Healthy Pregnancy & Birth Essentials – Be Fit! Be Prepared!

Moving relieves stress.

Moving relieves stress.

Do you want a healthy pregnancy, labor, birth and early mothering experience?

This post is designed to provide basic information about achieving this goal. As with any life situation, there are things you can do to help achieve the best outcome of your pregnancy. Some things will be outside your control. Your baby will have blue eyes or brown hair or attached ear lobes depending on genetic factors. But many things are in your control. If you are fit and eat well you will help your baby’s development.

Circumstances can also play a role. For example, where you live can impact how much you walk or whether you are exposed to second-hand smoke. Sometimes you can change these things, but not always. We have put together just the basics, the things you CAN do to help yourself have a healthy pregnancy and birth!

  1. PRENATAL CARE – Repeated studies show that women who have regular health care started early in pregnancy have the best outcomes.
  2. AIR & FOOD – Your muscles need oxygen and blood sugar in order to achieve activities of daily living (ADL), fitness activities, labor, birth, and caring for a newborn. Muscles – including the uterus – need these two essentials in order to this work. Therefore you must do these things:
    • Breathe deeply to strengthen your breathing apparatus.
    • Eat in a way that is balanced (carbs, fats & proteins in every meal or snack) and colorful (fresh fruit & veggies) to train your body to
      Fresh fruit provides vitamins & minerals!!

      Fresh fruit provides vitamins & minerals!!

      produce an even supply of blood sugar and provide needed vitamins & minerals. You need 200 – 300 calories every 2 – 3 hours, depending on your size. Prenatal vitamins are your backup safety mechanism. Eat real food, not edible food-like products (example: potatoes, not potato chips).

    • Drink fluids (primarily water) and eat protein to maintain an adequate blood volume. Blood delivers oxygen and sugar to your muscles, placenta and baby. Pregnancy increases needed blood volume by about 40%. More if you exercise regularly.
    • You don’t need other items, especially things that are dangerous, like alcohol, cigarettes and drugs. Continue safe sex.
  3. PHYSICAL FITNESS – Pregnancy, labor, birth and parenting are ENDURANCE events. Strength, flexibility and mindfulness will help, but only if you have stamina to tolerate the stress to your cardiovascular and respiratory systems.
    Aerobic Dancing improves stamina while having fun!

    Aerobic Dancing improves stamina while having fun!

    • Cardiovascular conditioning or aerobics is the cornerstone of fitness. Make sure to get 20 – 30 minutes of moderate to vigorous aerobic activity 3 or 4 days a week. Find a qualified prenatal aerobic fitness teacher. If you are more than 26 weeks pregnant, start very, very slowly.
    • Core, shoulders, hips, pelvic floor – these areas need adequate strength training and gentle flexibility for range of motion.
    • Relaxation practice has been shown to help reduce the active phase of labor.
    • Mindfulness can be a big help in birth if you have adequate endurance and are not in oxygen debt, out of blood sugar, dehydrated or too tired.
    • Find classes here: DTP Take-a-Class
  4. EDUCATION – Be sure these items are included in your childbirth education course:
    • Landmarks of labor & birth progress
    • Sensations at various points in labor
    • Physical skills that promote labor progress and help achieve a healthy birth

      Learn the benefits "skin-to-skin" after birth.

      Learn the benefits “skin-to-skin” after birth.

    • Pain Management techniques to help you deal with the intensity of birth
    • How to maintain oxygen and sugar supply in labor before going to the hospital and while in the hospital
    • Standard hospital procedures (so you can decide when to go to the hospital)
    • Complications that can lead to medical interventions, including surgery
  5. GET SUPPORT – Make sure you will have continuous support for your labor and birth
    • Spouses, partners, and female family members can be helpful if they accompany you to your Childbirth Education class and know how to help you during the process.
    • A Doula is a great option for support because they are trained to guide a mom and family through the birth process.
  6. POSTPARTUM ACTIVITY WITH BABY – This is a great way to get in shape after birth.
    • Early General Fitness in the first few weeks: walk with the baby in a stroller or carrier, work on kegels and suck in your belly.
    • After 4 – 8 weeks you will be ready to join a Mom-Baby fitness group!
Birth begins the bond or unique love between mother and child.

