Pregnancy Yoga with Dr. Leah Deutsh

During pregnancy, yoga can be a valuable tool for relieving tension and discomfort in the body as well as cultivating strength in preparation for labour. But there are a number of other benefits associated with practising antenatal yoga including its impact on an expectant mother’s emotional and mental well-being.

I have previously alluded on the long-term and sometimes irreparable adverse effects of anxiety and stress during pregnancy . Antenatal Yoga could therefore be used as a mind body practice to lessen stress, improve sleep, enhance immunity and perhaps reduce the rate of post-natal mood disorders (Hayase et al., 2018; Chen et al., 2017; Newham et al., 2014) .

I consequently have invited Dr. Leah Deutsch @yoga_doc , a senior registrar specialising in obstetrics and gynaecology and a pregnancy yoga teacher, to explain the mechanisms of maternity yoga and it’s impact on a mother’s mental, emotional and physical well-being.

Yoga is used for a variety of immunological, neuromuscular, psychological, and pain conditions. How different is prenatal yoga to other yoga practices ?

Yoga is the combination of moving, being and breathing and in pregnancy it should be exactly the same focus as yoga outside of pregnancy. What the practice outwardly looks like often tends to fall on a more gentle end of the spectrum though.

The physical poses or asana may need to be modified for the physiological changes of pregnancy and to account for the spatial restraints of having another human being growing inside of you. There are certain types of poses that are contraindicated in pregnancy like closed twists or prone postures, or if you have certain pregnancy associated conditions like pregnancy induced hypertension you would not want to be doing inversions.

What style or school of practice would you recommend for pregnancy yoga?

There is no particular school or practice of pregnancy yoga, I would always recommend to find a teacher or practice that feels right for you. I would probably suggest looking for a teacher with a RYPT qualification, this means they have completed an additional training in pregnancy yoga.

The standard yoga teacher training covers pregnancy in brief, but if you sign up to a pregnancy specific course, it just means that your teacher will have more of an understanding and the class will be targeted towards your needs.

There are plenty of teachers all teaching their own variations, from extremely gentle practices to those who try to adapt a more conventional practice towards pregnancy. I am probably in the latter approach in my style. Pregnancy is not a disease and we know that exercising in pregnancy is important, so I try to gear my style of teaching towards a fluid feminine practice that makes you feel as though you’ve been challenged. I equally acknowledge the benefits of mindfulness and focused breathing on activating the parasympathetic breathing, so make time for this part of the practice in my classes too.

Do the components or postures of antenatal yoga vary in each trimester? If so, what are the benefits and impact on mum and baby?

Many teacher’s will recommend not practising yoga until after the 12 week scan, this is because miscarriage’s are more common in the first trimester and although yoga itself will not cause harm to a pregnancy, there is a worry that women may form a causal link in her mind if the worst happens.

I alert women to this but think that yoga can be really beneficial in pregnancy. I would normally suggest a more gentle and recharging practice and depending on symptoms like nausea, steering clear of poses where the head is below the heart, like inversions or standing forward folds. This is the only trimester where prone (lying on your front) poses may be more possible and not potentially harmful, so poses like cobra might still feel nice.

As you move towards the third trimester and certainly from 34 weeks, it’s really helpful to focus on forwards and open poses like cat cow or lizard lunges, to help give your baby space to move in to an optimal position for birth. From 36-37 weeks poses like malasana or goddess pose can also be a great idea to help encourage your baby to move into the pelvis more.

Maternal stress and anxiety during pregnancy has been linked to a host of negative consequences for expecting mothers and their unborn child. How does yoga in pregnancy affect stress levels?

Studies are limited in terms of quality evidence for yoga in pregnancy, but a 2012 systematic review in 2012 looking at 3 randomised control and 3 control trials, showed improved psychological well-being and reduced stress scores in women that practised yoga in pregnancy (Muzik et al., 2012).

These were measured through self reported questionnaires and the assessment of vagal tone. We know that maternal stress and anxiety can influence neural programming and the development of the brain of your baby while it’s in the uterus, through exposure to stress peptides.

It has also been shown that yoga has additional benefits of a shortened length of labour and lower reported pain scores. There is also a suggestion of less pregnancy induced hypertension and lower rates of preterm labour, although these benefits were in the non-randomised groups and the study was criticised for use of inappropriate statistical tests and over liberal analysis in interpreting outcomes.

Can it be used as an alternative therapy for anxiety, mood disorders or depression in pregnancy? and does it have a postnatal effect?

Outside of pregnancy studies have shown that for mild depression and anxiety disorders, mindfulness practises, which yoga includes can be a great alternative or adjunct to conventional therapies. Nervous system regulation and physiological functioning can be affected through activation of the parasympathetic nervous system.

Postnatal yoga is a whole other topic, it can be a wonderful way to return to exercise after having a baby and can be really great for women experiencing the baby blues in the weeks following delivery.

What are the 3 yoga poses you would recommend pregnant women practice daily for mental & emotional well-being?

1. Child’s pose can be an incredibly settling pose, practise this with toes touching and knees wide in pregnancy to accommodate your bump. You can place cushions under your head and a blanket between your calves and thighs if this feels supportive.

2. Tree pose for me, is extremely centring, it’s a real mirror to what’s going on in your mind, by focussing inwardly controlling the breath

3. Meditation or mindfulness practices are a really important part of yoga and get really overlooked by the Western approach. More than anything, taking even 5 minutes each day, will reduce your stress and anxiety. If you’re new to this practice, using apps such as Headspace or Calm can be a really good starting point.

+References

Chen, P.J., Yang, L., Chou, C.C., Li, C.C., Chang, Y.C., and Liaw, J.J. (2017). Effects of prenatal yoga on women’s stress and immune function across pregnancy: A randomized controlled trial. Complementary Therapies in Medicine 31, 109–117.

Hayase, M., and Shimada, M. (2018). Effects of maternity yoga on the autonomic nervous system during pregnancy. Journal of Obstetrics and Gynaecology Research 44, 1887–1895.

Muzik, M., Hamilton, S.E., Lisa Rosenblum, K., Waxler, E., and Hadi, Z. (2012). Mindfulness yoga during pregnancy for psychiatrically at-risk women: Preliminary results from a pilot feasibility study. Complementary Therapies in Clinical Practice 18, 235–240.

Newham, J.J., Wittkowski, A., Hurley, J., Aplin, J.D., and Westwood, M. (2014). Effects of antenatal yoga on maternal anxiety and depression: A randomized controlled trial. Depression and Anxiety 31, 631–640.

Pregnancy Yoga with Dr. Leah Deutsch