Delivery complications after natural child birth are so#nbsp;common nowadays wide-spread to#nbsp;the extent that some of#nbsp;them might actually be#nbsp;excluded from the list of "complications". However, they decrease life quality of#nbsp;a#nbsp;young mum and require some treatment. The most frequent post-delivery complications are perineal rupture, uterus subinvolution (that is, uterus is#nbsp;slow in#nbsp;returning to#nbsp;its normal dimensions after delivery), post-delivery bleedings, hemorrhoids, chronic constipation, lactostasis and hypogalactia (problems with breast milk production and outflow), as#nbsp;well as#nbsp;problems of#nbsp;locomotorium and nervous system disorders.
Adequate yoga-therapy allows to#nbsp;tackle the majority (if#nbsp;not all!) of#nbsp;these disorders, taking into account their psychosomatic nature. That makes yoga-therapy one of#nbsp;the most effective treatment methods for the pathologies mentioned above.
In#nbsp;opinions of#nbsp;According to#nbsp;yoga-therapists and physical therapists, the time of#nbsp;starting an#nbsp;exercise routine even after non-complicated vaginal delivery varies from the second day to#nbsp;the third week. However, some yoga-therapeutic techniques (e.g. breathing and meditation) will be#nbsp;definitely useful for all women starting from the second post-delivery day. Certainly, it#nbsp;is#nbsp;necessary to#nbsp;take into account young mum’s general condition, as#nbsp;well as#nbsp;severity of#nbsp;complications and their combination in#nbsp;every individual case.
To#nbsp;make things clear and simple we#nbsp;shall review only a#nbsp;few of#nbsp;the most frequent complications and applied yoga-therapeutic techniques in#nbsp;these cases.
Perineal rupture There are three degrees of#nbsp;severity levels of#nbsp;perineal rupture. The first is#nbsp;the lightest one, when the muscles of#nbsp;perineum remain integral. Whereas the third implies that rupture affects not only the perineum skin, but also the vagina and muscles up#nbsp;to#nbsp;the anal sphincter, as#nbsp;well as#nbsp;the rectum. In#nbsp;theory of#nbsp;physical therapy, the third degree rupture is#nbsp;a#nbsp;contraindication to#nbsp;any exercise at#nbsp;all. However, experience and general understanding of#nbsp;yoga-therapy techniques prove that it#nbsp;is#nbsp;possible to#nbsp;exercise even in#nbsp;these cases in#nbsp;the following way.
First 7−10 days we#nbsp;exclude all sitting positions, both in#nbsp;everyday life and in#nbsp;yoga practice. We#nbsp;also exclude spreading the legs to#nbsp;avoid possible damage to#nbsp;the sutures. During two weeks, it#nbsp;is#nbsp;also necessary to#nbsp;avoid any body positions, which can cause rapid increase of#nbsp;intra-abdominal pressure (any tension of#nbsp;abdomen indeed).
When a#nbsp;young mum decides to#nbsp;start exercise, on#nbsp;the second post-delivery day she should concentrate on#nbsp;her pelvic floor muscles while lying in#nbsp;bed and become aware of#nbsp;their relaxation during 10−20 breath cycles, afterwards she may try to#nbsp;contract them very gently. The main thing is#nbsp;not to#nbsp;strive after any effect and not to#nbsp;get upset, if#nbsp;the muscles do#nbsp;not obey. That just means that you should take more rest and start exercising a#nbsp;bit later on.