Birth begins the bond or unique love between mother and child.

About Dancing

“When a normal, healthy child is born, usually in the father’s compound, the women perform the nkwa to rejoice. Then…they sing and dance their way to the compounds of the mother’s kin to inform them of the joyous event through the dance-play, gathering additional dancers as it moves from compound to compound. In this nkwa, in which only married women who have given birth perform, the dancers highlight procreative body parts, birth exercises and child care gestures.” – page 164, Hanna JL, To Dance is Human: a theory of non-verbal communication, 1979. Rev. ed. 1987.

From its inception in 1979, Dancing Thru Pregnancy® has been inspired by this passage from Judith Lynne Hanna’s amazing text, in which she describes how the Ubakala of Nigeria “announce” the birth of a child. The dance serves a dual purpose – it tells of the birth, but it also teaches the uninitiated how pregnancy and birth occur. For the dancers it also serves as a catharsis.

As a professional dancer, I long ago recognized the transformative power of dance to make experiences accessible.Molly and Miri Through Hanna’s writing we see how dance is itself one of the earliest and most profound ways in which common human experiences are taught and learned. Contemporary culture often removes this type of learning from our environment. Employing dance to help women approach birth has always struck me as an obvious first choice in preparing women for the physical, emotional, identity-forming and joyful process of birth.

In the intervening years, science and technology have reinforced our understanding of how this non-verbal learning happens. A most excellent discussion of mirror neurons appears in Acharya and Shukla’s article, Mirror Neurons: Enigma of the metaphysical modular brain, J Nat Sci Biol Med. 2012 Jul-Dec; 3(2): 118–124. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510904/. Mirror neurons are key to how empathy and understanding of experience are produced when people view movement and gesture. The mere perception of an action sets off a low level firing of the neural pathway that executes the actions we are seeing. The authors provide a thorough grounding in the history of how we have come to recognize that mirror neurons exist and how they work.

There are more arenas in which dance also shines as a preparation. Appropriately choreographed, dance enables excellent physical fitness and includes all the elements of physical activity that research demonstrates are effective for optimal health in pregnancy and coping with the rigors of birth. From the perspective of exercise physiology, labor is an ultra-distance endurance event, followed by a strength test (birth), a long physical recovery period and 18 years or more of sleep deprivation. And, further, such a preparation aids the mother in achieving a physiologic birth as described in Buckley’s “Hormonal Physiology of Childbearing: Evidence and implications for women, babies, and maternity care.” This recent groundbreaking article describes how labor, birth and breastfeeding are promoted through hormonal actions, as well as why some technological advances in childbirth are working against these processes.

DTP at YH 12:13Achieving cardiovascular endurance (aerobic fitness) is essential. There are so many benefits of aerobic fitness that a full recitation and hundreds of citations will not fit in a blog. Our teacher training aerobic component takes several days, even for experienced fitness pros. But, to summarize: cardiovascular fitness improves implantation, enhances nutrient and oxygen delivery, reduces the incidence or severity of some pregnancy disorders, reduces the risk of fetal distress, reduces stress on maternal cardiac reserve while pushing, reduces the risk of cesarean, hastens recovery, helps maintain a healthy weight, alleviates anxiety, builds body-image confidence (Cochrane) and enhances long term maternal and fetal health. The two forms of cardio or aerobic activity most often cited for effectiveness are running and aerobic dancing.

