Podcast: Yoga for Pregnancy and Birth with Guest, Dr Leah Deutsch

Yoga for Pregnancy and Birth with Guest, Dr Leah Deutsch

Season 1, Episode 6

Yoga is something often recommended by midwives as a helpful form of exercise for women during pregnancy. But yoga has many more benefits than simply exercise. In this episode I am joined by Dr Leah Deutsch (AKA 'The Yoga Doc') who, as well as being a practicing obstetrician is also a pregnancy yoga teacher. We take a look at what the practice of yoga involves and the benefits of this for labour, birth and beyond.

Yoga has influenced Leah’s work as an obstetrician, and we discuss the importance of holistic care for all women when it comes to pregnancy, labour and birth and exactly how this fits into the Maternity System as we know it. A really fun, inspiring and insightful chat!

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TRANSCRIPTION
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I know right now you have no idea what to expect from birth, what it's going to feel like, how it's going to pan out.

And so what you thought was going to be this glowing experience of pregnancy has turned you into a bunch of nerves.

Well, you were in the right place because I am here to hold your hand as you prepare for the birth of your baby through the birth-ed online course, the course that gives you the information you thought you were going to get from your antenatal appointments and didn't.

The birth-ed course opens your eyes to everything you need to navigate your pregnancy and birth choices so you can feel confident, informed, and ready to take back control.

Available worldwide for just £40 or $50, sign up now via the link in the show notes.

Welcome to The birth-ed podcast, where we open up conversations about all aspects of pregnancy, birth and parenthood.

So you feel fully informed, confident and positive about what this journey might entail.

I'm Megan Rossiter, founder of Birth-ed, and your host here at The birth-ed podcast.

Birth-ed offers comprehensive, positively presented antenatal and hypnobirthing classes, both in person and online.

So if you like what you hear, be sure to come check us out on our website or social media.

Don't forget to hit subscribe so you don't miss any of our upcoming episodes.

Believe me when I say we will leave no stone unturned when it comes to preparing you for your pregnancy, birth and the postnatal period.

So welcome back to The birth-ed podcast.

This week I am joined by Dr.

Leah Deutsch, who is a senior registrar working in obstetrics and gynecology in a busy London hospital within the NHS.

She's a member of the Royal College of Obstetricians and Gynecologists and is passionate about the promotion of women's health.

This episode, we're actually not necessarily gonna be focusing on the kind of medical side of birth.

We're actually gonna be focusing on yoga because Leah has also practiced yoga for over 20 years and holds her advanced 500-hour yoga teaching training certification, which helps shape her holistic approach to patient care.

Leah specializes in pregnancy yoga and is an advocate for the power of education, focused breathing and movement in helping to prepare and empower women for the life-changing shifts that becoming a mother brings.

So Leah, thank you so much for joining us today.

Absolute pleasure.

So sort of as we've kind of mentioned, obviously working in obstetrics and gynecology, you're kind of encountering women from the medical side of pregnancy and birth, basically.

But what came first for you?

Was it training to be a doctor or was it yoga?

Yoga.

So actually, I kind of had a bit of a meandering path into medicine, so I didn't go straight from university.

I actually did another degree and then went into medicine a bit later in life.

So yoga was already a part of my life before I went into medicine.

So I've been practicing for about 20 years.

And so I'd been doing yoga for probably about five years, I guess, before I went into my training.

And it wasn't like a major, major part of my life.

It was something that I did more for the, I guess, the physical benefits of it.

And then I went back to training when I was 26 and did a graduate entry medical degree.

And it was really, it's really interesting actually, because yoga then, as I became a junior doctor, I kind of came to rely on that a lot more.

So it was something that I kind of, I used to ease myself into because it was, you know, it was more, like I said before, for the physical aspect of practicing yoga.

And then I kind of just found myself leaving the yoga studio sort of feeling somehow different and just more released.

And it was just a period of time where I could just have a bit of space for my head.

And, you know, sort of, you know, working in the NHS is particularly stressful.

And especially in your first few years of being a doctor, I think, you know, there's a lot of pressure there.

You're learning new skills.

You've got more responsibility.

And so I came to more and more rely on that.