While sneezing, coughing and raising from bed (it#nbsp;is#nbsp;necessary to#nbsp;do#nbsp;it sideways!) you should try to#nbsp;gently tighten the pelvic floor muscles and keep them toned, which actually is a Mula bandha technique. Also, the Mula bandha should be#nbsp;done, either in#nbsp;full effort or#nbsp;in#nbsp;half the effort, depending on#nbsp;your current state, as#nbsp;an#nbsp;independent dynamic practice, as#nbsp;well as#nbsp;in#nbsp;combination with abdominal breathing. Besides, it#nbsp;is#nbsp;recommended to#nbsp;do#nbsp;an Ashvini mudra (contraction and relaxation of#nbsp;the anal sphincter only). Abdominal breathing implies keeping your lower abdomen slightly toned during inhalation, and strengthening it#nbsp;during exhalation, when we#nbsp;consciously tighten the abdomen, helping our diaphragm to#nbsp;raise and relax. At#nbsp;the end of#nbsp;inhalation you should tighten the pelvic floor muscles a#nbsp;bit more and keep them toned during exhalation. Thus there is#nbsp;no#nbsp;complete relaxation of#nbsp;pelvic floor muscles, and the muscle tone will gradually increase this way. This will help to#nbsp;develop awareness in#nbsp;this area and to#nbsp;tone perineal and abdominal muscles, assisting in#nbsp;speedy regeneration process as#nbsp;well as#nbsp;normal muscle tone recovery.
If#nbsp;the suggested Mula bandha exercise seems difficult at#nbsp;the beginning, it#nbsp;makes sense to#nbsp;stick to#nbsp;contraction-relaxation routine for some time, keeping your breath natural in#nbsp;supine position only. You can bend your legs or#nbsp;put them on#nbsp;a#nbsp;chair or#nbsp;on#nbsp;the wall. Proper physical exercise (as#nbsp;a#nbsp;rule, without directly affecting the "problem zone") is#nbsp;a#nbsp;guarantee for a#nbsp;speedy recovery after any trauma or#nbsp;operation. That is#nbsp;why starting from the second post-delivery day you should start your practice with gentle vyayama for arm and leg joints (not affecting, however, the pelvic joints). According to#nbsp;a#nbsp;young mum’s condition, they could be#nbsp;performed either lying in#nbsp;bed (if#nbsp;it’s not too soft) or#nbsp;on#nbsp;the floor, as#nbsp;well as#nbsp;standing.
If#nbsp;you feel well enough to#nbsp;do#nbsp;standing practice, it#nbsp;is#nbsp;really necessary to "build" Tadasana straight away. In#nbsp;this asana, if#nbsp;it’s performed correctly, you should feel pelvic floor and abdominal muscles tighten without overstraining. It#nbsp;also allows your lower back to#nbsp;relax, as#nbsp;the compression load to#nbsp;the lower back in#nbsp;standing position is#nbsp;four times less, than in#nbsp;sitting one. Moreover Tadasana gives an#nbsp;opportunity to#nbsp;feel oneself standing with both feet on#nbsp;the ground, really grounded, calm and confident.
It#nbsp;is#nbsp;better to#nbsp;start building your Tadasana from the feet#nbsp;— as#nbsp;it’s impossible to#nbsp;build a#nbsp;house without a#nbsp;foundation. It#nbsp;is#nbsp;very efficient to#nbsp;use a#nbsp;yoga block, if#nbsp;you put it#nbsp;between your hips as#nbsp;close to#nbsp;the crotch as#nbsp;possible. At#nbsp;first you should press your metatarsophalangeal articulations firmly to#nbsp;the floor#nbsp;— that is#nbsp;to#nbsp;raise your toes and to#nbsp;press the front part of#nbsp;your feet to#nbsp;the floor as#nbsp;if#nbsp;you were going to#nbsp;tip-toe. This way the calf muscles will be#nbsp;put to#nbsp;work. Then you should press the heels firmly to#nbsp;the floor tightening the thighs and pulling the knee-caps#nbsp;up. Next we#nbsp;try to#nbsp;push the yoga block backwards and imagine that there is#nbsp;a#nbsp;weight attached to#nbsp;the tailbone, at#nbsp;the same time raising the chest#nbsp;up. At#nbsp;this moment we#nbsp;can feel the pelvic floor muscles tightening upward and the navel moving towards the spine, while neither the buttocks nor the abdominals get overstrained.