Two other elements of dance that are useful for pregnant, birthing and parenting moms are strength and flexibility. There are Elongemany movement actions derived from numerous dance forms that promote both power and elasticity in the muscles, connective tissue and skeletal structure. Some effective positions, movements and skills are shared with other disciplines: Traditional childbirth preparation, weight training, gymnastics, physical therapy, yoga, t’ai chi, pilates, boot camp, plyometrics, proprioceptor neuromuscular facilitation (PNF) techniques, Feldenkrais, Alexander, somatic therapies, posture training, etc.

This letter I received recently from a (not pregnant) ballet student willing to share her experience is a clear reminder of how a well-designed dance class accomplishes enhancement of strength and flexibility, along with confidence about working with one’s body:

“Hi Ann,

I just wanted to let you know that I lifted weights at the gym last night… It had been at least 6 months since I had lifted weights at all, and so I figured I’d need to start at a relatively low weight and I’d be really sore the next day regardless. I was very surprised to find that I could easily lift the maximum weight I’ve ever lifted, which was the weight I used to lift at a time when I was lifting weights routinely several times a week. Every muscle group was strong. And today I am not sore at all. This is all to say that I am shocked at how much strength I’ve gained from ballet. I had no idea that just lifting my limbs against gravity could be so effective.

Thank you so much for having a class for beginner adults, and for your patience with all of us! I’m 42 years old at this point, and started ballet because I had noticed my core strength, flexibility and balance starting to really decline…I am so thrilled with the results from ballet even though I have such a long way to go!!! Plus it’s really fun. How I wish I would have discovered ballet in my 20s or 30s, since I didn’t learn it as a child!

Glenda G. Callender, MD FACS

An additional arena in which dance shines is in building mind-body skills. Dancing relies on centering – aligning with gravity to produce the greatest efficiency for movement (balance) along with breathing as a component of movement. Centering also reduces the load on the nervous system and allows the brain to modulate into the parasympathetic nervous system state, also known as the relaxation response (autogenic training, hypnosis, meditation, progressive relaxation), the zone (athletes’ term), mindfulness (big in research presently), the trophotropic response (the scientific term) or the alpha state (the current fad term). Dancers sometimes refer to this as tuning in to the unconscious. The actual coordination of motions, such as pushing, is primarily unconscious. The conscious piece is keeping a clear image of the goal, while allowing the body to work. This is the skill that allows the birthing mother to follow her body’s urges, flowing with the labor rather than trying to control what is going on. It gives her access to the cathartic nature of birth as a dance.

Centering 2:08Align

Breathe

Focus on the breath

Sense the movement within

Then, allow the body to dance…

A part of the dance experience I truly enjoy is a phenomenon known as muscle bonding. When a group does vigorous physical activity together – dancing together, a sports team, a drill team – a special kind of bond forms. Part of the euphoria is this muscle bonding experience.  Those of us whose interest lies in understanding the mechanics of such things have a pretty good idea how this works – some of which is laid out in this blog and the reading links. But, that is not the wonder of it. The wdancing_overview from backonder of it is what the Ubakala women experience moving together to announce the birth of a child.

When I am dancing with my pregnant ladies and we are in the grove with our modified hip hop routine, we are smiling at each other and feeling completely alive. We are breathing hard and working hard, but we are strong. My hope is always that when she senses that labor and birth are starting, a mom-to-be can get in that groove with the baby and support person. Birth as a dance.

No blog on pregnancy or birth is complete without a caveat. Every pregnancy and birth is unique. Sometimes things go wrong. But, mostly they go right! And, moms can optimize the experience. One of the greatest dangers to pregnancy and birth is sedentary behavior. Regular, vigorous, strength-inducing, flexibility gaining, mindfulness, relaxation muscle bonding fun is available. Check our U.S. and International Find-a-Class listing. If there is nothing near you, start something!

