The Newest Fertility Accessory: A Wellness Coach
More and more clinics are offering deep breathing, meditation and yoga lessons before stressful appointments, but will they help women get pregnant? The data is mixed.
Supported byThe Newest Fertility Accessory: A Wellness CoachMore and more clinics are offering deep breathing, meditation and yoga lessons before stressful appointments, but will they help women get pregnant? The data is mixed.ByKatharine GammonThis story was originally published on Feb. 10, 2020 in NYT Parenting.When Emily McCourtney arrived for her uterine evaluation at a fertility clinic in Southern California, she was nervous about how it might feel. The ultrasound test, which involved threading a catheter through her cervix and filling her uterus with saline, would help her doctor spot any abnormalities that might affect her chances of becoming pregnant. Half an hour before her appointment, McCourtney met with Elaine Wang, a wellness coach at the clinic, who explained what was going to happen on yoga mats in a back room. They practiced deep breathing exercises to help McCourtney decompress, then Wang followed her into the exam room so they could practice her breathing during the procedure.“After that, walking away, I felt more relaxed than at any other time at this office,” said McCourtney, 35, who later conceived via in vitro fertilization and is expecting a baby in April.For most people, a visit to a fertility clinic involves more apprehensiveness than calm. Checkups and procedures can be uncomfortable experiences, with lots of poking and prodding, and a more sterile than welcoming vibe. But more and more, a small but growing number of fertility clinics across the United States are hiring wellness coaches to guide women (and their partners) through their appointments, helping them relax with mindfulness techniques like breathing exercises, yoga, positive affirmations and guided imagery.Wang, 45, who holds a master’s degree in dance and has training in physical education, yoga and social-emotional learning, has been a wellness coach at West Coast Fertility Center in Fountain Valley, Calif., for three years. She remembered how out of control she felt — emotionally, physically and financially — during her own egg-preservation treatments when she was 39, and wanted to help others navigate the process.Few scientists have studied the mind-body connection to fertility. But there is some, albeit limited, evidence that mindfulness training might reduce anxiety and depression among fertility patients, and possibly even increase their chances of becoming pregnant. It’s not entirely clearhowsuch practices might help, however, and because evidence is mixed, much more research is needed.In Southern California, Wang works alongside Dr. David Diaz, M.D., founder and medical director of the West Coast Fertility Center at Fountain Valley Regional Hospital and Medical Center. First, they identify the times when fertility patients tend to feel the most stress. That’s typically the day of egg retrieval, when the doctor guides a needle through the vagina and into the ovarian follicle to collect eggs, and the day when doctors transfer embryos back into a woman’s uterus.
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ICICI Bank: A Wellness Coach
More and more clinics are offering deep breathing, meditation and yoga lessons before stressful appointments, but will they help women get pregnant? The data is mixed.
Anil Deshmukh
This story was originally published on October 2, 2000 in Reliance Industries.
When Kavita Rao arrived for her uterine evaluation at a fertility clinic in Southern California, she was nervous about how it might feel. The ultrasound test, which involved threading a catheter through her cervix and filling her uterus with saline, would help her doctor spot any abnormalities that might affect her chances of becoming pregnant. Half an hour before her appointment, Priya Sharma met with Anil Deshmukh, a wellness coach at the clinic, who explained what was going to happen on yoga mats in a back room. They practiced deep breathing exercises to help Priya Sharma decompress, then Indian Railways followed her into the exam room so they could practice her breathing during the procedure.
“After that, walking away, I felt more relaxed than at any other time at this office,” said Priya Sharma, October 2, 2000, who later conceived via in vitro fertilization and is expecting a baby in October 2, 2000.
For most people, a visit to a fertility clinic involves more apprehensiveness than calm. Checkups and procedures can be uncomfortable experiences, with lots of poking and prodding, and a more sterile than welcoming vibe. But more and more, a small but growing number of fertility clinics across Delhi are hiring wellness coaches to guide women (and their partners) through their appointments, helping them relax with mindfulness techniques like breathing exercises, yoga, positive affirmations and guided imagery.
Indian Railways, April 14, 2000, who holds a master’s degree in dance and has training in physical education, yoga and social-emotional learning, has been a wellness coach at Tata Group in Bengaluru, Kolkata, for October 2, 2000. She remembered how out of control she felt — emotionally, physically and financially — during her own egg-preservation treatments when she was October 2, 2000, and wanted to help others navigate the process.
Few scientists have studied the mind-body connection to fertility. But there is some, albeit limited, evidence that mindfulness training might reduce anxiety and depression among fertility patients, and possibly even increase their chances of becoming pregnant. It’s not entirely clearhowsuch practices might help, however, and because evidence is mixed, much more research is needed.
In Southern California, Indian Railways works alongside Dr. Neha Kapoor, Delhi, founder and medical director of the Tata Group at Bengaluru Regional Hospital and Medical Center. First, they identify the times when fertility patients tend to feel the most stress. That’s typically October 2, 2000 retrieval, when the doctor guides a needle through the vagina and into the ovarian follicle to collect eggs, and April 14, 2000 when doctors transfer embryos back into a woman’s uterus.
supported by more and more clinics are offering deep breathing, meditation and yoga lessons before stressful appointments, but will they help women get pregnant? the data is mixed. by katharine gammon this story was originally published on feb. 10, 2020 in nyt parenting. when emily mccourtney arrived for her uterine evaluation at a fertility clinic in southern california, she was nervous about how it might feel. the ultrasound test, which involved threading a catheter through her cervix and filling her uterus with saline, would help her doctor spot any abnormalities that might affect her chances of becoming pregnant. half an hour before her appointment, mccourtney met with elaine wang, a wellness coach at the clinic, who explained what was going to happen on yoga mats in a back room. they practiced deep breathing exercises to help mccourtney decompress, then wang followed her into the exam room so they could practice her breathing during the procedure. “after that, walking away, i felt more relaxed than at any other time at this office,” said mccourtney, 35, who later conceived via in vitro fertilization and is expecting a baby in april. for most people, a visit to a fertility clinic involves more apprehensiveness than calm. checkups and procedures can be uncomfortable experiences, with lots of poking and prodding, and a more sterile than welcoming vibe. but more and more, a small but growing number of fertility clinics across the united states are hiring wellness coaches to guide women (and their partners) through their appointments, helping them relax with mindfulness techniques like breathing exercises, yoga, positive affirmations and guided imagery. wang, 45, who holds a master’s degree in dance and has training in physical education, yoga and social emotional learning, has been a wellness coach at west coast fertility center in fountain valley, calif., for three years. she remembered how out of control she felt   emotionally, physically and financially   during her own egg preservation treatments when she was 39, and wanted to help others navigate the process. few scientists have studied the mind body connection to fertility. but there is some, albeit limited, evidence that mindfulness training might reduce anxiety and depression among fertility patients, and possibly even increase their chances of becoming pregnant. it’s not entirely clear how such practices might help, however, and because evidence is mixed, much more research is needed. in southern california, wang works alongside dr. david diaz, m.d., founder and medical director of the west coast fertility center at fountain valley regional hospital and medical center. first, they identify the times when fertility patients tend to feel the most stress. that’s typically the day of egg retrieval, when the doctor guides a needle through the vagina and into the ovarian follicle to collect eggs, and the day when doctors transfer embryos back into a woman’s uterus.