And then it was sort of really about four or five years into being a doctor that I decided actually I wanted to go and train.

I wanted to do something.

But initially, it was actually just to further my own knowledge.

When I was sort of working in Obst & Gyne, as a trainee initially, I was, I kind of, I found myself using the sort of the tools that I was using myself with the women that I was seeing in clinics and on Labour ward.

So, you know, I found maybe women were sort of distressed or scared in Labour, where things weren't going, perhaps, to plan or they hadn't anticipated.

And so it was kind of being able to use just those skills of breath and focus and calm, not necessarily even the physical aspect of yoga, to be able to just kind of like focus women more and sort of be able to kind of just remove that fear and that anxiety around the birth experience.

So yeah, so it was sort of, it's kind of just been a kind of organic kind of growth really.

And then yeah, I kind of decided that I wanted to train after I did my initial teacher training to teach because I loved it so much.

It was something that I really, really enjoyed and thought, right, okay, I'm going to specialize in pregnancy yoga.

So went on to do my pregnancy yoga teacher training as well.

And yeah, and it's something that I, it's lovely actually.

I managed to negotiate a day off a week within my job.

I know, people often say that.

So actually, I mean, I was, you know, sort of obs and gyne training.

We know that, you know, sort of within healthcare workers is a lot of burnout anyway.

And particularly in obstetrics and gynecology, there was actually a recent study that's been done.

It's a waiting publication where they interviewed thousands of obs and gyne doctors, so consultants, trainees, and found that one in 10 was suffering from symptoms of PTSD, clinical symptoms of PTSD, and one in five subclinical.

So that's quite significant, that's quite huge.

And I myself definitely had some experiences along the way during my time as an obs and gyne doctor, and found myself suffering from symptoms of burnout, so just sort of not enjoying my job really anymore.

So negotiated to go part-time, which was great.

So I now have a day off a week where I focus on yoga.

I teach a pregnancy yoga class, and it just makes me more available to women when I'm actually back in the hospital, I think.

You know, it makes me a better doctor.

So yeah.

Because if you're burnout and exhausted, and if you don't have time to look after yourself, that's what I always found, a job where your job is to care for people, often by the time you get to the end of the shift, you've run out of, you can't care for anybody else, but alone yourself.

So yeah, you've got to be able to look after kind of number one first.

Yeah, I mean, that was one thing I was definitely finding.

I was sort of, when my mum or my sister was phoning up and they were needing me to be there, then I was just like, I got nothing left basically for you.

And finding myself, I mean, it sounds awful to admit it, but sort of resenting patients, when I was in clinics and things like that.

And that's just not the kind of, I think that was the moment where I was just like, this is not who I am, and this is not the doctor that I am.

So it was time to sort of do something about it.

So yeah, it's been a real lifesaver for me, actually, yoga, just personally, and then being able to kind of incorporate it into my practice as a doctor as well.

So for people that are listening that kind of, so I've got family who kind of are very into yoga, work in the yoga world, but it's not, I've kind of dabbled in it and been to classes like at the gym and stuff, but not really practiced in the way that you sort of talk about practicing yoga and it being like a part of your life.

So for people that are listening, thinking that yoga is just something that you go and do at the gym in your funky leggings, what, can you describe what does yoga mean to you?

What is yoga?

The kind of, where does it come from?

The kind of proper practice of it?

I mean, that's huge.

So I mean, I mean, it's, I mean, historically, it's like, it's a really ancient tradition.

So they kind of think it's been around for about 5,000 years, but some sort of people sort of talk about it even 10,000 years.

So it's sort of, the first writing down of it was about 5,000 years ago.

And this was, you know, sort of in Northern India, where they were kind of, you know, the concepts were kind of coming into play about sort of focusing away from the ego and using sort of like wisdom to sort of just basically kind of, yeah, just sort of reach an enlightened state basically.

And then it kind of, there was a lot of different schools of thought, and it kind of got a bit more structurally formed in about the sort of second century, we think.

I mean, it's all a bit kind of vague.

So a long time ago, where they sort of started to write it down.

And it's actually, so Panthanjali, which who is like sort of, we don't know who he or she was, but you know, it's sort of, you know, it's talked about as a person, as a man.

