I’m a big advocate for moving in pregnancy and anecdotally, I have seen the benefits it brings for the women I care for. In this blog, we are breaking down the evidence-based benefits of exercising in pregnancy and more specifically, yoga in pregnancy.
A 2019 Systematic review 1 examined the various benefits of moving in pregnancy and this has also been validated by the UK Chief Medical Officer in recommendations published in September 2019.
Some of the top 5 benefits of moving and exercise in pregnancy are as follows:
You certainly shouldn’t be trying to lose weight in pregnancy, but exercise can help in maintaining a healthy weight. We know that increased weight gain in pregnancy and a higher BMI (body mass index >30) will increase your chances of developing some conditions and is an independent risk factor for still birth, caesaraean section, haemorrhage post-delivery and blood clots in the leg or lungs.
Exercise also significantly reduces your risk of gestational diabetes, pregnancy induced hypertension or preeclampsia. These conditions are unique to pregnancy & will disappear once you have your baby, but will impact on your antenatal care, leading to extra scans, clinic appointments and recommendation of early delivery.
We also know that endorphins released during exercise benefit mood and can improve depression and anxiety scores. Yoga (which we talk about in more detail below) can be hugely beneficial in this way; incorporating breathing and mindfulness techniques in addition to the physical benefits cardiovascular exercise brings.
There’s evolving research on how vital sleep is to our health, but it can sometimes be a challenge in pregnancy. Focusing on falling asleep on your side, various aches & pains that often go with pregnancy combined with a growing human being moving around, may add up to poor sleep. Exercising for 20-30 minutes each day can certainly aid sleep with yoga being great in helping with pelvic girdle pain and sciatica, which can help you to gain a more restful night’s sleep.
Something that many expectant mums might want to hear - doing weight bearing exercise such as yoga, can help lead to shorter labour time with fewer complications!
Yoga In Pregnancy
In my practice as an O&G doctor and pregnancy yoga teacher, I have noticed how significant mindfulness and focused breathing has been for many of the women I care for both mentally and physically.
The physical benefits of yoga in pregnancy, are pretty similar to general exercise. The mind-body aspect though, can be particularly effective in managing psycho-emotional changes that pregnancy & birth bring, in a way your average aerobics or swim class, just can’t.
The field of epigenetics tells us maternal stress & anxiety can influence neural programming & brain development of the foetus. This rapidly developing field describes how exposure to maternal stress peptides in uteruo, affects DNA methylation & may cause adverse health & behavioural outcomes in children. We also know that nervous system regulation & physiological functioning are affected through practising yoga, leading to reduced stress & anxiety
There’s not a huge amount of evidence on benefits of yoga in pregnancy (yet!), but a 2012 systematic review looked at 6 studies (3 RCT & 3 CT), describing the following benefits:
- Improved psychological wellbeing & reduced stress scores (𝘴𝘦𝘭𝘧 𝘳𝘦𝘱𝘰𝘳𝘵𝘦𝘥 & 𝘢𝘴𝘴𝘦𝘴𝘴𝘮𝘦𝘯𝘵 𝘰𝘧 𝘷𝘢𝘨𝘢𝘭 𝘵𝘰𝘯𝘦)
- Shortened length of labour
- Lower reported pain scores
- Less pregnancy induced hypertension
- Lower rates of preterm labour
- Less babies with growth restriction (there were more babies weighing >2500g, in the intervention group, but the mean weight was the same, both in the general population and groups at risk for small babies.)
It’s really important to note here that the last 3 benefits above were in the non-randomised group and an important criticism of the study was use of an inappropriate statistical test and over liberal analysis in interpreting outcomes, which is why it’s always important to look critically at the data we have and why yoga isn’t an evidence based intervention and part of NHS care! The improved outcomes in the high-risk groups, however, is reassuring.
Overall, moving and breathing in a more mindful way offers significant benefits in connecting to our bodies and the birthing process, which can surely only be a positive thing!
At The Birth Collective, we have a full prenatal yoga course which provides you with support and instruction on how to safely and comfortably practice yoga while pregnant. Take a look here. (?link)
Practicing Safely & Things To Avoid
It can be unnerving knowing what’s safe in pregnancy with everyone giving well intentioned advice. Here, we’re put together some things that you should avoid when yoga-ing:
Laying on your belly after 12 weeks – although to be honest, you probably wouldn’t want to anyway. At this point your uterus should be well out of your pelvis, meaning pressure being placed in an area best avoided.
Closed twists - This is one of the first things most yoga teachers learn, even if they’re not pregnancy trained. A closed twist compresses the side we’re turning toward, normally against a leg or thigh. The main reason to avoid this kind of movement, is increased pressure on the pelvic organs, potentially squishing your uterus. Open (away) twists are fine. In reality we probably do these types of movements day to day & so risk of any damage is fairly minimal.
Supine poses (lying on your back) - After 20 weeks your uterus is at the level of your belly button, which is this the point where the inferior vena cava forms from 2 smaller veins. This is a massive vessel carrying blood to your heart, when compressed (by your bigger bump), it may cause your blood pressure to drop. There’s an increased risk of still birth in women sleeping on their back, but no proven harm from short periods of floor- based movement. I teach some gentle hip raises and leg stretches but avoid any prolonged lying flat.
Deep Squats After 32 Weeks - Or if you’re known to have a short cervix, have had surgery to your cervix in the past or have a known low-lying placenta (placenta previa). Deep squats such as #malasana are great poses towards the end of pregnancy when you want to help your baby into an optimal position for birth. The downward pressure you create in this pose, has theoretical risks in someone already at risk of pre-term labour, so definitely avoided in the above cases.
Hot Yoga - Hot yoga is already a controversial exercise, which we will follow up on at a later date, however this should definitely be avoided in the 1st trimester. Hyperthermia is a teratogen & increases the risk of neural tube defects & other malformations.
As a final word of caution, if you have any pre-existing medical conditions, or you develop high blood pressure in pregnancy or are seeing an obstetrician due to complications in pregnancy, be sure to check with your healthcare provider before starting any new form of exercise.
If you have any questions regarding practicing yoga while pregnant, contact a member of our team or enrol in our online prenatal yoga course today!
1Sanabria-Martínez G, Poyatos-León R, Notario-Pacheco B, Álvarez-Bueno C, Cavero-Redondo I, Martinez-Vizcaino V. Effects of physical exercise during pregnancy on mothers' and neonates' health: a protocol for an umbrella review of systematic reviews and meta-analysis of randomised controlled trials. BMJ Open. 2019;9(9):e030162. Published 2019 Sep 13. doi:10.1136/bmjopen-2019-030162
2 Smith R, Reid H, Matthews A, Calderwood C, Knight M, Foster C, et al. Infographic:
physical activity for pregnant women. Br J Sports Med. 2018;52(8):532-3.
3 Mottola MF, Davenport MH, Ruchat S, et al
2019 Canadian guideline for physical activity throughout pregnancy
British Journal of Sports Medicine 2018;52:1339-1346.
4 Curtis K, Weinrib A, Katz J. Systematic review of yoga for pregnant women: current status and future directions. Evid Based Complement Alternat Med. 2012;2012:715942. doi:10.1155/2012/715942