Tips for Pregnant Moms Taking Yoga

Diane Cevallos, prenatal yoga
instructor and owner of
Charlotte Family Yoga Center

As a studio owner and Yoga Alliance Certified Pre and Post-Natal Yoga instructor, I am most often asked by prenatal students whether or not it is okay for them to attend yoga classes that are not geared specifically to soon-to-be-mamas. The answer is, heck yeah! Yoga means relationship and there is not a more beautiful time to practice yoga than when you are creating  a little being inside of you. Time commitments during prenatal classes or a love of a certain class, studio, or teacher may be reasons why moms-to-be may want to take yoga classes geared toward the general population.  Regular classes can be adapted during pregnancy with a little guidance.

General tips for  non-prenatal yoga classes:

1. Listen, listen, listen to your body! I cannot say this enough. At this time in your life, your body is at its most intuitive. You don’t need a yoga teacher or anyone else to tell you what is good for you and your body; your body will tell you. IF A POSE HURTS OR FEELS UNCOMFORTABLE, SKIP IT.

2. Tell the teacher you’re pregnant. Even if you think it’s obvious. He or she may not be paying attention to your middle, or may not feel comfortable asking. If your teacher knows, he or she can offer a modification suited to your body, and advise on which poses to skip. Keep in mind, your teacher cannot give you his or her full attention for the entire class. Take care of yourself and your baby by avoiding anything that is painful or uncomfortable.

3. Avoid  fast moving breaths. Fast-paced breaths increase your internal temperature and can lead to agitation. During pregnancy your resting body temperature rises and there is no need to raise it further with breathwork.  Inhale through nose and exhale out through your mouth.

4. Speaking of heat. Unless you have had a pretty consistent practice prior to be pregnant in a heated room, now is not the time to start. If you are continuing to practice in a heated room, hydrate. Hydrate, hydrate and hydrate.

5. Avoid jumping back into chatarunga, especially in the first trimester. If you don’t know what jumping back into chatarunga is, simply avoid jumping.

6. Avoid closed twists  The idea is to give your baby more space to grow. Closing off that space is both uncomfortable and counterintuitive.

Photo courtesy of Donamari D'Andrea
of Capture Fotography

7. Avoid over-stretching. Sometime during your second trimester your body releases a hormone called relaxin, which encourages flexibility in your joints. This is to help with labor, not to help you do that split you’ve always wanted to do! Be mindful of moving too far into stretches and back off before you reach your limit. While your joints are more flexible it is still possible to tear a muscle.

8. Don’t be afraid to work your body. If it feels good, and you don’t have any medical conditions advising against it, move and stretch and sweat! You are training for one of the greatest athletic feats of all time: motherhood.

9. Avoid core work or backbends on your stomach.  Again, the goal is to make more room for your baby, not condense and shrink their living quarters. You have your whole life to do core work!

10. Use props! Even if you didn’t use them before pregnancy, a couple blocks and a strap might be particularly helpful as your body changes.

11. Continue to do inversions. If you did inversions before your pregnancy, and want to continue to do them, and they feel good for both you and your baby it’s fine. Make sure you feel confident going upside down. 

12. Live in the moment. This is especially important to remember as your body changes. It is likely that the way you do poses, the poses you can “do”, and the poses you prefer will change throughout your pregnancy.  It is best to roll with it.  Try not to get caught up in poses you were doing before pregnancy, as your body is working on nourishing a being inside of you. Perhaps doing crow pose is not on your body’s list of priorities. Stay present and take time to notice how your body is feeling. When you roll out your mat, move in a way that feels good each day.

Effects of Stress on Pregnancy

Stress has impacted us all at one time or another. Family, work, money, time – whatever it is that’s causing the stress, we can always tell when it’s reacting in our bodies. We notice headaches and stiff shoulders; a loss of appetite and changes in weight; or maybe we simply notice that we lack the focus to complete the regular tasks of our day. When we are stressed, we release stress hormones into our body. These hormones are responsible for the headaches, loss of appetite and lack of focus.  When we are pregnant, these hormones are shared with your baby through your placenta. Oftentimes, we can easily identify the physical changes that we are experiencing due to stress, but what about the impact that these stress hormones are having on our unborn child?

Prenatal Impact of Stress

Insomnia and Trouble Sleeping

When we are stressed, our overactive minds can interfere with the amount and quality of sleep that we receive. When we lack quality sleep, it can affect our mood, our productivity, and our overall health.

