By Dr. Rita Khanna
Women Who Should Not Attend a Yoga Class
• Those carrying multiples.
• Those with pregnancy-induced hypertension (PIH).
• Those who are experiencing episodes of premature labor.
• Those with an incompetent cervix, or who have experienced a second trimester miscarriage.
• Those with persistent vaginal bleeding, or with a diagnosis of placenta previa.
• Those with any serious medical condition that prevented exercise during pre-pregnancy.
General Considerations
• Pregnant students should not lie flat on their backs after 20 weeks gestational age.
• During the first trimester, forward bending may produce nausea.
• Long periods of standing may result in dizziness.
• Due to a change in their center of gravity, pregnant women will have more difficulty with balancing Asanas.
• Lying on the abdomen in early pregnancy is safe, but may be uncomfortable due to breast tenderness.
• Pregnant students should be encouraged to drink adequate water in the hours before class.
• Pregnant students should position themselves near the door and be told that they may leave class to use the toilet at any time.
• Extra cushions or blankets will be necessary to support the pregnant students.
• Fans, or air conditioning, may be necessary during warm weather, due to pregnant women getting warmed up faster.
Keeping these general considerations in mind, rather than avoiding pregnant students, we can begin to challenge ourselves as Yoga teachers to discover new ways of doing Asanas, and this will facilitate our growth. We will also be able to provide a comfortable and secure environment for the pregnant student to experience the joy of Yoga.
Preparatory Practice Series
All of the Preparatory Practice Series (Parts 1, 2, and 3 – Energy Block Postures) is appropriate to pregnancy. The anti-rheumatics (Preparatory Practices Series1) are wonderful for gently stretching and massaging the joints that are under increased stress, due to the weight gain of pregnancy. By improving lymphatic flow, the anti-rheumatics help reduce fluid retention and improve immune functioning. They release muscular tension and are introverting when coordinated with the movement of the breath. In Prenatal Yoga classes, the students can sit against the wall while performing these Asanas.
The anti-gastrics (PPS 2) should be done lying on the side. Due to the progesterone- induced relaxation of the intestinal tract during pregnancy, the anti-gastrics may help stimulate digestion and relieve constipation. They will also help increase hip flexibility and strengthen the muscles surrounding the hip. This will help relieve hip pain, a common complaint of pregnancy. Jhulana lurhakanasana (rocking and rolling), Stage 1, done gently, helps relieve low back pain. Supta Udarakarshanasana (sleeping abdominal stretch pose) can be done, provided the student remains flat on the back for less than 30 seconds. A substitute for Naukasana (boat pose) is to sit with one knee bent and lift the straight leg off the floor.
The Energy Block Postures Series is useful for relieving pelvic discomfort and constipation. Squatting Asanas are an excellent preparation for labor and delivery. Since squatting is not a normal part of Western daily activities, supporting the squatting position with a low stool, blocks, or by having the student grasp door knobs, can be helpful, until flexibility and strength improve. Vayu Nishkasana (wind releasing pose) should be approached with caution, due to the radical change from squatting to standing position that may result in dizziness. Nauka Sanchalanasana (rowing the boat) may need to be done, with the legs wide apart, to make room for the abdomen. Many prenatal students find Chakki Chalanasana (churning the mill) helps relieve low back discomfort. Rajju Karshanasana (pulling the rope) is an excellent Asana for relieving neck and shoulder stress, and for developing coordination of breath and movement. It also teaches focus.
With minor adjustments, nearly all of the Preparatory Practices Exercises Series is well suited to the pregnant student.
Standing Asanas
Two factors must be remembered when teaching standing Asanas to pregnant students. Prolonged standing may result in dizziness, and pregnancy changes may make balancing Asanas particularly challenging. With this in mind, it may be wise to place a chair near the pregnant student, to use during standing Asanas, if she becomes dizzy, or to use as a prop to steady herself. Standing Asanas will strengthen legs and may relieve leg cramping and leg fatigue. Strong legs will lessen strain on the back. Virtually all standing poses can be done.