Where things were written down, and it was structured as eight limbs.

So basically the eight, people talk about the eight limbs of yoga.

So the physical practice that we see, like you talk about, you know, as you're going to the gym and stuff like that, is really just one aspect of it.

And so it's a sort of like a series of, they're not in any particular order, but we talk about the sort of the steps kind of to, to kind of just reach a state of, I guess, of enlightenment, which sounds a little bit like sitting cross-legged, chanting om and things, which can put, I can understand, puts a lot of people off, and it's a bit, kind of be a bit so very fairy.

But it's, I think, like from a practical point of view, it's about sort of being present.

We talk about that a lot in today's society, and just not kind of, I guess, having that sort of distraction all the time.

We're racing around, and we're never really focused on what's going on on our own bodies from a physical aspect, but also sort of emotionally, mentally.

And so, you know, there's distractions all the time, and it's, I think, you know, if you can take something that's useful from a day-to-day practice, it's just about kind of being more in the moment.

And so the aspects of it, so the physical practice is a great place to start, and that's something that I think we're really, I guess, more attracted to in the West.

It actually only came to the West, so at the end of the 19th century, it came to the America, where yogis have traveled.

There was a kind of big conference, and kind of that was when it started to kind of take legs, big legs.

So it's been a recent thing, and I think, you know, we're very focused on the physical, and it doesn't, but it doesn't have to be loads of like skinny women in leggings, you know, in like, you know, stuff, which I think can be really off-putting to people.

And it doesn't have to be, you know, lots of people say to me, you know, I can't even touch my toes, I wouldn't want to do yoga, and it's just like the kind of, it's almost, I kind of liken it to a sort of thing of saying, you know, stuff, I'm really hungry, I wouldn't want to eat, you know, it's almost like the kind of like, you need to kind of, you know, stuff, it doesn't necessarily mean you need to touch your toes.

It's about kind of just moving and staying active, and the more you do of it, the aspect of breath, so people sort of like kind of roll their eyes a bit, or sort of like sort of look a bit confused when you talk about breath work, but it's, I mean, I guess it's very linked into hypnobirthing in a way as well, like sort of that kind of, that focused breath.

So being kind of very sort of mindful of how you're breathing rather than just sort of like, I think, you know, so when you get anxious, you know yourself that you kind of hold your breath, like if you're stressed or you're nervous about something, or you breathe very quickly, and it's about kind of slowing down the breath and just being very conscious of each breath.

And you can just, I mean, so I, the last few years, I take sort of just 10, 15 minutes every morning where I just sit and do some breath exercises, and it really just sorts my head out for the day.

And that can be, the first time, whenever I even do just kind of like, literally one breath for both of people, if you've never altered your breath before, it can feel really weird.

Like you can get really short of breath, you can, the minute somebody tells me to breathe in a certain way, I forget how to breathe, and I get like, kind of short of breath.

So that's, it's the practice, I guess, of it, where the kind of magic comes from.

Exactly, and I think the more you do it, the more it becomes, you know, the more, it's less your sort of thinking and a kind of cerebral aspect.

It's more of a kind of a felt thing, and so that you can stop having to think about what you're doing, and more focus on just following each breath.

Yeah.

So yeah, so the different, I mean, so breathing Pranayama is one of the aspects of it, and the asana, the physical aspect is another.

And then, you know, meditations and mindfulness aspects come into it as well.

So it's a one big sort of mishmash of really great tools, I think personally.

And I think that it's, however you do it, whether it, like you say, whether it's in the gym doing a class, or whether it's going to Bali and having some like amazing experience at a sort of retreat or something, they're all really valid and really like helpful ways.

And I think, you know, if you don't want to even do the physical practice of it, that, you know, you can get into yoga in from the mindfulness and the breathwork aspect of it.

So I think it offers something potentially to everyone, really.

So, I mean, that's, I guess, I mean, that's not really, I don't even know if that's sort of answering your question, but yeah, it's sort of that kind of, like sort of that culmination of things.

Yeah, because I think it's just a case of some, it's one of the, again, one of those things, sort of like hypnobirthing that's sometimes kind of quite misunderstood as to what it is and kind of how it could be beneficial.