DTP Guest Blog – Elyse Hoffman: Live Fully Fitness

Elyse2

Elyse Hoffman, CPCC, is an expert in Fitness Training Specialized for Pre/Post Natal and Women Over Fifty. Her company – based in San Fransisco – is Live Fully Fitness, geared toward helping women be fit at every stage of their lives. Elyse has certifications and continuing education credits from Dancing thru Pregnancy, Health and Fitness Institute, Coaching Training Institute, Moms on the Move, Resist-a-Ball, Mat Pilates, and Zumba.

E-mail: elyse@livefullyfitness.com

Website: www.livefullyfitness.com

DTP: Describe the mission or focus of your program.

Elyse: To me, being healthy and engaged in every aspect of your life, at every stage of your life is what it’s all about.  I believe that integrating physical fitness and a mind/body connection plays a vital role in overall wellness.

My mission is to use both aspects to help women shift adverse patterns that may be holding them back and affect lasting change.  This way my clients create new patterns both in their muscles and psyche.

DTP: What do you most enjoy about your work?

Elyse: I love when a client accomplishes something they didn’t think was possible.  Whether that breakthrough occurs in increased strength, shedding of excess pounds, or releasing emotional blocks, it gets me so excited! Their success is my success. I feel elated and honored to be part of their process.

I especially love working with pre- and post-natal women. Helping clients get strong during pregnancy and helping them get back into shape after giving birth is very rewarding to me.

Simply put, I LOVE what I do.  Working with my clients is a real gift.  I’m lucky enough to get daily reinforcement that what I do has a positive impact on my clients’ quality of life.

DTP: What is the most important thing you have learned from working with moms and moms-to-be?

Elyse: I’ve learned to really listen to each woman individually–every woman has a different experience with her body. The same exercise is not always correct for each woman.

I have learned that although it’s important to stay healthy and fit, it is just as important to relax and breathe. I tend to ask women when they come in, ”What will best serve you today?” Sometimes it is a powerful workout and sometimes a slower pace and lots of breath. Each is wonderful and powerful in its own way.

I have learned that it’s really about listening and hearing my clients’ needs in the moment.

DTP: What is your future outlook for your program?  Elyse1

Elyse: I enjoy working with pre- and post-natal women and with women over the age of 50.  I see myself continuing to blend my expertise as a life coach and as a fitness specialist to guide women to live the lives they want to live.

DTP: Any comments from clients?

“Just 4 weeks after having my second child, Elyse helped me to begin rebuilding the (core) strength I needed to keep up with the demands of caring for both a newborn and an energetic toddler. A year and a half later she continues to challenge my strength and I am stronger than ever.”
– Valerie Saroyan

This is the third in a series of Dancing Thru Pregnancy offspring program guest blogs. Elyse has a long history with our program and is one of the best trainers we know; we love being able to send her clients!

Pregnancy Exercise – The Evolutionary Imperative for Vigorous Activity

I have long wanted to write this post. Recently two articles appeared in the NY Times prompting me to move forward. One article dealt with how it is that ongoing vigorous exercise produces brain enhancements. The second article dealt with how running creates its “high” and explained why the resulting addiction is an evolutionary benefit for human survival.

Every day in Africa a gazelle wakes up.
It knows it must run faster than the fastest lion or it will be killed.
 Every morning a lion wakes up. It knows that it must outrun the slowest gazelle or it will starve to death.
 It doesn’t matter whether you are a lion or a gazelle.
When the sun comes up, you better be running.

Abe Gubegna
Ethiopia, circa 1974

The pregnant mom who exercises vigorously and regularly – the one who runs or swims or does aerobic dancing – is not the one at risk, or whose infant is at risk, of a lack of tolerance for the rigors of labor or for lifestyle health problems. It is the sedentary or low activity mother and her offspring who are at risk. I have written at length on this reality in my chapter on Women and Exercise in Varney’s Midwifery.

This realization has plagued me for ages, and the two articles in the Times convinced me to make this statement, explain why it is true and exhort women of childbearing age to become aerobic animals.