From the third or#nbsp;fourth day of#nbsp;your exercise you could add to#nbsp;your abdominal breathing and Tadasana the practice of Marjariasana. Marjariasana is#nbsp;a#nbsp;wave-like movement of#nbsp;the spine while you are standing on#nbsp;all fours. The back bend is#nbsp;done gradually while inhaling, starting your movement from the tailbone. Arching your back is#nbsp;done in#nbsp;the same manner while exhaling and it#nbsp;is#nbsp;also necessary to#nbsp;tighten your pelvic floor muscles.
Chronic constipation
Constipation is#nbsp;a#nbsp;frequent young mum’s condition, partially due to#nbsp;disorders of#nbsp;intestinal peristalsis during pregnancy, partially due to#nbsp;the weakness of#nbsp;pelvic floor muscles after delivery as#nbsp;well as#nbsp;increased water absorption in#nbsp;the colon due to#nbsp;laсtation.
Movement, as#nbsp;well as#nbsp;the right diet, is#nbsp;the best medicine in#nbsp;this case. In#nbsp;this case#nbsp;— movement along with the correct diet is#nbsp;the best cure. We#nbsp;recommend starting your practice with abdominal breathing, while lying on#nbsp;your back with your legs bent or#nbsp;legs up#nbsp;the wall. You should observe your relaxed stomach raising and expanding on#nbsp;inhale, and consciously tighten your abdominals on#nbsp;exhale. It#nbsp;will be#nbsp;great to#nbsp;use Ujjayi breathing: constricting the throat muscles at#nbsp;least on#nbsp;exhale. It#nbsp;will help to#nbsp;control both prolongation of#nbsp;exhale and abdominals work and will also strengthen the tone of#nbsp;your parasympathetic nervous system, and that, in#nbsp;its turn, will have a#nbsp;very positive effect on#nbsp;gastrointestinal tract as#nbsp;a#nbsp;whole.
One should note that constipation in#nbsp;most cases has a#nbsp;well-defined psychosomatic nature. This condition, as#nbsp;a#nbsp;rule, characterizes people who can hardly ever relax and "let go", so#nbsp;called "control-freaks". That’s why it#nbsp;makes sense to#nbsp;add Nadi Shodhana breathing as#nbsp;a#nbsp;restorative technique for the nervous system, as#nbsp;well as#nbsp;yoga meditation techniques (e.g. concentration on#nbsp;various body parts, visualization, etc.).
A#nbsp;great way to#nbsp;tackle constipation is#nbsp;to#nbsp;do yoga twists, especially while it#nbsp;is#nbsp;not possible to#nbsp;perform abdominal manipulations due to#nbsp;post-delivery bleeding. You can start to#nbsp;do#nbsp;open twists in#nbsp;supine position, and later proceed to#nbsp;standing variations with support of#nbsp;a#nbsp;wall. It#nbsp;is#nbsp;necessary to#nbsp;hold Mula bandha while doing any variant of#nbsp;a#nbsp;twist. If#nbsp;there are no#nbsp;contraindications, it#nbsp;is#nbsp;recommended to#nbsp;make "closed" twists in#nbsp;sitting position, as#nbsp;they have the best effect on#nbsp;your hepatobiliary system functioning (that is, your liver and gall bladder work), as#nbsp;well as#nbsp;on#nbsp;your gastrointestinal motility. However, if#nbsp;there are any second or#nbsp;third degree ruptures, you should be#nbsp;extra careful while doing these twists during first two-three weeks after the child-birth. After you have a#nbsp;couple of#nbsp;classes in#nbsp;static mode, holding a#nbsp;position for up#nbsp;to#nbsp;five breaths, it#nbsp;is#nbsp;recommended to#nbsp;add dynamic variants#nbsp;— twisting on#nbsp;exhale and returning to#nbsp;initial position on#nbsp;inhale.
Marjariasana described aboveis also a#nbsp;great addition to#nbsp;your practice tackling the constipation problem.