But I guess the, I mean, I guess the main purpose of it is that kind of union.

I mean, that's what yoga means, really, so that union of, whether it be mind, body, breath, whatever it is, but just joining those things together.

Yeah, yeah.

So I want to touch a little bit on the kind of, the benefits of this for pregnancy, the benefits of this for birth.

And one of the things that kind of rung out from what you were just saying was the kind of living in the very present moment.

Because something that, I don't know if you find as well, but supporting women in labor, there's often very much a focus on what's happened so far.

How many contractions have happened?

How long has it lasted?

How many days has things been going on?

When did the signs stop?

Rather than kind of, where am I at right now?

And then also, on the other side, the kind of focus of how many did more, does that mean there is to go?

What's gonna happen next?

And if you can break it down, particularly with the contractions themselves, and be kind of focusing on this, all you have to do in that moment is manage or breathe or that one contraction that you're having, because nobody ever knows what is gonna happen in the next hour or 10 hours, and what's happened has kind of already happened.

So having tools to kind of be able to kind of live in the present is really helpful, and there's different ways of reaching that.

It sounds like yoga is a kind of way of being able to access that.

No, absolutely.

I mean, I think that's a really lovely way of putting it.

It's just that kind of, you know, sort of, you know, I mean, I obviously in my job, I deal with where there's medical intervention.

So it's like, you know, I see less of the normal, and I see lots of women who are being induced.

And I often say that to women in that kind of preparation stage, you know, sort of, you know, because I think we can be not that great as sort of medical professionals, maybe really explaining what that process is going to involve, for example, an induction, whatever, when there's sort of more medicalized birth.

And, you know, sort of having that, A, having that sort of preparation in your mind, so you kind of know where you're going, what the stages are, so you feel that empowerment of like, I know what's happening, rather than people are doing things to me.

But also, as you say, just that kind of treating each moment in its own sort of valid, right, you know?

And I think, you know, the breath definitely is a really useful skill.

So it's, you know, especially if you're kind of having, you know, sort of tightening or, you know, sort of contractions where you're kind of, you know, you're having, you're experiencing pain or discomfort, and you know, sort of, you know, breath can be an incredibly powerful tool to kind of, to work through that, you know, sort of it's something.

It's really underestimated.

Like there's research into breath as pain relief.

Absolutely.

Pain relief.

It's not just someone that's into yoga saying, oh, you should just breathe through it.

Like it actually works.

Yeah, it does.

It does.

It really does.

And I kind of, I think, so the breath aspect of it is definitely as a great tool to use, but yeah, the mindfulness aspect.

So if you're able to kind of just be in that moment, so be able to kind of just shut out all the other kind of crap going on around you, and just, and actually have that moment of stillness when you're, if you're in a hospital, that can be really hard when you've got like sort of people like coming in and out and sort of rustling around you and things.

So just taking those moments where you can just be a bit more still.

And you know, sort of, and meditation is something I think that takes practice.

So it's a really good thing to start off early in pregnancy so that you've got that tool.

I mean, you know, sort of, I guess it's less useful to pick it up the week before you're about to have your baby, you know?

So kind of getting into it within the kind of like the pregnancy period is a really great thing to do.

And I think that the physical aspect as well of yoga is gonna be super beneficial for you.

I mean, movement anyway, whatever kind of form of exercise, we know that women that stay active within pregnancy have, you know, shortened labors.

We know that, you know, if you're moving and you're keeping your body in those forward and open positions that we talk about in terms of kind of helping your baby kind of get into that optimal position for birth, all of those things are gonna be really beneficial for you when you actually go into labor.

So those whole, you know, you've got those sort of three aspects, the sort of the mindfulness, the breath, and the kind of movement that are gonna really benefit you when it kind of gets to that point of labor.

And I mean, to sort of go on and talk about, I guess the benefits of other benefits in terms of your pregnancy as a whole as well.

You know, we've talked about sort of stress a little bit.

Already we've touched on, and we know that stress affects DNA methylation.

So kind of sort of the field of epigenetics, I find fascinating, and it's not my area, so I won't pretend to be an expert in any way, but I find it really, really interesting.

And it's really quite, it's evolving now.