In the contemporary world, we are not as active as previous generations. Few women exercise to the extent required to develop the capacity to withstand the rigors of birth. It is little wonder that so often health care providers hear that women are afraid to exercise, and childbirth educators hear that pregnant moms are afraid of birth and don’t have confidence in their ability to do it. There are solutions for these issues…

The biggest bang for the buck is aerobics. This gets almost everything that helps you in labor. It increases endurance, strength and range of motion. It improves breathing capacity (you get more oxygen + less fatigue). It reduces your need to tap your cardiac reserve (your body works hard in labor but not to the degree it must if you are not fit). Plus, regular participation in a good cardio or aerobic workout gives you the mental toughness and confidence you need to know that your body is capable of the work and the recovery – what we call body trust. Fit Pregnancy has discussed the myths surrounding how hard a pregnant woman can work out.

Learning useful positions and movements is extremely helpful. Be sure that your workout also includes strength and coordination movements – such things as squatting, core movements for pelvis and spine, and other motions that aid your progress in labor. Being upright and moving are keys to a healthy labor. These require strength and coordination.

Mental focus and being present teach you to work with your body. Activities such as relaxation training, yoga, pilates for pregnancy and dance help you develop the mental skills (mindfulness and deep breathing) that accompany your movement. Learn to recognize your body’s signals so you know when it’s time to push.

A truly effective use of your time is a one hour class a couple times a week that combines all these elements. We have known this for decades. The evidence is clear that it works. Keep moving…right into labor and birth!

Find a safe and effective class or trainer.

Pregnancy Exercise Safety

Included in this Blog

There are three sections to this blog. One is for moms-to-be, the second for pregnancy fitness teachers and personal trainers and the third includes specific contraindicated and adapted exercises.  All information presented is based on peer-review research and evidence collected over a 30 year period of working with this population. More information is available at http://dancingthrupregnancy.com.

1) Safety & Exercise Guidelines for Moms-To-Be

First and foremost, be safe. Trust your body. Make sure your teacher or trainer is certified by an established organization that specializes in pre/postnatal exercise, has worked under master teachers during her preparation, and can answer or get answers to your questions.

These are the safety principles that we suggest to our participants:

  • get proper screen­ing from your health care provider
  • pro­tect yourself
  • do not over­reach your abilities
  • you are respon­si­ble for your body (and its contents)

Squatting is an example of a standard pregnancy exercise used for childbirth preparation that must be adapted by each individual based on body proportions, flexibility, strength and comfort.

Second, make sure you are getting the most from your activity. Keep these findings in mind when choosing your workout routine:

  • Aerobics and strength training provide the greatest health benefits, reduce the risk for some interventions in labor, help shorten labor, and reduce recovery time
  • Cen­ter­ing helps to prevent injury; relaxation and deep breathing reduce stress; and mild stretching can relieve some discomforts
  • Avoid fatigue and over-training; do reg­u­lar exer­cise 3 — 5 times a week
  • Eat small meals many times a day (200–300 calo­ries every 2–3 hours)
  • Drink at least 8 cups of water every day
  • Avoid hot, humid places
  • Wear good shoes dur­ing aer­o­bic activities
  • BE CAREFUL!   LISTEN TO YOUR BODY!

If you experience any of the following symptoms, stop exercising and call your health care provider:

  • Sudden pelvic or vaginal pain
  • Excessive fatigue
  • Dizziness or shortness of breath
  • Leaking fluid or bleeding from the vagina
  • Regular contractions, 4 or more per hour
  • Increased heartbeat while resting
  • Sudden abnormal decrease in fetal movement (note: it is completely normal for baby’s movements to decrease slightly during exercise)

2) Safety & Exercise Guidelines for Teachers & Trainers

A principle of practice that increases in importance for fitness professionals working with pregnant women is having the knowledge and skills to articulate the rationale and safety guidelines for every movement she asks clients to perform.

