Prenatal Yoga: The Essential Guidelines for Practice

Pregnancy is an exciting time for a woman, and also a time that must be approached with care and love. Maintaining a yoga practice while pregnant provides an expectant mother with an opportunity for deep connection with her unborn child. There are many important things to consider in the approach to practice to ensure a healthy mom and baby. Although every woman is different and pregnancies vary, here are some general guidelines of what to do and what not to do as you teach or practice:

This list is compiled for NORMAL pregnancies and does not constitute medical advice.

DO…
Check in with your health care provider to ensure it’s safe for you to practice.

It is generally not advised to start any new physical activity during the first trimester of any pregnancy. It is usually safe to continue with pre-pregnancy routines, however it’s always best to check with your doctor or midwife if you have any questions about safety.
Practice in a cool space or by an open window or door.
If you teach, save space where there is good airflow for your pregnant students, this will prevent overheating.
Stay hydrated; drink fluids as needed during practice.
It’s not usually recommended to consume anything while practicing, however pregnancy presents an exception. Your body will naturally give the first resources to your baby, and your requirement is higher than normal. When your body loses water faster than you put it in, you become dehydrated. Water plays an important role in baby’s development, the formation of the placenta, and amniotic fluid. The first sign of dehydration is maternal overheating, adequate water will facilitate body temperature regulation. Dehydration during pregnancy can lead to serious complications including neural tube defects, low amniotic fluid, inadequate breast milk production and even premature labor.
Eat something small before asana to ensure adequate glucose levels.
The hormones released during pregnancy have an increasing effect on a woman’s insulin resistance as a natural protection to ensure baby gets enough sugar. Not allowing maternal blood glucose to drop to low is vital for healthy fetal development, maternal energy and mental processes. Eating something small before practice will ensure you have enough energy to practice without blood sugar dropping too low.
Nourish & rehydrate immediately following practice.
A vigorous practice (if deemed safe by your practitioner) will use up the fuel you took in pre-practice, leaving a requirement for post-practice nourishment and fluids. Coconut water is a natural electrolyte rehydration formula, so if available it’s one of the best fluids you can intake after practice.
Monitor energy levels throughout the day and adjust practice accordingly.
Even though practice itself may not feel too taxing, you can feel the effects later in the day if you’ve overdone it. As pregnancy progresses, energy requirement to continue with asana will increase due to the increase in body weight, so energy levels should be paid close attention to.
Continue with practice, but include pregnancy modifications.
Depending on the style being practice, there are many options for modifying asana to accommodate a growing belly, ensuring comfort and no compression on the uterus.

This modification of Baddhakonasana opens the pelvis, allows for bandha work and opens the chest and diaphragm.

This modification of Baddhakonasana opens the pelvis, allows for bandha work and opens the chest and diaphragm.

Take Savasana or Balasana when needed during asana practice.
A flowing practice may require frequent breaks to prevent overheating, shortness of breath and fatigue.
Approach spinal twists with caution.
At any point in pregnancy, twists can cause too much pressure in the abdomen and be either uncomfortable or potentially limit blood flow to the uterus if the large vessels are compressed.
Above Left: Modified Trikonasana B for pregnancy.
Above Right: This open modification for Parsvakonasana B leaves room for the belly while maintaining a spinal twist.

