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This blog is for sharing interesting information about yoga, pregnancy, birth, parenting and anything else I think you might be interested in!

 

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By Tessa of www.tessayoga.co.uk, Jan 11 2017 01:59PM



I teach Pregnancy Yoga and the number of my clients that are induced is much higher than I would like. When I open an email with a birth story from a new mum and she writes “then I was induced”, my heart sinks because it often ends in a caesarean.1 Don’t misunderstand me; there are times when I am so grateful that we live in a place where women have access to that life-saving surgery. However, when I read their birthing stories, which are often very detailed, I can see that there is a grey area where if they had been given a little more time before being induced, or being augmented where contractions were weak, given consistent care so they felt in familiar hands or had a doula that could provide an underlying confidence in natural birth, the outcome may have been different. I sometimes feel that the system is failing pregnant women in this respect and I want to talk about two things that women who are planning to conceive can do to increase their confidence in making a decision around induction.



As a pregnancy yoga teacher I am very careful about what I say regarding whether to be induced or not. Some women who have told me their stories felt pressurised to be induced and talk about being emotionally bullied by health professionals. There is talk about putting the baby at risk of dying. It is a very strong woman who with that having been said out loud by their care-giver can say that they still want to wait and not be induced. Usually they will have done a lot of reading beforehand and are well versed in statistics, physiology and other things that make them resolute as long as their baby appears happy and healthy in utero. If you are a woman that did not know that induction can lead to a cascade of intervention you might not have thought to read up about it. Or you may just be so desperate to meet your baby, you ask to be induced earlier than recommended, perhaps having a sweep on your 40 week appointment. Given that due dates are an approximation, we can easily do something that will give us confidence about when our baby is likely to be ready to trigger labour.



Prevalence of induction

First, a bit of context. The 2014 NICE guidelines state that information to women at the 38 week appointment should cover the possibility of induction between 41+0 and 42+0 weeks.2 The Maternity Statistics for England for the year ending 2014, reported an induction rate of 25.0%, which is part of an upward trend.3 Locally, an ‘uncomplicated singleton’, that is, a healthy single baby, would be induced at 40+12 (rather than 42 weeks) and that has led to the number of inductions increasing to 15.5% in 2014-15. This is lower than the national average, but this does not include the women who were augmented for weak contractions, which account for another 13.4%. Of those induced (rather than augmented), 21.8% were induced within 7 days of the estimated date of delivery (EDD), 33.4% after 41 to 42 weeks and 9.3% at 42 weeks, and 53.9% of those induced were nulliparous (first babies). There were only two that went ‘significantly over’ the 42 weeks, with one being a typo with 50 weeks being recorded! These figures show you how importantly a hospital will take your ESTIMATED date of delivery (but also how mistakes are made).


A meeting organized by the World Health Organization on Appropriate Technology for Birth, held in Brazil in 1985, recommended that “No geographic region should have rates of induced labour over 10%”.4 Obviously we are well over that figure in England, but practices around the world show that lower rates are possible. Ina May Gaskin has delivered thousands of babies at ‘The Farm’ in Southern Tennessee with a spontaneous birth rate of 94.5%.5 This is compared to 60.3% of spontaneous births at my local hospital (which included the augmented deliveries, which The Farm’s data does not).1 Some practices within the UK have other thoughts, like the now-closed Albany Midwifery Practice, whose co-founder states: ‘some mothers with pregnancies of 42 weeks or longer need reassurance that they are neither crazy nor irresponsible for resisting induction when all signs are good’.4 I had a mother in my class who personally gestates for 43.5 weeks, so did her mother and grandmother: that is normal for her family.

My story of going overdue

With my first daughter, Zara, I was booked in for an induction at 42 weeks at my 40 week appointment. The 42 weeks arrived and I went into the hospital with my husband for the appointment. Zara was fine and it was suggested that I be given a pessary to start induction. I said that I would rather wait since she appeared very happy there and fortunately I wasn’t given a talk about risking my baby’s life. The maternity department was very busy that day and the midwife had to keep leaving to assist with births. Five times she came back and offered me the pessary and five times I reminded her that I didn’t want it thank you very much. On the fifth time, she suggested a sweep and I agreed, something that in retrospect I would refuse if I was in that situation again. I agreed that I would return for monitoring each day. I was happy that I had done my reading and had a supportive partner with me at the hospital. Fortunately I went into labour that night and she was born at 11am the next day. Our decision was based on two things: one, the fact that the monitoring said my baby was fine (I instinctively knew that to be the case) and, two, that I knew precisely when she had been conceived and that my EDD was wrong. She wasn’t an IVF baby, but I had been charting my cycle ahead of conceiving and knew when I had become pregnant by a sustained rise in basal temperature. That information gave me so much confidence.