And we know that the anxiety and stress that sort of response that we have in our bodies does affect DNA, and it affects neurodevelopment and sort of brain development in babies.

So anything that you can do where you're kind of focusing in, being more still, being more mindful.

So breath activates the parasympathetic nervous system.

So that kind of slowing down of breath, having long exhales.

Exactly, in labor, exactly.

And through your pregnancy as well.

So all of those things are going to be kind of really, really helpful to your baby and to you basically.

And I mean, in terms of evidence of what, where, how yoga can benefit pregnancy, there's not a huge amount around.

So there's one systematic review, which looked at six sort of studies, and they found that it reduced your risk of having gestational diabetes and high blood pressure.

So, and that's the same with all exercise, really.

And it shortened labor times.

And there's also some, it's not, the evidence isn't that great on it, but in terms of potentially reducing the risk of having a small baby, sort of a growth-restricted baby as well.

I mean, the statistical analysis they did on that was a bit dubious, but there is scientific evidence out there.

We talk about it's not just one person saying, yeah, it's really good for you.

I suppose yoga is probably one of the things, a little bit like hypnobirthing, but it's kind of quite difficult.

You can't blind somebody to whether or not they're doing yoga.

And also it's quite difficult to control what doing yoga means.

Is it an hour-long class in your gym?

Is it a practice that you take in to your absolute every day?

And for everybody, it will be kind of different.

And it's the same with the kind of research and to hypnobirthing, like there's research there, and there's research into kind of certain aspects of it, like breath and things like that.

But ultimately, it's very difficult to make everybody have the same experience at that intervention.

Exactly, and how much they're doing it and stuff like that.

Yeah, to monitor it is tricky, yeah.

So just going back a little bit to the kind of physical benefits of yoga, because that is kind of probably one of the reasons why a lot of women kind of come to yoga for the very first time in pregnancy.

It's one of the things that's kind of, I remember on the booking in appointments, it was always like, these are your kind of, if you have an exercise before, here are some good kind of exercise options.

It was often kind of like swimming and kind of aquanator.

I've never actually been to an aquanator class, I don't actually know what that involves.

In my head, it was always like aqua aerobics, but now I'm thinking maybe it's not, I don't know.

I feel like it would be.

I feel that would be like a-

Yes, just, yeah.

If anyone's listening and they know what aquanator is, just let us know.

Oh, and the other one that always came up was kind of pregnancy yoga.

So kind of, I did pregnancy yoga, this is one of my experiences.

I mainly went to pregnancy yoga because at the end, they had a really long nap and then everyone got biscuits.

So, that's a peak of the yoga class, was the nap at the end.

Do you get a nap at the end?

Maybe it's not that long, though.

I would extend my nap, yeah.

I mean, I'd have been happy if half an hour in, they were like, okay, lie down.

I'll put some music on and you can take a sleep.

It's not often that you get recommended naps.

Yeah, exactly.

So, particularly when you're working and pregnant.

I would happily pay 15 pounds for an hour on nap, though.

So, that's another benefit, pregnancy yoga is naps.

But yeah, so let's talk about perhaps maybe the kind of way that kind of works with the pelvic floor or encouraging kind of optimal positioning and things like that.

I mean, so yeah, sleep is definitely one of the benefits of yoga, so improve sleep.

And then we've already touched on, I guess, the sort of improvements in your risk of gestation, diabetes and hypertension and things like that.

But yeah, so from like a purely yoga point of view, so pelvic floor is really important.

So, we know that women that do pelvic floor exercises throughout pregnancy have reduced rates of incontinence and issues with their pelvic floor afterwards.

So, doing it through the pregnancy is gonna benefit you.

Afterwards is also really important, but you know, sort of having that and kind of keeping that pelvic floor toned.

So, there are lots of exercises that you can do.

I mean, generally through a yoga class, hopefully your teacher will be kind of like constantly referring you back to kind of engaging the pelvic floor.

So, the movements, I guess, different people have different styles of pregnancy yoga.

The classes that I teach tend to be, I guess, a little bit more active and more of a sort of kind of, if people have practiced yoga before and know the different styles and more of a vinyasa flow style.

So, we kind of, we move quite a lot, but we have big chunks at the beginning and the end of the class where we're relaxing and sleeping.

