Yoga for Moms-to-Be
Sitting cross-legged on sticky mats arranged in a wide circle, seven women inhale deeply, fling their arms wide, and turn their faces up toward the ceiling. Exhaling slowly, they round forward and wrap their arms around their big bellies to embrace their growing babies. The room, sea-foam green and mirrored, is pleasantly dim. Unstructured, relaxing music plays quietly in the background. It is almost like being underwater. Or in the womb.
The women, all in the second and third trimesters of their pregnancies, are here strengthening their bodies and spirits and finding a measure of comfort and community in Amanda Fitzgerald's prenatal yoga class at BodyMind Inc. in Winston-Salem, North Carolina. Fitzgerald is a childbirth educator who owns MotherSpirit, a company that provides education and support for natural childbirth and parenting.
Fitzgerald, other prenatal teachers and students, and even some medical professionals say that prenatal yoga can ease the discomforts of pregnancy, such as moodiness, shortness of breath, and swollen ankles; can give women time to bond with their babies; and can help them prepare for the rigors and mysteries of labor.
Angela Gallagher, another prenatal yoga teacher located in Winston-Salem, feels strongly that a sense of community is important during pregnancy. "I end class with a muffin, a cup of tea, time to talk, and sometimes different speakers," she says. She tells her students that if they don't feel up to a class, they should come at the end—just for the fellowship. Prenatal yoga classes can provide a chance to spend time with other pregnant women sharing experiences and concerns, especially helpful if a woman is feeling stressed, unsupported, or fearful.
Class is a place where information is exchanged and questions answered, so it's important that the teacher be trained in prenatal yoga—and it's even better if she's been through the experience of childbirth. Prenatal yoga is a great way to train for labor and to enhance the experience of pregnancy, explains Gallagher, whose daughter, Ruby, is 3. "Labor is one of the most physical things you'll ever do," she explains. "You would not run a marathon without preparation: Why would you go into labor without preparing for it?" asanas, the physical poses, can help build strength and stamina and improve circulation. Meditation can improve the abilities to relax and to concentrate. Pranayama, breathing exercises, can help manage the pain of contractions.
Standing postures, like Virabhadrasana II (Warrior II Pose), can increase your leg strength and also generate courage and self-confidence. Kneeling on hands and knees and rounding the back up toward the ceiling can help a woman rehearse tilting her pelvis to facilitate the baby's delivery. "This modified Cat-Cow is a good one to move the baby into the right position for the delivery," says Fitzgerald. Sitting in Baddha Konasana (Bound Angle Pose), with the soles of your feet together and the knees moving away from each other, and doing modified squats can increase blood circulation to the pelvic floor and help a woman get used to the feeling of opening up. "The most open you will ever be is in labor," says Gallagher. "Labor is no time to be shy."
Yoga class is no time to be shy either. It's a time to get to know your body and to build confidence in your ability to give birth. Yoga students and teachers alike stress the fact that women possess the innate skills to give birth in a natural and healthy way, despite Western medicine's inclination toward interventions like epidurals, forceps deliveries, and C-sections. In yoga class a woman can learn to tune in and respond to her body's needs, so that during her labor, when rational thought may be suspended, she'll be able to identify and ask for what she wants.
The process of birth is not a Hollywood script with harp music, diaphanous robes, and sweetly smiling cherubim. It is work made of muscle, sinew, sweat, blood, and love. By toning the body, mind, and spirit, yoga can help a mother be present for the miracle of birth.
What to Expect
Experts agree on some general rules for practicing yoga during pregnancy:
If you have never practiced yoga or have practiced very little before your pregnancy, you should practice only prenatal yoga while pregnant.
If you already had a strong yoga practice before your pregnancy, you may be able to continue a fairly vigorous practice-with modifications-after your first trimester.
During the first trimester both beginning and experienced yogis should only do a gentle practice or none at all, as the fetus is still implanting and the risk of miscarriage is highest.