When bleeding is#nbsp;over the best way to#nbsp;get rid of#nbsp;constipation will be Kapalabhati, Agnisara Dhauti and Nauli performed every morning, as#nbsp;well as#nbsp;the inverted positions preferably combined with twists (provided assuming you have mastered these techniques before).
Hemorrhoids
Hemorrhoids can appear after delivery or#nbsp;even during pregnancy; in#nbsp;the latter case it#nbsp;will get even worse after delivery. Medical science describes four stages of#nbsp;this condition; the fourth or#nbsp;sometimes, the thirddegree is#nbsp;an#nbsp;indication for operation. In#nbsp;case of#nbsp;the first or#nbsp;the second stage yoga-therapy alongside with proper diet will undoubtedly prove to#nbsp;be#nbsp;very effective.
First of#nbsp;all#nbsp;— all asanas should be#nbsp;performed with Mula bandha, especially those related to#nbsp;the increase in#nbsp;abdominal pressure. especially those involving the tension of#nbsp;compression of#nbsp;abdomen. It#nbsp;is#nbsp;absolutely necessary also to#nbsp;use hygienic shower instead of#nbsp;toilet paper.
In#nbsp;general, you could use the above-described practice for constipation relief, adding Urdhva Prasarita Padasana with wall support (lying on#nbsp;your back with legs stretched up#nbsp;the wall) with Ashwini mudra.
After bleeding is#nbsp;over, according to#nbsp;your general condition and level of#nbsp;practice, it#nbsp;is#nbsp;necessary to#nbsp;add inverted positions with Ashwini mudra to#nbsp;your exercise routine. The most simple, but very effective is Viparita Karani mudra with a#nbsp;bolster under your pelvis and your legs up#nbsp;the wall. Besides the inverted asanas, the most effective is MadhyamNauli (or#nbsp;at#nbsp;least simple Uddiyana Bandha) practice due to#nbsp;its pumping action#nbsp;— the blood and even the pelvic floor goes upwards while diaphragm is#nbsp;in#nbsp;its highest position and thoracic and abdominal pressure is#nbsp;low.
Pelvic bones hypermobility and back pain
The ligaments weakened during pregnancy by#nbsp;the effect of#nbsp;a#nbsp;hormone called relaxin, go#nbsp;back to#nbsp;the norm within an#nbsp;on#nbsp;average for 8 weeks. This explains most of#nbsp;the discomfort the majority of#nbsp;unpleasant sensations in#nbsp;the area of#nbsp;in#nbsp;the pelvic bones joints (pubic symphysis and sacroiliac joints), as#nbsp;well as#nbsp;in#nbsp;lower back and neck.
Some of#nbsp;these conditions above named pathologies in#nbsp;a#nbsp;severe form, such as#nbsp;symphyseopathy of#nbsp;the third degree (when pubic bones are more than two centimeters apart) are only to#nbsp;may be#nbsp;treated using a#nbsp;special corset and keeping at#nbsp;rest. However, even in#nbsp;such cases breathing and meditation as#nbsp;well as#nbsp;physical exercise without affecting the problem zone (e.g. vyayamas for arms, any variant of Chaturanga Dandasana, etc.) will have a#nbsp;general therapeutic effect.
If#nbsp;a#nbsp;young mum’s condition allows doing simple asanas, it#nbsp;is#nbsp;recommended to#nbsp;be#nbsp;extra careful while doing any positions for flexibility. At#nbsp;the same time one shouldn’t totally reject them, especially as#nbsp;compensation for strength development positions.
Besides the exercises, it#nbsp;is#nbsp;necessary to#nbsp;bring some more awareness to#nbsp;everyday routine: to#nbsp;find comfortable breastfeeding positions, to#nbsp;use a#nbsp;baby sling or#nbsp;other baby-carriers, as#nbsp;well as#nbsp;to "build" your Tadasana, trying to#nbsp;hold it#nbsp;as#nbsp;far as#nbsp;you can during your household activities which could be#nbsp;done standing.
