Prenatal yoga

One of the things I did not know before embarking on my second pregnancy was how much more painful it would be than the first. This is apparently not an uncommon experience with all those loose ligaments hurting a bit more the next time around. In my case, I am sure that a couple of years of sloppy lifting techniques, an abandonment of any formalised excercise regime and a fondness for high heel shoes probably contributed as well. So, as I tried to schedule some time to ice my aching back I began to wonder about taking up prenatal yoga to help. It looks good on the cover of all those pregnancy magazines right.
Anyway, rather than risking doing further damage I decided to do a little bit of research first. What I found, was actually surprisingly little research. Around eight observational studies and four randomised clinical trials exist examining the impact of prental yoga techniques. The majority of these studies are from India and other Asian countries where yoga is more heavily practised than it is western nations. Extending these findings to reach outside of these nations to nations with different cultural and medical systems is problematic. In particular, the studies from India have found that prenatal yoga has significant health effects including reducing intrauterine growth retardation, reducing pregnancy induced hypertension and low birth weights 1. It is biologically implausible that this is an effect of an exercise regime and the findings have not been replicated in a western setting. The findings are likely due to specificities of either the research subjects or India culturally or medically and are unlikely to be relevant outside of this system.

More plausible findings have been a:

  • Subjective reduction in pain throughout the pregnancy 2
  • Reduction in perceived stress and trait anxiety 2
  • Higher levels of comfort during labour and immediately post labour 3
  • Shorter duration of first stage of labour 3
  • Fewer pregnancy discomforts 4
  • Improved sleep 5
  • Improved quality of life in the physical, psychological and social domains 6

This all sounds very promising however all the studies have been on small subject numbers and some have had quite high drop out rates. As many of the studies are observational, the fact that the the improved outcomes are due to other lifestyle or personality traits of people that choose to do yoga can also not be excluded. Even the randomised control trials have been poor quality with CONSORT scores below what is considered to be the cut off for a quality study 7
Yet what they are suggesting is biologically plausible, yoga uses a series of relaxation techniques very similar to those encouraged for reducing pain and anxiety in child birth. It is considered to enhance vagal activity and reduce cortisol which may decrease pain and stress responses 8. Many would also argue that it can do no harm, and none of the studies reported any problems associated with doing the yoga.  However most of the studies did not specifically report on this, so it is possible that associated problems are being under-reported. 
Overall, pregnancy yoga may be beneficial due to the techniques being similar to those being considered to be beneficial in relieving pain associated with childbirth. Exercise in general is considered extremely beneficial for pregnant women and yoga is not on the list of excluded exercise. Considering the impact that 'normal' pregnancy and birth pain can have on women, it is a shame that there is not more research examining these links.


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