures after twenty weeks gestation, and should dress in a way that prevents overheating, continue to drink plenty of water, and eat 300 extra calories a day compared to when they were not pregnant. Women should not overstretch their muscles or joints because the hormones progestin and relaxin which are circulating in high concentrations in the body make these tissues looser and more prone to injury.

 

In the third trimester, women can continue to practice safety using a chair or the wall to help with balance. They may need to use blocks or straps to help with some poses due to their increasing abdominal girth. They won’t be holding poses too long as this may hinder circulation. They shouldn’t lie on their back, or do head or shoulder stands, they should avoid deep forward or back bends and deep twists, and avoid overheating.

 

Benefits of Mindful Breathing:

 

Mindful breathing is an important aspect of prenatal yoga. This is also very beneficial in childbirth. When women are encouraged to keep their breath steady, and focus on the steady breath this is directly useful in labor, especially for women who choose not to use an epidural.  Women who have practiced keeping their breath steady, and are comfortable hearing their own vocalizations, will be able to use these strategies successfully on the big day.  Women need to learn to keep their pitch on the low end of the range because lower sounds trigger the rest and relax hormone, oxytocin.  High-pitched sounds often occur in women who are becoming panicked and this triggers the fight or flight response associated with adrenalin release.  When adrenaline is released, and women are making high-pitched sounds, the cycle of fear can take over. Women who can learn to control their breath feel strong, steady, and confident in labor. One practice technique for breathing during a contraction would be chair pose against the wall for 60 seconds using focused breath control to distract from the pain of the muscle fatigue.

 

Another relaxation technique, progressive relaxation, can be practiced in a relaxation pose or during a chair pose by the wall again for 60 seconds. With this technique the instructor guides students from head to toe telling them to first inhale through the nose, and then out through the mouth saying, “HAAA.” Then the students are instructed to relax the crown of the head, relax the eyes, the jaw, and the neck. Inhale slowly, exhale while they sigh or make the sound, “HAAA.”  Relax the back of the neck, the shoulders, and let the arms drop heavy by their sides.  Then inhale, sending the breath all the way down to the baby. Continuing down the body using the muscles of the chest, the upper, middle, and lower back. They are guided to inhale, and exhale, “HAAA.”  Next, they relax the hips, relax the pelvic floor, relax the legs, calves and the feet.  By now, 60 seconds have gone by and the woman has made it through the time typical for a contraction.  This is also an excellent practice for relaxation between contractions.

 

Mantras are another relaxation technique. Mantras involve producing a verbal word or phrase, such as “the breath is the pathway through the contraction.” One popular mantra involves saying “Let” on the inhale, and “GO” on the exhale, with instruction to keep the throat round or open, and using a low pitch to promote relaxation.  Students may prefer to pick their own phrase and practice it at home.

 

Helpful Poses for Pregnancy:

 

Some helpful poses for pregnancy include:

  • Bound Angle Pose: helps open the pelvis, especially helpful in 3rd trimester.
  • Cat Pose: helps with low back pain.
  • Garland Pose: helps relax and open the pelvis and strengthen the upper legs.
  • Standing Warrior/Tree Pose: these poses help strengthen the joints, improve balance, ease back aches, and help with sciatica.

Talk with your provider to learn more about the benefits of prenatal yoga to support a healthy pregnancy and delivery.

 

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