Appetite Changes

The hormones that are released into our body when we are stressed often have an impact on our appetites. We may find ourselves eating more than usual and craving foods that are not very healthy. Or we may find that we aren’t hungry at all. Each of these can cause problems in the pregnant body as our babies and our bodies are dependent on a healthy intake of food to develop normally.  Weight loss, excessive weight gain, blood sugar irregularities, and vitamin & mineral deficiencies all have marked impacts on an unborn child.
 
Headaches/Body Pains

When we feel stress, we often notice a physical presentation in our bodies. Our shoulders may feel tighter than usual or we may get pains in our hips due to a buildup of stress and tension. The most common trigger of headaches in adults is stress. These headaches can be as minor as a tension headache or as debilitating as a migraine.  Those of us that tense our shoulders, clench our jaws, or stiffen our necks in response to stress are even more susceptible to these headaches.
 
High Blood Pressure or Hypertension

Your body produces a surge of hormones when you're in a stressful situation. These hormones temporarily increase your blood pressure by causing your heart to beat faster and your blood vessels to narrow.  Researchers haven’t concluded whether the stress by itself causes long-term high blood pressure but it may be that other behaviors linked to stress — such as eating unhealthy foods and poor sleeping habits — cause high blood pressure. There is evidence that supports that these short-term stress-related spikes in your blood pressure added up over time put you at risk of developing long-term high blood pressure.

Premature Labor

Chronic stress during pregnancy puts women at a higher risk for preterm labor. There are many theories about the connection between stress and prematurity – some researchers believe that the surge of hormones signals to the baby that things are not okay and labor begins; other researchers believe the connection to preterm labor is to through the side effects of stress, such as high blood pressure or changes in blood sugar levels.

Postnatal Impact of Stress

Complications at Birth/Low Birth Weight
   
A study done in Texas followed a group of pregnant women who were in the path of a hurricane during their third trimester. It was found that their babies had higher instances of requiring a ventilator after birth! Other studies have shown that stressful pregnancies can lead to low birth weights, though the exact connection is disputed in the scientific community.

Child Outcomes
   
Studies done on pregnant woman who were exposed to stressful situations during their pregnancies have shown connections to a decreased intellectual and language abilities. The differences were small between the children tested and their non-stressed peers, but scientists believe the connection is there.

Conclusion
   
Stress impacts pregnancy from conception through postnatal care. Practicing yoga has been shown to reduce stress and make people more aware of their bodies, and pre- and post-natal yoga helps to center the mother, reducing stress for the entire family.

Prenatal Yoga: It’s Good for You and Your Baby

Photo courtesy of Donamari D'Andrea of Capture Fotography

Pregnancy causes many changes in a woman’s body.  These changes bring about fluctuations in hormones and can increase physical, mental, and emotional stress in the mother and the baby.  Studies have shown that prenatal yoga can ease many of the symptoms and stressors of pregnancy for the mother.  This, in turn, brings better outcomes for the baby as well. Prenatal yoga programs that combine community time, breath work (pranayama), relaxation (shivasana and/or guided meditation), and physical poses (asana) show the most promise for benefits.

A regular prenatal yoga program can improve the psychological health of the mother.  One study (1), showed a decrease in depressive symptoms for mothers diagnosed with prenatal depression through a prenatal yoga class.  Many of the symptoms of prenatal depression were relieved.  The researchers believe that yoga helped because it stimulated the facial muscles and the muscles that control tone of voice, and it improved the mothers’ sleep, appetite, fatigue, and stress levels.  A second study (5) agreed that prenatal yoga helped mothers’ depression.  Prenatal yoga was shown to help with both depression and anger.  Yoga also appeared to help regulate the hormones and heart rates of the pregnant women. 

Another study (2) showed significant improvements in stress and anxiety for pregnant women.  This study combined prenatal yoga with mindfulness training.  This intervention taught participants to stay in the moment as part of the prenatal yoga class.  Additionally, a study (4) showed a reduction in stress and improvements in the way the mothers handled stress.  While the stress of the yoga participants went down significantly, it actually rose in the mothers who did not participate in yoga.  This study also showed that breath work during yoga also reduces stress.  Several other studies have supported these findings of improved mental health during the pregnancy and delivery and after delivery as well.  Yoga improved the psychological health of the mother on both short term and long term outcomes.  This improved mental health also led to better outcomes for the children, as well.

