Prior to starting an exercise regimen in pregnancy, it is crucial to first consult your healthcare provider. Get their help developing an individualized exercise regimen tailored to your unique needs.
When I took my first prenatal yoga teacher training, I was surprised to observe that what pregnant people were actually doing in my yoga classes was very different from what was recommended in our manual. This was especially apparent with people in their second or third pregnancies. The rule follower in me was confused as I watched students with fully blossomed bellies lying on their backs or twisting. Wait, I wondered, I thought they weren’t supposed to do that!
Then I got pregnant.
As I began to research further which exercises are considered safe during pregnancy, I found myself in a sea of contradictory information. One website referred to something as the most dangerous thing in the world; another said the opposite. Even from prenatal yoga teachers, I heard conflicting information. To top it all off, what I was feeling in my own body was often very different from what I was being advised by my teachers.
What I realized was that although there are a lot of prenatal do’s and don’ts out there, the right answer to the question, “Is this safe to do while pregnant?” is usually “Maybe” or “It depends.” As it is with most things pregnancy-related. And not so different from the rest of life.
Not only is every pregnant person unique, but every pregnancy is as well. Because of this, Dr. Sarah Hebl, an OB/GYN based in the San Francisco Bay Area, believes that the most important aspect of exercise during pregnancy and postpartum is not the workout itself, but listening to your body. She emphasizes “modifying as needed and avoiding anything that causes discomfort.” And she encourages pregnant people to “work with a licensed instructor.”
Teachers and any “experts” are definitely important guides, but ultimately, you are the one who is likely to know your body best. Pregnancy is a unique time when you are completely immersed in what is going on inside of you. This makes it a particularly good time to hone your intuition and body awareness.
Instead of being overwhelmed by all the conflicting information about prenatal fitness, remember that you already have the answers within you. This is true both when you are with child and when you are not. Just as you can start to feel the baby’s kicks more distinctly, in time you can also recognize your own gut reactions.
Here are some common prenatal yoga myths and a few suggestions for figuring out what works for you.
Myth #1: You should not twist. At. All.
Truth: Twisting throughout the pregnancy is okay, as long as you twist from your upper spine and your belly is not obstructed.
What to check: Can you breathe easily?
One of the more common myths about pregnancy is that all twisting is dangerous. But not all twists are created equal. Patti Quintero is a leading women’s wellness expert and doula based in Los Angeles who founded Uma Mother, which provides yoga, meditation, and prenatal and postnatal education for women. She explains that “Advanced closed twists have a compressing effect on the body” and that holding them “can create deep stimulation.” An example of a deep closed twist is marichyasana C, in which the elbow crosses the knee. Quintero explains: “Since a pregnant body carries more blood volume and is working with limited space because of organ displacement, it is better to not put this added pressure on the body and blood flow.”
Open twists, however, are encouraged during pregnancy as they can help support digestion and blood flow. An example is twisting crescent lunge with the bottom hand on the floor inside the front foot and the top arm reaching to the sky. (If you opted for prayer hands and hooked the elbow outside the knee, that would become a closed twist.)
Other benefits of open twists include strengthening the obliques, which are important lower back stabilizers (specifically, the internal obliques), and opening the chest, which can get tight as the uterus expands and pulls the body’s weight forward.
Myth #2: You shouldn’t lie on your back after the second trimester.
Truth: For most people, lying on the back in the second trimester for short periods is okay—up to a point. What to check: Are you dizzy or short of breath?
While many top pregnancy apps and sites toe the party line that pregnant women should not lie flat anytime after the second trimester, Courtney Satow, a birth doula and pre- and postnatal yoga teacher based in the South Bay area of Los Angeles, says that the timing of when someone should stop is more personal and that a person’s body will let them know when it’s time to stop.