Important standing poses, during pregnancy, include Tadasana (palm tree pose) and Tiryaka Tadasana (swaying palm tree pose). In my prenatal class, the students have renamed Tadasana as‘Heartburnasana’ because of its value in relieving heartburn – a common complaint especially in the third trimester. In Tiryaka Tadasana – the extension in the pose, rather than the sideways bend, can be further emphasized.
In side bending Asanas, such as Trikonasana (Triangle Pose), a chair can be used to prevent bending forward. Side bending helps open lower lungs and creates a sense of space in pregnancy.
Teaching good posture, as part of the standing practice, is especially useful to the pregnant student, who tends to slouch. Instruct her to keep the feet close together, with the outer edges parallel, lifting and spreading the toes, lifting the spine out of the pelvis, bringing the shoulders up and into the back of the body to keep the arms from ‘hanging’ off the neck. Point out the difference in energy flow between standing straight and strong versus standing with the feet apart, or fanned outward, with the shoulders collapsing forward.
Forward Bending Asanas
Forward bending Asanas help relieve the backache of pregnancy and are calming and introverting; but with the increased abdominal size, they may present a challenge. Most forward bending can be done by having the pregnant student separate her legs. Shashankasana (pose of the moon) will definitely require widening the space between the knees, as pregnancy progresses. It may also require supporting the torso on a bolster or blankets. Shashankasana is an important Asana for students to learn and to be able to hold comfortably. During the process of labor, a simplified knee chest position is frequently used if the fetal heart rate decreases.
Because of the weight of the abdomen, in the later stages of pregnancy, supporting the body with the arms or with blocks, in forward bending, will assist the student to keep good spinal alignment. In Janu Sirshasana (head to knee pose), the student can bend forward – angling between the legs, instead of straight forward over the straight leg. This allows room for the abdomen and increases the hip stretch.
Back Bending Asanas
Some Prenatal Yoga books stress that backward bending can be dangerous because it will compress the lumbar spine and over-stretch the abdomen. This is not true if Asanas are taught and done correctly. Obviously, some backward bending Asanas will be difficult, due to an inability to lie on the floor. However, I feel strongly that backward bending Asanas must be included and are an important method to strengthen the back and relieve backaches that are frequent in the pregnant student.
Asanas, such as – Ardha Shalabhasana (Half Locust Pose) variations, can be done on the hands and knees, and Ardha Dhanurasana (Half Bow), can be done lying on the side. To keep the thighs stretched, and to help relieve iliopsoas, (a blending of two muscles (the iliacus and psoas major) that run from the lumbar portion of the vertebral column to the femur). The main action of the iliopsoas is to flex the thigh at the hip joint) Ardha Ushtrasana (Half Camel Pose) and Ardha Chandrasana (Crescent Moon Pose) can be done.
It’s important to emphasize extension of the spine, while bending backwards. I have found that offering a suggestion to lift the shoulders up and back, and to lead with the shoulders rather than the head, helps prevent lower back compression.
Although backward bending does stretch the abdominal wall, most prenatal students find that they feel as though they have ‘more space’ after doing them. Considering how large that abdomen can become, especially with twins or multiples, I don’t think overstretching should be a concern in backward bending.
Spinal Twists
Emphasizing elongation of the spine, without flexion at the waist, is important in spinal twisting. Most pregnant women feel that they have difficulty with spinal twisting, due to their size, but spinal twisting helps to relieve backache and stress in the sacroiliac joint. Meru Prishthasana (Spine and Back Pose) can be done with the hands behind the head, keeping the elbows in line with the ears, which creates more lift in the spine, and provides more stretch through the neck and shoulders.
Another favorite is placing the legs as though doing Saithalyasana (Animal Relaxation Pose), but then adjusting it into a nice twist. Spinal twists, in the lying position, may create round ligament pain during the second trimester. This is because the uterus is dramatically increasing in size, pulling on the round ligaments, but not being supported by the pelvis yet.
Favorite Asana
In the years I’ve been teaching prenatal, I’ve found that Marjari-asana (Cat Stretch Pose) is a universal favorite. Often we begin with the student allowing the belly to release toward the floor, and holding that position for several breaths – then rounding up and holding that position again, before moving with the breath. This seems to increase relaxation with the stretch. Marjariasana is very good for reducing pelvic congestion and backache.