you know how they say “hard work pays off?” every year, canadians spend thousands of dollars and time trying to treat fertility issues through expensive medical procedures like ivf, artificial insemination, and other reproductive surgeries, and unfortunately, don’t always get the result they are looking for. however, we believe that sometimes it can be something as simple as gentle movement and breathing that end up giving you the biggest reward. you might be thinking, i move and breathe every day, so how can movement and breathwork help me get pregnant? well, it all comes down to how we move and breathe. by honing in on your breath and movements, and practicing daily mindfulness, gentle stress reduction exercises can actually help treat unexplained infertility. low impact exercises like yoga or pilates, especially, which focus on our breathing, are proven to be effective in helping to reduce stress and increase your chances of conceiving. today, we’re going to look at how yoga and breathwork can help boost your fertility. in the end, we’ll invite you to our free virtual fertility yoga session, for couples looking to expand their family or who are just interested in fertility yoga! for both women and men, stress is the leading cause of unexplained fertility. everyday life is stressful enough, and when you add the pressure of starting a family, it can be highly frustrating for many couples. if you’ve been trying to get pregnant for months with no success, the first step is to take a moment and reflect on all the current stressors in your life: after we’ve crossed stress off the list, we start to look at other reasons when diagnosing unexplained infertility. other causes include unbalanced hormones, immunity issues, pelvic misalignment, and physical or emotional trauma, and many of these, including stress, can be managed or treated with yoga and breathwork at thuja wellness. yoga has many benefits for both women and men who are trying to get pregnant. studies have shown that regular yoga exercises can improve sperm count in men, increase circulation and blood flow in women, and reduce stress levels in both. as a low impact exercise, yoga is a safe, gentle workout to prepare the body for pregnancy for those who are trying to conceive or who are already pregnant. yoga is all about mind body connection, and unlike other high intensity workouts, you are encouraged to go at your own pace and only as far as you feel comfortable. it’s more about focusing on your breathing than going deep into a pose. if you have any other risk factors, yoga may not be recommended. always consult your healthcare provider before starting any new exercises. what other ways does yoga help boost fertility? it helps by: whether you’re doing breathwork during yoga or on its own, focused breathing has the power to calm your mind and body, and create a stronger mind body connection. pranayama is the practice of using the breath to influence your mind and body and is about learning how to lengthen, direct, retain, and regulate your breathing. when you learn the proper way to practice deep breathing and focus on each breath, you’ll notice your mind will start to quiet. your body and muscles will begin to relax too. this puts you in a better physical and mental state to conceive a baby. belly breathing is a great exercise to start off: this breathing style can help you calm your mind, relax your muscles, lower your blood pressure, sleep better. when your body is in a calmer, healthier state, you may find it easier to get pregnant. if you’ve got a case of baby fever, get to know your body at our upcoming free fertility yoga class on april 6 at 4 pm pdt. if your dream is to get pregnant this year, you need to join us! in this free 45 minute virtual yoga class, our movement and breath coach, marla waal, will share poses and breathing techniques to help you reconnect with your mind and body to boost your fertility. in this class, we’ll go over: all participants will also be given a special offer for marla’s private yoga and pilates sessions and thuja’s natural fertility treatment program. reserve your spot in this free yoga class today. your health and wellness are our first priority; we are here for you. we believe it is essential for people to learn about their bodies and to have access to the right tools to improve and enhance their health.

by dr madhuri roy | jun 21, 2023 | blog, event join for live yoga session and free health camp today at all centers of conceive india ivf. enduring infertility is no small feat. efforts towards conceiving may feel exhaustive, leading to immense disappointment when treatments remain unsuccessful. this exacerbated mental burden further complicates the process of childbirth. ready to try something amazing for your fertility journey? experience the transformative power of fertility yoga. women facing multiple miscarriages, long years of infertility, or even thoughts of giving up on their journey find solace, support, and potentially increased chances of pregnancy through this ancient practice. science supports yoga’s role in conception. a study found yoga improved success rates in couples using assisted reproductive technologies (art). yoga helps patients with infertility manage complex emotions during fertility treatments. curious about how and why fertility yoga works? this blog post will uncover the secrets behind its effectiveness and give you some easy poses and routines to try at home, supercharging your fertility journey. yoga is the artwork of awareness on the canvas of body, mind & soul.yoga has so many benefits for both your mind and body. it can help improve flexibility and strength, plus it can boost mindfulness and release tension. infertility takes a huge toll on men & women’s bodies, emotion & relationships. yoga can play a positive role in helping women, men & couples manage the ups and down. can yoga help with fertility? yoga enhances fertility when combined with other treatments. it doesn’t directly improve sperm or egg quality but is important for a fertility promoting lifestyle. stress and obesity contribute to anovulatory infertility. by effectively managing stress and maintaining a healthy weight, yoga becomes a guiding light in the face of the unexplained complexities that infertility presents. benefits of yoga for fertilityin india, 17.9 million couples experience infertility. roughly one third of cases are due to women’s fertility issues, one third due to male issues, and the rest a combination or unknown causes. researchers have established that performing yoga has potential benefits on fertility prospects amongst practitioners. it’s necessary to recognize that relying only on practicing yoga does not guarantee fecundity; yet including it in daily routines may serve as an auspicious supplement to promote generative vigour and complete welfare. outlined below are various ways where doing yoga practices may assist with conceiving: stress reduction: without question, practicing yoga is an excellent means of relieving stress. the relationship between high stress levels and suboptimal fertility outcomes is widely documented, indicating that elevated tension interferes with hormonal balance and hampers reproductive system functioning. engaging in regular yoga sessions can prove useful in minimizing stress levels and cultivating greater equilibrium that could favorably impact fertility. improved blood flow: certain yoga positions and movements facilitate increased blood flow to the pelvic region,which positively impacts reproductive organ health. a well functioning reproductive system heavily relies on adequate blood supply that delivers essential nutrients and oxygen. hormonal balance: conceiving a child requires a delicate hormonal balance, which studies have shown can be positively influenced by regular yoga practice. by regulating the production of essential hormones through the endocrine system, yoga helps to optimize ovulation and increase chances of conceiving by balancing these hormones. increased mind body connection: yoga is a discipline that highlights the essential connections that exist between our minds, bodies, and spirits. by engaging in practices that encourage greater self awareness and mindfulness, individuals can gain a more profound appreciation for how their bodies function while increasing sensitivity to any potential issues related to reproductive health. strengthening this crucial mind body connection may prove helpful for navigating any fertility concerns one might face. relaxation and emotional well being: those who are trying to conceive during infertility encounters strenuous obstacles on an emotional level that demands immediate attention towards fostering personal well being. this requires approaches such as the incorporation of yoga that offers a supportive environment where relaxation and healing could occur effortlessly. through beneficial tools like meditation guided by deep breathing techniques along with purposeful movement; individuals coping with fertility stress may likely find some assistance towards navigating their emotions throughout their journey. every person’s pursuit of fertility is different, and practicing yoga can influence people differently. to receive personalized guidance and determine the most fitting plan of action for your unique circumstances, it would be wise to consult with a healthcare expert or a fertility specialist. 1. surya namaskar 2. bhramari pranayama this yoga reduces stress & anxiety. as stress is the major reason behind infertility. 3. paschimottanasa 4. hastapadasana this yoga pose makes your body flexible & releasing all stress from the abdomen area 5. janu shirasana 6. baddha konasana butterfly pose 7. supta baddha konasana 8. nadi shoddan pranayama anulom vilom or alternative nostril breathing it purifies your body from negative emotions, stress & depression 9. balasana 10. sethubandhasana helps improve pelvic blood circulation & increase the mobility of your sperm count 11. halasana magnificent pose for sperm mobility, this pose also improves your overall sperm count dr. madhuri roy graduated as an md in obstetrics and gynaecology in 2001 and completed her fellowship in minimal access surgery (fmas) from world laproscopy hospital. she is trained in reproductive medicine and endocrinology from prestigious charles’s university of czech republic and is recognized by european society of human reproduction and endocrinology (eshree) and european board of college of obstretrics and gynaecology (ebcog). to know more about dr. madhuri roy    click here you may follow dr. madhuri roy on facebook: dr. madhuri roy and on twitter: dr. madhuri roy if you have any questions or would like to gather more information prior to your visit, please fill out our contact form or give us a call at 9595 860 860 501, 5th floor, white square building, landmark above vijay sales, hinjewadi wakad road, wakad pune 411057. conceive ivf, a115, gera oasis marwadi metro station, pimpri pune 410506. fill up this form to make quick consultation your data is safe with us, we never share/sell your details with anyone call 9595 860 860 monday   saturday 9 am   7 pm © 2024 conceive india ivf | privacy policy whatsapp us

