Downward Facing Yoga Mama
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Downward Facing Mama: Inversion Issues During Pregnancy Here is an "Ask the Monkey" question we received recently: "I've been told pregnant women should not do Adho Mukha Svanasana (Downward Dog). What are some alternative poses I could offer my pregnant students (in a non pre-natal class) that offer the same benefits?" I was really happy to see this question come into the 90Monkeys mailbox, because it means that pregnant women are going to class, and that yoga teachers want to keep them safe. It also gives me the perfect opportunity to talk about inversions in pregnancy, which is a common question for teachers and yoginis. What is an inversion? Believe it or not, there are differing opinions in the yoga world on what exactly constitutes an “inversion”. In some circles, it is defined as any pose where your feet are above your head. This definition of an inversion would then include poses such as Viparita Karini (Legs Up the Wall), Sirsasasna (Headstand), Sarvangasana (Shoulderstand), Adho Mukha Vrksasana (Handstand), and Pincha Mayurasana (Scorpion). Depending on whom you ask, you may also get the answer that inversions are any pose where the head is below the heart. With the second definition of an inversion, we add more poses to the above list including; Adho Mukha Svanasana (Downward Dog), Uttanasana (Standing Forward Fold), and Prasarita Padottanasana (Standing Straddle Fold). It is important to our discussion of inversions during pregnancy that we are clear on which definition and type of inversion we are referring to. This is because in pregnancy, one of the most important factors is where the pelvis is in relation to the heart, rather than simply the heart’s relationship to the feet or head. With this in mind, I would like to introduce to you a third way of considering inversions, especially as they relate to pregnancy. For our purposes then, the definition of an inversion is any pose where the pelvis AND feet are elevated above the heart. With this working definition, the following poses would then be considered inversions during pregnancy; Sirsasana (Headstand), Sarvangasana (Shoulderstand), Adho Mukha Vriksasana (Handstand), and Pincha Mayurasana (Scorpion). These poses would not be considered inversions during pregnancy; Adho Mukha Svanasana (Downward Facing Dog), Viparita Karani (Legs Up the Wall), with no props elevating the hips. Are inversions safe during pregnancy? Let me start off by making two important points in regards to practicing yoga during pregnancy. Firstly, pregnancy is not a time to start an inversion practice. The American College of Obstetricians and Gynecologists (ACOG) does not recommend that pregnant women start new forms of exercise during their pregnancy that have a risk of falling. This caution by ACOG is partially to do with a woman’s center of gravity being shifted during pregnancy, which can affect her balance and increase chances of falling. Also, with the hormones produced during pregnancy (namely Relaxin) a woman’s joints and ligaments are more at risk of injury as they adjust to the new center of gravity. This time of adjustment for the body is a time when the back and pelvis can be vulnerable to possible strain and injury. Therefore, inversions should only be a done by women who have an established inversion practice, know their limits, and have experience in getting up and down from their inversions safely. Secondly, a woman should always listen to her body and her intuition while practicing yoga, especially during pregnancy. Thusly, a woman should never come into an inversion on a day when she doesn’t feel completely grounded, safe, and comfortable. With that being said, there are differing opinions on the practice of inversions during pregnancy. I have practiced yoga through three pregnancies, and have taught Prenatal Yoga for over 8 years. My opinion on the matter of inversions during pregnancy draws from my own experience, my education as a childbirth educator and doula, and my multiple trainings in Prenatal Yoga. The following guidelines are for women with normal, healthy pregnancies. Any questions regarding the practice of yoga for special conditions should be directed to the woman’s care provider. Inversion Considerations for the first trimester: I do not recommend women practice inversions during their first trimester. This is because during the first trimester of pregnancy, the risk of miscarriage is at it’s highest and we are trying to establish a healthy pregnancy, setting the stage for the next 40 weeks. The first 12 weeks of pregnancy are also a time when a woman’s energy levels can be very low, hormone levels can be unpredictable, and often there is nausea and morning sickness. Many times a woman’s intuition will