Pranayama
Through the process of connecting with the breath and internalizing the awareness, Pranayama practices are very useful in pregnancy and will help the student greatly through labor and delivery. Essentially, all Pranayama practices, that have been done prior to pregnancy, can continue through pregnancy. Vitalizing Pranayamas can be done gently and slowly. Kumbhaka should be minimized.
For new students to Yoga, practices for increasing breath capacity, sensitizing Pranayamas, Rhythmic Breathing, balancing and tranquillizing Pranayamas, are most important. Anulome-Viloma and Ujjayi are favorites of my prenatal students.
Mudras
Perineal Mudras are extremely beneficial during, and after, pregnancy. As mentioned earlier, as pregnancy progresses, there is an increase in pelvic stress and congestion, with the pressure of the baby against the pelvic floor. This area can become quite weak. The whole inner pelvic floor must stretch out to the bony structure to allow childbirth. Perineal Mudras help strengthen this area and allow a quicker recovery after delivery. By practicing Vajroli and Ashwini Mudras, along with Moola Bandha, some of the common complaints of pregnancy and post-delivery can be relieved.
All hand Mudras are beneficial. For women who are experiencing radical shifts in mood, or are having difficulty dealing with the emotions of their pregnancy, Hridaya Mudra may be helpful. Of course, Yoni Mudra is most suited to pregnancy.
Khechari Mudra is said to help stabilize labor. I normally teach this, along with Ujjayi, to my prenatal students, with the assumption that it might be useful during their labor, and certainly won’t be harmful.
Bandhas
There is no contra-indication to doing Moola Bandha during pregnancy. In fact, in obstetrics, physicians encourage pregnant women to do Perineal contracting exercises, known as Kegels, which contract the entire pelvic floor. Uddiyana Bandha is not appropriate, but Jalandhara Bandha may be used.
Meditation and Yoga Nidra
Developing intuitive awareness, and providing an opportunity for deep relaxation, is of great benefit to the Pregnant Yoga students. The only concern for the Yoga teacher is in making sure that the students are well supported. During sitting Meditations, pregnant students can sit against the wall, if necessary, and have adequate padding.
Matsya Kridasana (flapping fish pose) is often used for Yoga Nidra. Lying on the side seems to support the body more thoroughly and pads points of pressure or stress. This does, however, require approximately five to six blankets per student. If these are unavailable, the student should be instructed to bring pillows and blankets from home.
Yoga-nidra is about the best practice for pregnancy. If a student only had time to do one thing per day, I would recommend Yoga-nidra, over all else. It is important that the student be able to practice this technique at home. Students will greatly appreciate having tapes, or compact discs available, of various Yoga-nidra practices. During the visualization stage of Yoga-nidra, you can instruct the expectant mother through a body rotation of the infant’s body parts. This is enjoyed by prenatal students, and should be done on a recording, as it might confuse the other students in a regular class!
SUMMARY
In teaching prenatal students, I often feel the energy of the cycle of birth and rebirth. I believe that pregnancy is the perfect time to engage in Yoga. As teachers, we owe it to our students to learn enough to feel comfortable teaching and guiding them through the dramatic changes in their being. We also owe it to their infants, who will ultimately manifest the teachings.
Aum Shanti
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Courtesy: Dr. Rita Khanna’s Yogashaastra Studio.
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Dr. Rita Khanna
Dr. Rita Khanna is a well-known name in the field of Yoga and Naturopathy. She was initiated into this discipline over 25 years ago by world famous Swami Adyatmananda of Sivananda Ashram in Rishikesh (India).
She believes firmly that Yoga is a scientific process, which helps us to lead a healthy and disease-free life. She is also actively involved in practicing alternative medicines like Naturopathy. Over the years, she has been successfully practicing these therapies and providing succour to several chronic and terminally ill patients through Yoga, Diet and Naturopathy. She is also imparting Yoga Teachers Training.
At present, Dr. Rita Khanna is running a Yoga Studio in Secunderabad (Hyderabad, India).
Thanks Dr. Rita Khanna for writing this informative article.