Sunday, December 9, 2012

Pregnancy and Yoga


 

 

 

 

 

Pregnancy and Yoga

 

 

 

 

 

 

Mindy Wyllie

CSOCS 3452 Yoga: Theory, Culture and Practice

Professor Laura Douglass, Ph.D.

December 6, 2012

Abstract

            Yoga has been recognized for the curative byproducts kindled from the practice and adapted to facilitate modern needs, despite the initial intention to bring the yogi closer to enlightenment.  Modernized views of yoga emphasize yoga as a physical exercise; interestingly, yoga for pregnancy takes on an integrated approach including breathing techniques as well as meditation.  Yoga during pregnancy focuses on the mind body connection for the reduction of stress, physical fitness, as well as a means of adaptation to the constant changes which are occurring within the women’s body.  The research available supports yoga as beneficial for pregnancy, but has limitations and needs to be further explored. 


Introduction

            Yoga is a holistic practice that may be adapted to aide women throughout their pregnancy.  The research done on this subject is quite limited to women of a particular social and economic status.  Women, who are considered middle class, are often married and they themselves are working.  Despite the limitations in research, it does appear a yoga practice is beneficial to the physical and emotional wellbeing of a woman during pregnancy.  It is hard to know if the results would be the same in women who are struggling to meet their basic needs.  Relaxation seems to be the primary focus of yoga for a pregnant mother.  The expectant mother is going through a lot of physical and hormonal changes.  Stress induced ailments, as well as excessive weight gain and lack of sleep are physical symptoms that maybe minimalized through a yoga practice during pregnancy. 

            I have recently found my peers are beginning to start their families.  As I hope to do sometime in the near future.  I feel if I’m going to take on the responsibility of parenthood, I should learn what I can to be a consciences parent right from the start.  My personal beliefs are deeply intertwined in my desire to learn more about the benefits of yoga to an expecting mother.  I know how yoga has improved my life, but I was curious what information is available for pregnant women who wish to practice yoga.  I feel, in our society nowadays, yoga is commonly recommended for pregnant women, but that wasn’t always the case.  Over the last twenty-five years, there has been focus on the healthy development of the fetus, in which moderate exercise is now considered a healthy practice for pregnant women. (Pruett & Caputo, 2011)

In addition to looking at the pregnancy through the lens of physical wellbeing, more emphasis is being placed on the mother’s emotional state as well.  I feel the mother’s emotional state is equally important to the development of her child as her physical state.  Stress and anxiety can be maladaptive to the health of the mother and the unborn child.  Yoga is a way to promote emotional balance, physical strength and flexibility and turn the women’s consciousness inward to tune into her own needs. 

Who Does Yoga While They Are Pregnant?

The people who have the time to incorporate yoga into their lives are a certain population in and of themselves.  Traditionally, it seems as though yoga was a male dominated, spiritually driven, pursuit; that being said incorporating yoga as a means to aide women through pregnancy, in my opinion, is a reflection of our modern cultures ability to extract an element of a philosophy to be incorporated into our modern lifestyles.  Yoga is not being used to draw the individual closer to enlightenment.  Yoga for the expecting mother is to facilitate the changes associated with pregnancy.  The women who are able to incorporate yoga into their lives tend to be of a certain social and economic status.

The research available on the subject shows the people participating in these studies to be of a fairly specific population.  “Because participants in this sample were predominantly, White, middle class, employed, well educated, and married, results cannot be generalized to other ethnicities or socioeconomic groups; nor should results be generalized to women with pregnancy complications.” (Beddoe, Lee, Weiss, Kennedy & Yang, 2010, p. 368)  The women who have been shown to benefit from yoga are relatively well off and are low risk or what would be considered to be experiencing a normal pregnancy.  Although pregnant women of all income levels could potentially benefit from yoga, it doesn’t seem realistic that they would be incorporating the practice into their life.  Yoga seems as though it is a practice for those with the luxury of time and many cases money.  The image I get of yoga in regards to pregnancy is the modern westernized women.  She is working and pencils her yoga class into her life when she can. 