guide her to pause her inversion practice during the first trimester, because it just doesn’t feel right. Please note that Viparita Karani (Legs Up the Wall), with no props to elevate the hips, is safe to practice during the first trimester during a normal pregnancy. Inversion Considerations for the second & third trimesters: Once a woman gets past her first trimester, and begins her second and third trimesters, she may return to her inversion practice if she so desires. By then, the risk of miscarriage is greatly decreased, and the pregnancy will have been established. In addition, many women see a decrease in nausea and morning sickness by 12 weeks, and an increase in their energy levels. Even with the green light to practice inversions during the second and third trimesters, it is important that the woman continue to listen to her body on a daily basis, and only practice inversions on the days that it feels right. At about 16 weeks in a woman’s pregnancy, just past the beginning of her second trimester, a few milestones of growth need to be addressed. This is an important time of transition in her yoga practice, as a few changes will need to be made. A woman’s blood volume at this time has increased by up to 50%. With this increase in blood volume, some women may notice a tendency to get dizzy as the body adjusts to the increase in fluid. This can happen during quick changes in position, in relation of the heart to the head. This may occur during the practice of inversions, and is something for the teacher and student to be aware of. Some pregnant women also report a feeling of “wooziness” during vinyasa transitions, such as in Surya Namaskars as they come to standing. Awareness of this possibility is key, and if this does happen, a woman can simply move more gradually back to an upright position. So, is Adho Mukha Svanasana (Downward Dog) safe during pregnancy? During a normal pregnancy, yes! Because according to our definition of an inversion stated above, Adho Mukha Svanasana isn’t a true inversion, since it’s a pose that does not have the pelvis and feet above the heart. Therefore, it can safely be practiced during all phases of pregnancy according to the woman’s comfort level. However, a slight widening of the feet is recommended to accommodate the growing belly and create space in the pelvis. There are a few things to keep in mind, for our safe practice of Adho Mukha Svanasana during pregnancy: - After the 30-week mark, holds of 30 seconds or less in the pose are recommended. - On days when the expectant mother is feeling queasy or suffering from symptoms of reflux, she should avoid having her head below her heart. In this case, a good substitute for Adho Mukha Svanasana would be Balasana (Child’s Pose). - Do not practice Adho Mukha Svanasana if you have been diagnosed with very high or very low blood pressure, placenta problems, and/or are being monitored weekly for excess amniotic fluid. Will Adho Mukha Svanasana (Downward Facing Dog) cause a “breech baby”? No! In fact, it may be that the forward-leaning position of the body may help to keep the baby head down in the pelvis. Studies have shown that holding the forward- leaning position, such as in Adho Mukha Svanasana (Downward Facing Dog), for periods of 30 seconds can be beneficial in encouraging the baby into an optimal birthing position. Remember the magic number of 30! After 30 weeks, only hold Adho Mukha Svanasana (Downward Facing Dog) for 30 seconds per hold (about 5 breaths), in order to maintain the optimal positioning of the baby in the pelvis. What are some alternatives to Adho Mukha Svanasana (Downward Facing Dog)? There may be times, when an expectant mother does not feel like practicing Adho Mukha Svanasana. There are several options for poses that can be practiced instead, depending on the effect you want the pose to have: - Resting Pose: Balasana (Child’s Pose), Cat/Cow, Anahatasana (Puppy Pose) - Hamstring Opening: Uttanasana (Standing Forward Fold), Prasarita Padottanasana (Standing Straddle Fold) - Transition Pose: All Fours, Cat/Cow, Anahatasana (Puppy Pose) - Inversion Quality: Uttanasana (Standing Forward Fold), Prasarita Padottanasana (Standing Straddle Fold), Viparita Karani (use prop to elevate hips after 16 week mark in pregnancy) - Shoulder Opener: Anahatasana (Puppy Pose), Gomukasana (Cow Pose) - Hip Opener: Balasana (Child’s Pose), Anahatasana (Puppy Pose), Malasana (Yogic Squat) Most important take-aways about inversions: - Encourage the expectant mother to honor her body and her pregnancy, as this is a short time in the life of her practice, and there is always time to add things back into the practice once baby arrives - Pregnancy is not the time to begin learning inversions - First Trimester: Avoid Inversions where both the feet and the pelvis are above the