If#nbsp;there is#nbsp;any lumbalgia condition (lower back pain) of#nbsp;different types, the variants of Supta Padangushtasana 1 & 3, as#nbsp;well as Marjariasana, can prove to#nbsp;be#nbsp;very effective. If#nbsp;you are in#nbsp;real pain, you shouldn’t try to "build up" your back muscles with power backbends, it#nbsp;is#nbsp;much better to#nbsp;pay attention to#nbsp;strengthening the pelvic floor and abdominal muscles.
It#nbsp;is#nbsp;also very effective to#nbsp;add some sound-healing techniques to#nbsp;yoga practice. Especially using a#nbsp;low humming sound (the lowest available to#nbsp;your voice but comfortable so#nbsp;that your lower jaw and neck are relaxed) while performing Tadasana for 10 breaths and direct the sound to#nbsp;the feet feeling or#nbsp;imagining your roots deep in#nbsp;the ground and filling your legs and pelvis with the sound vibration.
Nervous system disorders
Delivery is#nbsp;actually a#nbsp;stress for the whole body. No#nbsp;wonder that different nervous system disorders could follow, starting from eating disorders and general weakness to#nbsp;post-delivery depression.
That is#nbsp;where yoga-therapy exercises could achieve valuable results with the most important of#nbsp;them#nbsp;— the harmonization of#nbsp;all body system efficiency.
Naturally, regular practice of#nbsp;even the most simple yoga asanas will have a#nbsp;positive effect on#nbsp;nervous system in#nbsp;general. But we’ll review a#nbsp;few of#nbsp;specific techniques.
First of#nbsp;all, there is#nbsp;a#nbsp;normal abdominal breathing with a#nbsp;prolonged Ujjayi exhale. This breathing type has a#nbsp;substantial sedative effect, and you can practice it#nbsp;any time and basically in#nbsp;any body position many times per day.
Second technique which one should practice at#nbsp;least twice a#nbsp;day for 5−10 minutes (if#nbsp;you have time and strength#nbsp;— up#nbsp;to#nbsp;half an#nbsp;hour) is Nadi Shodhana pranayam. Nadi Shodhana harmonizes the work of#nbsp;cerebral hemispheres and aligns their activity. In#nbsp;case of#nbsp;sleep disorders you can put one drop of#nbsp;essential oil of#nbsp;lavender to#nbsp;your middle or#nbsp;index finger and enjoy the healing aroma with every inhalation. If#nbsp;there are other clearly manifested symptoms of#nbsp;post-delivery depression, essential oil of#nbsp;vetiver will have a#nbsp;miraculous healing effect and you will feel calm and confident again.
The third effective technique is Kapalabhati. This shatkarma stimulates reticular formation which is#nbsp;responsible for stimulation-inhibition processes in#nbsp;the brain cortex and it#nbsp;also has a#nbsp;gentle stimulation effect. It#nbsp;should be#nbsp;done either regularly in#nbsp;the mornings as#nbsp;an#nbsp;independent practice, or#nbsp;before Nadi Shodhana pranayam. However, you shouldn’t start Kapalabhati during first ten post-delivery days if#nbsp;there are perineal ruptures of#nbsp;or#nbsp;first or#nbsp;second degree; in#nbsp;case of#nbsp;third degree rupture, you should wait until the crotch heals completely. In#nbsp;case of#nbsp;hemorrhoids, you should be#nbsp;extra careful while doing this shatkarma, taking into account your condition and only while performing Mula bandha.
Experience shows that cyclic meditation, practiced in Vivekananda Yoga Research Institute (VYASA), is#nbsp;an#nbsp;effective way to#nbsp;work with post-delivery nervous disorders.
The advantage of#nbsp;this particular meditation form is#nbsp;that physical movement is#nbsp;not only possible, but it’s required. The practice consists of#nbsp;doing a#nbsp;few simple asanas in#nbsp;a#nbsp;very slow mode with maximum awareness and closed eyes. The practice finishes with Shavasana and signing of mantraOm.