I had read Taking Charge of Your Fertility by Toni Weschler (www.tcoyf.com) and was charting my basal temperature, cervical mucus (or juices as I prefer a non-clinical sounding term), and recording when we made love. I found this process of charting exciting and it made me appreciate the intricacies of my body. The charting helps you understand when you are ovulating and make the most of your fertile phase (or conversely to avoid it if you are not wanting to become pregnant). You can tell when you are pregnant because instead of the temperature going down again, it remains elevated and signals buying the pregnancy test. Just imagine how having this piece of information of the day of conception can give you ammunition in the face of induction! When I was pregnant with my second daughter, I not only knew again the precise date of her conception, but also the length of gestation with my first baby. Before my first baby, my cycle was usually 32 days long and so the EDD would have always have been a bit out, notwithstanding sperm sometimes taking a couple of days to reach their target! Imagine how if my daughters have children, they could know not only the date of conception for their baby, but how long they were in utero before a spontaneous delivery. Generation on generation, we will know what has happened in our family: that is, what is normal for us.


Developing menstrual awareness

Since having Zara, I came across Alexandra Pope and her incredible work on menstruality. In her workbook, Women’s Quest, she focuses more on the emotional journey of the menstrual cycle than the physical signs. With Sjanie Hugo Wurlitzer, she has set up the Red School Online that enables a woman to reflect deeply on her menstrual cycle and the wisdom inherent in it. I intimately know my menstrual cycle and chart my emotions, physical signs and dreams day by day. It has given me a deep trust in my body and I am aware when I have not taken enough rest or paced myself kindly. I know that every four or five months I will have a longer cycle of 36 days and so I don’t worry about it; I’m happy to wait. I dream that more and more women will come to see their cycle not as a nuisance, but as a highly-tuned well-being sensor. And that their bodies are amazing.



If women trust that their bodies are amazing that would make my work as a Pregnancy Yoga teacher much easier! Sometimes I feel as if I am asking women to make a giant leap from distrusting their bodies that for so long they were worried about becoming pregnant through their teens, twenties, (thirties), that leaked menstrual blood at inconvenient times, or that they took pills to regulate the bleeding or to get rid of it totally, to feeling that their (pregnant) body was incredible and natural birth was possible. I do see that giant leap happening in class because pregnancy is a time of openness and the upcoming birth is a big motivator, but how much easier it would be if women were supported to already appreciate the awesomeness of their bodies. The transformation of pregnancy would be just the proof. This knowledge may result, not an induction where control of birth is given over to the hospital, but in allowing time to birth at the woman and her baby’s own pace. How empowering would that be?



For those women who experienced a challenging birth, you might find support from meeting with your Consultant Midwife to understand what happened, meeting with a Talking Therapies counsellor (postnatal women are prioritised), giving feedback through the local Maternity Forum anonymously or otherwise, seeking support through online groups or keep on talking it through with friends (but please not pregnant ones!) I hope though that you might approach your cycle, when it returns after the birth, with a new perspective. I feel that cycle awareness can provide a lot of healing and help us prepare for future children, and down the line, a smoother menopause.



Gifts of menstrual awareness for pregnancy and birth

By practising menstrual awareness we become experts on our own well-being, and thus can make more informed decisions when it comes to the well-being of our unborn babies too and trusting our instincts about our embodied experience. We realise through connecting with other women who are cycle aware that there is a diversity in the length of our cycles and we experience them differently (and similarly pregnancies last different lengths). Through charting our cycles before becoming pregnant, we have more accurate information on the date of conception rather than an estimate based on every woman’s cycle being the same length. This knowledge is personal power in the face of institutional policies and constraints.



Want to get started? Find a Red Tent near you ( I host the Caversham, Berkshire one) or visit the Red School Online. I am planning to run menstrual awareness workshops for couples so please get in touch if you are interested at www.tessayoga.co.uk (or for workshops for pregnancy yoga teachers/ doulas or mother blessings or FREE resources for pregnancy/postnatal women).



