HOW PREGNANCY IMPACTS MATERNAL ANATOMY AND PHYSIOLOGY

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Skin system- influenced by hormones

-Increased perspiration, oiliness, hair growth 

-Odor changes

-Skin stretches (stretch marks- striae gravidarum)

-Increased pigmentation due to estrogen and adrenal hormones

-Linea Alba becomes Linea Negra

-Facial discoloration- chloasma may be a symptom of folic acid deficiency

-Itching (pruritis)  20% of women experience this, when its only on the belly its normal

-Pruritis gravidarum- itching all over the body, unique to pregnancy due to estrogen and progesterone

 

Skeletal system

-Calcium absorption has doubles by the beginning of the 3 trimester and remains elevated through postpartum if lactating

-Maternal bones utilize what baby does not

-Postpartum calcium and phosphorous may decrease due to decreased bone density during breast feeding- need for calcium increases

-Increased lordosis (low back curvature)

-Gait changes ( changes in balance)

-Increase backache due to relaxation of pelvic joints and ligaments

 

Muscular system

-generalized relaxation due to relaxin and progesterone

-at risk for pulled muscles or more severe damage

 

The senses

-visual changes due to hormonal  fluid balance changes

-taste is dulled

-smell is heightened

-touch is heightened

 

Endocrine glands

-thyroid – basal metabolism increases 10-30% by the 16th week to ensure availability of glucose to baby for increased brain and body growth

-parathyroids- increases sue to fetal calcium requirements

-pituitary, responsible for estrogen, progesterone, prostaglandins and prolactin

 

Estrogen

-Increases 1000 times

-growth and function of the uterus and breast

-sodium and water retention

-may influence emotional mood swings

-increases pliability of connective tissues

-external genitalia changes

 

Progesterone

-Increases 10 times

-may play a role in suppression of maternal immunologic response to baby

-develops lobes of alveolar system of breasts

-Infuences hypothalamus gland to cause fat storage

-stimulates respiratory cells

-increases basal body temperature (heat!)

-relaxes smooth muscles

-decreases gastrointestinal motility to increase absorption

-decreases muscle tone of bladder and uterus

 

Prostaglandins

-produced by the mother and baby

-soften the cervix and prepare body for labor

 

Prolactin

-maternal and fetal pituitary glands

-milk production 

-enhances mother’s ability to attach emotionally to her baby

 

Oxytocin

-stimulates uterine contractions

-milk let down and ejection

-distention of the cervix and vagina stimulate the release of oxytocin and prostaglandins during labor

-fight or flight response (adrenaline) do not allow the body to release oxytocin

 

Circulatory and cardiovascular

Blood volume increases 50-60% more to support the growing placenta; to protect against shock if increased loss after birth

Generalized dilation of arteries- helps to lower vascular resistance

Cardiac output ( volume of blood pumped by each ventricle per minute) increased by 30- 45% by the 20th week, then plateaus; 

Enlarging uterus causes diaphragm to rise, displacing heart up to the left

Blood viscosity (thickness) is decreased, and slight twisting of large abdominal blood vessels occurs due to enlarged uterus

Vena Cava Syndrome- after the 20th week size of the baby partially impairs venous return from inferior vena cava

Pulse rate increases 1-=15 points as pregnancy advances

Shortness of breath increases

Edema increases

Physiological anemia- related to increased blood plasma volume which dilutes the red blood cells. Red blood cells increase sue to the need for extra oxygen.

Sources of natural iron: liquid chlorophyll, dandelion, yellow dock, nettles, Floradix (herbs) 

 

Immune system

Changes related to implantation of fertilized egg and ensuring that the pregnancy is established

No predisposition to infectious diseases

 

Respiratory system

Oxygen consumption increases 15-20%: 1/3 necessary for metabolism of baby and placenta, 2/3 used to support increased maternal metabolism

40% increase in tidal volume (air inhaled and exhaled) in one breath

There is a 26% increase in respiratory minute volume (tidal volume and respiratory rate)

Lungs slightly displaced causes breathlessness

Diaphragm is elevated by enlarging uterus so breathing becomes more costal

Nasal congestion due to the increased vascularity

 

Digestive system

Increased dental caries

Gum tissue softer and bleeds more easily ( recommend floss daily and rinse with salt water)

Some women hyper salivate (all above related to hormones)

Gastro secretion of hydrochloric acid and pepsin are decreased 

Intestines are displaced

Stomach is displaced

Heartburn related to relaxation of the smooth muscles (recommend papaya enzymes VS Tums- antiacids neutralize stomach acids thus arresting digestions leading to increased acid production) 

Gastric emptying time and intestinal motility decreases which increases constipation and bloating

Transit time prolonged by as much as 40% to enhance absorptions of nutrients

Gallbladder distended, and takes longer to empty may result in gallstone formation 

Hemorrhoids caused by constipation

 

Urinary

Ureters are more likely compressed by the growing uterus

Increased UTI

Urination frequency increases at 6 weeks, decreases at 12 weeks due to uterus rising out of the pelvis, then increases again in third trimester

Kidneys work harder

 

Metabolic- Liver functions

Performs over 500 metabolic functions

Albumin synthesis liver combines ammonia into protein molecules which attract water into circulation

Hormone metabolism- liver cleanses bloodstream of hormones (in pregnancy hormone levels increase to the equivalent of 100 birth control pills a day!!!)

Detoxification- liver metabolizes toxic by -products

A well balanced diet is essential to efficient liver functions

Increased fetal and placental demands place more stress on the liver to increase blood volume. The liver must have the proper nutrients to do this

Kidneys respond to decreased blood volume by reabsorbing water and salt and returning it to the circulation. 

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GENERAL PRENATAL YOGA ROUTINE

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General routine
No specific points to observe for safety in each category of poses, i.e.; hip joint, alignment. What are the risks versus benefits in the first, second, and third trimester is?

Breath: Ujjayi, Nadi Shodhana 

Warm up
Cat cow with variations
Child’s pose
Opposite limb extension
Dog pose

Standing poses
Triangle
Extended side angle
Warrior one
Warrior two
Half moon
Pyramid
Forward fold
Extended leg stretch
Wide legged forward fold

Forward folds
Head to knee forward fold
Three limbs intense west stretch pose
Seated forward fold
Cobblers pose
Seated wide-angle pose
Garland pose
Heroes pose
Simple seeded pose

 

Twists

Simple twist

With chair or block in wide leg forward fold

Wide knees on back knees bent

Wide knees on back with one leg straight one leg bent (crocodile)

Seated wide angle twist

Revolved head to knee

 

Backbends - No core poses

Bridge

Heart Bed

 

Restorative

Supine cobblers pose

Reclined heroes pose

Forward fold with chair

Savasana

 

Inversions

Headstand

Shoulder stand (supported) with chair at wall centre of room

Plow (supporteD)

Legs up the wall

No handstand / No elbow stand

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COMMON DISCOMFORTS OF PREGNANCY

-sacroiliac joint

-sciatica

-pubic pain

-round ligament pain

-mid back pain

-swelling (edema)

-congestion

-increased susceptibility to colds, allergy, hay fever

-heartburn

-pain in feet related to pelvis changes

-headaches

-bowel changes

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