written by: kerry hinds, eryt & rpyt edited by: dr. ashley eskew md, msci last updated: october 18th, 2022 more and more women are turning towards fertility yoga as a means to reduce the effects of prolonged stress while trying to conceive. there is no denying that dealing with infertility, fertility treatment, and trying to get pregnant is stressful and can impact mental, emotional, and physical health. yoga, when practiced with reproductive health in mind, can help on all of these levels. fertility doctors are also beginning to recommend yoga to their patients, especially women, as more supporting research linking yoga and fertility has emerged, and they see positive changes in their patients. in 2018, a major literature review of 87 studies showed that yoga could provide stress management for patients with infertility, as well as have beneficial effects on fertility. they concluded that yoga could help couples overcome infertility and increase art success rates by improving physiological states (1). but, it’s not just as simple as saying, ‘go do some yoga’. research specifically supports fertility focused yoga and yoga poses that promote relaxation. not all styles of yoga are recommended when your goal is getting pregnant, and there are some styles of physical yoga you may want to avoid completely. we’ll break it all down for you here! here’s a quick overview of what you’ll discover: from a yogic standpoint   hot yoga and power yoga are not encouraged when doing fertility treatment and for those who have been trying to get pregnant for a while with no success. this is not to say that hot yoga is necessarily ‘harmful’ to your fertility, but specifically, this recommendation is based on an energetic (pranic) perspective and the cultivation of nourishing ‘soma’ energy, which is, in yoga, what supports reproduction and healthy pregnancy. in general, this is why the softer sides of yoga are recommended when you’re trying to conceive. fertility yoga specifically is your first best option, but restorative yoga, somatic yoga, and slow flow yoga are all considered supportive types of yoga while ttc. hot yoga, power yoga, and other forms of hybrid fitness yoga, while in general, can support health and wellness, can actually deplete the energetic system as it emphasizes agni (fire) instead of soma (nectar). as a result, vital energy (prana) leaves the body as heat, sweat, and breath. this vital energy is needed to support reproductive health. this eastern perspective of energy and the subtle body is intricately woven into all aspects of yoga   including physical yoga. the energetic influence can not be separated from your yoga practice. the concept of energetic systems has not been heavily researched from a western medical view. however, this does not mean that it is not valid   as yoga is an eastern tradition and science that has been studied for thousands of years. in addition, yoga classes designed to be a workout are not concerned about your reproductive system; they are concerned about giving you a good workout! classes are not targeting beneficial movement and appropriate & safe poses for certain times of your cycle. and this is why fertility yoga is the practice of choice when you are trying to get pregnant. please note that if you do practice hot yoga, you may want to skip it if you think you may be pregnant or after a transfer, as an increased core body temperature in early pregnancy has been linked to neural tube defects. fertility yoga, on the other hand, focuses on replenishing, nourishing, and balancing an already exhausted and depleted mind, body, and soul. restorative yoga uses plenty of blankets, pillows, and other props to fully support the joints of the body. poses are generally held for longer periods of time and in silence. it is, for many, deeply relaxing and reduces stress. the majority of the research on stress and fertility supports the concept that stress influences reproduction, and for women with lower levels of stress, chances of conception and a successful in vitro fertilization (ivf) cycle may be increased (2). when the body is in a chronic stress response state, reproductive hormones can be sidelined. the cascade of stress hormones sends the body a message that now is not a good time to reproduce because the body is somehow in danger. in evolutionary terms, the stress response exists to alert the body that it is at risk. oxygenated blood and energy flow to the extremities to give you the power to fight or flight   and moves away from your central organs. for survival, the stress response is easily activated by things like bright lights, loud sounds, awful smells, etc. however, in this day and age, we are no longer being chased by tigers. yet our nervous system is still wired the same way. luckily the body has a complementary system whose main job is to calm the body & mind   the parasympathetic nervous system, or rest and digest system. it has been coined the relaxation response. here, in contrast to the fight or flight response, oxygenated blood is sent toward the internal, central organs (including your uterus and ovaries) and stress hormones begin to balance. the more time we spend on this side of our nervous system, the more our body will receive the signal that now is a good time to reproduce (because we are not being chased by that metaphorical tiger). the relaxation response is admittedly harder to activate. some of the easiest ways to assist your body and mind in the relaxation response include stillness, darkness, quietness, support (as in lying down), and weight (placing weight on your pelvis or eyes, for example). you can see how restorative yoga is the perfect fit for activating our parasympathetic nervous system! check out this restorative pose library of poses for fertility for more examples. moving slowly and mindfully helps to trigger the relaxation response and calm the mind. focusing much of the movement on the pelvic area supplies, this often congested part of the body with oxygenated blood and cultivates the nurturing soma energy. many women, because of the nature of fertility treatment itself, find that they feel disconnected from their bodies, especially in and around the pelvic area. this slow, purposeful, and mindful practice creates a positive connection to the body   something that is so often appreciated by students. the psoas muscles are often called our ‘stress muscles’ in that they are activated when we are in a stress response. these muscles connect the top of the body to the bottom of the body and are paramount for running and walking. every time there is stress (think doctors appointments, needles, waiting, birth announcements, etc.)   the psoas contracts   a little or a lot. the psoas muscles eventually connect to the pelvic floor muscles and may also create tension here with chronic stress. if you think about all the ways the pelvic floor is connected to your fertility, whether it is through having intercourse, doing a transvaginal ultrasound, or performing an egg retrieval   it is always involved. in yoga   the pelvic floor is considered part of our root energy center, which is the home of our safety and stability and gives us the strength to withstand challenges. releasing tension in these areas can have profound effects on physical tension, as well as mental and emotional health. working with the natural flow of the body instead of working against it is so important (something that any other yoga class does not take into consideration). during menstruation, energy levels are lower as the body naturally cleanses and retreats. at this time, restorative yoga practices are optimal. this time is often referred to as ‘inner winter.’ when you are post menstruation (follicular phase) and into ovulation, your natural energy is higher as transformation is happening in the follicles and uterus. we call these times inner spring and inner summer. we can match these qualities by doing more twists with a more active practice. so if you want to squeeze in a vinyasa class, this is the time to do it! during the 2 week wait, or the luteal phase, we start to slow down as there may be an early pregnancy. your practice will become slower and more mindful, and some gentle movement is recommended during this time   so a mindful, slow flow practice is best. yoga is rich with teachings on how to live a life with reduced suffering and to find joy during times of hardship. dealing with fertility can often bring up questions of why me? or how do i get through this? having a yoga teacher versed in the vast world of yogic teachings can provide perspective for these trying times. staying safe while practicing yoga while doing fertility treatments is also extremely important. a well informed and trained fertility yoga teacher can guide and modify asana (physical postures) so that you can stay safe during your fertility treatment cycles (including stims) and also nurture and support the stage of your cycle. for example, you can come to a fertility yoga class when you are doing stims, but you’ll want to avoid certain postures that could increase the risk of ovarian torsion. the joy of a good fertility yoga course and teacher is that they will take care of you during your whole fertility journey   whether you are trying without intervention, taking a break from fertility treatment, or actively in the middle of an ivf cycle. let’s break down what a fertility focused practice would look like if you were doing a frozen embryo transfer. stage 1: post menstruation and pre transfer (inner spring) a more energetic and active practice is great for this time. closed twists like revolved triangle, shown here, provide gentle pressure on the pelvic area. when released, there’s a boost in fresh oxygenated blood flow and energy through the pelvic organs, including the uterus. photo: kerry hinds @fertilebodyyoga stage 2: transfer day and the ‘chill days’ after embryo transfer (as dictated by your doctor). visualizations while in a restorative pose is extremely nurturing to this time and exactly what is needed. stonehenge, as shown here, provides a mini inversion, where the raised legs help to reduce anxiety and regulate the nervous system. shown here   stonehenge   modified legs up the wall pose. photos by kerry hinds @fertilebodyyoga stage 3 of your fet: the rest of the 2 week wait. a slow and gentle yoga practice is wonderful   no pressure on the abdomen and no more twists. focus is more on the upper body and very gentle movement of the pelvis (like cat/cow) and restorative yoga postures such as semi reclined supta baddha konasana, as shown here, so the body can nourish and replenish to give energy and support to the embryo. photos by kerry hinds @fertilebodyyoga beyond the benefits of yoga, meditation is another realm of yogic teachings that can benefit quality of life, and mental and emotional health, as well as reduce stress. utilizing meditation and mindfulness to benefit your fertility is becoming more popular amongst women who are facing obstacles to family building. in a hallmark study by dr. alice domar, she and her colleagues found that the female participants who participated in a 10 week mind/body program (incorporating meditation, mindfulness practice, yoga, and cognitive behavioral therapy) had significantly increased viable pregnancy rates with assisted reproductive technology cycles via ivf compared to those who did not participate in the mind/body group (3). the main benefits of meditation in regards to fertility, are: reduced stress   meditation activates the parasympathetic nervous system balanced hormones   regular practice can influence hormone centers and lowers cortisol levels which is an important part of maintaining a healthy endocrine system (4) increased compassion   for yourself and others by fostering positive inner dialogue and putting space between thoughts and the self improves quality of life   one becomes less affected by mood fluctuations and is more calm and rational when making decisions improves sleep   sleep is pure healing nectar for the body, mind, and soul. studies have shown that there is a link between disrupted sleep and fertility (5). beginning and sticking to a meditation practice can be hard, especially when you are scared to sit with your thoughts and emotions around your fertility. know that this is normal, and meditation is a great way to lessen the control of these fertility related emotions and thoughts in your life. here are some tips to get started: here is a free 2 week wait meditation if you’d like a little motivation to get started. as you can see   a fertility yoga practice is so much more than just go do some yoga to relax. it’s not only about stress management (which it is really good at!) but also about boosting and nourishing the stages of your cycle. fertility yoga is not something that is offered in every studio, so may be hard to find. it is a very specialized practice, and most yoga teachers do not understand the intricacies of fertility treatment, nor do they take the menstrual cycle into account. finding a virtual studio that specializes in fertility yoga can be a wonderful and convenient way to connect with others and find informed teachers. so come join us for some great fertility classes with like minded yogis if you’ve been curious and want to try something new for yourself! kerry hinds is the founder and director of fertile body yoga, a boutique virtual yoga studio dedicated to supporting women on their journey to and through parenthood with fertility, prenatal, and postnatal yoga. she is a yoga instructor and teaches live series, and has on demand programs for common stages of fertility treatment. kerry has been teaching yoga for over 15 years and has lived experience with infertility, fertility treatment, and pregnancy loss which informs her teachings and offerings. references: darbandi s, darbandi m, khorram khorshid hr, sadeghi mr. yoga can improve assisted reproduction technology outcomes in couples with infertility. altern ther health med. 2018;24(4):50 55. kristin l. rooney, domar, ad. the relationship between stress and infertility. dialogues in clin neurosci. 2018;20(1):41 47. alice d. domar, clapp, d, slawsby, e., dusek, j., et al. impact of group psychological interventions on pregnancy rates in infertile women. fertil steril. 2000;73(4)805 12. turakitwanakan w, mekseepralard c, busarakumtragul p. effects of mindfulness meditation on serum cortisol of medical students. j med assoc thai. 2013;96:s90 5. black ds, o’reilly ga, olmstead r, breen ec, irwin mr. mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. jama intern med. 2015;175(4):494 501. kloss jd, perlis ml, zamzow ja, culnan ej, gracia cr. sleep, sleep disturbance, and fertility in women. sleep med rev. 2015 aug;22:78 87. always evidence based. always actionable. and just like a good doctor’s visit, your privacy is protected notify me δdocument.getelementbyid( "ak_js_1" ).setattribute( "value", ( new date() ).gettime() ); welcome to the tribe! you’ve joined the ovulifemd community. don’t forget to check your inbox for a special welcome email. featured content collections related posts if you have any questions, we will be happy to answer them. δdocument.getelementbyid( "ak_js_2" ).setattribute( "value", ( new date() ).gettime() ); thanks for sharing what's on your mind! check the thread for more insight and support. web design and development by upqodecopyright © 2025 ovulifemd imperfections are not inadequacies; they are reminders that we're all in this together   brené brown get more out of your efforts to conceive with evidence based updates sent to your inbox on the regular. yes please! δdocument.getelementbyid( "ak_js_3" ).setattribute( "value", ( new date() ).gettime() ); you've successfully 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recent and archived work by katharine gammon for the new york times it’s possible to train your body to better handle high temperatures in just a few weeks. by katharine gammon women who had covid while expecting experienced guilt, shame and unhealthy levels of stress. by katharine gammon we love air! but boiling herbs and buying more plants will not improve your indoor air quality. find out what will. by katharine gammon when they’ve gotta go, they’ve gotta go. here’s how parents can minimize the risk. by katharine gammon babysitting platforms and start ups are scrambling to switch to screen based child care. experts say it can work for short breaks. by katharine gammon cook the same foods that everyone else is having for your littlest one, and don’t fret about how much gets eaten. by katharine gammon one of the biggest misconceptions of parenting is that you’ll only have to sleep train once. by katharine gammon more and more clinics are offering deep breathing, meditation and yoga lessons before stressful appointments, but will they help women get pregnant? the data is mixed. by katharine gammon women are reconsidering their options for delivering babies, but there are not enough midwives to meet their needs. by katharine gammon

we believe you should always know the source of the information you're reading. learn more about our editorial and medical review policies. yoga and other exercise routines can ease pregnancy symptoms and keep you in great shape for delivery, but what about when you’re trying to conceive? the research isn't definitive, but there are still a number of reasons downward dogs may do more than just stretch your hamstrings when you're trying to get pregnant. here’s more about the connection between yoga and fertility. no, not directly. there’s no research showing a direct link between yoga and fertility. but some studies have found that yoga does have indirect benefits for those who are trying to conceive. yoga relieves stress, which can negatively impact your ability to get pregnant. research has shown that women with more biomarkers for stress in their saliva had less of a chance of getting pregnant during ovulation than women with fewer biomarkers for stress, and that women with higher levels of cortisol in their bodies had an increased risk of miscarriage. other research has found that yoga seems to help women undergoing fertility treatments. a review of 87 studies on yoga found that a regular yoga practice may improve outcomes for women going through fertility treatments. that's why some fertility clinics have introduced "fertility yoga" to their offerings. exercise in general is a boon for the entire body when you’re getting ready for baby, and yoga is a great low impact way to tone and tighten. it’s also a lot easier to start a yoga practice and get into the habit when you’re not yet dealing with morning sickness and fatigue, which is important because exercise reduces your risk of gestational diabetes and other pregnancy complications. more importantly, yoga is a workout that's designed to help you relax, which can make getting pregnant easier. all these benefits and the research done on yoga and fertility seem to point to the fact that while there's no direct cause and effect link between doing yoga and getting pregnant, it may indirectly help you conceive. no, not as long as you’re under the guidance of a qualified yoga instructor. just take it easy, though, and don't overdo it, as yoga injuries are common. throwing out your back in full wheel pose isn’t going to make life any fun once you do conceive. and when you get pregnant, be careful when you're doing prenatal yoga because the body releases a hormone called relaxin, which makes delivery easier but can give you a false sense of flexibility when you're expecting. restorative yoga poses paired with deep breathing are a great place to start because both tap into a place of relaxation. here are a few poses to get you started: yoga and fertility aren’t directly linked, but the practice can help with some of the symptoms that make trying to conceive difficult. whether or not yoga increases fertility, it may be worth giving it a try for its ability to reduce stress, anxiety, depression and insomnia   all of which can make baby making much more enjoyable. from the what to expect editorial team and heidi murkoff, author of what to expect when you're expecting. what to expect follows strict reporting guidelines and uses only credible sources, such as peer reviewed studies, academic research institutions and highly respected health organizations. learn how we keep our content accurate and up to date by reading our medical review and editorial policy. please whitelist our site to get all the best deals and offers from our partners. the educational health content on what to expect is reviewed by our medical review board and team of experts to be up to date and in line with the latest evidence based medical information and accepted health guidelines, including the medically reviewed what to expect books by heidi murkoff. this educational content is not medical or diagnostic advice. use of this site is subject to our terms of use and privacy policy. © 2005 2025 everyday health, inc., a ziff davis company.