Decrease the number of asana days per week according to energy levels.
If energy levels seem sporadic or decreasing, it may be necessary to decrease the number of practice days, especially if practice is vigorous. Replacing an “active” practice with a restorative, recovery practice can help to balance energy as well as allow the parasympathetic nervous system to bring a sense of calm to the body and mind.
Include restorative asana or full restorative practice days.
Supported restorative asana at the end of a vigorous practice can serve to rejuvenate as well as counteract any over stimulation of the sympathetic nervous system that may have occurred during the practice.
Be informed and qualified.
As a teacher, it is important that you are staying within your scope. If you do not have experience working with pregnant women, then taking a course that will specifically focus on pre and postnatal teaching is a wise decision.
Continue with a seated practice.
Pregnancy is an optimal time to begin or spend more time on a seated practice. Pranayama and meditation techniques are proven to calm the nervous system, increase concentration, increase alertness and decrease fatigue. These are excellent practices to continue postpartum as stress levels are high and sleep is low causing drain on the adrenal glands. Pranayama, if practiced properly and consistently is a tool that can increase the body’s ability to expel carbon dioxide, a useful tool when breath capacity is limited during pregnancy.
Practice asana or yoga therapy exercises that support sacroiliac joint stability and balance.
To cover this in detail would be a complete article by itself. It is important, however, to understand that ligaments are more lax during pregnancy, in particular in the pelvis, due to hormone secretion. This means stability is decreased. Stability in the Sacroilliac joint can be promoted with things like ardha urdhva dhanurasana while squeezing something between the knees (half bridge), prone and side planks or single leg planks, navasana, and Prone 4-point or quadruped exercises, to name a few. SI joint balance is promoted in bilateral movements, where both “sides” are being done simultaneously. Unilateral asana are safe, however can increase an already present imbalance if the pelvis does not remain square.
Above: This yoga therapy exercise is excellent for bringing balance to the SI joint.
Above Left: An example of Ardha urdhva dhanurasana, with a focus on hip adduction and internal rotation.
Above Right:Navasana – this may need to be modified depending on practitioner level.

Include more asana that open the front of the body
Classic hip flexor stretching and chest openers or back bending like Upward dog, parsvottansana, Urdhva or Parsva Dhanurasana and ustrasana that focus on opening the front of the body will help to counteract rounded shoulders, tight hip flexors and a compressed chest that is often seen with later pregnancy biomechanical shifts.
Above Left : Ustrasana feels fantastic for a pregnant woman as she opens her chest and upper abdomen and lifts her belly.
Above Right: Many asana that lengthen the hip flexors can be modified to suit pregnancy.

Practice inversions; use a wall or confident spotter
For inversion asanas where there was pre-pregnancy proficiency and confidence, a spotter or wall should still be used in case support is needed to prevent falling.
Shown here are Pincha mayurasana (Above Left) and Sirsasana (Above Right) using the wall.

Widen your stance as your body changes
Maintaining a balanced position is easier with a wide stance, which is recommended once centre of gravity shifts forward with a growing belly.
For example, Samasthitiḥ with the legs hip distance, or wider, rather than together.

For example, Samasthitiḥ with the legs hip distance, or wider, rather than together.

Prepare for birthing using yoga techniques
Birthing takes extreme focus and concentration and is easier if the core is strong enough to assist the uterus during transition. Deep, relaxed breathing techniques also assist the birthing process, allowing the uterus to do it’s job. Concentration, strength and breath-work can be combined in one practice or segmented as individual practices.
Practice Mula Bandha or Pelvic Floor exercises
The pelvic floor will definitely need to relax during a natural birth, however a strong one will support the additional weight of the baby. Having a strong pelvic floor (or more specifically, good control over the pelvic floor) during pregnancy will help to minimize pregnancy postural shifts as well as speed up postpartum recovery.

DON’T…
Stretch to your maximum, never go beyond what you were capable of pre-pregnancy

Ligament laxity puts a pregnant woman at risk for injury to soft tissue. “Going deeper” shouldn’t be a focus and can cause problems long after birth if symphysis pubis dysfunction or diastistis recti are severe.
Overheat; this could lead to neurological damage of the growing baby
See above point on hydration and airflow. Although some asana styles promote generating heat within, this needs to be approached with caution during pregnancy, and certainly external heat (e.g. a hot room) should be minimized.
Practice through dizziness; stop immediately and rest
Dizziness is a signal from your body to stop doing what you’re doing. It’s often caused by postural hypotension and disappears quickly, however momentary rest is needed in the presence of dizziness to allow blood pressure to return to normal.
Practice any asana that puts pressure on the uterus; modify
Any asana involving a padmasana (lotus) position, even if only on one side, and in particular if it involves a forward fold may put undo pressure on the uterus once it’s left the pelvic bowl at about 10-12 weeks.