Women in our modern culture are dealing with a great amount of stress.  It would be nice to think we have the time and patience to create the ideal environment in which to be pregnant.  However, in today’s world this may be unrealistic.   Yoga offers the opportunity to cultivate a quiet place for the pregnant women to find within her and hopefully carry throughout her day.  “The pregnant woman, focusing inward, can begin to discover and utilize the techniques that provide her with the greatest comfort.” (Worzer, 2004, p.18)  The idea of providing the expectant mother with her greatest comfort is a very lovely image, but it does make one think, what of the mother who doesn’t have a home, or doesn’t know how she will feed her unborn child?  It seems as though her greatest comfort would look quite different for this women.

Why is Yoga Beneficial for Pregnancy?

Today women in our society are multifaceted, not only are they mothers, but they are employees or employers.  Even something as natural as pregnancy has been adapted to our modern way of living.  “It is as though many women simply do not have time to focus on the special needs of pregnancy- pregnancy just unfolds while the woman continues her daily routine.” (Worzer, 2004, p.16)  Women are empowered to do it all; there is no need to choose between a family and a career.  However, due to the nature of our busy on the go lifestyles stress seems inevitable. 

Studies are showing a direct correlation between emotional and physical health.  Negative emotions such as stress and anxiety are detrimental to the psyche and cause physical harm.  “Recent well controlled human studies indicate that pregnant women with high stress and anxiety levels are at increased risk of spontaneous abortion, preterm labor, malformations, and asymmetric growth retardation.” (Narendran, Nagarathna, Narendran, Gunasheela, & Nangendra, 2005, p.238)  Seeing the relationship between the mental and physical aspects of the body, it makes sense to implement a practice that embraces treatment for a person as a whole. 

The nature of yoga is to incorporate all aspects of the self to find a greater sense of wellbeing.  Pregnancy is a time where optimal health is needed for the proper development of the fetus.  “Yoga is non-invasive, economical, and easy to learn solution to improve the quality of life of pregnant women, improve their abilities to perform their social roles, and potentially prevent adverse obstetrics outcome.” (Rakhshani, Maharana, Raghuram, Nagendra, & Venkatram, 2010, p.1454)  I agree with the benefits of yoga for pregnant women, but I’m not sure I agree about the economical part.  Yoga for pregnant women is encouraged under the supervision of a well-trained practitioner.  Such classes are expensive and may seem unattainable for families of low economic status. 

Physical exercise in general is beneficially for pregnant women; however, yoga specifically has many qualities that lend the practice to accommodating pregnancy.  Yoga is gentle and meant to be adapted to fit the needs of the individual.  One case study compared the benefits of appropriate exercise for pregnancy with an integrated yoga practice.  The yoga included breathing exercises and meditation in addition to postures.  The study showed the women who participated in the yoga group scored higher on the World Health Organization Quality of Life assessment instrument. These results indicated yoga offered greater emotional well-being in addition to the typical benefits of physical exercise. (Rakhshani, Maharana, Raghuram, Nagendra, & Venkatram, 2010) 

Another study compared birth outcomes for pregnant women practicing yoga to the general benefits attributed to exercise.  Once again an integrated approach to yoga was used and the control group consisted of a walking regimen.   The respective aspects of yoga to be used were seen to be beneficial in the following ways, “Reduction in stress through the integration approach of yoga therapy is achieved by the practice of deep relaxation at the somatic level in different postures (asanas), slow controlled breathing to decrease the respiratory rate (pranayama), and mind calming techniques such as meditation and chanting.” (Narendran, Nagarathna, Narendran, Gunasheela, & Nagendra, 2005, p.238)  The results indicated not only was yoga deemed a safe form of exercise for pregnancy, but the yoga group had a reduction in preterm birth and the babies had a higher number of ideal birth weights. 

            Yoga is used in pregnancy for the relaxation techniques, as well as to benefit the physical body.  Many of the problems that arise for women during pregnancy are due to gaining too much additional weight, such as gestational diabetes, hypertension, or possible delivery complications.  Yoga may also help with the low back pain commonly attributed to pregnancy.  The benefits are not exclusively related to a yoga practice, many health benefits may be accomplished by incorporating exercise in general into a pregnancy.  However, a hatha yoga practice is a safe way for women to stay in shape, not only are the postures modified to accommodate each stage of pregnancy, but the individual’s specific needs as well. (Pruett & Caputo, 2011)  The strength cultivated in a yoga practice will also help keep her strong for her delivery.  Women who had practiced yoga showed to have a shorter labor. (Curtis, Weinrib, & Katz, 2012)  The only yoga contraindicated to pregnancy is Bikram, due to the heating of the room.  The effect is similar to what maybe experienced in a hot tub and is considered unsafe for pregnancy. (Pruett &Caputo, 2011)