But like the middle chunk is more moving.

So, that kind of, you know, I'm generally constantly referring people to sort of imagining that sort of that squeezing and that lifting sort of sensation to kind of use the pelvic floor.

And so, if you're doing that a few times a week, that's gonna really be very beneficial to you.

The other thing that's really important is, I think a lot of women don't do, we talk about activating pelvic floor, but also relaxing it.

So, you know, if you need to be able to release it and soften it so that you can actually, will help you kind of be able to birth your baby.

And so, having some kind of connection with your pelvic floor, being aware of it, because a lot of women are like, where is my pelvic floor?

What is it?

I, you know, I sort of, you know, sort of am I doing it right?

I'm sort of like squeezing, squinting my eye a little bit and thinking that I'm still doing it.

And so, I think the more you do it and the more you can kind of tune in to where it is.

So, it's essentially, it's the muscles that kind of support your pelvic organs that are in the perineum.

So, between the sort of around the vagina and around the anus.

And so, they're the muscles that, they're sort of sets of muscles.

So, it's not just one muscle.

And if you imagine yourself, I'm just doing it now.

So, imagine yourself-

Imagine yourself squeezing as if you're trying to stop yourself from weeing.

That's kind of the front bit of your pelvic floor.

And then lifting and squeezing the vaginal muscles so as if you're sort of squeezing up and holding on to something is another set.

And then the back passage.

So, imagine you're stopping yourself from passing wind.

Yeah, exactly, I'm making squeezing, so I'm doing it as I'm talking.

And so that whole area at the base around the perineum is gonna be that support.

And so tuning into that and getting familiar with your pelvic floor, making friends with your pelvic floor is gonna be a really helpful thing to do through your pregnancy.

And then it will help you as well afterwards in terms of, for example, if you had to have an episiotomy or you had a tear or something like that, being able to easily get back into grips with that is gonna be good.

And then once you're in tune with that, you're able to more relax it.

You can use breath, you can use those focused calming sensations to just allow it to go as well.

Often when we talk through pelvic floor exercises and things in our courses, and often the women who've never realized that you're supposed to relax it as well, people that have done a lot of ballet, exercise, any kind of exercise where talking about engaging your pelvis, when people say that hold your core, any of that kind of exercise, that's when you can get quite an overly tight pelvic floor as well, can't you?

So it's kind of being able to relax it is just as important, and it is kind of often overlooked.

We kind of, I talk about it like if you were pumping iron, you wouldn't just kind of hold the weight and then kind of like gently pulse it.

The whole point is that you kind of completely relax and extend it in between.

And the same thing kind of goes to the pelvic floor.

And dads are always surprised when I tell them that they've got a pelvic floor as well.

Exactly, exactly, exactly.

Yeah, so that's, I mean, that's definitely a really super helpful benefit of yoga.

And we talk about the bandas in yoga.

So these are sort of like energetic locks, and one of them is around the pelvic floor.

So the Moola banda is an area where you can lift and hold on.

So that's one aspect.

And then, you mentioned about getting into those optimal birth positions.

So lots of yoga positions are forward and open.

So especially pregnancy yoga, we tend to focus on that more, sort of those all four kind of tabletop positions, and when we're doing the cat cowl kind of movements.

And if you don't know what I'm talking about, then Google is great for these sort of things.

You can have a look and see.

But anything that's kind of getting your baby sort of hanging down and forward, giving your baby that space, because we often kind of, I mean, I'm sure you've talked about this before, but that kind of thing of sitting in chairs, sitting on the sofa at night, we slouch back, we slouch back, and our babies kind of fall into that curve of our spine.

And it's a comfy position for your baby to be in.

It's a nice little hammock for them to nestle into, but it's not gonna be the best position for you to birth in.

We want the back of your baby's head to be facing the front, so a back-to-front position.

And by doing that, I normally say from about 32 weeks, to be doing even like 10, 15 minutes worth of those kind of positions a few times a week, it's gonna be really, really beneficial.

And we've all got, even if you're super, super busy and you've got a really busy job, we've all got 10, 15 minutes to just do that.

So I think that's a really, really great thing that perhaps other forms of exercise don't offer necessarily.