Modified Ardha Baddha Padmottanasana

Modified Ardha Baddha Padmottanasana

Change positions too quickly if you are suffering from morning sickness
Moving too quickly can make nausea worse, take your time in transitioning between asana and modify or don’t practice asana that seem to make nausea worse (often these are forward folding movements or twists). Supta virasana, vipariti karani and supta baddha konasana can help alleviate nausea for some women.
Practice anything that feels uncomfortable
Comfort, especially in the late stages of pregnancy will become the priority. Practice should assist in alleviating any physical symptoms, not make them worse.
Hold your breath – EVER (including pranayama retention)
Holding of the breath increases intra-abdominal pressure, which can restrict blood flow to the placenta. This pressure may be followed by an increase in blood pressure as the heart tries to pump the same volume of blood through restricted vessels. Though small instances may not be detrimental, they are not ideal for mom or baby.
Practice Kriyas involving the abdominal area
Uddiyana bandha kryia or Nauli, although on a retained exhale, create too much negative pressure on the abdominal region and should be avoided during pregnancy.
Practice kapala bhati
Kapala bhati, when practiced properly will rise internal heat which is not optimal during pregnancy.
Practice any “heating” pranayama
If you are at the point in your yoga path when you have been taught proper pranayama by a qualified and experienced teacher, then that teacher should be able to guide you in what specific pranayamas should be avoided. (e.g. Surya Bhedana, Bastrika)
Practice during the first trimester if there is a history of miscarriages
Some traditions recommend women do no practice at all in their first trimester. If a woman has a practice pre-pregnancy, she can continue at the same level with an o.k. from her doctor. However, if there is a history of miscarriage, she should rest from asana until 14 weeks has past.
Worry about “advancing” in asana practice
Pregnancy is not a time to “progress” in asana. It is, however an opportunity to advance practice on a different level in terms of concentration and patience.
Lie flat on your back for Savasana after the first trimester
Lying flat after 14 weeks can put pressure on the inferior vena cava and restrict placental blood flow. As a cautionary measure, women should lie on their left side, or use a semi-reclined supported position.
savasana-web
Lie on your abdomen after the first trimester
Most women will feel uncomfortable on their stomach at some point in the early second trimester, some sooner. Asana that require this position should be modified or omitted from practice due to comfort and possible pressure on the uterus.
Start a practice during the first trimester if you are new to yoga
General exercise guidelines are to not start anything new in the first trimester. Women who are new to yoga should start in the second trimester in a prenatal class.
Practice on an empty stomach
Having a small bit of nourishment before practice will help to moderate blood sugar levels as well can help in preventing nausea.

Skeleton-webArielle Nash-DegagneWith a degree in Sport Science, extensive professional courses and certifications, and over a decade training professional athletes, Arielle is well versed in biomechanics and movement patterning. She has been teaching yoga for more than 10 years, and is a holistic anatomy educator for teacher trainings, advanced trainings and at conferences. Arielle works and teaches at Samahita Retreat (formerly known as Yoga Thailand) on Koh Samui, where she lives with her husband and twin toddlers. She is the founder of the Ashtanga Yoga Research Project, who has conducted global research on Ashtanga, gender difference and injury. Her continuing education courses for teachers focus on women’s anatomy, prenatal yoga, injury prevention and rehab, and adjustment techniques. Visit Arielle’s website to view her course schedule and subscribe to her blog. www.travellingom.com

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3 Responses

  1. Jean says:

    I am interested in that you are still doing navasana in the 3rd trimester. It is of course a personal choice, but my understanding is engaging the abdomen in this way could possibly increase the diastasis post natally? Is there a particular focus you use in the posture to avoid this, or you havent; seen it be an issue? Also what would the benefits be for continuing inversions such as pincha mayurasana during pregnancy?

