Pregnancy is a pivotal life change for every woman; physically, emotionally and mentally. I believe that a holistic practice such as yoga can help to aid each of these areas and offer women support throughout their pregnancy. In this essay, I will be looking the benefit of yoga practice in all three trimesters, focusing on asanas, meditation and pranayama.
The word ‘yoga’ comes from the Sanskrit word, ‘yug’ – which is translated as ‘to unite’. So, as a practice, yoga works on the basic principles of harmony and unification. In my personal experience, I expand on these principles by using the yoga to achieve balance – connecting how my body and mind are feeling whilst working towards a more unified sense of self. It energizes me, and when combined with meditation and pranayama techniques, it helps me feel stronger and improves my overall health. I find it essential to staying healthy whilst maintaining an increasingly busy and hectic lifestyle.
My personal experiences with yoga are shared around the world, supported by a rapid growth in yoga schools and studios. In my opinion, the spiritual and emotional growth that can come from committing to yoga can often be ignored in favour of the physical benefits of the practice. This is where I see pregnancy yoga being an important area in which to incorporate more of the traditional practice; using asanas for meditation and relaxation, and incorporating pranayama and meditative techniques.
Yoga during pregnancy is a great way to stay in shape – building your muscles to support the growth of the baby, and to prepare you for delivery. It gives you tools to slow down, connect with your body and the transformation that is occurring. Pregnancy can be a very daunting time for every expectant mother, with so many with so many rapid changes; hormonal changes, physical changes and changes to the way you live your life. These changes are all completely out of your control which can often lead to a disconnected sense of self and a feeling that your body is no longer your own. These factors can contribute to pre-and post-natal depression in mothers.
Maternal stress and anxiety in pregnancy can lead to risk factors for potential negative outcomes for children, such as attention deficit hyperactive disorder or anxiety. It may also alter fetal development through diminished blood flow and oxygen to the uterus during critical periods of change or growth. Therefore, it is essential for pregnant mothers to regulate this stress, and as yoga teachers – it is our job to provide coping strategies to maximize infant health and development.
Physical exercise can be helpful in the management of stress and other pregnancy conditions such as edema, gestational hypertension, water retention, swollen limbs, gestational diabetes, mood changes, musco-skeletal discomfort, general aches and weight gain. Relaxation therapies for pain management in labour have become increasingly popular as women seek to find more alternatives to traditional treatment, such as epidural and anesthesia both of which carry a significant level of risk to mother and baby. Meditation and pranayama are key parts of yoga that could help with this, potentially aiding delivery and reducing the stress factors of labour (ref 1) Pranayama has been found to make significant positive changes to fetal heart rate. (ref 2)
The key to teaching pregnancy yoga is to recognize that change is constant. Each time you step on the mat, you will have a different experience. Your body will feel different. Your mind will experience something different. When it comes to using asanas in the practice of yoga during pregnancy, you must adhere to the advice of a healthcare professional. No physical exercise is exempt from risk, and some asanas will put additional pressure on the abdomen, the pelvis and the hips. Before 12 weeks, yoga asanas should be gentle and considerable caution must be taken.
First Trimester (0-12 weeks)
In the first trimester, you may find yourself experiencing the challenges of nausea and fatigue. Hormonal changes will be most significant in the following:
- Estrogen:
- Increase of blood flow, growth and function of the uterus and breath.
- Sodium and increased water retention
- Potential mood changes
- Progesterone:
- Increased hypothalamus function
- Increased basal body temperature
- Increased sodium excreted by kidneys
- Decrease of gastrointestinal mobility
- Relaxin (released immediately after conception, peaking at 12 weeks):
- Relaxes the tendons, muscles and ligaments
- Prepares your body for birth
Naturally, as a result of these changes, the body will become unstable and there will be a loosening effect on the body to make space for the baby. Muscle tissue will begin to relax and joints will loosen to facilitate the growth of the fetus. The first trimester has the highest risk of miscarriage, so compression of the abdomen muscles should be avoided. The postures best left out of your practice will be in the inversion group, closed twists, backbends and any other abdominal compression postures. It is also important to be mindful of standing hip openers and modify these poses accordingly.
A safe posture to do in the first trimester is Baddah Konasana (Bound Angle or Cobblers Pose). This is a classic prenatal posture which serves to open the hips, stretch the hip flexors and groin muscles. These areas can become tight throughout pregnancy, so if practiced from the first trimester, it can aid the birthing process. Spiritually, this posture can be very grounding in times of change and anxiety. You can come into this posture from an easy cross legged position. Take the soles of your feet together and draw them as close to the pelvis as is comfortable. Press evenly through your sit-bones and adjust your buttocks for comfort. Feeling the connection to the ground and length in the spine up to the crown chakra. Hands can be placed on the ankles, feet, or lower legs. Ensure the spine is straight and dristi is either on third eye or between the eyebrows. Alternatively, look straight.