Shari Barkin, M.D., a pediatrician with Wake Forest University Health Services/ Brenner Children's Hospital in Winston-Salem, who practiced yoga during her two pregnancies, cautions against starting "any new kinds of strenuous activities during pregnancy. However do spend at least 10 minutes a day doing Ujjayi breathing (Victorious Breath). Do some hip openers, forward folds, and Cat-Cow poses," she says. "If you are used to doing yoga, then keeping up your regular routine with modifications is important."
In all three trimesters pregnant women can expect to experience hormone surges, mood swings, bouts of insomnia, and frequent urges to urinate, explains Stephanie Keach, director of the Asheville Yoga Center and mother of two boys. Two kinds of pranayama are especially beneficial during pregnancy: Ujjayi, a long, strong, deep breath that helps you to focus on the present moment and maintain calm, and Nadi Shodhana, (Alternate Nostril Breathing), which according to yogic teachings helps to balance the body's energy flows. Avoid any kind of breath retention or hyperventilation that could limit the baby's oxygen supply. "As the circulatory, cardiovascular, endocrine, digestive, and nervous systems get nurtured by correct deep breathing, sleep comes easier and moodiness is less intense," Keach says.
During pregnancy the body produces the hormone relaxin, which softens the connective tissue. The good news is that this allows the pelvic joints to become more flexible while the uterus expands, making space for the baby. The bad news is that it can lead to instability in the sacroiliac joints and can cause lower back pain, so pregnant women need to be careful not to overstretch in their asana practice. "Pregnancy is not a time to strive for more flexibility, although it may occur" adds Keach.
First Trimester (0 to 13 weeks)
The first trimester holds mixed blessings for most women. There can be a lot of joy as well as much discomfort. Most women experience nausea and fatigue. They may not look pregnant, but profound biological and musculoskeletal changes are occurring in the body. "It is rare to want to do anything physical during this time, so I don't have many first trimester mamas," Keach says. Although most experts advise against starting a yoga practice in the first trimester, they also say if you already have a strong practice, you can continue yoga with modifications."Do not do inversions, twists, or jumps in your first trimester," Barkin says. "Step back; don't jump back in Sun Salutations. It's important not to jar or threaten implantation of the fetus and placenta." Barkin also advises substituting Ustrasana (Camel Pose) and Setu Bandha Sarvangasana (Bridge Pose) for Urdhva Dhanurasana (Upward-Facing Bow Pose) during your first trimester. Consult with a prenatal yoga teacher to find out how to modify your practice as your body changes.
Second Trimester (14 to 28 weeks)
Most women begin their prenatal practice during the second trimester. Often they may feel very good. "They are not too huge and can do just about anything they feel comfortable doing, with or without props, as long as they can breathe deeply," Keach says. A woman may feel faint or light-headed during this time. "She will feel like eating more," Crawford says. "Pregnancy is a natural low blood sugar state." During pregnancy, explains Barkin, "the volume of blood in the body expands 40 to 60 percent to support the fetus and placenta, the blood circulates faster, your rate of metabolism increases, and your resting heart rate rises. You're using up your body's sugar faster; important reserves are being used to support the placenta and fetus." To meet the needs of your changing metabolism, eat a light meal or snack about an hour before class, drink plenty of liquids, and don't push yourself. Increasing your protein intake (as long as the kidneys are healthy) to about 60 grams a day is the best way to keep the blood sugar steady, Barkin says.
Third Trimester (29 to 40 weeks)
Now your body is really changing. The baby's movement is strong. The sacroiliac joints are loose, and breathing may be difficult. The extra weight and your protruding belly will likely challenge your balance in every posture. "Balance is an issue, as is weight, and the presence of a protruding belly makes a lot of poses difficult, requiring modifications and props," Keach says. Barkin, however, says she loved doing balance postures throughout her pregnancies. "Balance postures made me feel lighter and more aligned...but do them near a wall if you are feeling unsteady." Although some experts advise against lying on your back after the sixth month so as to avoid putting pressure on the vena cava (a large vein that runs along the side of the spine and curves behind the uterus), others say it's acceptable for short periods of time. It is especially important for a woman to do deep breathing when she is lying on her back, says Keach.
