Protecting the Pelvic Floor- Breathwork & Movement Through Yoga in Pregnancy & Birth
Yoga changed my life in so many ways. I had a hard time being still and being quiet in my mind. Yoga helped with both of those things and taught me how to lean into it when things get hard. I was never an athletic person growing up and saw yoga as just “too hard” for me. Not flexible enough, not strong enough, too scared to take a class in front of other people. I had a lot of fear around trying new things because I was a perfectionist who didn’t want to do anything if I wasn’t immediately great at it. It was LAME.
Note: I’m coming up on my five year yoga anniversary and my heels still don’t touch the mat in downward dog; still haven’t perfected Crow pose; I started with Yoga With Adrienne on YouTube, graduated to Yoga With Cassandra, and then started taking classes at my local YMCA.
Shout out to the Dirty Dena (Pasadena) location & the Arnold Y! I’ve since gone to a few yoga retreats that I look forward to every year.
Anyone can do yoga. Literally anyone. I think every pregnant person should do it.
From all the different kinds of bodies I’ve witnessed give birth over the years, I didn’t see one that wouldn’t benefit from yoga. So please don’t be afraid and give it a try.
What can Yoga do for you prenatally?
Most pregnant women report pain at some point throughout their pregnancies. It could be pubic symphysis pain, lightning crotch, lower back pain, hip pain, or rib pain. Yoga can make a big difference with all of these issues.
Pregnancy itself might get uncomfortable, but something is going on when there is pain.
Definitely mention any issues to your provider. A good Webster certified chiropractor, acupuncturist, or pelvic floor physical therapist can make a huge difference in pregnancy pain as well, in addition to yoga.
Not only can yoga help with pain prenatally, it can help with your labor! If you’re already in pain before you’re even in labor, think about how much worse labor will feel. You have to address those issues before you go into labor. Yoga will help with this.
During labor, your powerful amazing uterus will be contracting like a beast 60 pounds of pressure per square inch-all to bring your baby Earthside.
A pelvis that moves in pregnancy is a pelvis that’ll move during labor.
We need you mobile, loose, and limber for labor. If your hips are tight during labor, you’ll have a harder time getting into lunging positions that’ll help your baby move down into your pelvis.
If your psoas is tight, that can keep your baby at a higher station in your pelvis, making it more difficult for them to descend and/or for you to dilate without having baby’s head on that cervix to help it open, soften, and thin out.
If you clench your glutes, you are releasing stress hormones into your body that tell your baby “this is not a safe place to birth” and your labor might stall out.
Relaxing your mind and body, and preparing your body for the demands of labor with yoga will help in a million different ways.
And while we’re on the subject of labor—yoga isn’t only about the poses, it’s also about breathwork, or Pranayama.
One of the best ways to protect your pelvic floor during pregnancy, birth, and beyond is to learn how to do diaphragmatic breathing.
When you think of your pelvic floor, picture a bowl or hammock that’s holding up your muscles connected to sexual functions, urine, poop, and your uterus. During the pushing stage of birth, these muscles can stretch up to three times their normal size. Studies have shown you are more likely to have pelvic floor damage with prolonged pushing using the traditional Valsalva pushing technique (Ahmadi et al., 2017).
Image: Garner Pelvic Health. Medical image of pelvic floor in pregnancy.
What is Valsalva pushing?
It’s also called “purple pushing.” Women in labor (in the hospital setting usually) are encouraged to hold their breath and push to the count of 10, repeated three times per contraction. This way of pushing can be the appropriate way for some women to push. But it shouldn’t be the standard any longer because we know the risk to your pelvic floor. Also, please note- your pelvic floor is NOT what pushes out your baby. Your uterus does that.
Image: Research Gate. Model of pelvic floor
In one study from 2017, open glottis pushing was associated with a 41% intact perineum rate (no tearing) compared to the closed glottis of 19.3% no tearing (Ahmadi et al., 2017).
The hell is a glottis?
It’s part of your vocal chords. When it is open during pushing, it means you can be heard breathing air out, making a sustained exhale or hum. The glottis is closed during the Valsalva pushing because you’re holding your breath and no sound is made.
Image: Lamaze International. Medical chart of open glottis vs closed glottis.
In one study, making sounds decreased the risk of a perineal tear bigger than two centimeters by 68% (Neta et al., 2022)!
GUYS! That’s HUGE. To rephrase that- making a vocalization by keeping that glottis open reduced the risk of a perineal tear greater than 2 cm by 68%.
I don’t know about you, but every centimeter of my perineum counts when it comes to tears.
In another study done on open glottis pushing combined with blowing out during crowning, it was found that 41% of women had no perineal tears compared to only 19% in the group pushing with a closed glottis and blowing while crowning (Ahmadi et al., 2017).
So What Does This Have To Do With Yoga?
I’m glad you asked. How does one learn how to breathe and push with an open glottis? In yoga, it is called Ujjayi breath, otherwise known as Ocean Breathing.
It’s called Ocean Breathing because it sounds like… the ocean. Or we sometimes call it Darth Vadar breath because it’s loud! To practice this, take your hand in front of your mouth. Take a deep breath down into your diaphragm (fill up your belly, expand your rib cage) and exhale through your mouth onto your hand as though your hand was a mirror you are trying to fog up.
Now do that exact breath, but keep your mouth closed. That’s Ujjayi breathing!
Image: Description of Ujjayi breathing. Figure 3.8: Yogi Doctor
See why it’s called Ocean Breath?
This not only helps your pelvic floor. It relaxes your nervous system.
Ujjayi breathing activates the Vagus nerve. If you’re not familiar with this little miracle of a nerve, you’re about to go down a google rabbit hole of your own.
Image: The Guardian. Medical drawing of the inside of a person’s face.
The Vagus nerve activates the parasympathetic nervous system, which helps you relax and reduce your stress level.
Being relaxed in labor is going to make a huge difference to the overall feeling you have about your birth and how it all unfolds. A relaxed pelvic floor means baby will come down with more ease than a pelvic floor that’s contracted and not relaxed.
You can practice this breath throughout your prenatal yoga sessions. And you don’t have to be fancy (YouTube has some excellent prenatal stretches/prenatal yoga classes), but you could go to local yoga studios.
Annapolis has a few different places that offer prenatal yoga.
I love Yoga Barn in Severna Park. And True Moon Yoga in Arnold is great. The YMCAs in Pasadena and Arnold are also a favorite, especially for beginners. Any great instructor will make suggestions/accommodations for you in a regular yoga class, but you should really try to find a prenatal specific class, if you’re able.
Check out my next post about The Best Yoga Poses for Pregnancy and Beyond for which poses to add to your practice!
Sources
Ahmadi, Z., Torkzahrani, S., Roosta, F., Shakeri, N., & Mhmoodi, Z. (2017). Effect of Breathing Technique of Blowing on the Extent of Damage to the Perineum at the Moment of Delivery: A Randomized Clinical Trial. Iranian Journal of Nursing and Midwifery Research, 22(1), 62-6.
Neta, J.N., Amorim, M.M., Guendler, J., Delgado, A., Lemos, A., & Katz, L. (2022). Vocalization during the second stage of labor to prevent perineal trauma: A randomized controlled trial. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 275, 46-53.