1 At my local hospital, the Royal Berkshire Hospital, if a nulliparous woman is induced she has a 33% chance of that leading to a caesarean. Source: Siddall, J. Maternity Services Report 2014-5; Royal Berkshire Hospital, Reading.

2See here for a summary of the guidelines: https://www.nice.org.uk/guidance/cg70/chapter/1-Guidance

3The NHS Maternity Statistics, England: 2013-14 can be found on the Health and Social Care Information Centre website at http://www.hscic.gov.uk/catalogue/PUB16725

4Wagner, M. Pursuing the Birth Machine: The search for appropriate birth technology. Camperdown, NSW, Australia: ACE Graphics, 1994.

5Gaskin, IM (2003) Ina May Gaskin’s guide to childbirth. Bantom Books: New York.

6Reed, B. (2016) Birth in Focus: Stories and photos to inform, educate and inspire. Pinter & Martin; London.












By Tessa of www.tessayoga.co.uk, Jul 5 2016 08:39AM

In the pregnancy yoga classes that I teach, I'm always talking about the importance of being able to move your pelvis to help your baby move through more easily. Recently, I've also been talking about how you can physically make more space through the pelvic girdle. Here are three documents that illustrate what I'm talking about: Diagram of female pelvis; Pelvic inlet and outlet; and Increasing the spine to pelvis angle.


**These documents are part of a super duper new antental education course that I am starting with a multidsciplinary team in January 2017, but it seems mean not to share these with you now**


The 'Diagram of the female pelvis' shows you what your pelvis looks like. It is a different shape from a male pelvis and has evolved to let babies, even big babies, move through. It's really good to relate it to your own body: start with finding the hip bones (labelled iliac crests), then from your navel move down to the pubic symphysis (the pubic bone in the centre, which is front of your urethra), then trace down your spine to the sacrum and feel between the buttocks for the coccyx (tailbone).


The 'Pelvic inlet and outlet' document shows you in life-size that the inlet is widest from side to side and the outlet is widest from front to back. Moving around during labour enables you to get your tailbone and ischial spines out of the way. If women are lying on their back during labour, they will try to push their bottom up away from the bed to enable this 'foetal ejection reflex' or what is called 'opening of the back' in some some cultures.


The increasing the spine to pelvis angle' document shows you the ideal position to be in to increase the space for your baby to get into the optimal position for entering the pelvic inlet. The birth canal isn't straight, but curves and therefore having the front of the pelvis tipped forward gives the baby a lot more space to enter the birth canal in the best position.


You might like to try this exercise at home. Lie briefly on your back to measure from the back of the pubic bone to the sacrum. You are looking for a rough measure not scientific accuracy! Usually you can just reach between the tip of your thumb and middle finger. Then move into the standing posture in the third document. Make sure your hips are higher than your knees, your tailbone is lifting and that your legs are at least hip width apart. Try to measure again and you will no longer be able reach! Add to this the peak of hormones that will be circulating at the end of pregnancy to soften the pelvic joints and the moving you will be doing during birth, and this all adds up to MORE SPACE for the baby to move through!


I would thoroughly recommend The Female Pelvis by B. Calais-Germain and Understanding and Teaching Optimal Foetal Positioning by J. Sutton and P. Scott for more about this topic.

By Tessa of www.tessayoga.co.uk, Apr 25 2016 09:50AM

You may or may not have heard of the Dirty Dozen and the Clean Fifteen. These are lists published each year by the USA Environmental Working Group (EWG) with the fruit and vegetables with the highest concentration of pesticides (Dirty Dozen) and those with the lowest (Clean Fifteen). They also examine the number of different pesticides that each one contains. This is important because research shows that children have "unique susceptibilities to [pesticide residues'] potential toxicity” (American Academy of Pediatrics 2012). The pediatricians' organization cited research that linked pesticide exposures in early life and "pediatric cancers, decreased cognitive function, and behavioral problems."


In the UK we have the Pesticide Action Network (PAN) that has a list that you can find here: http://www.pan-uk.org/food/best-worst-food-for-pesticide-residues. This is based on older data, rather than being updated yearly like the US one, but you see the same culprits occurring again and again in the lists. It is also worth knowing that some pesticides that are used in the US are banned in the EU so that can be a reason for fruits and vegetables being in different places in different lists.