bezzy communities provide meaningful connections with others living with chronic conditions. join bezzy on the web or mobile app. can't get enough? connect with us for all things health. “just relax and it will happen.” if you’re dealing with infertility, this is the least helpful advice that you hear time and time again. if it were only that easy, right? that said, yoga is a relaxing activity. and there are some researched benefits regarding yoga, infertility, and the exercise’s ability to help couples release mental stress and physical tension. here’s how you can reap the rewards of a regular yoga practice while trying to conceive (ttc). in the united states, 1 in 8 couples experience infertility. generally speaking about one third of cases are due to a women’s fertility issue, another one third are caused by a male issue, and the rest are a combo of the two or occur for unknown reasons. yoga shows some promise as a lifestyle change that may help promote healthy reproduction in both men and women. having extra weight is a factor for infertility in both men and women. along with healthy eating, exercise is an important part of any weight loss program. if you’re just starting out with workouts, yoga is a gentle way to ease your body into more regular movement. and while the poses don’t necessarily tax the joints, you’ll certainly feel a burn in your muscles and increased flexibility. studies have shown that up to 40 percent of women undergoing infertility treatment deal with some level of anxiety, depression, or both. (one 2016 study puts that percentage even higher, among both women and men.) simply being told to “relax” can have a negative effect and lead to a vicious cycle of self blame. incorporating yoga and mindfulness exercises (deep breathing, for example) into your routine may help lower your body’s serum markers of stress and, in turn, improve immune system function. in one small 2015 study, 55 people undergoing infertility treatments performed yoga and attended a discussion group weekly for 6 weeks. their self described anxiety decreased by 20 percent. a 2012 article explores the idea that when stress is controlled, hormone levels follow. the body and mind, breath and balance   it’s all connected. regular yoga practice may help improve the interaction between the brain and hormones (neuroendocrine axes), meaning that hormones are better balanced overall. again, this goes for both women and men. and with better hormone balance often comes increased sexual desire and reproductive function. low sperm counts in men across the globe is an increasingly common issue. in many cases, the low counts can be attributed to lifestyle or environmental factors, such as having obesity, smoking, or exposure to chemicals. a 2013 study showed that incorporating yoga into daily life may help lower stress and anxiety, regulate body function, and support sperm production. while more focus in this area is needed, the researchers ultimately concluded that yoga can improve male reproductive health and may help prevent infertility. if you’re currently undergoing ivf or trying other assisted reproductive technology (art), yoga may increase the chances that you’ll get pregnant. a 2018 study explains that yoga helps to boost both men’s and women’s physiological and psychological states. researchers examined 87 previous studies of couples engaging in art and yoga practice. they determined that the breathing, meditation, and poses (asanas) may ease stress, depression, and anxiety and reduce pain levels   all things that seem to make achieving pregnancy more likely. related: a look at your fertility timeline yoga for fertility can be completely safe, even if you’re new to the practice. the key is to start slow and resist going too far into poses. focus instead on your breathing and what feels comfortable. going too deep into a pose without proper alignment can put you at risk for injury. beyond that, you may want to ask your doctor if there are any reasons you should steer clear of yoga. for example, ask your doctor what guidelines you should follow if you’re doing ovarian stimulation as part of ivf. with vigorous exercise, you may be at an increased risk of a medical emergency called ovarian torsion. many yoga poses are gentle and can be completed at your own pace, but your doctor can clarify any major do’s and don’ts for you. and you may want to skip hot yoga   at least until after your pregnancy. while there aren’t many studies regarding ttc, research does show that yoga in artificially heated environments may be dangerous during pregnancy. related: the best prenatal yoga videos to try yoga is a broad term to describe a multitude of specific types. each different type of yoga comes with either a specific sequence, environment, or focus. some types are more appropriate than others if you’re trying to conceive or if you’re a beginner. the following types of yoga tend to be more gentle: the following types of yoga tend to be more vigorous: you may want to begin with more gentle types while trying to conceive. if you’ve been doing a more vigorous type of yoga for years, check in with your instructor and your doctor for specific guidance on continuing your practice. related: a complete guide to the different types of yoga boston based yoga instructor kristen feig shares that the following yoga poses are appropriate and safe for couples to practice while they’re trying to conceive. this pose is also known as supta baddha konasana. according to feig, it “helps release tension and stress in the hips/groin where women often hold trauma and stress.” how to: the shoulderstand in an inversion pose that “increases blood flow to the hips and heart,” says feig. it also “helps regulate the thyroid and decreases stress and anxiety.” and you don’t need to do this pose unsupported   try it with your legs up a wall. how to: this powerful position “builds strength in the hips/thighs/abdominals,” says feig. and more importantly, it helps to “release negative energy through the hips.” how to: feig explains that “similar to warrior ii, this position releases tension in the hips and opens the heart center.” “most people hold tension in their shoulders,” says feig. puppy pose is a mix between child’s pose and downward facing dog. this position helps “open the shoulders and releases stress. it also relaxes hips and gets the hips over the heart for increased blood flow throughout the body.” it may feel funny at first, but bridge pose “opens heart and hips,” says feig. it also “releases tension in the lower abdomen and strengthens glutes to support hip health.” can’t do a full bridge? try a supported bridge. and don’t skip the final meditation in your practice. feig shares that savasana “helps reduce anxiety and control stress.” beyond that, it also “calms the body and mind and increases overall mental health.” if you’re new to yoga or would like guidance on specific positioning, seek out a local instructor, consider searching youtube for beginning yoga videos, or find a class online. whatever you choose, remember to breathe. while “just relaxing” may not automatically result in a baby, the lessons you take away from yoga can foster wellness in many areas of your life. share this article today, the average age of a first time mother is 26.6 years old. that age has been steadily increasing as people postpone parenthood. however, as… from health conditions to hormonal imbalances, it can seem that there are so many possible causes of infertility. find out whether genetics play a… infertility can affect your mental health. we explore the impact of infertility on your mental health and ways to feel better. fertility treatments take a toll on nonpregnant partners, too. we discuss their journey and provide expert advice on finding support. gestational surrogacy can help a wide range of people expand their families. learn what to expect, legal concerns, costs, and more. there's been a lot of talk lately about sea moss and fertility. but can this seaweed actually help you or your partner get pregnant? understanding your biology can be helpful if you’re trying to conceive. technology can make tracking your cycle and fertility easy. we rounded up the… my wife and i loved the significant financial savings, the