A note about inclusive language:
Given that many people who have uteri—such as women, transgender men and non-binary people—can and do carry pregnancies, I use non-binary language throughout this newsletter. We talk a lot about creating “safe” spaces in yoga and inclusive language plays a big role here. And a gentle reminder for anyone who struggles with the idea of non-binary language – teaching isn’t about you: it’s about meeting your students exactly where they are.
Yoga is widely used during pregnancy, and many pregnant people report that it helps them feel more confident, grounded, and supported throughout the childbearing experience. Let us look at what the research shows about yoga’s potential impact on pregnancy, labour, and birth outcomes. Below is an evidence-based excerpt adapted from my book The Physiology of Yoga, with practical guidance for yoga teachers.
👉 Can yoga influence pregnancy and labour outcomes?
A 2012 systematic review examining yoga for pregnant people concluded that yoga appears well indicated during pregnancy and may support improvements in a range of pregnancy, labour, and birth outcomes (Curtis et al 2012). The authors highlighted that yoga is low impact, easily modified, and considered safe when adapted to the individual. They also noted the need for further randomised controlled trials.
A systematic review by Riley and Drake (2013) explored the effects of prenatal yoga on birth outcomes. Due to limited research at the time, the review included both controlled and qualitative studies. They reported several potential benefits, including higher infant birth weight, fewer pregnancy complications, shorter labour, less reported pain, improved sleep quality, increased confidence, and improved interpersonal relationships. No adverse events were reported.
Kinser and colleagues (2017) reviewed yoga-based and physical activity approaches for pregnancy-related low back and pelvic pain. Their findings suggested that gentle movement, including yoga, can play a useful role in managing these symptoms.
Narendran and colleagues (2005) reported that an integrated approach to yoga during pregnancy reduced rates of intrauterine growth restriction, including cases associated with pregnancy-induced hypertension, without increasing complications.
Sleep has also been studied. A controlled trial by Beddoe and colleagues (2010) found no significant overall improvement in sleep with yoga. However, participants who began yoga in the second trimester experienced fewer awakenings and less awake time at night than those beginning in the third trimester.
👉 Does relaxin make joints more mobile?
It is common for people to associate increased flexibility in pregnancy with the hormone relaxin. Although joint laxity does increase during pregnancy and plays an important role in accommodating the growing foetus, the relationship with relaxin is not straightforward.
Generalised and metacarpophalangeal joint laxity appear to increase particularly in the second trimester (Cherni et al 2019). Around 45 percent of pregnant people and 25 percent of postpartum people experience pregnancy-related pelvic girdle pain or low back pain (Wu et al 2004). Low back pain is also more common in the second trimester (Carvalho et al 2017), and hand and wrist pain are frequently reported (Nygaard et al 1989).
However, the contribution of hormones to joint laxity remains unclear. A review by Dehghan and colleagues (2014) identified conflicting evidence, and Aldabe et al (2012) reported that high relaxin levels have not been directly linked to increased pelvic or peripheral joint mobility. Marnach et al (2003) similarly found that peripheral joint laxity does not correlate strongly with oestrogen, progesterone, or relaxin.
More research is needed to clarify the underlying mechanisms influencing joint mobility in pregnancy.
👉 Supine positioning in later pregnancy
From mid pregnancy onward, lying fully supine can compress the inferior vena cava and aorta, which may reduce venous return and lead to dizziness or a drop in blood pressure. To reduce this risk, avoid prolonged full supine rest after about 16 to 20 weeks. Side-lying, slight left tilt, or semi-reclined positions provide comfortable alternatives (ACOG 2020, RCOG 2017).
A common belief suggests that pregnant people should avoid lying on a particular side because it may obstruct blood flow. In reality, the concern relates primarily to lying flat on the back. Left lateral positioning may help optimise venous return later in pregnancy, but short periods on either side are generally safe.
In yoga, students traditionally roll onto the right side after savasana. This brief transition is typically safe for most pregnant students. For longer rest, especially in later pregnancy, teachers can offer left side-lying or a slight left-tilted position, or encourage students to choose any position that feels easeful and reduces dizziness.
👉 Other practical recommendations for yoga teachers
• If a student is new to yoga, prenatal yoga classes are the safest entry point.
• If a student already has an established practice, they may be able to continue with modifications, particularly after the first trimester.
• Movement and exercise, including yoga, are generally safe with respect to miscarriage and perinatal mortality (Davenport et al 2019).
• Encourage comfort-based pacing rather than intensity-based goals.
• Modify asymmetrical closed-chain poses for those with pelvic girdle pain. For example, in Warrior I, shorten and slightly widen the stance and lift the back heel to reduce pelvic strain.