This goal requires adherence to safety as the number one priority. Here is how we delineate safety and the procedures we require of our instructors for achieving safety in practice:

First priority:  safety [First, do no harm]

  • sometimes medical conditions preclude exercise
  • find an appropriate starting point for each individual
  • individual tolerances affect modification
  • general safety guidelines are physical
  • pregnant women also need psychological safety

Mind-Body Safety Procedures

Centering enhances movement efficiency and safety. Always begin with…

  • balanced, neutral posture
  • deep or rhythmic breathing
  • mindfulness
  • safe range of motion

Strength Training Cautions

  • avoid Valsalva maneuver
  • avoid free weights after mid pregnancy (open chain; control issue)
  • avoid supine after 1st trimester
  • avoid semi-recumbent 3rd trimester
  • keep in mind the common joint displacements, and nerve and blood vessel entrapment when designing specific exercises

Aerobics or Cardiovascular Conditioning Procedures

Monitor for safety..

  • take a pulse
  • assess perceived exertion (RPE)

Instructional style needs to be appropriate…

Walking steps with natural gestures can be done throughout pregnancy

Vigorous steps with large gestures are more intense, appropriate as fitness increases

The ability to create movement that will be safe and work for various levels of fitness and at different points in pregnancy is one of the most critical skills for pregnancy fitness instructors.

  • steps with leg gestures and/or arm gestures increase intensity
  • size affects intensity of movement
  • speed affects intensity of movement
  • jumping increases the ground force or impact on the joints
  • stepping up (e.g., step aerobics or stair climbing) increases intensity
  • some effort/shapes are ballistic and should be avoided
  • movement needs to be modified for each woman’s comfort

Venue Safety

  • Setting should provide physical and emotional safety
  • Equipment must be well-maintained

3) Contraindicated  and adapted exercises

Exercises for which case studies and research have shown that there are serious medical issues include the “down dog” position, resting on the back after the 4th month, and abdominal crunches and oblique exercises. Here is more information and adaptation suggestions:

Contraindicated: “Down Dog” requires that the pelvic floor and vaginal area are quite stretched, bringing porous blood vessels at the surface of the vagina close to air. There are records of air entering the blood stream in this position and moving to the heart as a fatal air embolism.

Adaptation: Use the child’s pose, with the seat down resting on the heels and the elbows on the ground, hands one on top of the other, and forehead resting on the hands. Keep the heart above the pelvis.

_________

Contraindicated: Resting on the back during relaxation.

Adaptation: Rest in the side-lying position. About 75% prefer the left side, 25% prefer the right side.

_________

Contraindicated: Abdominal crunches and oblique exercises can contribute to diastasis recti in some women. The transverse abdominal muscle is not always able to maintain vertical integrity at the linea alba, and thus there is tearing and/or plasticity of that central connective tissue.

Adaptation: Splinting with curl-downs, see positions below. By pressing the sides of the abdomen toward the center, women can continue to strengthen the transverse abdominals without the shearing forces that place lateral pressure on the linea alba.

Splint by crossing arms and pulling toward center

Or, splint by placing hands at sides and pressing toward center

Beyond Yoga

Beyond Yoga

I love Yoga. But…Power Yoga, Hot Yoga, Fast Yoga, Pilates-Yoga, Fresh Yoga, Baby Yoga and even Prenatal Yoga…not so much. I find these phenomena strange.

Why? Well, 40 years ago – when I first learned Yoga – it was a privilege. A person came to Yoga in the search for a meaningful life path. It was a blend of the spiritual and the physical, and it required a commitment to what was revealed within the practice. Before being allowed to take my first class, I had to demonstrate that I already practiced meditation. It was not exercise per se.

It was not adaptable like it is today. Depending on the teacher, you learned an ancient system – Hatha, Vinyasa, Ashtanga, Iyengar, or Kundalini. Those were the major methods that have Hindu roots, and those who practiced these art forms knew what they were doing. The teachers themselves had worked on their craft for decades. Today, I know only a few teachers who have a profound grasp of each of these methods.