Yeah, absolutely.

Cool, so it's kind of, everything that we're talking about, it's always kind of quite easy to see how this fits in for women who have got uncomplicated pregnancies, fairly kind of straightforward births.

And generally, those women don't tend to meet obstetricians or doctors in pregnancy or in labor, where everything's kind of completely straightforward.

In the UK, we're just, it's a case of midwifery-led care in those situations.

So how can we start to incorporate some of this into pregnancy and birth for women who are kind of potentially facing more complex experiences?

And what can women be doing, but also what can we do as kind of healthcare providers to kind of maximize that experience for them?

Yeah, I mean, so I often get sort of people sort of saying to me, is it safe to do yoga when I've got X, Y, or Z?

So there's no evidence that it's not safe.

And in fact, the systematic review that I referred to, they alluded to the fact that they had some high risk women in that and it didn't worsen any of the outcomes for those women.

So there's a sort of extrapolation there that we can assume that it's not.

So in terms of evidence, it's not kind of unsafe.

So if you, for example, if you have complications like gestational diabetes or high blood pressure in pregnancy, it's not gonna do you any harm.

And in fact, it would probably do you some kind of benefit because any kind of movement and exercise is gonna help you maintain your weight, which is gonna make, hopefully maintain any kind of condition that you do have.

There are certain, I think there are certain things, for example, if you had a low-lying placenta, so if your placenta is over the cervix, there are certain things like squats and things like that that you probably shouldn't be doing.

Low squats are probably not the best thing to avoid.

But if you go to a yoga class and you tell your yoga teacher they should be able to adapt things for you.

Things like pelvic girdle pain as well.

A lot of women experience those kind of painful symptoms.

So again, when you're doing one-legged squat lunges and things like that, avoiding those kind of asymmetrical movements are probably sensible to do.

But again, that's something that if you're going to a class, a teacher should be able to help you with.

So those are really, I guess, the only main contraindications.

But otherwise, I think it should be something that is accessible to all women, and women shouldn't be put off.

Absolutely, if you've got any concerns, speak to whoever's looking after your care, your midwife or your obstetrician or your GP to just check in.

I don't want to be giving any advice out there.

But if you've got twin pregnancy, it's absolutely fun.

So one of my teachers, she had a twin pregnancy and practiced all the way up until birth.

So it's only going to benefit you.

We're not talking about running 10K.

We're talking about generally quite slow focused movements here, and it's going to help you with your joint mobility.

It's going to help you with balance and muscle strength, and tone, which will all be beneficial to you after birth as well.

So yeah, I mean, I don't know if that answers your question.

Yeah, yeah, yeah, absolutely.

I suppose kind of touching on that, do you find that your own yoga practice, and particularly working with pregnant women kind of outside of the obstetric setting, do you find that that's made your care as a doctor, would you say, more holistic?

Do you find that it affects that in any way?

I think so, definitely.

I mean, like I sort of talked about when we first started talking, that was my yoga practice before I even started being in a training in yoga.

I was using it just sort of like here and there, so we're women in labor.

And I often would recommend it to women.

I find myself sometimes in a kind of, we have the obstetric emergency units, it's sort of like an A&E for pregnant women and women that are coming in with various headaches and pains, I find myself down on the floor sort of demonstrating various poses that they can try and take home with them.

So I feel that I sit on both fences in a way, like for both sides of the fence, yeah.

And I think sometimes some of my colleagues maybe think I'm a bit odd for kind of doing it.

But most of the time, I tend to get really positive kind of feedback, because I think most women don't want an overly medicalised birth, and so if you're able to meet them on a more human level, rather than being this sort of distance doctor, it's gonna help those lines of communication, it's gonna help having that sort of shared kind of care towards their birth and what they want to have done.

And I think just being able to be more open and listen, and I think just practising yoga, it makes me more in tune with myself, and I think it makes me more in tune with myself.

You pick up a lot more in terms of maybe those levels of if people are feeling stressed or anxious, just being able to just take a moment to go, I can see you look nervous, what is it that's bothering you?

And just being able to take a bit more time to explore that.