• Use props freely to support balance as the centre of mass shifts.
• For students experiencing dizziness in standing poses, encourage slower transitions and wider stances.
• Avoid overheating, particularly in hot yoga environments.
• Maintain open conversations. Students are the experts on their bodies, and their lived experience should guide your teaching choices.
Teaching yoga to pregnant students is not about restricting movement. Instead, it is about supporting comfort, confidence, physiological safety, and autonomy.
References:
Aldabe, D., Ribeiro, D., Milosavljevic, S., and Bussey, M. D. 2012. “Pregnancy-Related Pelvic Girdle Pain and Its Relationship with Relaxin Levels During Pregnancy.” European Spine Journal 21 (9): 1769-1776.
American College of Obstetricians and Gynecologists. 2020. “Physical Activity and Exercise During Pregnancy and the Postpartum Period.” ACOG Committee Opinion No. 804.
Beddoe, A., Lee, K., Weiss, S., Kennedy, H., and Yang, C. 2010. “Effects of Mindful Yoga on Sleep in Pregnant Women.” Biological Research for Nursing 11 (4): 363-370.
Carvalho, M., Lima, L., de Lira Terceiro, C., Pinto, D., Silva, M., Cozer, G., and Couceiro, T. 2017. “Low Back Pain During Pregnancy.” Revista Brasileira de Anestesiologia 67 (3): 266-270.
Cherni, Y., Desseauve, D., Decatoire, A., Veit-Rubinc, N., Begon, M., Pierre, F., and Fradet, L. 2019. “Evaluation of Ligament Laxity During Pregnancy.” Journal of Gynecology Obstetrics and Human Reproduction 48 (5): 351-357.
Cramer, H., Frawley, J., Steel, A., Hall, H., Adams, J., Broom, A., and Sibbritt, D. 2015. “Characteristics of Women Who Practise Yoga During Pregnancy.” BMJ Open 5 (8).
Curtis, K., Weinrib, A., and Katz, J. 2012. “Systematic Review of Yoga for Pregnant Women.” Evidence-Based Complementary and Alternative Medicine 2012: 715942.
Davenport, M., Kathol, A., Mottola, M., Skow, R., Meah, V., Poitras, V., Garcia, A., et al. 2019. “Prenatal Exercise is Not Associated with Foetal Mortality.” British Journal of Sports Medicine 53: 108-115.
Dehghan, F., Haerian, B., Muniandy, S., Yusof, A., Dragoo, J., and Salleh, N. 2014. “The Effect of Relaxin on the Musculoskeletal System.” Scandinavian Journal of Medicine and Science in Sports 24 (4): e220-e229.
Evenson, K. R., et al. 2014. “Guidelines for Physical Activity During Pregnancy.” Journal of Women’s Health 23 (6): 487-505.
Goldsmith, L., and Weiss, G. 2009. “Relaxin in Human Pregnancy.” Annals of the New York Academy of Sciences 1160: 130-135.
Kinser, P., Pauli, J., Jallo, N., Shall, M., Karst, K., Hoekstra, M., and Starkweather, A. 2017. “Physical Activity and Yoga-Based Approaches for Pregnancy-Related Low Back and Pelvic Pain.” Journal of Obstetric, Gynaecologic and Neonatal Nursing 46 (3): 334-346.
Marnach, M., Ramin, K., Ramsey, P., Song, S., Stensland, J., and An, K. 2003. “Joint Laxity and Maternal Hormones in Pregnancy.” Obstetrics and Gynecology 101 (2): 331-335.
Nygaard, I., Saltzman, C., Whitehouse, M., and Hankin, F. 1989. “Hand Problems in Pregnancy.” American Family Physician 39: 123-126.
Narendran, S., Nagarathna, R., Narendran, V., Gunasheela, S., and Nagendra, H. 2005. “Efficacy of Yoga on Pregnancy Outcome.” Journal of Alternative and Complementary Medicine 11 (2): 237-244.
RCOG. 2017. “Exercise in Pregnancy.” Royal College of Obstetricians and Gynaecologists.
Riley, K., and Drake, E. 2013. “Effects of Prenatal Yoga on Birth Outcomes.” Journal of Prenatal and Perinatal Psychology and Health 28 (1): 3-19.
StatPearls Publishing. 2023. “Aortocaval Compression.”
Wu, W., Meijer, O., Uegaki, K., Mens, J., van Dieën, J., Wuisman, P., and Ostgaard, H. 2004. “Pregnancy-Related Pelvic Girdle Pain.” European Spine Journal 13: 575-589.