Yoga as Medicine for Labor and Postpartum

Current standards of practice in maternal care have been cited as “a human rights failure” in the US¹. Not due to the lack of medical services but the overuse of medical interventions during birth,^2,3,4 hospitals that have “reduced medical interventions” and have improved “access to woman-centered care have fewer deaths and lower health care costs”^1,3,4

Enter yoga as an ideal paradigm for “woman-centered care” that minimizes the need for technocratic birth, the medicalization of pregnancy and birth as a pathology rather than a natural condition. Patient satisfaction and self-confidence, which also suffers under the current biomedical model, is likewise improved by the self-care and self-empowerment emphasis of yogic medicine and its philosophy.

Yoga as a contemplative science and practice is a burgeoning field whose evidence-base is fast growing. This course combines pelvic rehabilitation and yoga in order to optimize childbirth outcomes and postpartum rehabilitation.

Yoga offers an evolutionary paradigm-shift that modernizes standard biomedical prenatal and postpartum care, through the WHO and IOM-endorsed lens of biopsychosocial practice⁵. Even more is yoga, when informed by rehabilitative science, can advance the creative dialogue of rehabilitation and yoga practice, paving the way for yoga to become an innovative best-care practice in prenatal and postpartum rehabilitative care.

Prenatal yogic medicine can be used in childbirth education and coaching, as well as postpartum care, and has been shown to improve labor and delivery outcomes, affect genetic transcription and expression, improve HPA Axis regulation and gut microbiome colonization, and can also well address pre-existing or perpetuating issues such as chronic pain, depression, anxiety, diabetes, cardiovascular disease, and weight management. All of these comorbid conditions have a vital role in determining rehabilitation outcomes and should be addressed in regular care. However, for example, in comorbid conditions like pelvic pain and depression, pharmacological side effects, and the stigma of seeking mental health treatment can severely diminish adherence to biomedical interventions⁶. As a mind-body intervention, yoga during pregnancy can increase birth weight, shorten labor, decrease pre-term birth, decrease instrument-assisted birth, reduce perceived pain, stress, anxiety sleep disturbances, and general pregnancy-related discomfort and quality of life physical domains^7,8. Yoga offers an optimal evidence-based strategy that can positively affect the underlying neuroendocrine issues that ultimately dictate therapeutic outcomes.

The WHO recommends that postpartum checkups include screening for back pain, incontinence, hemorrhoids, constipation, fatigue, breast pain, perineal pain, depression, painful intercourse, headaches, bowel problems, and dizziness or fainting. The yogic medicine paradigm can influence all of these conditions through systems-based intervention.

A combination of didactic lecture and interactive lab formats, including differential diagnosis and general prenatal and postpartum biopsychosocial screening will prepare the clinician to immediately apply the medical therapeutic yoga paradigm of practice. The 2-day course will also include business practice discussion and technical support for developing your new platform and clinical specialty niche in medical therapeutic yoga practice.

Sources
1. Coeytauz et al., Maternal Mortality in the US: A Human Rights Failure. Contraception Editorial, March 2011. http://www.arhp.org/publications-and-resources/contraception-journal/march-2011
2. Kuklina E, Meikle S, Jamieson D, et al. Severe obstetric morbidity in the US, 1998–2005. Obstet Gynecol. 2009;113:293–299.
3. Tita ATN, Landon MB, Spong CY, et al. Timing of elective cesarean delivery at term and neonatal outcomes. NEJM. 2009;360:111–120.
4. Clark SL, Belfort MA, Byrum SL, Meyers JA, Perlin JB. Improved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety. Am J Obstet Gynecol. 2008;199:e1–105.e7.Abstract | Full Text | Full-Text PDF (100 KB)
5. WORLD HEALTH ORGANIZATION., 2002. Towards a common language for functioning, disability and health : ICF. Geneva: World Health Organisation.
6. Buttner, M. M., Brock, R. L., O'Hara, M. W., & Stuart, S. (2015). Efficacy of yoga for depressed postpartum women: A randomized controlled trial. Complementary Therapies in Clinical Practice, 21(2), 94-100. doi:10.1016/j.ctcp.2015.03.003 [doi]
7. Sharma, M., & Branscum, P. (2015). Yoga interventions in pregnancy: A qualitative review. Journal of Alternative and Complementary Medicine (New York, N.Y.), 21(4), 208-216. doi:10.1089/acm.2014.0033 [doi]
8. Curtis, K., Weinrib, A., & Katz, J. (2012). Systematic review of yoga for pregnant women: Current status and future directions. Evidence-Based Complementary and Alternative Medicine : ECAM, 2012, 715942. doi:10.1155/2012/715942 [doi]

Audience:

This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.

Prerequisites: None

Pre-Readings: There are no assigned pre-readings for this course

What to bring:
1 yoga mat
2 yoga blankets (Mexican blankets are fine)
1 yoga strap (quick release buckle)
2 yoga blocks
Participants should wear comfortable exercise clothes for this course