Many studies demonstrate the benefits of yoga during pregnancy, including shorter labor and improved newborn outcomes. The American College of Obstetricians and Gynecologists states that modified yoga is one of the safest exercises for pregnant women. But what exactly does modified yoga mean? ACOG cautions against specific poses and hot yoga. As with any activity, there is nuance in determining which activities are safe. This episode will examine the research on specific poses and on practicing yoga in a heated environment. Plus, the physical changes that can affect your practice, precautions, and tips for modifying yoga during pregnancy.

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Exercise in Pregnancy

There is a separate episode that provides an overview of exercise during pregnancy. That episode covers general recommendations, safety considerations, and how pregnancy-related changes and common symptoms can affect your workouts. It lays the foundation for understanding how to approach exercise during pregnancy, so I recommend listening to it first before diving into this episode on yoga.

What is Yoga?

Yoga is an ancient practice that has become increasingly popular. In general, yoga is a form of exercise that uses postures and movements to build strength, flexibility, and balance. It also incorporates breathing and meditation. There are many different types of yoga, ranging from practices focused on meditation and relaxation to faster-paced styles that emphasize strength and endurance. Within these disciplines, individual instructors also have their own teaching styles. This variety means you can find a yoga practice that matches your preferences, experience level, and pregnancy needs.

Benefits of Yoga

There is quite a lot of research on the benefits of yoga. Evidence shows that yogic practices enhance muscular strength and body flexibility, promote and improve respiratory and cardiovascular function, promote recovery from and treatment of addiction, reduce stress, anxiety, depression, and chronic pain, improve sleep patterns, and enhance overall well-being and quality of life.

Benefits of Yoga During Pregnancy

There are also many studies demonstrating the benefits of yoga during pregnancy. A clinical trial found prenatal yoga reduced labor induction rates, preterm delivery, cesarean sections, and time in labor. It also improved newborn outcomes and APGAR scores. A study found yoga can empower pregnant women in increasing their quality of life by reducing the uncomfortable experiences, stress, anxiety, and depression pronounced during the COVID-19 pandemic. A randomized controlled trial found lower cesarean rates among participants who practiced yoga. They also had a shorter first stage of labor and a better tolerance for pain. Some research shows you can use yoga as an intervention for depression and anxiety during pregnancy.

Researchers often exclude women with high-risk pregnancies or complications from studies on exercise during pregnancy. This is not the case when examining research on prenatal yoga. Studies show that yoga is safe for high-risk mothers and has mental and physical benefits. A randomized study of yoga in high-risk pregnancies suggests that guided yogic practices and visualization can improve fetal growth and placental blood circulation. Another study found yoga to be an effective therapy to reduce maternal stress levels in high-risk pregnancies.

Physical Changes During Pregnancy that Can Impact Your Yoga Practice

Before we dive into specific safety considerations, it is helpful to understand how pregnancy changes your body in ways that directly affect your yoga practice. Being aware of these changes helps explain why certain precautions are in place and why modifications may feel necessary as your pregnancy progresses.

Relaxin and Joint Stability

The hormone relaxin makes your ligaments, tendons, and joints more relaxed during pregnancy. This is helpful for your growing body and for birth, but it also increases your risk of injury. Ligaments provide joint stability, and when they are looser, you may be able to stretch further than usual. While this increased flexibility might feel good in the moment, it can put you at greater risk of overstretching or straining a joint. You want to be mindful not to push too far into stretches, even if your body feels like it can go deeper than it did before pregnancy.

Changes to Your Center of Balance

Your growing belly throws off your center of balance, making advanced poses requiring a lot of balance more challenging. As your pregnancy progresses and your belly grows, your center of gravity shifts forward. This affects your stability in poses, particularly standing balances or inversions. A pose that felt easy in your first trimester may feel unstable in your third trimester.

Core Strength and Abdominal Changes

Your core is likely not as strong because you have a baby growing, and all of the ligaments in your belly are stretched. Your abdominal muscles are working hard to accommodate your growing uterus, and they may even separate slightly, a condition called diastasis recti. This changes how your core functions and may affect poses that rely heavily on core engagement.

Cardiovascular Changes

During pregnancy, your blood volume increases by 50%. This affects your heart rate and blood pressure because your heart pumps more blood volume. You may notice that your heart rate rises more quickly during movement or that you feel more winded during a yoga flow than you did before pregnancy. These are normal adaptations, not a sign that you need to stop practicing.