When we lie on our backs late in pregnancy, there is a risk of “too much weight on the vena cava, the main vein that carries blood back to the heart,” Satow explains. This can cause nausea or lightheadedness or shortness of breath. Satow warns, “If you do lie on your back and you feel these symptoms, it’s time to get up,” she warns. Doctor Hebl agrees, emphasizing that lying on the back is safe “in most uncomplicated pregnancies," but echoes that if lying flat causes any adverse reactions, people should not only stop, but also “discuss these symptoms with [their] healthcare provider immediately.”
In summary, if your pregnancy is low risk and you are not experiencing any symptoms of distress (in other words, if it feels okay for you), both experts agree that being supine for short periods after the second trimester is okay.
If you are going to spend a long time on your back (such as during the latter part of class), Satow encourages students to prop themselves up on an inclined bolster. This is especially important for , when we can sometimes recline for seven minutes or more.
Myth #3: Doing inversions is contraindicated.
Truth: Going upside down throughout pregnancy is okay as long as you are experienced doing so and you feel stable. However, pregnancy is not the time to start learning more advanced inversions.
What to check: Do you already have an inversion practice?
There are “experts” that believe people should stop doing inversions immediately upon conception. But like everything else, it depends. As inversions are any shape in which the legs are above the heart, there are different grades of inversions. Whenever we reach for our toes we are inverting. In yoga class, students spend a good amount of time upside down in mild inversions, such as folding forward and downward facing dog.
In 2015 the Journal of Obstetrics and Gynecology published a study looking at 26 different yoga postures, including some inversions once thought dangerous in pregnancy. The study concluded that they “were not associated with acute adverse maternal or fetal responses” and therefore could be considered safe.
However, for those who attend yoga classes that include more challenging inversions, Quintero suggests not introducing “poses like headstand and handstand if your body is not previously familiar with them.” There are a number of reasons for this. Most notable is that during pregnancy, there is an increase of the hormone relaxin, which loosens the connective tissue throughout the body in preparation for birth, and can cause hypermobility and instability in the joints. There is also a shift of weight distribution as your uterus and baby grow. Even those with a strong handstand practice may be wise to use the wall during pregnancy to mitigate the risk of a fall.
Myth #4: Core work is a no-no.
Truth: Too many crunches and rounded shapes may lead to postpartum complications, such as diastasis recti. But movements with a neutral spine could be helpful for preventing low back issues.
What to check: Is your belly “coning” (forming a football shape)?
Compressing the abdomen should be avoided during pregnancy. Satow recommends “staying away from crunches, even early on, because they limit your baby’s space.” She explains that “flexion movement during crunching [rounding the spine] may lead to diastasis recti.” Diastasis recti is the separation of the “six-pack” abdominal muscles, the rectus abdominis. This can involve either a partial spreading or a full separation and it can lead to lower back pain, digestive issues, and in extreme cases, hernia.
Every pregnant person experiences some form of abdominal separation. But according to Satow, “Exercising safely during pregnancy can lessen complications throughout the remainder of the prenatal period and postpartum.”
Quintero agrees, adding that sometimes "overly developed rectus abdominis muscles and tight hip flexors restrict babies from getting into an optimal fetal position and dropping down into the pelvis toward the end of pregnancy.”
While rounding the spine is not encouraged, core strength can help prevent lower back pain. Luckily, it can still be developed in numerous other ways; for example, with poses like plank or tabletop, in which the spine is neutral. That said, Satow cautions that even plank can be overdone, as it “forces too much pressure downward, causing ‘coning,’ in which the belly begins to look more like a football shape rather than round.” She explains that this is an early warning sign of diastasis and advises backing off. She encourages side planks instead. Lifting the opposite leg and arm in tabletop is another way to work the core and can be practiced throughout pregnancy.
There are a lot of hard and fast rules about practicing yoga while pregnant, and not all of them will apply to you. Consult with your healthcare provider regularly, and take this time to begin working more thoughtfully, figuring out what is best for your body. Consider this good training for when your baby arrives and you are bombarded by “expert” baby advice. In the end, you know yourself best, just as you will know your baby best.