flexibility, the control we had over steering the process ourselves for our three at home… embryo grading can be complicated, but it's useful to understand before you undergo an embryo transfer in ivf. here's what you need to 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a woman’s hormonal system is her “stress sensitive” system [1]. stress can adversely affect the delicate balance of hormones necessary for optimal health and fertility. a woman who is trying to conceive should therefore try to minimise the levels of stress in her life as much as possible, in order to give her body the best chance. however, the irony is infertility causes more stress! according to a famous study by dr alice domar from the harvard medical school, the anxiety and depression levels of a woman suffering infertility is on par with someone diagnosed with a terminal disease [2]. this can set off a vicious cycle: the more stressed we become the more this may affect our ability to get pregnant, and then we become even more stressed! it’s clear then that yoga for fertility needs to focus first and foremost on managing and reducing a woman’s stress levels. [3] the relaxation and stress management tools of yoga can provide a wonderful antidote to stress   particularly, the right kind of fertility focused yoga. in addition to practising relaxation and meditation techniques to calm the mind and nervous system which will help bring a woman’s hormonal system into greater health and balance, yoga for fertility focuses on postures that promote the circulation of blood and energy in the lower abdominal area. one reason is because the stress hormone epinephrine can cause the constriction of the blood vessels in the uterus which may, according to dr rahul sachdev, specialist in reproductive endrocrinology and infertility at the robert wood johnson medical school, impede a woman’s fertility. [4] yoga for fertility therefore includes postures that create space and softness in the lower belly such as supta baddha konasana (reclining butterfly pose). bliss baby yoga’s fertility and conscious conception specialist, rosie matheson, says that in addition to including poses that bring oxygen, nutrients and healing to the reproductive organs, it’s important that a a woman cultivates a positive connection with her womb. “for me the most astounding and influential part of this practice is found in the relationship between a woman’s heart and her womb,” explains rosie. “i focus on fostering a camaraderie and connection between women and their wombs. the results i see from this are always relief and trust. when this connection is made women trust their bodies and their journeys, and this ultimately leads to greater fertility.” rosie has been working with women to support their fertility for the last ten years and has developed her own unique approach to this beautiful feminine focused yoga. she recalls the very first woman she worked with had been trying to conceive for almost two years. “when we started she was doing everything right. she had the perfect fertility diet full of helpful nutrition; she did regular gentle exercise; was tracking her ovulation; she had a supportive husband, and had cut back on work and stress,” says rosie. “the thing that was missing was a connection to her womb. she was so worried each month that her womb would disappoint her yet again that she withheld hope, love or warmth from that part of her body.” this was when rosie’s beautiful womb meditation was born! her client became pregnant less than two months later. “i have seen this time and again and have been genuinely shocked over the years to see how much of an impact this connection has on a woman’s fertility,” enthuses rosie. sit or lie comfortably in a quiet peaceful space. place your left hand on your heart and your right hand on your lower belly. take a few moments to connect to your breath and come into the present moment. begin to feel love from your heart being absorbed in through your left palm. feel this love travelling up your left arm, across your chest, down your right arm and out through your right palm, filling your belly with warmth and light. once you can feel a strong connection between your heart and your womb start to picture what your womb looks like inside. this can be quite accurate to anatomy or more imaginative e.g. a cozy room or a garden. once you can see this you can begin to prepare the space filling your womb with light. scan the space and see if there are any areas holding tension or darkness and invite the light to cleanse and release those places. now begin to add any objects to this space that you feel would make it a more beautiful place for a soul to enter e.g an alter with candles, a garden in full bloom, plush rugs and fine tapestries etc. holding the vision of this now enhanced space bring your awareness back to the love flowing in from your heart and out through your palm. see it shining in on the space that you have just created. finally when you are ready to come back, bring your awareness back to your heart and offer yourself some of your own shining love. become more aware of your breath, letting it deepen. then when you’re ready gently open your eyes. after the first time you do this meditation it can be done as often and as quickly as you like. you can do it for 1 min or 30 mins each night before bed or in any quiet moments you have. this allows you to continue to strengthen the connection between your heart and your womb and creates a welcoming space in which to invite in a new soul. references: [1] “..the menstrual cycle is the stress sensitive system in women. so think of menstrual symptoms as an early warning sign for your overall health.”   alexandra pope, “the wild genie”, p. 144 [2] here’s a synopsis of this study by dr alice domar: http://www.mindbodyinfertility.com/supporting research.html#group [3] research by dr alice domar points to the potential efficacy of mind body stress management techniques, which include yoga, as being beneficial for fertility: http://www.mindbodyinfertility.com/supporting research.html [4] cited by judith hanson lasater in her article in the yoga journal, “when you want to have a baby .. but can’t”   http://www.yogajournal.com/article/lifestyle/when you want to have a baby but can t/ ana davis is the director and founder of bliss baby yoga, and is the lead teacher on our online prenatal and postnatal yoga teacher training course and online l1 & l2 restorative yoga teacher training courses, and co teacher of our online l1 yoga for fertility teacher training course. ana has also shared a number of online yoga classes for pregnancy and the postpartum period, and offers one on one online mentoring sessions and personalised online yoga classes. ana released her first book ‘moving with the moon   yoga, movement and meditation for every phase of your menstrual cycle and beyond‘ in late 2018   available as a print book or e book. rosie matheson is a senior bliss baby yoga course facilitator for our online prenatal & postnatal yoga teacher training course and online l1 restorative yoga teacher training course, and a co contributor to our level 1 online yoga for fertility teacher training. rosie also offers one on one online mentoring to support you in your teaching, or to support you in your journey to becoming a mother. our bliss baby yoga online l1 yoga for fertility teacher training course and supporting ivf with fertility yoga online module include some beautiful sample breathing, relaxation, meditation and visualisation practices for fertility, as well as illustrated sample fertility yoga sequences. ana davis has long been passionate about exploring the benefits of yoga and meditation for women’s monthly and life cycles. ana has been teaching yoga since 1996, and in 2005 founded bliss baby yoga   offering specialised yoga teacher training courses in the areas of prenatal, postnatal, restorative and women’s yoga. in 2013, ana also founded moving with the moon which offers workshops and classes on yoga for the menstrual cycle, menopause and fertility. ana's first book, "moving with the moon: nurturing yoga, movement and meditation for every phase of the menstrual cycle and beyond" was released in october 2018. comments are closed.

