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Float like a butterfly... yoga and birth

Yoga in pregnancy is a holistic approach, respecting the whole woman and using the mind, body and breath to prepare for birth. Yoga is a way of working with the mind and the body with the breath as the link. When you take your arm up you breathe in: when you take your arm down you breathe out. Another of the beauties of yoga is that it is non-competitive - it adapts to the needs of the individual. Yoga is often portrayed in the media as something that is not accessible to the majority: people standing on one leg with the other behind their neck; individual in all sorts of positions that are only really appropriate if you are very supple; people jumping in and out of postures or sitting around meditating. That is yoga but only one small aspect of it. You do not have to be young, fit, slim, healthy and supple to be able to practise yoga. You just need to find a good teacher who can adapt to your individual needs. Yoga is mental, physical, emotional and spiritual. It does keep you fit, but as a whole person. It is not a religion: it is appropriate to those with religious beliefs and to those with none. It is a way of working with the whole person, and to some it becomes an approach to life. Yoga is practical, basic and down to earth, and thus can fit into our everyday life. I teach a wide variety of groups, specialising in both pregnancy and learning disabilities. In the latter area I work with students who have PMLD (profound an multiple learning disabilities) using yoga and aromatherapy. So if yoga can work in this area, it can work in any.

Ideal for pregnancy and labour

I run three Yoga for Pregnancy classes a week through the WEA in Leicester in term time. My classes are always full, with a waiting list, so when one woman gives birth another quickly steps in to take her place. The nature of the class is that we work on yoga movements that are beneficial when pregnant, and also on yoga movements and birth positions that might be useful in labour. We also take time out to talk: discussion in pregnancy is so important. It is good for pregnant women to be with each other and also to be in touch with other mothers after the baby is born. We talk about whatever comes up, from fears and anxieties about the birth to various aches and pains and down to earth practicalities. I find this part of the session is just as important as when we are practising yoga. I also show videos of a variety of births, as well as on breast feeding, and post natal depression if women are interested. Every term, women from a previous term come in with their babies and give us a blow by blow account of their birth. I usually ask women who have had very different births to come in so that we can hear a range of experiences. The dynamics of the group vary. Some groups continue to meet up afterwards - often for years. I also run Saturday sessions with women and their birthing partners, focusing on how the woman and her partner can work together in pregnancy to prepare for the birth and the practical role that a birthing partner can play in labour.

Holistic approach

Yoga for pregnant women is a holistic approach, respecting the whole woman mentally, physically and emotionally. Yoga uses the mind, body and breath to prepare us for birth - and for dealing with any eventuality. Practising yoga while pregnant does not guarantee a perfect birth. Events can happen in labour that are out of our control, whether it is the cervix failing to dilate or not dilating enough, or a hand on the baby's head or the baby being distressed, and so forth. We therefore need to be very well prepared so as to be able to deal with whatever happens. We wouldn't climb Everest or run a marathon without preparation. That is what we are doing when we are practising yoga in pregnancy - preparing ourselves to handle any eventuality. From a mental point of view, we are working on concentration, on being focused, as well as on having an open mind. We need to clear about what type of birth we want and to go on and prepare for that birth. But always keeping an open mind. In labour we need to work on the approach of 'letting go', 'opening up': this combined with the breath is a mental, physical and emotional approach. It is our birth, our baby, our labour - every birth is a one off creative experience. From about 34/35 weeks it is good idea to be able to take ourselves inside, like a tortoise going inside her shell, and prepare for the birth from an internal perspective. Giving birth is not just a physical experience but a total experience, and thus it is essential to be well prepared from every point of view. Once in labour, it is important to be able to focus on the baby and on the birth in a positive, constructive and creative way.

Balancing act

Emotionally, we are working with balance while pregnant and taking that into labour so that we can be balanced and in control. Our hormones have a great deal to answer for, from the onset of menstruation to the other side of the menopause - pregnancy is no exception. Our hormones can be totally out of balance in pregnancy and that is one of the many aspects yoga helps to deal with - bringing about that sense of balance. However, physically (and we must be careful not to separate the physical, the mental and the emotional - these three go together) yoga helps us to stretch, strengthen and tone the whole body. Even if the woman is going to have an elective caesarean practising yoga is still beneficial. We use yoga movements that are useful in pregnancy, and work with a variety of symptoms with which women present, from backache, sciatica, cramp and varicose veins to oedema, insomnia and heartburn. The yoga movements are adapted to the needs of the individual, taking every woman's specific requirements into account and adapting them as appropriate.