The worst fruits listed by PAN are: soft citrus, pineapples, pears, apples, grapes, strawberries, peaches, nectarines and apricots. The worst vegetables are: tomatoes, parsnips, cucumber, carrots, lettuce, beans in a pod, peas in a pod, sweet potatoes, courgettes, marrows and yams.




So what does this mean for you as a shopper? Obviously, I’m not suggesting you avoid eating these foods because a variety of fruit and vegetables are good for you. Instead, I would suggest buying organic for those that are on the worst list. This means that you don’t have the cost of buying everything organic if you can’t afford to, but can be selective in where you put your money. Not listed there, but also susceptible to high concentrations of pesticides are leafy greens so better to buy your salad leaves, kale etc as organic produce or, better still, grow your own! So if you are starting solids with your little one, you might want to buy organic apples for him/her to eat. Very often, especially in season, a bag of organic apples is as little as 5p more expensive than the normal produce. Or if you are pregnant, you might decide to buy the organic tomatoes and salad leaves, and forgo that Costa Coffee drink.


A study by Cynthia Curl of the University of Washington found that people who report they "often or always" buy organic produce had significantly less organophosphate insecticides in their urine samples, even though they reported eating 70 percent more servings of fruits and vegetables per day than adults reporting they "rarely or never" purchase organic produce (Curl 2015). Obviously pesticides are healthy for anyone, but several long-term observational studies have indicated that organophosphate insecticides may impair children’s brain development so it’s a particular worry for little ones. Although some cynics say the amounts of pesticides are minimal (in studies using rats to rate toxicity), I think they are missing the point! It is the accumulation of pesticides over a lifetime that is problematic. These toxins aren’t water-soluble like Vitamin C for example.


So, I suggest you shop clever. Write a list of the worst culprits and see what the difference in cost is when you buy organic. Balance these with the fruit and veg on the clean list so it doesn’t break the bank balance.


PS See my other blog on what’s in your toiletries.


AAP 2012. Organic Foods: Health and Environmental Advantages and Disadvantages. American Academy of Pediatrics Committee on Nutrition and Council on Environmental Health. e1406 -e1415. DOI: 10.1542/peds.2012-2579. http://pediatrics.aappublications.org/content/130/5/e1406


Curl CL, Beresford SAA, Fenske RA, et al. 2015. Estimating Pesticide Exposure from Dietary Intake and Organic Food Choices: The Multi-Ethnic Study of Atherosclerosis (MESA). Environmental Health Perspectives. Advanced publication February 5, 2015. DOI: 10.1289/ehp1408197 http://ehp.niehs.nih.gov/wp-content/uploads/advpub/2015/2/ehp.1408197.acco.pdf



By Tessa of www.tessayoga.co.uk, Feb 14 2016 08:48PM

I am always thrilled to hear about the births of babies from my pregnancy yoga classes. You can read the birth stories and see the lovely photos at www.facebook.com/tessavenutiyoga. I'm even more thrilled when I hear that the yoga has helped in some way during the pregnancy, birth or afterwards. Here are the Top 5 benefits (amongst many!) that I have compiled from the new mums who've attend my classes and birth preparation workshops.


1. Stay calm using the power of the breath

Sometimes people look at me like "Why do you need to teach pregnant women to breath? We're all breathing, all the time." However, most of the time we breathe automatically and take it very much for granted. The most common comment from new mums is that the breathing techniques and awareness that they learned during the class made all the difference, and very often meant that they were able to birth their baby with gas and air alone (if that's what they wanted). They often describe how midwives were impressed with their calm breathing and focus through their birthing journeys, even when it didn't go as planned.


When you practice different breathing techniques, you begin to understand how your breath can have a huge impact on your state of mind and level of relaxation. And relaxation is essential to a smooth birthing journey. If you remain relaxed, your body can get on with what it knows how to do. The golden thread breath is fantastic and you can see a video of it here: www.tessayoga.co.uk/pregnancy-resources.



[Photo from Tina Cleary of Expecting Photography]


2. Empowered about your role in the birth

Occasionally I will hear a story about an expectant mum who experiences regular uterine contractions, is asked to come on into hospital, only for them to fade on arrival and to be sent home. This is SO disappointing when you thought you'd be meeting your baby soon. Sometimes this is because the woman felt vunerable and unsure when she arrived at the unfamiliar enviroment of the hospital.