Researchers have also shown a connection between prenatal yoga and lessening of pain and duration of labor (3).  Women who participated in prenatal yoga had less leg and back pain (5).  Prenatal yoga participants reported shorter labor and less pain than women who did not participate in prenatal yoga.  The breath work and mindfulness taught in prenatal yoga also helped women in other studies to relax and handle the stress of labor.  

Prenatal Yoga has also been shown to improve birth outcomes.  Babies whose mothers attended prenatal yoga had better birth weight and tended to be born at term, rather than early (3).  Mothers who attended prenatal yoga tended to have fewer complications than mothers who didn’t attend yoga (3).  Even those with high risk pregnancies who attended prenatal yoga were shown to have fewer complications for pregnancy and delivery, and their babies tended to be healthier (6).   

All of the studies showed that regular yoga practice was necessary to gain maximum effects from the activity.  Sonia, one of our prenatal students, is happy to attest to this as well.  She feels that regular prenatal yoga practice helped her enjoy her pregnancy and delivery.  She says she wouldn’t change a thing!

References

1. Mitchell, Field, Diego, Bendell, Newton, & Pelaez (2012).  Yoga Reduces Prenatal Depression Symptoms. Psychology, 3, 782-786.

2. Beddoe, Yang, Powell Kennedy, Weiss, & Lee (2009). The Effects of Mindfulness-Based Yoga During Pregnancy on Maternal Psychological and physical Distress.  Journal of Obstetric, Gynecologic, and Neonatal Nursing, 38, 310-319.

3. Curtis, Weinrib, & Katz (2012). Systematic Review of Yoga for Pregnant Women: Current Status and Future Directions. Evidence-Based Complementary and Alternative Medicine, 2012.

4. Satyapriya, Nagendra, Nagarathna, & Padmalatha (2009).  Effect of Integrated Yoga on Stress and Heart Rate Variability in Pregnant Women.  International Journal of Gynecology and Obstetrics, 104, 218-222.

5.Field, Diego, Delgado, & Medina (2012). Yoga and Social Support Reduce Prenatal Depression, Anxiety and Cortisol. Yoga Physical Therapy, 2, 124.

6. Rakhshani, Nagarathna, Mhaskar, Mhaskar, Thomas, Gunasheels (2012).  The Effcts of Yoga in Prevention of Pregnancy Complications in High-Risk Pregnancies: A Randomized Controlled Trial.  Preventive Medicine, 55 (4), 333-340.

The Twists and Turns of Childbirth Through History

The history of childbirth has been recorded as early back as the biblical times.  From then until today, the ways in which a woman has birthed a child have changed, yet stayed the same.  Culture appears to be the biggest difference.  Women all over the world have labored alongside other women, sharing the experience and feeling the collective energies that only females can empower one another with.

Historically, laboring was left to the women as men knew very little of how children were born.  Men believed it to be a hellish experience as back then, not every mother or child made it out alive.  Medicine, drugs, surgery, and other advancements have changed that perspective.

Midwifery (literally translated to “with woman”) is the name given to female birth attendants. Unfortunately, there was a period in time (around the 14th-17th centuries) where midwives did not communicate or share with one another their birthing experiences and in some cultures midwives were considered witches – they were hunted and hanged!  Midwives were self-taught till about the mid 1800’s.

In the 1800's Male physicians began
to convince women that it was much healthier
to have a doctor deliver a baby

Home births continued through the end of the 1800’s.  Around that time men became hungry for business and started attending births, promising pain relief and safer deliveries. Male physicians stated that it was much healthier to have a doctor deliver a baby, even using trashy pictures of old, gnarly women to scare expecting mothers into their offices.  Midwives were losing their status and income as a result.
The introduction of male physician birth attendees soon after led to the use of sedatives and other interventions to ease the pain of birthing. 

The following is a brief history of some of these interventions:
 
1600s – Forceps were first created in Europe. Later (early 1700s) they were re-invented by Dr. Smellie.  Smellie was London’s most famous man-midwife.  He set up a midwifery school in London and in doing so, began to change history.  Women were not permitted to study in universities at the time.  Soon word spread that it was safer to deliver a baby in a hospital setting with a doctor, not a midwife or female healer.  Propaganda was spread and women of wealth began to labor and deliver in hospitals.  Not long after, women began to receive chloroform and other pain killers to numb the experience.  Women were no longer birthing in the natural squatting position but rather, flat on their backs.  There are reports of women being strapped down to a gurney for periods of up to 8 hours so as not to hurt themselves during labor.

