Yoga and Miscarriage

There is a lot written about yoga for pregnancy, menstruation, menopause, mums and bubs yoga, and yoga for fertility however not many authors venture into how to teach and how to practice during miscarriage and pregnancy loss.

MISCARRIAGE

Recently a yoga student emailed me to say hi as I had wondered how she was going. She mentioned she recently had a miscarriage, and I know it is not her first. As a female yoga teacher, I often hear women’s stories of miscarriage and pregnancy loss. The sad reality is that many women will experience a miscarriage at some point, and if they don’t, someone very close to them will. There is a lot written about yoga for pregnancy, menstruation, menopause, mums and bubs yoga, and yoga for fertility (a lot of the fertility writings are fallacious). However, not many authors venture into how to teach and how to practice during miscarriage. This article will hopefully give a bit of insight into the how and what of miscarriage, then some practical advice for guiding your or your student’s practice during this time.

The first thing to know is it’s not yours, or your student’s fault. Miscarriages happen for a variety of reasons, and generally, there is nothing you as a pregnant woman, or you as someone teaching a pregnant woman, could have done to avoid it happening. The reasons for miscarriage are complex, and I am not a medical doctor – but in brief, often it is natural selection occurring in which the body ends the pregnancy due to chromosomal abnormalities, sometimes the pregnancy does not embed on the uterine wall, and their maybe issues with the luteal phase of a woman’s cycle.

Yoga doesn’t cause miscarriages, however, if you are pregnant, practicing yoga, and worry it might cause you a miscarriage, my advice is always: DON’T PRACTICE. While it may be illogical that you think that, if you do think yoga increases your risk, then if you have a miscarriage you may blame yourself and your practice. So take a break.

Miscarriage occurs up to 20 weeks, after 20 weeks the term used is stillbirth. This article is about miscarriage. Sometimes women spontaneously miscarry by bleeding, sometimes women are treated as an outpatient and given medicine to induce labour, other times women need surgery (a ‘D&C’ – Dilation & Curettage), in which under general anesthetic the cervix is dilated and the uterine lining is scraped. Women who have terminated a pregnancy either have labour induced at home or a D & C, so this discussion also applies to that situation.

No matter how early or late in a pregnancy it is most likely devastating for the woman experiencing the loss.  I thought I knew how devastating a miscarriage was when my students went through them. I thought I knew – until I had one. Until you have had a miscarriage you can not fathom it, and even then every woman and their situation is vastly different. The pregnancy may be wanted or unwanted, it may be 6 weeks or 20, and the baby may or may not have had a heartbeat. I remember the hospital staff wheeling me into the theatre, and because of due process, asking me ”Can you tell me why you are here today?” I had held it together until then, even when the midwife had given me the symbolic cushion heart to represent the baby that was not to be. But then the tears simply welled up when I had to say “I was pregnant”. The loss was so overwhelming it was hard to process. Life moves on, and as the research shows the pain of miscarriage is usually only healed (or somewhat so) with a subsequent successful pregnancy. I was one of the lucky ones to have that successful pregnancy. Yoga however has enormous potential to heal women physically and emotionally.

In short, miscarriage is heartbreaking and happens to between 15-20% of women who know they are pregnant. So if you are a teacher it is very likely you will be faced with this situation, and hopefully, your students feel safe enough to practice with you following a miscarriage.

Please do share your experience of how you practiced after a miscarriage, but below are some general guidelines for women and yoga teachers:

– With miscarriage comes bleeding. The general advice is to engage in practice as you might during menstruation. Most important is that you do not engage in vigorous exercise or asana as this will increase your bleeding and prolong the process. Also avoid closed, twisting postures as you would during menstruation.

-No Inversions. While you are bleeding inversions are not recommended. Be gentle and allow the body to do what needs to be done to bring an end to the pregnancy. Allow the downward flow of energy, known in yoga as ‘apana’.

-Nurture yourself. Do a practice that feels soft and healing and with lots of bolsters, cushions, and blankets supporting you. Recommended postures included a very supported reclined butterfly, supported child posture, and supported upavishta konasana and savasana. Use sandbags, not for an extra stretch, but to help you feel grounded, held, and safe.

-Chant. Your or your student’s mind may be busy and getting carried away in the story of why and how the miscarriage occurred. Sometimes chanting can be a wonderful way to become grounded in the moment and to allow the mind to quieten. Meditation may not always help as at first it may allow there to be a lot of space for thoughts and ‘story’. If it is overwhelming, try mantra practice, pranayama, and return slowly to sitting meditation.

– Be aware that the body is probably softer than usual and still remains more prone to injury. In many respects, and depending on how long you were pregnant, the practice of yoga after a miscarriage is somewhat like the post-natal period. The pelvic floor needs to strengthen and we need to be aware of laxity in the body. It can take months to return to your pre-pregnancy practice.

-Go to class. It can be helpful to return to your community of fellow practitioners and teachers and be guided through this process by a teacher you trust.

– Don’t go to class. If you need time alone, or with your partner to grieve, then that is fine too. There is no right and wrong.

-Acceptance. Depending on how long you were pregnant and how many changes you had made to your practice it may take time to return to your same practice vitality. This is normal, give yourself a break.

-Lastly, if the only thing that is going to get you or your student through it is returning to your dynamic asana practice and you can do this and manage the bleeding (as you are not supposed to use tampons during this time)  GO FOR IT (with your doctor’s permission). Yes, I said it. It’s not what is indicated in terms of yoga, and 100% not what I recommend. But most likely any small harm you may be caused by pulling a muscle or some such occurrence might outweigh the mental suffering your practice will alleviate. Also bleeding may just naturally continue even lightly for some weeks, and this is simply too long psychologically for some people to not have their practice to help them manage. At the end of the day, while this is not my advice, it is your body and you get to decide (but please listen to your doctor).

And, talk about it. Speak to your doctor or midwife.

This is life, birth, and death we can’t escape it. But we can travel along this road with our fellow yogis our family, partner, and friends. And by talking about it, you may just help another woman come to terms with her own loss. It is devastating indeed, but it is also part of our experience in life as women, and I wouldn’t have it any differently.

Namaste and with love,

Jean xx