Maintaining health while pregnant does not just involve what happens during the day.  Sleep is crucial.  “Short-term restriction of sleep, even in healthy people, results in a variety of adverse physiologic effects including elevated blood pressure, activation of the sympathetic nervous system, impaired glucose control, and increased inflammation. During pregnancy, it is particularly important for a person to have optimum functioning for her cardiovascular system and well-modulated glucose control.” (Beddoe, Lee, Weiss, Kennedy, &Yang, 2010, p.368)  One pilot study compared the sleep habits of pregnant women before and after implementing yet again, an integrated yoga practice into their lives.  The two groups of women who participated in the study differed by how far along in their pregnancy they were.  Women who were introduced to a mindful-yoga practice during their second trimester were able to improve their sleep.  The effects of mindful-yoga were less beneficial for the women in the third trimester; however the sleep disturbances for the women in the second trimester were greater. (Beddoe, Lee, Weiss, Kennedy, &Yang, 2010)

Yoga Practice

Asana refers to the physical postures our modern culture identifies with yoga.  It is especially important the asana portion of yoga for pregnant women be practiced the instruction of a knowledgeable teacher.  This ensures the practice will be adapted to meet the needs of the women and maintain a safe experience. (Bala, 2012)

Yoga asana may be practiced throughout the entire pregnancy; however, not all postures are to be performed.  Women, who are new to yoga, often find an increase in nausea during the first trimester.  In this case, it would be better to wait until the nausea subsides to begin an asana practice. Women who are accustomed to a yoga practice are encouraged to not push themselves as hard as they use to, honoring that they are now pregnant. (Bachman, 2010)    

Poses should be modified to meet the needs of the individual; a few examples of typically safe and beneficial postures for pregnant women include Malasana or squatting, or Bidalasana or cat pose.  Malasana helps prepare the women’s body for the opening in her pelvic area that needs to occur in order to give birth.  The pose can be done with various supports, either by placing something in immovable in front of the women to hold on to or perhaps using yoga blocks placed under her bottom for support.  Bidalasana is taken while on hands and knees.  It is known to be helpful to elevate back pain associated with pregnancy. (White, 2001)

In contrast, various poses should be avoided.  During pregnancy, women’s joints are changing to accommodate child birth.  It is important to be cautious of overstretching.  Poses that put pressure on the abdomen should also be avoided.  All poses should be done slowly and mindfully. As with asana in general, anything that doesn’t feel good, should not be done. (Bala, 2012)

Yoga in relationship to pregnancy embraces more than just yoga asana.  The research available focused on integrated approaches to yoga.  “The various components of a yoga practice that were included in the reviewed trials included postures (asana), breathing practices (pranayama), concentration/meditation (dharana/dhyana), deep relaxation or yoga sleep (yoga nidra), lectures/counseling sessions on lifestyle change, and information on anatomy and chanting.” (Curtis, Weinrib, & Katz, 2012, p.3)  I found this interesting, because in our culture there seems to be such a heavy emphasis on yoga as an exercise.  All of the studies I found were testing an integrated approach to yoga.  I feel this maybe why yoga could be confidently recommended for all stages of pregnancy, even if asana could no longer be practiced, pranayama for example would be beneficial.  The various forms of integrated yoga used in these studies had a component focusing on breathe, whether it was cultivating a particular breathing pattern, aligning breathe with movement or in a simple meditation that required an awareness of the breath. Other techniques included in the umbrella of yoga were also included, such as meditation, chanting, mindfulness and deep relaxation. 

Conclusion

            One of the documents I found was a collection of the research that already exists exploring the benefits of yoga.  In terms of looking at yoga scientifically, the study suggested yoga was being looked at from too many angles.  How could they pin point curative aspects to specific yogic practices?  I think this is a good example of what we like to do with things in the west.  Pull them apart into pieces and see how the individual pieces work, separately.  I feel yoga is beneficial because it is holistic and adaptive to the needs of the individual.  So yoga changes to meet you where you are at.  How do you research that?  There are too many variables to prove, if yoga works differently for everyone.   I think part of the mysticism involved in yogic practices should be accepted as it is.  We are seeing in modern research how stress, although a mental process, causes physical harm.  The two are so closely related, it seems silly to try and treat one aspect and disregard the whole.  I feel yoga is an asset, because it already encompasses wholeness.  To pick apart yoga for the purpose of empirical data seems to lose the essence of why yoga works at all. 