1742 – Episiotomy was first used in Ireland. It was in the 1870s that Dr. DeLee began to use the cut along with forceps whenever delivering. Dr. DeLee created the bed with stirrups where a woman would lie flat on her back to deliver.
 
1898 – A German doctor, Karl August Bier, originally injected cocaine as an early form of an epidural.  As late as 1970, epidurals were still imperfect. Today it is better as levels of anesthesia can be adjusted.  90% of births in America today involve an epidural.  Other countries use epidurals only minimally. Japan’s epidural rate is about 1%.  In the Netherlands home births are the most popular route of delivery.

1914 – Twighlight Sleep was a drug that combined morphine and scopolamine as an amnesiac that caused women to have no memories of giving birth.

1915 – Dr. Joseph DeLee said it was better to prevent the pains associated with labor rather than to deal with issues or problems as they arose. He was very influential and soon all doctors were using sedatives, ether, episiotomies, and forceps.  He taught that birth was a malady, something to be treated, and treated by a doctor only.

A cesarean section is the act of cutting open a woman to retrieve the unborn child.  Records of a successful C-section date back over 500 years ago with survival of both the mother and son.  However, most cases had a 50/50 survival rate due to infection and knife cuts.   1794 is the year of the first successful cesarean section in the US (opium was the sedative of choice).  In today’s world, the Brazilian City of Rio de Janeiro has a 90% cesarean rate amongst their wealthy women. It has become a common surgery in the last century as seen by the following numbers: 40% in Chile, 36% in Mexico, 35% in Italy, 29% for America, and 22% in Canada and England.  Women today are having larger babies due to current diets, not genetics.  The problem has been that women’s bodies have not evolved to carry larger fetuses, perhaps causing more C-sections.  Women today may choose a C-section ahead of time if they are carrying multiples, have preeclampsia, diabetes, placenta issues, or if the baby is in a breeched position.  Female genital mutilation is another cause for a cesarean section, as is common in Somalia where 95% of women there undergo pharaonic circumcision (inner lips of vagina are removed and outer lips are sewn together). Somalia is one of the deadliest places on earth to give birth.

Grantly Dick-Read was a young obstetric trainee that found birth to be more of a natural occurrence.  He believed that women needed to relax and less pain would be experienced and laboring would be shorter.  He was criticized by his colleagues and soon after left the hospital atmosphere for a practice in the English countryside where he found women to be more accepting of his ideas of childbirth.  He later wrote a book in 1942 titled Childbirth without Fear, which received positive feedback and became a bestseller.  His teachings were brought to the US where many obstetricians were turned on to the natural child birthing process.

By 1910 midwives in America were only delivering 10% of babies and by 1973, less than 1%.  Today we’re back up to 10% with a resurgence of the natural childbirth movement (a return to a kinder and gentler delivery). 

Up until the 1960’s it was common for men to wait outside of the delivery room whereas today a woman can have present whomever she wishes for the birth of her child.  The 60’s and 70’s also brought about the establishment of birthing centers.  These centers were located near hospitals but cost less than half the price of a hospital delivery.  However, the birthing centers did not give out epidurals or anesthesia, and therefore, no Cesarean sections.  Mothers-to-be wishing for a natural childbirth could opt for a homelike setting at the birthing center.  Such centers brought competition to hospitals that stepped up their game plan by offering new maternity wards with mother being allowed to labor, deliver, and recover in the same room.  Hospitals also offered to follow along with a mother’s birthing plan.  This has been a great show to expecting women and has driven birthing centers to closing (along with astronomical malpractice insurance the birthing centers are required to carry).

With all of the options available today, women can decide where, when, and with whom to deliver their baby.  Sometimes, these attempts fail and fate steps in.  A mother may unexpectedly go into labor on an airplane or while traveling underground.  At times, mothers may have to make a decision to have an emergency cesarean section if she finds that her baby’s health is at risk.  The best attitude to have when it comes to labor is to have an open mind and an open heart.  No matter the method, in the end, the mother will be joined by her child, and how he got here will hold little value.