The cyclic meditation increases proprioceptive (posture) sensibility and allows a#nbsp;young mum to#nbsp;restore the feeling of#nbsp;being in#nbsp;contact with her own body, separate from her baby.
To#nbsp;remove neck tension it#nbsp;is#nbsp;great to#nbsp;do#nbsp;arm Gomukhasana, followed by Garudasana, as#nbsp;well as arm asanas, practiced by#nbsp;Andrei Lappa (Universal Yoga school): the dragonfly and the arm half-lotus.
From theory to#nbsp;practice
Below is#nbsp;an#nbsp;example of#nbsp;an#nbsp;adequate yoga-therapeutic asana sequence for the potential post-delivery complications:
1. Dynamic Marjariasana, as#nbsp;described above;
2. Static Marjariasana, with raising one arm parallel to#nbsp;the floor and the opposite leg simultaneously (when you become confident enough you can add raising the same side arm and leg);
3. Shashankasana followed by Adho Mukha Shvanasana, when the bleeding stops;
4. Gomukhasana, followed by#nbsp;arm Garudasana, as#nbsp;described above;
5. Urdhva Prasarita Padasana with legs on#nbsp;the wall, or Viparita Karani mudra with a#nbsp;bolster under pelvis, when the bleeding stops. If#nbsp;you have time, you can precede by Supta Padangushtasana 1;
6. Adho Mukha Vrikshasana#nbsp;— variant with legs on#nbsp;the wall; the so-called "corner"
7. Shavasana with a#nbsp;bolster under the knees and some neck or#nbsp;head support (not high).
This is#nbsp;a#nbsp;detailed enough sequence for a#nbsp;young mum, which takes from 15 to#nbsp;30 minutes, depending on#nbsp;the time of#nbsp;holding each asana. No#nbsp;doubt the general therapeutic effect of#nbsp;this sequence will increase if#nbsp;you can breathe Ujjayi during the practice.
Conclusion: if#nbsp;you run after two hares, you will catch… three!
Yoga therapy allows for harmonizing all body system functions, as#nbsp;it#nbsp;is, in#nbsp;its essence, a#nbsp;method of#nbsp;psychosomatic therapy.
Yoga therapy allows you to "build" the functioning of#nbsp;all systems of#nbsp;the body, being in#nbsp;fact a#nbsp;method of#nbsp;psychosomatic therapy.
However, there are certain "buts". First of#nbsp;all, it’s necessary to#nbsp;take into account the multifactorial current state of#nbsp;a#nbsp;young mum. This is#nbsp;a#nbsp;rare case, when you can and should concentrate on#nbsp;a#nbsp;few pathologies at#nbsp;once, so#nbsp;that to#nbsp;avoid "fix one thing and break another" situation.
Second, it#nbsp;is#nbsp;necessary to#nbsp;get a#nbsp;young mum inspired for a#nbsp;daily, or#nbsp;sometimes twice daily, exercise, as#nbsp;only in#nbsp;this case the practice will be#nbsp;effective. This is#nbsp;especially relevant during post-delivery complications therapy as#nbsp;the young mums usually complain about the chronic lack of#nbsp;time rather than actual problems with their bodies. That is#nbsp;why it#nbsp;is#nbsp;better to#nbsp;recommend to#nbsp;a#nbsp;young mum to#nbsp;do#nbsp;at least suitable breathing exercises for 5−10 minutes a#nbsp;day, followed by#nbsp;2−3 asanas for another 15 minutes a#nbsp;day.
Third, to#nbsp;have a#nbsp;for systemic effect on#nbsp;the whole body, you should add generally restorative techniques to#nbsp;every individual sequence and take into account the psychosomatic nature of#nbsp;a#nbsp;majority of#nbsp;health problems. It#nbsp;is#nbsp;also very important to#nbsp;teach a#nbsp;young mum to#nbsp;work with her attention and awareness.