You can place your hands next to the hips to help create length in the spine. To intensify the posture, you can lean forward a fraction, but be mindful of your abdominal muscles and ensure you are still creating space. Hold for 5 breaths or as long as you feel comfortable.
Modifications can be used, with bolster or cushioning under the knees. Alternatively, instead of placing the hands by your side, you can lie back on a bolster, but do ensure that both sit-bones are on the ground and that the stretch is not overextending the abdomen. Your breathing should remain normal at this stage, so as not to further increase temperature. This means that Baddah Konasana offers an effective way to meditate and it can be very helpful for imagining the baby growing inside you. Lotus flower visualisation or tree roots growing can also be an excellent way for you to get in touch with the connection to your baby.
Second Trimester (13-26 weeks)
The second trimester is an excellent stage in which to practice pregnancy yoga. In most cases, morning sickness will have alleviated. The rapid hormonal changes will have slowed somewhat so your energy will be a little higher. It is worth bearing in mind that in this stage, the uterus is not protected by the pelvis anymore so poses where you have to lie on your stomach are best avoided, and deep twists.
I recommend trying standing postures during this stage to encourage leg strength and balance for focus and grounding. An ideal pose is Virabhadrasana II (Warrior II). This pose is a challenging, providing strength for all areas of the body. It is a deep hip and upper body opener and can alleviate backaches. You can come to Virabhadrasana II from standing, mountain pose or downward dog. Starting with the right foot, you will step back as wide as is comfortable, turning your right foot so that it is at a 90-degree angle and your front and back hells are aligned. Press down through the lateral arch of your back foot and turn in as you feel comfortable.
The first alignment adjustment should be hips facing forward, in one line. Inhale and sink your left leg down, ankle over the knee and thighs parallel to the mat. Lift your arms up by your sides at shoulder level, keeping your shoulder blades relaxed and your chest up. Your arms should be in one line, as per your hips. If it is comfortable, turn your dristi to the middle finger of your left hand. Sink further into the posture if you can and make sure your weight is even across both legs (your right leg will be straight, with a micro bend if necessary.) Feel the contrast of your legs and feet grounding into the earth while your spine lifts and pulls you up. Repeat on the opposite side. It is best to hold this pose for 5 breaths, breathing deeply with ujjayi breath if possible to help channel more energy and focus. Modifications come in the form of a chair under your bent leg and you can adjust the positioning of your bent leg knee to lessen the intensity.
The Third (final) Trimester (27-40 weeks)
This stage sees a rapid increase in the growth of your baby. Most babies begin to turn to settle into head first position, preparing for delivery. Common changes include abdominal aches, fatigue, heartburn, backache and reduced bladder control. Balance is a challenge and breathing is made difficult through compression on the vital organs.
Yoga asanas can be of great help during this stage and can be used to alleviate some of these symptoms. As you prepare for birth, strengthening the pelvic floor muscle is crucial to muscle engagement and keeping the vaginal wall strong to prevent any unnecessary tearing or distress. Forward folds and stomach compression postures should be avoided, and modifications should be encouraged. The heart should remain lifted to ensure that blood flow isn’t impacted. Savasana can compress the vena cava and should be modified with props or changed to seated meditation postures. To assist with the physical and mental challenges that come in this trimester, I recommend a strong posture such as Utakata Konasana.
Utkata Konasana is a deep, squatting pose that strengthens the pelvic floor and helps to open the hips in preparation for childbirth. It strengthens the quadriceps, the inner thighs, the calves and the core muscles. It also helps with concentration, balance and stability. Spiritually, this posture, known as Goddess pose, is from the Sanskrit ‘Utkata’ meaning powerful or fierce. This is a great motivation for any expectant mother, encouraging you to get in touch with your inner goddess and feminine power. Utkata Konasa can be a difficult and strong pose, particularly as your delivery date nears and your baby grows and begins to engage its head. This means it is best to warm up sufficiently beforehand, using exercises that target the hips, thighs and core.
You will need to take a wide stance on the mat (preferably lengthways/horizontally) with legs 3-4 feet apart, dependent on comfort. Turn the feet out so that your toes are pointing towards either end of your mat and make sure that your knees are rotated out sufficiently so that when you bend, your knees are in line with your ankles. However, take care to not rotate the knees to the point of overstretching the groin. Make sure that your hips are in a straight line and that your tailbone is gently tucked under. Engage the core muscles as you start to bend slowly down. Do not take the knees over the ankles. Keep your chest lifted, heart up, shoulders in one line as with the hips. Dristi should be straight ahead and you can focus on an unmoving point to aid with balance.