 

References

Bachman, M. (2010). Insights on pregnancy from yoga and Ayurveda. Yoga Therapy Today,

6(1), 12-14. Retrieved from Alt HealthWatch EBSCOhost database.

Bala, K. (2012). Pregnancy & yoga. Midwifery Today, (103), 38-39. Retrieved from Alt HealthWatch EBSCOhost database.

Beddoe, A. E., Lee, K. A., Weiss, S. J., Kennedy, H., & Yang, C. (2010). Effects of mindful       yoga on sleep in pregnant women: A pilot study. Biological Research for Nursing, 11(4),     363-370. doi: 10.1177/1099800409356320

Curtis, K., Weinrib, A., & Katz, J. (2012). Systematic review of yoga for pregnant women: Current status and future directions. Evidence-Based Complementary and Alternative Medicine, 2012(715942), 1-13. doi: 10.1155/2012/715942

Field, T. (2008). Pregnancy and labor alternative therapy research. Alternative Therapies in Health and Medicine, 14(5), 28-34. Retrieved from http://ezproxyles.flo.org/login?url=http://search.proquest.com/docview/204837338?accountid=12060

Faulkner, M. (2012). Transforming culture: A spirituality of healing. International Journal of         Childbirth Education, 27(1), 77-82. Retrieved from        http://ezproxyles.flo.org/login?url=http://search.proquest.com/docview/920597409?accou   ntid=12060

Gaffney, L., & Smith, C. A. (2004). Use of complementary therapies in pregnancy: The    perceptions of obstetricians and midwives in South Australia. Australian & New Zealand Journal of Obstetrics & Gynaecology, 44(1), 24-29. doi:10.1111/j.1479-       828X.2004.00161.x

Narendran, S., Nagarathna, R., Narendran, V., Gunasheela, S., & Nagendra, H., (2005). Efficacy of yoga on pregnancy outcome. Journal of Alternative & Complementary Medicine, 11(2), 237-244. doi:10.1089/acm.2005.11.237

Pruett, M., & Caputo, J. (2011). Exercise guidelines for pregnant and postpartum women.             Strength and Conditioning Journal, 33(3), 100-103. Retrieved from          http://ezproxyles.flo.org/login?url=http://search.proquest.com/docview/877651649?accou   ntid=12060

Rakhshani, A., Maharana, S., Raghuram, N., Nagendra, H. R., & Venkatram, P. (2010). Effects   of integrated yoga on quality of life and interpersonal relationship of pregnant women.            Quality of Life Research, 19(10), 1447-1455. doi:10.1007/s11136-010-9709-2

Robertshawe, P. (2009). Effects of yoga on maternal comfort, labor pain and birth outcomes.       Journal of the Australian Traditional-Medicine Society, 15(2), 81. Retrieved from Alt        HealthWatch EBSCOhost database.

Wang, S., DeZinno, P., Fermo, L., William, K., Caldwell-Andrews, A., & Bravemen, F (2005). Complementary and Alternative Medicine for Low-Back Pain in Pregnancy: A Cross-Sectional Survey. Journal of Alternative & Complementary Medicine, 11(3), 459-464. doi:108/acm.2005.11.459

Weiss, R. (2010). Prenatal yoga for partners. International Journal of Childbirth Education, 25(2), 24-24. Retrieved from: http://ezproxyles.flo.org/login?url=http://search.proquest.com/docview/748815512?accontid=12060

Wilkerson, N. N. (1997). Optimal pregnancy fitness: For women of all stages of pregnancy and    pre-& postnatal yoga; From the classic moves series. Journal of Perinatal Education, 6(2), 55. Retrieved from Alt HealthWatch EBSCOhost database.

White, M. (2001). Yoga for pregnancy. International Journal of Childbirth Education, 16(4), 5-    9. Retrieved from Alt HealthWatch EBSCOhost database.

Worzer, L. (2004). Stress and sleep deprivation in Pregnancy. International Journal of Childbirth Education, 19(1), 16-18. Retrieved from Alt HealthWatch EBSCOhost database.

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