I think all aspects of how yoga has changed my life, just having had the time out and having a bit more time in my week gives me more patience and being more understanding when I interact with the women that I see in the NHS, but also my experience in teaching women in my classes.

I tend to avoid focusing on the obstetric side of the stuff.

It's interesting, actually.

I get the odd question, but most of my students that come to me know that I'm an obstetrician as well.

And we just tend to focus on the yoga side of things.

So there's not a huge crossover, actually, into the yoga, but reverse-wise, bringing the yoga into the NHS is something that has been really, really great.

And it's actually really good.

I think we're starting to get...

There's a lot more healthcare workers that are becoming involved in various aspects of holistic care, whether it's acupuncture or yoga, and trying to bring that in.

Obviously, funding can be an issue, but there's ways around these things.

I know a local hospital near to me is not the one I work in, but it's great.

They do subsidised yoga classes in the hospital for the women that come to see them.

They do a free session of acupuncture and a subsidised reflexology.

I think the NHS is slowly starting to wake up, but there are real benefits that we can gain from these other services.

There's a trust near us that have their first line induction clinic.

There is no medical involvement whatsoever.

It's all acupuncture, relaxation, as getting women into a place where they're not full of cortisol and adrenaline and totally stressed from stopping the entire birth process.

But just getting them to go, so that if their baby's ready to be born, then they're more likely to go into labour.

I think that's really good results of it.

So before, we're kind of sometimes, the system that we're in at the moment, the guidelines and everything, we're kind of quite quick to jump to going straight for the medical solution to something.

But there's definitely a lot to be said for looking at a picture very holistically and considering not just the medical side of things, but the emotional side, the physiological side, all of it.

And when you consider them all together, you tend to get better results.

Better results and also just a better experience for women.

So I think it's amazing what you're doing.

That's great.

And how fantastic is that?

Because it's almost like, if they introduce that kind of policy, it means that they can use that as evidence to kind of put forward in other places, might start taking that up, if they're having good results with that.

Because that's what it needs.

Unfortunately, NHS can be a bit of a, clogs turning and so things get happening slowly.

So if you've got some kind of clear, this is a project that another hospital have done, and these are the results they've had, so you can put that forward and try and wheel it out to other hospitals.

It's a funny thing, isn't it?

Because it's always to do with money.

But you're like, in the long term, if we could have less inductions, then we'd be saving a hell of a lot of money.

And lots of less failed inductions, so things don't work, because women just aren't ready, and they're stressed in a hospital environment.

We've got political now.

I always end up getting political.

It's good.

It used to be said.

So the final question that I always ask all guests, I don't know if I prepared you for this one, but if you could gift a pregnant woman one thing, what would you give them?

Yeah, so I had to think about this.

In actual fact, this was a shameless plug as well.

So I film for my mums, I film pregnancy yoga videos, which are completely free.

It's a very low budget, self-filming kind of thing that a lot of my mums started asking for more classes.

So I filmed a set of anywhere between 15 and 30 minutes classes that are available on YouTube.

So basically, my gift would be, take 15 to 20 minutes for yourself each day.

Maybe do some breathing exercises.

There's breathing exercises on there.

Maybe do some yoga.

And just try and doing that for yourself three times a week.

So 15 minutes, three times a week to set aside for yourself and check in, do some whatever aspect of yoga you find useful.

And I think it will really benefit you for your pregnancy.

Amazing.

Fantastic.

So if people want to find that or they want to come to one of your in-person classes or they want to kind of reach out to you or get in touch, how can they do that?

So my website is www.yogadocuk.com, so yoga D-O-C-U-K.

And then I'm also on Instagram, yoga underscore doc.

And then if you want to check out my YouTube videos, I always find it really hard to find them.

But it's yoga doc TV if you're searching, and you should be able to find it.

And again, the link's available on my Instagram, so if you want to check it out there, then yeah, go ahead and find me.

And I teach in North London, so if you're around the area and you want to come and join in one of my pregnancy yoga classes, that's on a Thursday evening.

So yeah, come and get in contact.

Fantastic.

Well, that kind of wraps us up.

So thank you so much for joining me.

No, absolute pleasure.

Thank you so much for having me.

It's been really lovely.

Thank you so much for listening to this week's episode.

I hope you enjoyed it.

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