Most birth professionals know that yoga during pregnancy is of great benefit to expectant mothers. As both a certified prenatal yoga instructor and a Lamaze Certified Childbirth Educator, I often field questions from birth professionals regarding referring clients to a prenatal yoga class. In this article, I'll discuss how to help your clients find a class that's appropriate to them.

Mothers generally start attending a prenatal yoga class at the end of their first trimester. This is due mainly to two factors - the end of morning sickness, and a public acknowledgement of their pregnancies. So, a prenatal yoga instructor has many weeks to build a relationship with her students and help influence the outcome of those pregnancies. Keep in mind that it's never too early or too late in a pregnancy to start taking a class.

'Over the years, I have found that I can offer my yoga students the opportunity to try things out - to practice the techniques we use in childbirth while holding a challenging yoga pose. The similarities are strong and the learning opportunities are immeasurable. The marriage of the two disciplines, yoga and childbirth education, provides so much opportunity for women to practice and gain confidence in their abilities and their body.'

Prenatal Yoga and Childbirth Education: A Response to Tracy Posner's Birth Story by Ann L. Israel, MA, E-RYT, LCCE, FACCE

So much of modern American yoga is related to that which we teach in our childbirth education classes. It behooves us to talk to mothers about the benefits of the practice: a mother's overall wellbeing, her confidence and for her birth experience.

'The practice of yoga has many positive effects on pregnant women. Yoga is a multifaceted approach to exercise that encompasses physical stretching, mental centering and breath awareness, making it an ideal preparation for labor and childbirth. Yoga encourages relaxation, internal focus and slowed breathing patterns, goals that are common in many types of childbirth preparation classes. Yoga may help relieve many of the common discomforts of pregnancy, such as lower back pain, nausea, insomnia, carpal tunnel syndrome and headaches.4,5 In addition, prenatal yoga classes often offer a supportive environment in which pregnant women can share their experiences, which may help relieve feelings of anxiety or depression.'

Prenatal Yoga: Guidance for Providers and Patients by Patricia Kinser, NP, and Carrie Williams, NP

This supportive environment is one aspect of a prenatal yoga class that isn't much discussed, but it can often be the most important part of a class. Many expectant mothers don't have friends who are pregnant or even friends with children. Finding a whole room full of women who are pregnant with you is a wonderful thing. Some yoga classes even offer time to talk afterwards and provide snacks or tea. Fostering this sense of community has long term benefits as many of the mothers will go on to become friends and share baby play-dates down the road.

So, how do you know the prenatal yoga instructor is qualified to teach?

Let's look at some of the certifications:

• Yoga Alliance, the largest Yoga instructor organization offers the RPYT - Registered Prenatal Yoga Teacher certification. This requires 85 hours of additional training on top of another yoga certification. Details here about the certification. However, each yoga school has the flexibility to teach how they see best and there is no oversight by Yoga Alliance over the Registered Yoga Schools. So, you'll have a variety of training and quality of instructors within the RPYT certification.
• Kripalu offers a 31 hour training.
• Goldenbridge offers a Kundalini Yoga Prenatal Teacher training, 60 hours. I took this training.
• Yogaworks offers their own flavor of Prenatal Yoga certification, but gives us no details about the program
• Yogafit offers one-day training and then an instructor can say they are a prenatal yoga instructor.
• Here's one that's homestudy only, with no practical experience needed to get your certification.

There are many other studios and styles of yoga. Some yoga teachers out there are not certified in any style of yoga. Many prenatal yoga instructors teach without a prenatal yoga certification. There is no oversight in the yoga industry, so it is important that you talk to the prenatal yoga instructor prior to referring a client. (Within the yoga community there is a debate as to whether or not oversight is necessary.) Really do your due diligence. Observe one or more of her classes. Ask her how she modifies poses for things like symphysis pubis dysfunction, carpal tunnel, sciatica, etc. She should be able to tell you specifically what she does, rather than saying 'I tell the student to sit out the poses that bother her.' Most poses can be modified to accommodate complications such as the above.

Make sure that the yoga instructor is not working outside her scope of practice. A yoga teacher should not be giving medical advice. This happens occasionally with a turn of phrase such as,'this is the best position to birth in!' Or with direct advice 'Oh you want to induce at home, well try this herb. I heard it works well.'

Working within her scope of practice means knowing the anatomy and physiology of a pregnancy body; suggesting certain movements, breathwork or meditation to help a mother work though an issue; most of all it means knowing when and how to say 'please talk to your doctor or midwife about that.' As yoga instructors we teach our students to work within their limitations; to only work up to their edge, but not past it. Yoga instructors need to maintain their own edge, and work within their own limitations.

A yoga class, of any variety, should make a person feel better afterwards. Your clients should feel relaxed, renewed, and even blissful. They should feel more confident in their own bodies and their abilities. They should be able to take the skills they learn on their yoga mat and be able to apply them to any life situation.

'Thanks for your help during this process - I never really was into yoga before I was pregnant. I always liked working out at the gym or running - but found that your class was really great for me especially in late pregnancy. It really made me feel like I was taking time to breathe deeply and take care of myself physically and mentally, and I'm sure that I should continue doing that as a new mama!'
~J. November 2011

This was from one of my students. This is what yoga can do. Encourage your clients to start early in their pregnancies and to develop a consistent practice over their 40-ish weeks. The more you practice, the more it becomes second nature to breathe a certain way, or move your body into a posture. Encourage your clients to ask questions of their prenatal yoga teacher. Make sure both you and they are comfortable with the class and the teacher. Tell your client that if they aren't happy with the class, not only to switch classes, but to tell their teacher why they were unhappy. Yoga teachers need to grow and improve too.

Some of the more common questions both birth professionals and expectant mothers ask can be found in my blog posting on Giving Birth with Confidence: Choosing a Prenatal Yoga Class. Please do share the link with your clients.

A prenatal yoga class should also incorporate meditation, relaxation and breathing. We will examine these in Part 2, as well as how and why yoga during pregnancy reduces pain during labor; reduces anxiety and improves the overall well-being of mother and baby.

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