In contrast, I know midwives who say that they know when a woman has done pregnancy yoga or hypnobirthing because she is confident when she arrives. Looking around to see what she can use - maybe a birthing ball, or leaning into the wall to ride the surge of a uterine contraction. She will be focused or in 'The Zone', using relaxation techniques that she has practiced beforehand. Birthing partners who have attended my birth preparation workshops also comment that they feel useful during the birth: they can offer practical and emotional support, be an advocate for their special lady in this unique journey. My greatest wish is that a woman feels like she has been empowered by the experience of birth (even if it was not exactly how she imagined it!) and rose to the challenge of this rite of passage.


3. Space to enjoy your pregnancy

If you're busy at work, doing DIY to get the house ready for your baby or already have children, it can be hard to stop and have time to connect with your baby and enjoy the pregnancy. Having a weekly pregnancy yoga class gives you the space to prepare emotionally. In addition, the yoga movements support you physically to enjoy a healthy pregnancy. As the weeks pass, the classes show you how to move as your baby gets bigger and you may feel uncomfortable (although I'm sure you'll be blooming on the outside!) Occasionally, an expectant mum may develop something like pelvic pain or wrist pain, and with the experience of hundreds of women coming through my classes I am able to show her how to manage these side effects of pregnancy until the baby is born.


Most importantly, expectant women enjoy the relaxation during the class and from the free downloads that are available from my website. It is essential that the expectant mum goes into the birth with her energy levels high, batteries full-charged for the journey ahead, rather than being depleted from 'finishing everything before the baby comes'. This can mean that rather than a cascade of interventions happening when she is exhausted, you are maximising your change of an intervention-free birth and an alert baby on arrival, ready to feed.


4. Trust the natural process of birth

In the pregnancy yoga classes and birth preparation workshops, I hope that expectant parents come to believe in the natural process of birth that has served us well for millenia! Although over the past decades, birth has become medicalised and moved into hospital (as shown in recent episodes of Call the Midwife), in a normal, healthy pregnancy there is absolutely no reason why a woman cannot manage the birthing journey, and dare I say it, enjoy it (as some might enjoy a marathon!) In the Pregnancy and Birth Colouring Book that I illustrated last summer, I wanted to give expectant mamas the chance to reflect on how amazing their bodies are and see how there are lotsof options when it comes to birthing your baby.


We are used to seeing women lying on their backs or with their feet in stirrups for birth on TV, but there are so many positions you can give birth in: on all fours, squatting, lying on your side if tired, in water.... During the yoga classes we practice these positions so that they begin to feel natural. Then during the birth you will find the position that suits you and your baby, and you will trust your instinct to move around. When you learn in the classes about how changing the position of your pelvis can help your baby's journey, or the amazing interplay between your baby and your body, you may even be excited about the birth.


5. Quicker recovery after birth

There are several ways in which pregnancy yoga aids your postnatal recovery. During the pregnancy yoga classes, we practice pelvic floor exercises to prepare for birth. By using those muscles, you aid circulation to keep them healthy, but also are able to relax them in preparation for dilation (the opening of the cervix to allow your baby passage through the birth canal). When you are in the habit of practicing these exercises antenatally, it is much easier to remember to do them postnatal to aid any healing that is needed (e.g. around stiches). A good tip is to do some pelvic floor squeezes every time you feed your baby.


In addition, by exercising safely during pregnancy, it is possible to keep tone around the abdominal area. Although some women may find that they have a separation of the abdominal muscles (diastasis recti), it is much easier to fuse these muscles back together when you were in shape previously. If you have been careful during pregnancy, when ligaments are more likely to stretch due to the relaxing relaxin hormone, then you are likely to get moving more readily.


It is important to be patient with your body though. If it has taken 9 months to grow a baby, I think you owe yourself at least that amount to getting back to your 'pre-pregnancy' body. Having attended pregnancy yoga classes, I find mums are more likely to be patient with their bodies. My Mother & Baby Yoga DVD introduces yoga practices at a kind pace so that you can enjoy the fourth trimester with your baby and increase stability and strength at a sustainable level.


I hope I've convinced you that pregnancy yoga is very beneficial. I'd love to hear how pregnancy yoga has helped you in your pregnancy so please leave a comment below.


Best wishes for YOUR birth!


Tessa x





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