Delivery Pain and Yoga

Labor Pain Definition: Childbirth is not easy. Regardless of how meaningful the event, the romanticized scenarios of the mind, or stories of other labors, labor and delivery are intensely hard work. Contractions may be painful and require you to draw from all of your energy reserves (Sloane, Benedict and Mintzer 1986). One can not plan on having a rapid, painless labor. Instead, it is safest to assume that the duration of labor and delivery will be steadily intense for many hours (Sloane, Benedict and Mintzer 1986). This is a result of factors that are out of the expectant mother’s control. Uncontrollable factors include: the intensity of the contractions, the position of the baby, or the amount of room in the pelvis (Slaone, Benedict and Mintzer).

Manageable labors happen to women who have prepared for delivery by means of resting, learning, taking care of general health, and having adequate support (Sloane, Benedict and Mintzer). There are things that can be done to keep from being overwhelmed or overstressed by labor and delivery. Perhaps, yoga, which can offer the expectant mother comfort spiritually, mentally, and physically, is the key to being under whelmed.

Delivery Pain and Yoga: Labor is one of the most physical things a woman could ever do. Prenatal yoga can be an excellent way to prepare for labor and delivery with the use of numerous physical benefits (Weller 1981). Asanas, the physical poses, can help build strength and stamina and improve circulation. Knowing how to position your body, during times of contraction and relaxation, will lead to a smooth transitioning labor (Weller 1981). Likewise, the squats of yoga combined with a sort of kegel movement tone the muscles of the pelvic floor and give the expectant mother practice in tightening and releasing them (Weller 1981). Meditation can improve the abilities to relax and to concentrate. Through yoga, you can learn how to identify when you are holding the tension that leads to pain in your body. A body that is tense is not going to facilitate the birth process as easily as one that is relaxed. Tension can lead to withholding of breath, and with yoga preparation, one can identify the tension, soften the body, relax the thoughts and release the breath. Pranayama, breathing exercises, can help manage the pain of contraction (Weller 1981). One way to prepare mentally and physically for labor is to practice yoga every day. Yoga teaches people to listen to the needs of the body and trust the natural procedures that come from the wisdom of the body. Deeper intimacy with the body, perhaps, even allows women to rely less on rational thinking and more on intuitive wisdom (Weller 1981).

Observational Study: The objective of this study was to discover the efficacy of yoga on pregnancy outcomes. Three hundred thirty five women attending the antenatal clinic at Gunasheela Surgical and Maternity Hospital in Bangalore, India, were enrolled between 18 and 20 weeks of pregnancy in a prospective, matched, observational study: 169 women in the yoga group and 166 women in the control group. Women were matched for age, parity, body weight, and Doppler velocimetry scores of umbilical and uterine arteries. Yoga practices, including physical postures, breathing, and meditation were practiced by the yoga group one hour daily, from the date of entry into the study until delivery. The control group walked 30 minutes twice a day (standard obstetric advice) during the study period. Compliance in both groups was ensured by frequent telephone calls and strict maintenance of an activity diary. The main outcomes focused on birth weight and gestational age at delivery. The results showed that the number of babies with a birth weight of greater than or equal to 2500 grams was significantly higher in the yoga group. Preterm labor was significantly lower in the yoga group. However, most important to our topic is the 54% of normal vaginal delivery in the yoga group, as opposed to a smaller percentage in the control group, as well as the smaller percentage of pregnancy-induced hypertension for the yoga group. There were no significant adverse effects noted in the yoga group (Narendran, Nagarathna, Narendran, Gunasheela and Nagendra 2005).

Survey: The purpose of this two-part anonymous survey is to identify common treatments used for low-back pain (LBP) during pregnancy. Pregnant women and providers of prenatal health care (nurse educators, nurse midwives, and obstetricians) in New Haven, Connecticut, were surveyed over a seventeen month period. The results indicate that the majority of pregnant women who participated in the survey (61.7%) reported that they would accept complementary and alternative medicine (CAM) therapy as treatment for LBP during pregnancy. Similarly, 61% of providers of prenatal health care in the sample reported that they would consider using CAM as treatment for LBP during pregnancy. Massage (61.4%), acupuncture (44.6%), relaxation (42.6%), yoga (40.6%), and chiropractic (36.6%) were the most common CAM therapies recommended for LBP in pregnancy by the providers of prenatal health care in the sample. This two-part survey study found that both providers of prenatal health care and pregnant women in New Haven county are likely to use CAM treatments for pregnancy-induced LBP. Further investigation should focus on whether it is a nationwide phenomenon, as well as if various CAM therapies are an efficacious treatment for LBP during pregnancy (Wang, DeZinno, Fermo, William, Caldwell-Andrews, Bravemen and Kain 2005).

How To:
Women should know how to breathe during the pain of contractions, holding the Virabhadrasana II (Warrior II) pose for about a minute aids in the ability to do so (Carrico 2005).
http://yoga.about.com/od/yogaposes/a/warrior2.htm

So that women can learn to tolerate the sear of the stretching of the birth canal, it is recommended to take the Thai Goddess Pose (sitting back on the heels with the toes tucked under) and breathe through the pain in the toes for several moments (Carrico 2005).

To rehearse the tilting of the pelvis required to facilitate the baby’s delivery, women should kneel on their and knees and round the back upwards toward the ceiling (Carrico 2005). This maneuver is called the Cat-Cow and is also useful in moving the baby into the right position for delivery (Carrico 2005).
http://yoga.about.com/od/yogasequences/ss/catcow.htm

Baddha Konasana (Bound Angle Pose) is a sitting pose where the soles of the feet are placed together and the knees move away from each other (Carrico 2005). This, along with modified squats, can increase blood circulation to the pelvic floor and help women get used to the feeling of opening up (Carrico 2005).
http://yoga.about.com/od/yogaposes/a/baddhakonasana.htm





Bibliography:

Carrico M. The eight limbs, from yoga basics. Yoga Journal [Internet]. 2002 [cited 2005 Sept 20]; Available from: http:www.yogajournal.com

Narendran S, Nagarathna R, Narendran V, Gunasheela S, Nagendra HRR. Efficacy of yoga on pregnancy outcome. J Altern Complement Med 2005; 2(2): 237-244.

Sloane PD, Benedict S, Mintzer M. The complete pregnancy workbook: a guide for parents-to-be. Chapel Hill: Alconquin Books; 1986.

Wang SM, DeZinno P, Fermo L, William K, Caldwell-Andrews AA, Bravemen F, Kain ZN. Complementary and alternative medicine for low-back pain in pregnancy: a cross-sectional survey. J Altern Complement Med 2005; 2(3): 459-464.

Weller S. Yoga and pregnancy: unbending thoughts. Nurs Mirror 1981 Apr 30; 152(18): 20-2.