ACOG Recommendations for Yoga During Pregnancy

The American College of Obstetricians and Gynecologists states that modified yoga is one of the safest exercises for pregnant women. ACOG notes that yoga reduces stress, improves flexibility, and encourages stretching and focused breathing. There are prenatal yoga and Pilates classes designed for pregnant women. These classes often teach modified poses that accommodate a pregnant woman’s shifting balance. ACOG does caution that you should avoid poses that require you to be still or lie on your back for long periods. The organization also advises against hot yoga, which may cause you to become overheated. It is important to remember that guidelines from the American College of Obstetricians and Gynecologists will always err on the side of caution and are blanket recommendations designed to apply to most pregnant mothers. Let’s examine the research on yoga in pregnancy regarding safety to understand the nuances behind these recommendations.

What the Research Says About Specific Poses

In the past, many poses were avoided during pregnancy due to safety concerns. One study examined 26 poses and found them safe during pregnancy. This included poses such as happy baby and child pose, which were previously discouraged during pregnancy. See this Harvard University article for an excellent summary of the research and a list of all poses.

This research is encouraging because it shows that many poses previously thought to be unsafe are actually fine for most pregnant women. That said, safety during pregnancy is always about context. Your experience level, how your body feels, and any pregnancy complications matter when deciding which poses work for you.

Inversion Poses

There have been some questions about the safety of inversions during pregnancy. An inversion is any pose where your head is lower than your heart. This can range from downward-facing dog to a handstand, with many poses in between. Inversion poses require your heart to work harder to pump blood against gravity to the part of your body above it.

Unfortunately, I could not locate any research on yoga inversions during pregnancy. From a liability standpoint, it is always safer to advise against something during pregnancy, especially when there are unknowns or insufficient evidence. Like any yoga practice, you must consider your experience level and comfort.

A small study examined the effects of inversion using an inversion table, which allows you to invert by strapping your feet to a device and hanging upside down. As the participants were inverted, their heart rate decreased, and their blood pressure increased. If you have any issues with blood pressure during pregnancy, like high blood pressure (hypertension), preeclampsia, or eclampsia, you should talk to your doctor or midwife before attempting any inversions.

For most healthy pregnant women with yoga experience, gentle inversions like downward-facing dog are likely fine. More advanced inversions, like headstands or handstands, carry a higher risk simply because of the potential for falling. If you have a regular inversion practice and feel comfortable continuing, discuss it with your care provider and pay close attention to how your body feels.

Poses on Your Back

The American College of Obstetricians and Gynecologists cautions that you should avoid poses that require you to be still or lie on your back for long periods. This is because, as your uterus grows, it puts more pressure on your vena cava. Your vena cava is the main vein that carries deoxygenated blood from the lower half of your body back to your heart. If there is a lot of pressure on this vein, it could decrease the flow of blood, which could ultimately reduce your oxygen and oxygen getting to your baby.

When researchers have looked at this more closely, the evidence is less definitive than many people expect. A systematic review to determine whether prenatal supine exercise is associated with adverse outcomes found that although many countries caution against supine exercise after 16 weeks, these recommendations are primarily based on expert opinion rather than explicit scientific evidence. The researchers concluded that supine exercise is not associated with adverse pregnancy outcomes. There is insufficient evidence to determine whether exercise in the supine position is safe or should be avoided during pregnancy.

There is a difference between spending several hours on your back and lying on your back for a few minutes during a yoga pose. You can modify some poses to be in a more inclined position rather than flat on your back. You can also alternate between poses on your back and other upright positions, or reduce your time in the supine position.

The most important factor is how you feel. If you feel lightheaded, nauseated, short of breath, or uncomfortable while on your back, that is a signal to change position. You can always skip any poses or positions that make you uncomfortable.

Hot Yoga and Bikram Yoga

ACOG advises against hot yoga due to the risk of overheating. There is a concern about an elevated core temperature causing neural tube defects, spontaneous abortion, and other abnormalities when you are expecting.

We have decades of studies in animals and humans showing a strong correlation between hyperthermia and neural tube defects. Hyperthermia occurs when your core temperature remains elevated for a prolonged period. There is evidence of an increased risk of neural tube defects among fetuses exposed to excessive heat during the first trimester. This research primarily focused on hot tubs and saunas.

It is generally recommended that you limit hot tub use to less than 15 minutes or avoid it altogether. You tend to reach a higher core temperature in a hot tub than in a sauna or a hot yoga room. You sweat in a sauna or yoga studio, which can help lower your core temperature, rather than submerging yourself in a hot tub where perspiration prevents you from cooling down.