The movements

There are a whole variety of yoga movements that I find really useful in pregnancy. The muscles we use in labour are the quadriceps, the abdominals, the lower back and the whole of the pelvic area. So although we are working with the whole body many of the movements that we use focus on keeping this part of the body well stretched, strengthened, toned and thus able to be mobile. This includes movements such as the cat, the butterfly, pelvic tilts and pelvic floor exercises. I also have a Seven Way Stretch, both seated and standing, which I have devised for pregnant women. This includes stretching the spine upwards, a gentle sidebend, a gentle twist and a gentle backward and forward bend. We look too at movements that may be useful in labour - and I say 'may' because we do not know what will be useful until the day comes We practise many movements that include rocking and rotating the hips while in an all fours position, kneeling, standing with or without the wall or using a chair or working with a partner for support, We also practise a whole variety of birthing positions; again, we do not know what we will want to use in that second stage of labour until the time comes. However, experimenting with a variety of postures means that we are familiar with lots of possibilities. What is important is that women should have the choice in labour to move their body in whatever way feels comfortable and right at the time, working ideally in a way that is upright, forward and allows them to be mobile. It is important, too, to find postures to rest in that keep to the concept of being upright, forward and mobile - for example resting against the bed or chair in the kneeling position (a partner can be sitting on the chair or on the bed and even be massaging the neck and shoulders), sitting astride a chair leaning forwards or just resting forwards over a beanbag or birthing ball. I say to women that if they lie down they might find that they never get up again!

Learning to breathe

What is really key in pregnancy and labour is the breath. This is fundamental in yoga. What we want in labour is for the breath to be comfortable, to be free-flowing, in unison with the body - mind, body, breath and contraction working together. We need to be able to breathe through the contractions and to have control over the breath. The breath is what will see us through any eventuality, whether we have a wonderful active birth, or need a ventouse, forceps or emergency caesarean - or even lose control. If we lose control we can regain it. Working with and having control over the breath is the key to staying in control. Generally, when we teach and practise yoga, we are breathing in through the nose and out through the nose. In labour we will probably find that we want to breathe in through the nose but sigh our breath out through the mouth. It is therefore important in pregnancy to work on a whole variety of breathing exercises that give us control over our breath. Many women come to yoga when pregnant with no prior experience at all and have to learn how to breathe. All the breathing exercises practised while pregnant are the foundation for breathing in labour.

Relax

We are all superwomen. We do everything - run the home, do a demanding job, look after children, etc. etc. What is rest? In yoga we work on relaxation techniques that let go of the whole body. It is thus important not only to get the right amount of appropriate exercise but also the right amount of rest. I can't emphasise enough how important this is. Relaxation is fundamental while pregnant. I believe that women are still having as many 'prem' babies as ever, and one of the reasons is that they do not take enough rest and work right to the end of their pregnancy. They give up work at 35/36 weeks, thinking they have a few weeks left before the birth - and then go into labour! Last term, one woman went into labour while still at work at 35 weeks.

A spiritual experience

Finally - and this is one of the most important aspects of both yoga and of pregnancy - there is the spiritual aspect of being pregnant, of carrying this very important life. A pregnant woman needs to be in touch with her baby, to be aware of this being inside her, to be able to reach inside offering security, warmth, love. That has to be the underlying element of both pregnancy and birth. This is just the beginning of a new life for both mother and child - a new and very special path. The role of the midwife in this new and special path is absolutely fundamental. She can be reassuring in pregnancy or even make a pregnant mother anxious. Being a midwife is one of the most powerful jobs in the hospital and in the community. It is a great pity, both for midwifes, and pregnant women, that a pregnant woman does not have the same midwife or same team (though the latter does happen in some areas) in pregnancy, in labour and afterwards. What the midwife says to a pregnant mum can have far reaching effects: comments such as 'too small for dates', too large for dates', 'you have put on too much weight', 'you have not put on enough weight', 'it is important to sleep on the left side' can all cause anxiety. All these points are important but, as comedians know, 'It's the way you tell 'em'. There are some wonderful midwifes from heaven who take into account how even the strongest and most dynamic of women can become very vulnerable and emotional while pregnant. This carries through to labour; women need to forget about dignity and to get in touch with their inner self, their primal self and feel free and confident to be however they want. They need the support of their midwife, and if labour doesn't go to plan they need that continued support and medical aid as well.

A personal choice

Giving birth is a one-off creative experience and women need to have as much control as they want. Some choose not to have an active birth, some want or need to have a caesarean, some choose an active birth and it may or may not go to plan. Whichever choice she makes it is her choice with the support of those around her. As I say to pregnant women over and over again: 'It is your birth, your baby, your labour'. It is a privilege and a joy to work with pregnant women. As a yoga teacher it is also very important to me to join with other professionals in this area, complementing and support each other's work. It is a wonderful way to earn a living!