"Pretty much six months and on, I prop mama's head and heart up." She advises the same modification for Viparita Karani (Legs-up-the-Wall Pose)—"so she is like a 'V' with legs up the wall and head above heart above pelvis, breathing deeply." The medical perspective, says Barkin, "is that compressing the vena cava for long periods of time (as when sleeping) is dangerous . . . It is not clear if small bursts of lying on your back are problematic or not." Lying on the left side with pillows for props is the modification most often made for Savasana (Corpse Pose) during the relaxation period at end-of-class.
For those women who are practicing with a prenatal teacher and listening to their bodies, the third trimester is as good a time as any to build stamina and courage. "When I notice a pregnant woman at 38 weeks, say, in Warrior Pose, and her knee is hardly bent and her breath is short, my job is to encourage her to take her breath down deeper, to face her feelings of weakness and doubt," Crawford explains. "Then she can take that step into the unknown with her baby. Pregnancy is a time of changing, an opportunity to transform her feelings of weakness into strength."
Barkin says that "backbends and inversions are great in the last trimester for the practiced yogi. The caveat is, if you're body doesn't feel good doing it, stop." To avoid compressing the belly, Fitzgerald and Keach instruct women to take their legs apart during standing or seated forward folds. They also recommend moving the knees apart when resting in Balasana (Child's Pose).
Many women who practice prenatal yoga and give birth at home, in birthing centers, or in any situation that they helped create, describe their labors as amazing. But both prenatal yoga teachers and their students say that when approaching labor, it is best to expect the unexpected. "A woman brings everything from her whole life to this moment," Crawford explains. "You can not go into a birth planning what you are going to do. You have to go in empty, so that life guides you."
"With my very first contraction, it became clear to me that nothing anyone had ever said about labor had prepared me for this," says Camille Mulchi, who studied prenatal yoga with Crawford. "But my prenatal practice reminded me to simply be fully present in each moment and to allow my baby's birth to follow its path."
To teach women to breathe through the pain of the contractions, Fitzgerald invites them to hold Warrior II for one minute, about the length of a contraction. To help her students tolerate the burning pain of stretching open to accommodate a baby, Gallagher has her students take Thai Goddess Pose (sitting back on their heels with the toes tucked under) and breathe through the pain in their toes for several moments. "It may not seem like a very long time, but even 10 seconds can seem like infinity for someone in labor or holding a difficult yoga posture."
"The way to prepare mentally and physically for labor is to practice yoga every day," Gallagher explains. "We live from the neck up. Birth happens from the neck down." Yoga teaches us to listen to the needs of our bodies and to trust the wisdom of our bodies. Deeper intimacy with the body allows pregnant women to rely less on rational thinking and more on intuitive wisdom.
In Fitzgerald's class the women speak quietly to one another as they move into position for a seated, partner stretch. They work together, gently bending and stretching, elegantly balancing effort and surrender. When class is nearly over and they are lying in final relaxation, Fitzgerald softly invites them, "Imagine your baby, floating inside you, happy, healthy, and growing, soothed by the beating of your heart." Like life and yoga, pregnancy is not only a destination but also a journey—a time to savor the experience of having a life growing inside. "I love being pregnant, because it is the only time you can take your child everywhere," Barkin says.
Watching a class full of pregnant women with round bellies, it is easy to see where the concept of the Earth as a mother came from. Just as the Earth sustains all life, a mother-to-be provides a life-sustaining environment for her baby. And a prenatal yoga class can create an environment that nurtures the nurturer. At a time when you may feel tired, moody, nauseous, and out of control, a regular prenatal yoga practice can give you the energy to enjoy your pregnancy, the serenity to build a deeper intimacy with your own body and spirit, and also the presence of mind to expect the unexpected and be fully present for the miracle of birth.