The big question is whether hyperthermia can occur during hot yoga. An American Council on Exercise study took a group of participants who swallowed a core body temperature sensor. Researchers could remotely monitor core temperatures while participants underwent a 60-minute yoga class in a room heated to 70 degrees Fahrenheit (21.1 degrees Celsius). Then, 24 hours later, the same participants underwent a yoga class in a room heated to 92 degrees Fahrenheit (33.3 degrees Celsius). The researchers did not find a difference in the core temperature increase between the two rooms. The highest recorded temperature among participants was 102.4 degrees Fahrenheit, just over the 102 degrees Fahrenheit (38.9 degrees Celsius) threshold we prefer to keep temperatures below during pregnancy. In a room heated to a temperature higher than 92 degrees Fahrenheit (33.3 degrees Celsius), it is possible you could see more of an increase in core temperature.

The takeaway is that hot yoga may raise your core temperature, particularly if the room is very hot or if you are working at high intensity. The risk is highest in the first trimester when neural tube development is occurring. Please discuss practicing yoga in a heated environment with your doctor or midwife. If you are comfortable and continue heated yoga during pregnancy, please remember to leave the room and cool off if you feel overheated. In addition, being in hotter temperatures and sweating require drinking more fluids to stay hydrated.

Experience Level Matters

There is a big difference between someone new to yoga and someone with regular practice. Someone with extensive yoga experience can perform more advanced poses for longer periods with less fatigue. With regular practice, you learn the correct way to perform poses and how to regulate your breathing. If you have a well-established yoga practice, you likely have good body awareness and know when something does not feel right.

For someone new to yoga, it takes time to learn how to correctly position your body in poses and movements to get the most out of a pose and stay safe from injury. A yoga class is a fantastic resource for beginners. A class allows you to learn and get instruction and feedback on poses from an experienced teacher.

Your experience level should inform your approach to yoga during pregnancy. If you are an experienced yogi, you may feel comfortable continuing many of the poses you practiced before pregnancy with appropriate modifications. If you are new to yoga, starting with a prenatal or gentle beginner class can help you build a safe foundation.

Finding a Prenatal Yoga Class or Instructor

If you are interested in taking a yoga class during pregnancy, prenatal yoga classes are specifically designed for expectant mothers. These classes are taught by instructors who understand the physical changes of pregnancy and can offer appropriate modifications.

Prenatal classes also provide an opportunity to connect with other pregnant women, which can be a valuable source of support. When looking for a prenatal yoga class or instructor, consider the following. Look for instructors with prenatal yoga certification or training. This ensures they understand pregnancy-specific safety considerations and modifications. Ask about class size. Smaller classes allow for more individual attention and personalized guidance. Check what trimester the class is designed for. Some studios offer classes for specific trimesters, while others have mixed groups. Consider the class environment. Is the studio easily accessible? Is the temperature comfortable? Do they provide props like blocks, bolsters, and straps?

If you cannot access in-person prenatal yoga classes, there are many online options available. YouTube has free prenatal yoga videos, and several apps and websites offer prenatal yoga programs. When practicing at home, make sure you have a safe space with enough room to move and access to props or household items you can use.

Modifying Your Yoga Practice for Pregnancy

The beauty of yoga is that you can modify any pose. You can use a block for stability or shorten the distance you need to stretch. A wall can help you balance. You control how far you take each stretch and how long you hold each pose. Awareness of how you feel will go a long way toward telling you whether your body agrees with a pose or is uncomfortable. As your body changes, your yoga practice may need to change too.

Here are some general guidelines for modifying your yoga practice during pregnancy. In standing poses, you may want to widen your stance to accommodate your belly and improve your balance. For twists, focus on twisting from your upper back and shoulders rather than your belly. Avoid deep twists that compress your abdomen. In forward folds, create space for your belly by widening your legs or using props. You do not need to fold as deeply as you did before pregnancy. For balancing poses, use a wall or chair for support. Your shifted center of gravity makes balancing more challenging, and there is no shame in using support. In poses on your belly, like cobra or bow pose, you can modify by doing them on your hands and knees or skipping them altogether.

Props can be incredibly helpful during pregnancy. Blocks can bring the ground closer to you in standing poses. Bolsters or pillows can provide support in restorative poses. Straps can help you reach your feet in seated forward folds without straining. Blankets can provide cushioning for your knees or support under your hips.

