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Anne-Marie H. Zulkahari Director of Pilates & Yoga Movement at Clerkenwellbeing shares some advice about how post natal yoga can help you feel better after labour and birth.

Clerkenwellbeing provides a range of primal health services for women and children from pre-conception through birth and the early years 

Problems for many women become worse after childbirth when there is less time to spend on yourself and the demands on you both physically and mentally increase considerably.

Women generally suffer from tension, usually posture related, plus back and shoulder problems due to the every day stresses and strains such as breast-feeding, carrying infants and so forth. Many physical problems are aggravated by returning to full-time occupation without having adapted completely to the physical consequences of childbirth and motherhood. These problems need to be considered when doing yoga postnatally.

For those who have had a straightforward labour, it is best to start primarily with deep breathing and small, minimal exercises that work on core stabilization (Gentle strengthening and toning of the deep abdominal muscles which in turn give support for the lower back and pelvis). These can be done immediately. Whilst doing this, your teacher can help you check for any separation of the Rectus Abdominus muscles that may have occurred during pregnancy.

For those of you who have had a Caesarean or other complications, do not start yoga until you have had an all clear from your doctor or health worker.  In all cases, it is preferable not to start back until at least six to eight weeks after labour.

Those of you with carpal-tunnel syndrome, symphysis pubis dysfunction, instability of the sacroiliac joints and any other back problems, should only start back into yoga class under the guidance of your practitioner. Your yoga teacher should be clear about asanas that are contraindicative to the condition.

The first few classes should progress slowly bearing in mind that post natal hormones and bodies are still settling down. Tiredness and interrupted nights sleep can also make you more prone to injury, so be gentle with yourself and always listen to your body and stop if ever in doubt.

In your classes, correct posture and alignment in Tadasana is important so that the muscles are balanced and not strained by incorrect stance. You will need to readjust the body back to its pre pregnancy state. It is not unusual for postnatal students to stand like they are still pregnant with feet too wide and holding a lordotic (overly curved lumbar spine) posture. Pay attention to sitting in the most optimal position for your neck, shoulder and back whilst breast feeding and holding your baby.

Things to take into consideration are:

• Dangers of joint laxity and the length of time it takes for these muscles and ligaments to adjust back, bearing in mind, exhaustion and the tolls Labour has taken on the body depending on any complications which may have arisen.
• Awareness and control of the pelvic floor muscles. Strengthening these muscles:
• stop/start urine (no longer considered the best way to strengthen these muscles as it can lead to infection)
• Start by first slowly engaging the back passage release. Repeat a few times. Do the same with the front passage. The weaker of the two is the one that needs practising more. Finally, engage the perineum which is between the two.
• Sit and slowly engage the pelvic floor muscles “hold & release“ use the breath to help: inhale, hold, exhale , release. Imagine an elevator and stop at each of 5/6  floors up & down. Release totally at the end but do not force. Isolate  the different areas , holding for as long as possible at each stage repeating each one increasingly -up to 5 times- holding for longer.

Structure of the pelvic floor:

The pelvic floor is a multi-layered sheet of muscle stretched between the pubis and coccyx, forming the inferior support to the abdominopelvic cavity. These inner muscles form a shape like an inverted dome, like the diaphragm, but unlike the diaphragm, it forms a floor instead of a roof. The pelvic floor is pierced by the urethra, vagina, and rectum. The muscle fibbers are arranged around these openings. looping and connecting around each opening. The inner layer is known as the pelvic diaphragm, the outer forms the perineal muscles. The major muscle of the pelvic floor is the pubococcygeal muscle.

Function of the pelvic floor

• Provides support for the pelvic organs and their contents
• Withstands increases in intra-abdominal pressure
• Provides sphincter control of the perineal openings
• Functions in reproductive and sexual activities

Dysfunction

Muscle and soft tissues laxity
a) The muscles drop from their normal alignment due to increased pressure on the pelvic floor musculature, and organ prolapse may occur.
b) Urinary stress incontinence may occur and worsen with pregnancies, increases of weight and ageing.

Pelvic floor disruption such as: episiotomy when an incision is made in the pelvic floor during labour to enlarge the vaginal opening. Also tears and lacerations from childbirth.

Hyper tonicity
An increase of muscle tension or fascial tightness of the pelvic floor. It is significant enough to impair sexual and elimination functions. This problem can occur as a result of improper postpartum healing and may be quite painful.

Anne Marie has bee practicing Pilates since 1975. As one of the founders of the PILATES Foundation UK Ltd, she helped establish the teacher training syllabus and examination procedures for teacher training members. She also co-directs the London Yoga Teacher Training Course (LYTTC) that is accredited by the British Wheel of Yoga.

Contact PYM Studio at 020 7490 4042 or email: enquiries@pilatesyoga.com

For more information about Clerkenwellbeing’s classes: Mother and Baby Yoga classes with Roisin Montgomery and many other services and therapies for pre and post natal women.

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