    I like you trikonasana B variation. I was doign something similar when pregnant and Sharath told me not to and to repeat Trikonasana A.

    Also how might you adapt a practice for someone with pubic symphysis pain? It’s quite a common issue for many women that makes it hard for them to even get into warrior or sitting crosslegged?

    Thansk for the article
    Best,
    Jean

  2. Hi Jean, Thanks for reading and for your comment!

    In regards to your question about diastasis recti-
    I could write an entire article on answering that one question, so I’ll try to answer it while being concise.
    Most women do experience some diastasis in the third trimester. The extent varies greatly and often not known until the postpartum period. What to do and what not to do as far as physical exercise goes is not entirely conclusive. Much of the information available is contradictory, so I always turn to the anatomy and biomechanics, and absolutely consider fascia, as that’s what’s actually weakened in diastasis. We also must consider practitioner abdominal strength in general. Any exercise done without proper core support will be a recipe for disaster.
    In general, anything that requires too much spreading or pushing outward of the abdomen should be avoided. This is one of the reasons (along with circulation and a big belly in the way) that any twists should focus on the upper T spine through to the C spine, and they should remain very gentle. As you know, Navasana is not like your typical gym crunch (lying on back, lifting shoulders off the floor). When done correctly, the transverse abdominals are working very hard to “hug” the core – that’s their job. They pull everything together, but if they’re not firing, then the more superficial rectus abdominals will take over and there will be too much pressure, strain in the lower back and hip flexors and a higher risk for diastasis.
    Also, where a traditional primary series practice calls for 5 x 5 breaths, a pregnancy version may just be a few breaths with the feet on the floor – done with proper transverse abdominal engagement of course. It can also be followed by something that encourages the linea alba together – like a kneeling side plank.
    So the focus is below the navel, strong and steady (up & in), do not push the abdominals out.

    Why Pincha? In part, because it’s fun:) and gives a sense of play. Many women actually find it easier while pregnant, I know I did. Any inversion gives a sense of relief from the weight on the pelvis, and in pincha you get that with a totally different mobility/strength combination and range of motion that say shoulder stand or head stand – and it’s impossible to put weighted pressure on the head and neck, which can be quite easy with those extra kilos [in sirsasana or shoulder stand]!

    The repeat of Trikonasana A is a good option, or you could just leave out B all together. The modification I’ve shown ends up being more of a chest opener than anything due to the wide stance.

    I think you’ve just given me a topic for another article “Practice adaptations for symphysis pubis dysfunction”:)

    My first recommendation for pain in the pubic area is to go VERY slowly and keep things quite linear and together. By that, I mean, nothing wide spread or split stance. Yes, this severely limits the options. What is needed is stability and a lot of it. Things like the bridge with something between the knees can help build the stability, and some pilates based exercises help as well. We have to leave out what is causing pain for sure. We can change crossed legs for kneeling when it comes to sitting. We can have a very complete practice with just a few asana and focus on the psychological benefits.
    The unfortunate part is that it’s the ligament laxity causing the issue due to hormones so we can’t “cure” it during pregnancy. The fortunate part is, for most women the ligaments bounce back quite quickly and pain disappears almost immediately after birth.

    I hope this helps!
    -Arielle

  3. Carolina Dutt Bhatt says:

    Hello there!

    I am teaching pregnancy Yoga too and am very surpised of the given choice of Asanas here. In my training and most books Ustrasana (deep backbend), Sirsasana (can complicate the blood flow tothe uterus), Navasana (strengthening the abdominal) are tought to be avoided completely while pregnancy.
    It is interesting to see that some ppl still do all of those but seem to be fine. I also believe it is depending on the practise before pregnancy. I am pregnant myself too at moment and am not doing any of those, i feel I can surrender during that time and go back to my regular prectise after baby is born.

    Lovely greetings Namaste

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