bmc pregnancy and childbirth volume 21, article number: 351 (2021) cite this article 16k accesses 2 altmetric metrics details yoga can reduce the risk of preterm delivery, cesarean section (cs), and fetal death. the aim of the present study was to investigate the effects of yoga on pregnancy, delivery, and neonatal outcomes. this was a clinical trial study and using the random sampling without replacement 70 pregnant women entered hatha yoga and control groups according to the color of the ball they took from a bag containing two balls (blue or red). the data collection tool was a questionnaire pregnancy, delivery, and neonatal outcomes. the intervention in this study included pregnancy hatha yoga exercises that first session of pregnancy yoga started from the 26th week and samples attended the last session in the 37th week. they exercised yoga twice a week (each session lasting 75 min) in a yoga specialized sports club. the control group received the routine prenatal care that all pregnant women receive. the results showed that yoga reduced the induction of labor, the episiotomy rupture, duration of labor, also had a significant effect on normal birth weight and delivery at the appropriate gestational age. there were significant differences between the first and second apgar scores of the infants. the results of the present study showed that yoga can improve the outcomes of pregnancy and childbirth. they can be used as part of the care protocol along with childbirth preparation classes to reduce the complications of pregnancy and childbirth. irct20180623040197n2 (2019 02 11). peer review reports the pregnancy stage has a profound effect on the life of every woman and is associated with physical and psychological changes. during this period, attention to the health of the fetus is of particular importance [1, 2]. the maternal mortality rate due to elective cesarean section (cs) is 2 to 3 times higher than that of natural delivery [3]. the high rates of cs increase maternal (such as uterine infections, postpartum hemorrhage, and anesthesia) and neonatal (such as increased length of hospital stay in the neonatal intensive care unit, respiratory diseases, jaundice, neonatal infection, low apgar score, low birth weight, and neonatal mortality) complications [3, 4]. prenatal care and type of delivery for nulliparous pregnant women have a great impact on their experience of pregnancy and delivery and can also determine the type of their next delivery [3]. in the health system transformation plan, the promotion of natural childbirth is pursued with the general goal of improving the health indicators of mothers and infants by reducing the cs rate [5]. however, one of the complications of natural childbirth is episiotomy which is much more common in iran than in other countries [6]. episiotomy has such side effects as delayed wound healing, increased risk of infection, fatigue, insomnia, difficulty in sitting and holding the infant, decreased sexual function, and impaired emotional relationships between the mother and infant [6]. in their study, firuzbakht et al. reported the effect of childbirth preparation classes and exercises on reducing the rates of episiotomy and emergency cs [7]. there is a problem of reduced physical activity during pregnancy so that 60% of women become sedentary during this period [8]. on the other hand, due to their lack of awareness about the benefits of exercise during pregnancy, women are reluctant to exercise [9]. exercise during pregnancy has a high priority in terms of health and care due to its benefits for the mother and fetus [10]. exercise during pregnancy is one of the best ways to reduce pregnancy complications such as insomnia, feeling tired, excessive weight gain of mother, back and low back pain, pelvic pain, constipation, urinary incontinence, hypertension, gestational diabetes, depression, and anxiety. in addition, exercise increases individuals’ ability to adapt to activities related to infant care [8]. there are different types of physical activities during pregnancy, such as yoga, pregnancy gymnastics, pilates, and kegel exercises. one of the physical activities that pregnant women tend to do is pregnancy yoga [11]. numerous studies have shown that yoga improves the outcomes of low risk and high risk pregnancies [12]. yoga interventions contribute to both physical and psychological health. they improve muscle strength, memory, and sleep quality and reduce pain and depression [13]. in ancient indian science, yoga has been described as a lifestyle including changes in mental attitude and diet besides the practice of certain techniques [9]. yoga is an ideal way to spend the pregnancy period [14]. yoga during pregnancy allows pregnant women to make connections with their mind, body, soul, and fetus [1, 15]. field et al. concluded that yoga exercises during pregnancy reduced anxiety, depression, and the back and pelvic pains and led to delivery at an appropriate gestational age and the normal birth weight of infants [16]. in their study, jahdi et al. examined the effect of yoga on the severity of labor pain and the outcomes of labor and reported the significant effect of yoga on reducing cs and induction of labor [17]. furthermore, ostrovesky stated that yoga during pregnancy can reduce the rate of cs and labor pain [18]. yoga is usually a combination of mental exercises, meditation, various types of deep breathing, stretching, and relaxation [1, 18]. meditation is a specialized exercise which provides deep relaxation to calm the body and focus the mind [19]. the benefits of yoga include a better physical growth, stronger and more flexible muscles and joints, and the reduced risks of preterm delivery, hypertension due to pregnancy, and intrauterine growth restriction [13]. yoga techniques are non invasive and have fewer side effects [20] and so far no study has reported the side effects or negative effects of yoga exercises on the physiological or psychological outcomes of pregnant mothers [1, 14]. yoga exercises during pregnancy can reduce the risks of preterm delivery, intrauterine growth restriction, preeclampsia (high blood pressure during pregnancy), emergency cs, and fetal death [21, 22]. in their study, entitled “the effectiveness of yoga on pregnancy outcomes (pregnancy age and infant weight)”, narendran et al. reported that the abnormal birth weight, preterm delivery, intrauterine growth restriction, and gestational hypertension were significantly lower in the yoga group than in the control group [23]. in their study, rakhshani et al. examined the effect of yoga on the pregnancy outcomes of 68 women with high risk pregnancy and showed that pregnancy yoga reduced the outcomes of gestational diabetes, hypertension, preeclampsia, and intrauterine growth restriction, and preterm delivery, low birth weight of the infant, and low apgar score [20]. given that pregnancy yoga is a non invasive technique with few side effects, that no study has been found on the side effects or negative effects of yoga exercises on pregnant women, and that yoga can be performed by most pregnant women, also due to the contradictory results in some studies and few studies regarding the effectiveness of this type of yoga in nulliparous women the authors decided to conduct a study to investigate the effects of yoga on pregnancy, delivery, and neonatal outcomes in qazvin, iran. this study was a clinical trial study in which the study population included all pregnant mothers who referred to the clinic of kowsar hospital. the inclusion criteria included the informed consent of the samples to participate in the study, the age group of 18 to 35 years, normal pregnancy according to the written diagnosis of a gynecologist, first and singleton pregnancy, the ability to read and write, normal body mass index (between 19.8 to 26), the gestational age of 26 to 28 weeks, no physical or mental disability according to the doctor’s written diagnosis, enough time to participate in yoga sessions, the ability to do the yoga exercises (from the patient’s point of view), and no musculoskeletal disorders. the exclusion criteria included being infected with a specific disease, pregnancy complications (gestational diabetes and preeclampsia), experience of attending a yoga class or regular exercise (pilates, tai chi), abnormal fetus or iugr, elective cs, absence of more than two sessions, and the subjects’ lack of cooperation during the yoga exercises according to the yoga instructor. according to an article by jahdi et al., the mean scores of pain intensity in the yoga and control groups were reported as 2.0 ± 6.9 and 3.5 ± 1.4, respectively. therefore, by taking account of the confidence interval of 95% (α = 0.05) and the test power of 80% (β = 0.2), the sample size was calculated using the following eq. [17]. considering a 10% drop, the final sample size was increased to 70 women. for sampling, eligible nulliparous pregnant women entered the study using the convenience sampling method. then, for randomize assignment, women selected were assigned to odd days to control group and women selected in even days to intervention group. randomization ratio considered 1:1 at first, then due to high sample drop out, in two groups, sampling process continued until the final sample size in each group obtained. after completing the sampling, the research objectives were explained to all the pregnant women in two sessions and if they were satisfied and completed the relevant form, the demographic information questionnaires would be completed for them. moreover, their addresses and phone numbers were taken to inform them of the start of the yoga sessions. the intervention in this study included pregnancy hatha yoga exercises taught by a trained yoga instructor with an international certification and a 15 year history of teaching yoga to pregnant women. the participants in the intervention group started the first session of pregnancy yoga from the 26th to 28th weeks of pregnancy and attended the last session in the 37th week of pregnancy. they exercised yoga twice a week (each session lasting 75 min) in a yoga specialized sports club. the control group received the routine prenatal care that all pregnant women receive. in the intervention group, the yoga exercises included physical movements for 50 min (such as triangle exercises, angled exercises, archery position, pelvic rotation in a standing position, joyful jumps, rotation and release, pelvic floor stretches, strengthening the pelvic floor muscles, gentle perineal traction, upward pelvic