It is best to hold this pose for 5 breaths, breathing deeply with ujjayi breath if possible to help channel more energy and focus. To modify, you can simply reduce the squat, or use a chair to sit on, focusing on the hip opening aspect of the pose. You can also make this pose more active, by pulsing up and down before coming into to the full stretch. Palms can be together in Anjali Mudra, or you can place one hand on your heart and the other on your belly, rubbing it in a clockwise direction. This is an excellent way to connect with your baby and to aid digestion. Alternatively, you can just hold the bump for comfort, but make sure you continue to keep your chest and heart lifted.
For further spiritual connection, taking the hands into Yoni Mudra is a great way to channel all that power and feminine energy. This mudra is shaped like a womb, invoking the primal energy inherent in the source of life. It will help you to stabilise your body and mind, develop greater concentration and awareness, and encourage deep, internal physical relaxation (ref 3). It also directs prana back into the body which can be very energising – highly useful in the third trimester when fatigue increases.
Pranayama Techniques for Pregnancy Yoga
Nadi Shodhana pranayama (psychic network purification) is safe to do during pregnancy, providing you use the preparatory practice technique or alternate nostril breathing. The Antar Kumbhaka technique is not suitable for women in the later half of pregnancy so is best avoided in all trimesters to alleviate any risk.
Nadi Shodhana is a useful technique to slow down your mind, reduce stress, encourage mindfulness and help with balance. It can be practiced at any time of day, even outside of physical yoga practice. Props and modifications can be used depending on the length of time Nadi Shodhana is being practiced for. The recommended time for preparatory practice is 5 rounds, or for 3-5 minutes. Alternate nostril breathing can be practiced for up to 10 rounds or 5-8 minutes(ref 4).
Additional Lifestyle Support Ayurveda can also support pregnancy, and has proven to be useful when facing hyperemis gravidarum (severe morning sickness), gestational diabetes, hypertension, water retention, or skin sensitivity – all of which can be triggered by stress and sudden changes to the body. Ayurveda takes a holistic approach to healing and can help you to get in touch with your body and mind, especially when combined with yoga. The key message is to listen to your body and tune in with what you and your baby need.
Your whole body can be very sensitive during this time, so it is best to seek proper advice from an Ayurveda specialist to make sure you are following the right guidelines. There are also many simple techniques you can follow that don’t require overhauling your diet completely. For example, digestion is an important issue in every trimester, so replacing cold food and drink with warm ones can be an excellent digestive aid.
Summary
When used holistically, with the addition of meditation and pranayama, and when combined with the advice of a healthcare professional, I believe yoga to be one of the most effective practices for pregnancy and birth preparation. Given the complicated risk factors and unique experience of pregnancy for each mother, it can be difficult to know exactly how to practice yoga and what guidelines to follow. I firmly believe that pregnancy is all about intuition and spirit, which should be reiterated in every aspect of the practice.
As an expectant parent, you should be encouraged to listen to your body, your intuition and to connect with your baby on a deeper level. Asanas, meditation, pranayama are all key parts of yoga that can support each trimester safely and effectively. They can aid with delivery and support the body for post birth. One of the most important factors that is outlined in research is that physical exercise and meditation can help reduce the risk of pre and post-natal depression, something which is increasing due to the rapid growth of lifestyle stresses.
Most mothers will have to work up until their delivery date, so strength, focus and engagement with the baby is so important to this. It important to recognize that not all types of yoga will be suitable in pregnancy. Ashtanga and Vinyasa yoga are not advised, but Hatha and Yin yoga can offer a host of benefits to expectant mothers. The final point to remember is that change is constant.
The asanas, meditation techniques and pranayama I have outlined in this essay is to be used as a guideline. Yoga practice should be encouraged as a lifestyle tool to support these consistent and sometimes daunting changes. It is not just a physical practice, it is an essential for the mind, for the baby connection and for the health and strength of your body.
References
- Duncan LG, Bardacke N. Mindfulness based childbirth and parenting education: promoting family mindfulness during the perinatal period. Journal of Child and Family Studies. 2010;19(2):190-202
- Monk C, Fifer WP, Myers MM, et al. Effects of maternal breathing rate, psychiatric status and cortisol on fetal heart rate. Developmental Psychobiology 2011;53(3):221-233
- Swami Satyananda Saraswati. Asana Pranayama Mudra Bandha. Bihar School of Yoga 2008: 427
- Swami Satyananda Saraswati. Asana Pranayama Mudra Bandha. Bihar School of Yoga 2008: 385