Breath, Core, and Pelvic Floor in Yoga

Yoga emphasizes breath, which becomes even more important during pregnancy. Breathing plays a central role in how your core and pelvic floor function. When we talk about the core during pregnancy, we are not just talking about the abs. Your core includes your abdominal muscles, your diaphragm, back muscles, and pelvic floor. These muscles work together to manage pressure inside your body and support movement.

Holding your breath or constantly clenching your abdominal or pelvic floor muscles can increase pressure in ways that are not helpful, especially as your uterus grows. On the other hand, gentle coordination between breath and movement can help support your spine, reduce strain, and make poses feel more comfortable.

In yoga, you will often hear cues to breathe deeply or to coordinate breath with movement. This practice of conscious breathing can be incredibly beneficial during pregnancy and can also serve you well during labor and birth. You do not need to overthink breathing or consciously control every breath. It means avoiding prolonged breath holding, avoiding constant tightening, and paying attention to how your body responds.

Many prenatal yoga classes also incorporate pelvic floor awareness and gentle exercises. Your pelvic floor supports your growing uterus, and learning to engage and relax these muscles can be helpful for birth and postpartum recovery.

Warning Signs

Most of the warning signs that indicate you should stop exercising or halt your yoga practice are obvious. The list from ACOG includes regular, painful contractions of the uterus, bleeding, fluid gushing, or leaking from the vagina. Other warning signs include feeling dizzy or faint, shortness of breath before starting, chest pain, headache, muscle weakness, calf pain, or swelling. If you are uncomfortable at any point, skip the pose, change positions, or take a break.

In addition to these warning signs, pay attention to how your body feels during your practice. If a pose causes sharp pain, stop immediately. Mild discomfort or a stretching sensation is normal, but pain is a signal that something is wrong. If you feel overly winded or like your heart rate is uncomfortably high, slow down or take a child’s pose. If you feel pressure in your pelvic floor or a sensation of heaviness, this could be a sign to modify or avoid certain poses.

Yoga Gear and Clothing for Pregnancy

You do not need much equipment to practice yoga. A yoga mat provides cushioning and helps prevent slipping. If you are practicing at home on a hard floor, a mat is essential for comfort. As your pregnancy progresses and your belly grows, you may find that your regular workout clothes feel too tight or restrictive. Maternity yoga pants or leggings with a supportive belly band can improve comfort. A supportive sports bra is important, especially as your breasts grow and become more sensitive.

Props like blocks, straps, and bolsters can be helpful but are not essential when starting. Many household items can serve as substitutes. A firm pillow or folded blanket can replace a bolster. A belt or towel can work as a strap. Books can substitute for blocks in some poses.

Practicing Yoga at Different Stages of Pregnancy

Your yoga practice may look different in each trimester. In the first trimester, fatigue and morning sickness may make it challenging to maintain your usual practice. You may need to practice at different times of day when you feel better or reduce the length or intensity of your sessions. Many women feel their best in the second trimester and may be able to practice more regularly or with more intensity. In the third trimester, your growing belly, fatigue, and other physical changes may require more modifications. You may find that restorative or gentle yoga feels better than more vigorous practices.

Throughout your pregnancy, the most important thing is to listen to your body and adjust your practice accordingly. There is no need to maintain the same level of intensity or achieve the same poses you did before pregnancy. The goal is to stay active and feel good in your body.

Yoga After Birth

While this episode focuses on prenatal yoga, it is worth briefly mentioning postpartum yoga as well. After your baby is born, yoga can be a gentle way to reconnect with your body, rebuild core and pelvic floor strength, and take time for yourself. Most care providers recommend waiting until after your postpartum checkup, typically around six weeks after birth, before returning to exercise. Postpartum yoga classes are designed to address the specific needs of new mothers, including core restoration, pelvic floor health, and stress relief. If you do not have access to a postpartum yoga class, starting with gentle, restorative practices and gradually building back to more vigorous practice can be a safe approach.

Talk to Your Doctor or Midwife

You should discuss your exercise and activity with your doctor or midwife in the context of your level of experience and the particulars of your pregnancy. Yoga is considered one of the safest exercises you can do during pregnancy. Some types of yoga or specific poses may have additional risks when you are pregnant. Whether you are an experienced yogi or are just starting, you can modify almost any pose to be safe and comfortable, even when you are nine months pregnant.

If your care provider has reservations about your yoga practice, take the time to understand their concerns. If you have a high-risk pregnancy or specific complications, their guidance may be more conservative, and there may be good reasons for that. On the other hand, if you are healthy and have an uncomplicated pregnancy, many providers will support you in continuing the yoga practice that feels right for you.

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