Thursday, September 16, 2010

Yoga Before, During, and After Pregnancy, part 1

Yoga is a comprehensive system for achieving total health. It calms and focuses the mind, strengthens and heals the body, and can even lead to spiritual fulfillment. The asanas of yoga are much gentler on the body than traditional aggressive physical exercise. For these reasons, yoga is ideal for keeping mother and fetus healthy during pregnancy. A regular yoga practice will prevent back pain, excessive weight gain, and will make delivery easier. Pregnancy yoga is a huge topic, much too broad to be adequately covered in a three page essay, but this treatment can be considered a jumping-off point toward further study.

A regular yoga practice will not only prepare the mother for birth, it will also provide a loving environment for the child from the very beginning of its gestation. Physical fitness will lead to an easier delivery, and yoga not only can make you fit, but will also provide the ability to remain calm and in control of the situation during labor. A regular practice of pranayama and meditation teaches the yogi to live in the moment, embracing the present and all its effects. This is especially important for pregnant mothers, who will no doubt fear their upcoming labor and subsequent sleepless nights. Meditation especially is known to keep fear and discomfort at bay, so the meditator is able to face any eventuality with calm and equanimity. It is easy to see that regular meditation can make one a better mother.

Yoga can be helpful during pregnancy for the seasoned practitioner or the beginner. In fact, the more adept yogini may notice improvement in her asana form during pregnancy. This is because a hormone called relaxin is being secreted at this time, which loosens the muscles and ligaments (3). Because she may be more flexible than before, the yogini may try to push herself further than she should, which can lead to soreness and injury. It is best to work with a knowledgeable teacher who will guide the yogini in the poses appropriate for her condition. Relaxin continues to surge in the body for about three months after the birth, so the yogini must continue to be vigilant not to over-stretch even then (1). Injuries from overstretching can lead to inflammation of the joints that may never really go away. One of the most basic rules of yoga is to avoid over-exertion, and this is especially true for pregnant women. Bikram and other “hot yogas” are to be avoided because of the risks of dehydration and overheating (3).

Pregnancy is a time of rapid change in the body, and different asanas become appropriate as the body changes. If there is a high risk of miscarriage, asana may have to be avoided altogether. Pranayama and meditation can and should still be practiced, but pregnant women are advised to avoid kumbhaka, or breath retention, as well as rapid breathing such as Kapalabhati or Bhastrika (1). Slow, steady breathing is best, as the surge of prana is beneficial and the slow pace will slow the heart rate. After the first trimester, the yogini should avoid poses which require lying on the back or belly. Backbends stretch the linea alba, a fibrous structure separating the rectus muscles of the abdomen, which is already being stretched by pregnancy (3). Lying on the belly will become more uncomfortable as pregnancy goes on, so side-reclining variations of asanas should be adapted. Also to be avoided after the first trimester are vigorous twists as well as forward bends with the legs close together, which puts pressure on the uterus (3). Standing forward bends should be practiced with a concave back to avoid bringing the lower ribs too close to the uterus (1). In the second and third trimesters, sitting poses gain critical importance because they help open the pelvis to prepare for the birth. Padmasana, Sukhasana, and wide-legged forward bends are all beneficial (3). Standing poses and all poses that strengthen the legs are helpful as well because a strong foundation becomes vital as the baby grows. Having strong legs will enable the mother to carry the fetus in as much comfort as possible (1). Perineal exercises will tone and create elasticity in the pelvic floor, helping the muscles stretch fully during birth and return easily to their previous position. To tone the pelvic floor, the yogini can lie down and clench the muscles of the thighs and buttocks with the lower back pressed into the floor (3). Alternately, she can perform the mula bandha, or root lock, in which the muscles of the anus are squeezed for a few seconds then relaxed (3). After the perineal exercises, the yogini should do a gentle squatting pose to open the pelvis. Women in countries where squatting and sitting on the floor are more common tend to have easier births because squatting opens the pelvic area and strengthens the legs (3).

The further into pregnancy one goes, the more cumbersome she will feel. Poses will have to be modified to accommodate the extra weight and special concerns pregnancy brings. As previously mentioned, the legs should be wide apart in forward bends. The hands can be used to maintain balance; for example, pressing the hands into the lower back during Surya Namaskar instead of raising them in Urdvha Hastasana, or leaning the arms on the front leg in Crescent Pose (1). Instead of leg raises to strengthen the abdomen, pregnancy sit-ups can be performed. To do them, one lies on the back, knees bent, feet flat on the floor, elbows behind the head, and crunches the left elbow toward the right knee, lowers down, then switches sides. This will keep the abdominals strong throughout pregnancy and hold the baby in proper position (3). Inversions are only recommended during pregnancy if the yogini is already used to practicing them. Modified shoulderstand against a wall or a half-headstand, with the knees bent and feet on the ground, can be performed instead of their more vigorous counterparts. These poses rest the lower back and legs, and ensure the womb reverts to its proper position after birth (3). Again, inversions should only be practiced if one is already familiar with them, and only as long as they are comfortable. It will be nearly impossible to perform headstand or shoulderstand in the latter stages of the third trimester. Supta Badha Konasana is also valuable for opening the pelvis, and can be modified by either lying back with the feet together, lifted a few inches from the ground, against a wall, or, alternately, props such as bolsters and pillows can be used to keep the upper body at an incline. This prevents compression of the vena cava, a vein that runs on the right side of the body and delivers blood back to the heart (3). Side Savasana is the pregnancy modification of Savasana. It is done by lying on the left side (again to reduce compression of the vena cava) with a pillow or bolster between the legs (1). A pillow under the head will add to the relaxing effect of this pose.

I know this has been a long post. Tomorrow I will post the much shorter Part 2

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