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Ask the Teacher is an advice column that connects Yoga Journal members directly with our team of expert yoga teachers. Every other week, we’ll answer a question from our readers. Submit your questions here, or drop us a line at asktheteacher@yogajournal.com.
Do you have any tips for practicing yoga if you have prenatal placenta previa?
—Sandy in Silverdale, Washington
It can be easy to overlook placenta previa because you may not experience any symptoms. The condition is only detected during a prenatal exam. But it’s one that requires you to take care with how you approach your yoga practice.
What is Prenatal Placenta Previa?
The placenta develops during pregnancy to supply oxygen and nourishment to your baby as well as remove waste. Usually, the organ attaches to the top or side of your uterus. In placenta previa, however, it attaches lower in the uterus, where it may partially or completely cover the cervix, or the opening of the uterus, according to the Mayo Clinic.
Because your uterus grows as the baby develops, the condition can correct itself. If it doesn’t, however, it can cause bleeding during pregnancy or during and after delivery. Placenta previa is a major risk factor for postpartum hemorrhage and can lead to severe or even fatal outcomes for the mother and infant. For that reason, if your prenatal exam indicates placenta previa, your doctors are likely to suggest delivering your baby by C-section to avoid attempting a potentially dangerous vaginal birth.
But what does that mean for your yoga practice?
If you have placenta previa, chances are you won’t have to give up yoga, but you do have to be careful with your practice.
Check with your healthcare provider first, says Caitlin Harwood, a yoga teacher, doula, and childbirth educator who has been teaching prenatal yoga in the Cleveland, Ohio, area for more than 10 years.
“Yoga guidelines are not ever meant to replace any advice from a healthcare provider,” Harwood says. “People should always default to the recommendations of their provider.” They suggest that you ask your provider for specific guidelines. Learn about the severity of your condition and what level of movement is safe—then communicate those recommendations to your yoga teacher.
What are guidelines for practicing yoga with placenta previa?
People with placenta previa may be placed on pelvic rest, which means avoiding types of movement that might cause contractions. That means no jumping and no abdominal compressions, Harwood says. Hot yoga is also contraindicated. These are generally avoided in prenatal yoga classes, in any case.
A practitioner with prenatal placenta previa would also avoid asanas that cause deep pelvic opening. “We want to avoid full squatting,” Harwood says. That means skipping Malasana (Garland Pose), Goddess Pose, or any posture that requires a squat in preparation, such as Bakasana (Crane (Crow) Pose).
You would also decrease the distance between the legs in poses that typically ask you to take a wide stance. “When you’re thinking about something like the Warrior series, you’re lessening the distance between the feet at that point, because we don’t want the pelvic opening to be too wide,” Harwood says.
This also applies to poses such as Hanumanasana (Monkey Pose), Urdhva Prasarita Eka Padasana (Standing Splits), Utthita Parsvakonasana (Extended Side-Angle Pose), Trikonasana (Triangle Pose), Prasarita Padottanasana (Wide-Legged Standing Forward Bend), Upavistha Konasana (Wide-Legged Seated Forward Bend), or Baddha Konasana (Bound Angle)
Practicing chair yoga may be a safer option, since your body is fully supported by the seat.
Practice the other limbs of yoga
Remember, yoga is more than just a physical practice. Researchers in India published a study in Advances in Preventive Medicine that suggests yogic breathing, relaxation, and visualization exercises can be beneficial for high-risk pregnancy. Harwood’s prenatal yoga students say they benefit most from pranayama.
“I often recommend people do partner breathing practices: sitting back-to-back with your partner, and just feeling their breath against your breath,” they say. “And then maybe transitioning from that to some ujjayi, some ocean breath.” Avoid pranayama techniques that involve stomach contractions such as Kapalabhati Pranayama (Skull Shining Breath).
Harwood says that breathwork is also a helpful preparation for a Cesarean, because the parent is undergoing two major procedures simultaneously—both of which can be stressful to body and mind. “A C-section is not only giving birth, its major abdominal surgery,” they say. “You’re navigating both of those things together. And it’s a lot.”
Breathing practices can have benefits for you and the baby. “After about 22 weeks, babies can hear that [breathing],” Harwood says. “They can feel that vibration.”
Afi-Odelia Scruggs is an award-winning multi-media journalist, author, and content creator. Her work has appeared in The Guardian, The Washington Post, USA Today and many other media outlets.