Why is Yoga so popular?

Is there something within the work itself – even in the diluted forms, hybrid versions and the celebrity/competitive studios – that allows it to thrive in the self-centered, free-wheeling, branding-crazy marketplace of the early 21st century developed world?

I find the answer to this in a strange place:  Zen practice, Bhuddism. One of my favorite notions is from Suzuki’s text Zen Mind, Beginner’s Mind. “When you feel disagreeable, it is best to sit.” This is an element of nin – constancy – or being present in the moment. Not patience, which requires a rejection of impatience and therefore cannot accept the present as it is. When you sit – just sit period, that’s it – all that is real is the moment. This is at the heart of all spiritual experience.

I’m not an expert in Yoga. I don’t teach Yoga, although I have integrated Yoga-based skills into my work. I have practiced Hatha and Vinyasa over the years enough to learn how certain skills are treated…belly breathing, slow deep breathing, maintaining position and listening to the wisdom of the body, and isometric strengthening in preparation for more expansive shapes or motions. Long ago, I integrated these skills from my Yoga experience into my teaching style because these skills are effective for the populations with which I work. But, I do not teach Yoga.

Can Research Help Us?

Researchers find Yoga a nightmare. There is so much variance now in the practice that findings from any one study cannot be transferred to the general population. One of the most revealing experimental-design studies found that none of the claims of Yoga improving metabolism could be demonstrated. When asked why they thought this outcome had occurred, the teachers who were used in the study said they thought the participants in the study were not fit enough to do Yoga!

One of the most successful Yoga teachers in my area, and one of my favorites, has for decades used a bicycle for her primary mode of transportation. She credits her longevity and success to Yoga. I attribute it to bicycling. Dr. Cooper is right…fitness (which means aerobic fitness) is the biggest bang for the buck. Unless you are fit, it is hard to execute some of the more subtle demands of many exercise regimens.

Some Yoga teachers will say that you can make Yoga aerobic or that some forms are aerobic. OK, then it’s aerobics, not Yoga. Whenever I see “aerobic Yoga” it reminds me of aerobic dancing. It’s helpful to remember that Yoga developed in a time and place where survival was dependent upon fitness. People didn’t need to do more aerobics to find enlightenment. They needed reflection and to be present in the moment.

So, I insist on aerobic fitness as the first goal of a fitness regimen. In the pre/postnatal field, this is the only consistently demonstrated factor in improved outcomes. As a birth preparation there are Yoga-based factors that will help in labor and birth IF THE WOMAN IS FIT ENOUGH. It is the fact that some Yoga-based skills help fit people find nin that is my justification for continuing to use them in conjunction with aerobics and special pre/postnatal preparation and recovery exercises.

But, there are cautions. Not all Yoga assanas (positions) are safe for pregnancy. Down-dog, in particular, scares me because of incidents reported in obstetrical literature in the 1980s and 1990s that indicate such a position is implicated in fatal embolisms. Some shapes are just not doable and others become less comfortable over time. The ones that work have been identified since the 1940s and 1950s and integrated into birth preparation courses.

What’s Next?

All exercise components –

  • Mind/Body
  • Strength
  • Flexibility
  • Aerobic or Cardiovascular Fitness

– are necessary for a balanced fitness routine. Too much emphasis on any one factor often results in injury. Aerobics is where the greatest health benefits reside. Recent research has demonstrated that it is physical “fitness” (which we can measure) as opposed to just spending time in physical activity (which can be a wide range of intensities) that is responsible for improved health outcomes. Strength and flexibility training need to be purposive. There are things we don’t need to do unless we are going to play pro football or dance Swan Lake! Mind/Body skills help us recover and prepare.

I for one will be glad when we get beyond yoga and back to cross training!