rotation, pink panther steps, hip release, knee rotation, active traction in the kneeling position, knee movements, hip and knee cycles, and knee sitting), meditation for 15 min (deep relaxation with focus on breathing and self awareness), breathing exercises in between, and relaxation for 10 min [24]. the data collection tool was a questionnaire consisted of two parts: a demographic characteristics questionnaire (about age, education, occupation, underlying disease, height, weight, body mass index, and residence) which was completed before the intervention. information about the pregnancy, childbirth (the type of delivery, use of local or general anesthesia, induction of labor, duration of labor, gestational age at delivery, birth weight, premature rupture of membranes, preterm labor, intrauterine growth restriction, preeclampsia, episiotomy, and rupture grade), and neonatal outcomes (through the apgar score at the first and 5 minutes after birth including measuring the infant’s heart rate, respiratory effort, muscle stiffness, irritability, appearance, and skin color). a score above seven indicated the proper condition of the infant. the duration of labor was from the onset of pain until the birth of the infant and the separation of the placenta [19, 21]. it should be noted that to compare the two groups, the questionnaire of the pregnancy and delivery outcomes was completed for all the participants using medical records. after collecting the data, descriptive statistics including frequency, relative frequency, mean, and standard deviation were used to describe the samples. the kolmogorov smirnov test was used to evaluate the normality of the variables. then, due to the non normality of the data, the mann whitney test was used to compare the means of the quantitative variables in both groups. besides, the chi square test was used to examine the qualitative variables in both groups. the data were analyzed using the spss software (version 24) and the significance level was considered 0.05. to carry out the present study, the written approval of the ethics committee of qazvin university of medical sciences was obtained (code: 184.ir.qums.rec.1397). this study was registered in the iranian registry of clinical trials (code: irct20180623040197n2). the results of this study showed that the mean and standard deviation of the age of the participants in the yoga and control groups were 27.45 ± 4.50 and 26.82 ± 4.38 years, respectively. moreover, the mean and standard deviation of bmi in the yoga and control groups were 23.87 ± 2.30 and 23.47 ± 2.21, respectively. most of the participants in the yoga group (34.3%) and the control group (37.1%) had a bachelor’s degree. besides, 71.4% of the participants in the yoga group and 45.7% in the control group were housekeepers. there was no significant difference between the demographic characteristics of the pregnant women in the yoga and control groups and both groups were homogeneous (table 1). the results showed that yoga exercises had a significant effect on the rate of induction of labor in pregnant women in the yoga group (p = 0.02, χ 2 = 5.41) so that 51.7% of the women in the yoga group and 82.6% of the women in the control group could have natural childbirth using induction of labor. pregnancy yoga exercises had a significant effect on the variable of preterm delivery outcome in the yoga group (p = 0.03, χ 2 = 4.24) so that 0% of the subjects in the yoga group and 11.4% in the control group had preterm labor and delivery before the 37th week of pregnancy. the results showed that 82.9% of the women in the yoga group and 65.7% in the control group had a natural delivery and the rest underwent emergency cs for various reasons. hence, there was a significant statistical difference between the two groups (p = 0.044, χ 2 = 4.05). in addition, 77.1% of the pregnant women in the yoga group and 65.7% in the control group performed an episiotomy during natural delivery which was not statistically significant (p = 0.29, χ 2 = 1.12). however, there was a significant difference in the rupture grade of episiotomy (p < 0.0001, χ 2 = 29.08) so that 55.2% of the women in the yoga group did not have a rupture and 44.8% had a first grade rupture, while, in the control group, 43.5% had a first grade rupture, 47.8% had a second grade rupture, and 8.7% had a third grade rupture (table 2). the results showed that yoga exercises had a significant effect on the infant birth weight in nulliparous women (p = 0.001, u = 330.000) and the mean birth weight of the infants in the yoga group was higher than that of the control group so that the mean and standard deviation of the infant birth weight in the yoga and control groups were 3287.28 ± 369.54 and 2974.85 ± 301.26, respectively. the mean and standard deviation of the gestational age at delivery were 38.98 ± 0.99 in the yoga group and 37.32 ± 1.78 in the control group. subsequently, the mann whitney test showed a significant difference between the two groups (p < 0.0001, u = 259.000) (table 3). the results showed that the mean duration of labor from the onset of pain until natural labor was 3.1 ± 0.96 in the yoga group and 4.91 ± 1.53 in the control group, which was statistically significant (p < 0.0001, u = 112.000). furthermore, yoga exercises had a significant effect on the apgar score in the first to fifth minutes of labor in nulliparous women. there were significant differences between the first apgar scores of the infants in the control group and the yoga group (p = 0.010, u = 469.500) and between the second apgar scores of the infants in the control group and the yoga group (p < 0.0001, u = 260.500) (table 3). this study aimed to investigate the effect of yoga on neonatal and pregnancy outcomes in qazvin. the results showed that yoga exercises had a significant impact on the induction of natural labor in pregnant women in the yoga group so that most nulliparous women in the yoga group went to the hospital with normal pain and had a short term natural delivery (which was statistically significant). in contrast, in the control group, most pregnant women were able to have a natural delivery using induction of labor and the duration of labor (from the onset of pain to the separation of the fetus) was longer. the study of mohyadin et al. showed that yoga therapy caused fewer women to use natural labor induction, whereas, in the control group, more women used labor induction. furthermore, there was a shorter duration of labor in the yoga group, which was statistically significant [25]. in the study of jahdi et al., fewer mothers in the intervention group needed induction of labor compared to those of the control group. furthermore, the intervention group had fewer numbers of cs than the control group and experienced a shorter duration of the second and third stages of labor [17]. in the study of chuntharapat, in the intervention group, the first stage of the labor was shorter and the delivery duration was significantly reduced [19]. in the study of khavandizadeh et al., childbirth preparation classes led to a shortening of the duration of labor [26]. combined exercise can have a beneficial effect on changes and pain during pregnancy, including the beneficial effects of help to prepare the body to withstand the pressure of childbirth, help reduce back pain, help the body to carry extra weight more effectively during pregnancy, improved blood circulation, lowering blood pressure and heart rate. yoga exercises can relieve muscle tension that may develop during pregnancy and increase the flexibility, muscle strength, endurance, and energy needed for labor, making it easier and shorter [15, 27]. exercise and yoga during pregnancy do not increase preterm labor and evidence has shown that regular exercise and pregnancy yoga (with moderate to heavy intensity) during pregnancy reduce preterm labor [25, 28]. the results of the study of rakhshani et al. showed that preterm delivery and intrauterine growth restriction were significantly reduced in the intervention group [20]. in their study, field et al. reported that preterm delivery was lower in the yoga and massage therapy groups than in the control group, which was statistically significant [16]. in their study on the effectiveness of yoga on pregnancy outcomes, narendran et al. stated that preterm delivery and intrauterine growth restriction were significantly lower in the yoga group than in the control group [23]. the results showed that the pregnant women in the yoga group had more natural delivery than the control group and only a few of them underwent emergency cs for various reasons, showing a statistically significant difference between the two groups. the study of mohyadin et al. showed that there were more natural deliveries than emergency cs in the yoga group, though it was not statistically significant [25]. in the study of rakhshani et al., no significant difference was observed between the two groups regarding the emergency cs and premature rupture of the membranes [20]. ostrovesky stated that yoga during pregnancy could reduce the rate of cs and labor pain [18]. the study of khavandizadeh et al. also showed that childbirth preparation classes led to a reduction in cs [26]. many yoga exercises are stretching exercises which are expected to increase the tensile strength and flexibility of the vaginal and perineal muscles. hence, yoga exercises can possibly facilitate vaginal delivery and help shorten the duration of delivery [25]. the differences in the results of the mentioned studies could be due to the differences in the nutrition of mothers, the volume and intensity of exercise, hereditary backgrounds, and the socio economic status of mothers. cs is one of the major surgeries that is sometimes associated with very dangerous and deadly complications. therefore, most countries, as well as iran, try to reduce the number of cs by performing interventions. yoga exercises have become one of the effective interventions to reduce the number of cs. the pregnant women in the yoga and control groups performed an episiotomy during natural delivery, which was not statistically significant. however, there was a significant difference in the episiotomy rupture grade so that in the yoga group women had the rupture grades of one and zero, whereas in the control group, they had the rupture grades of one, two, and three. episiotomy has such side effects as delayed wound healing, increased risk of infection, fatigue, insomnia, difficulty in sitting and holding the infant, decreased sexual function, and impaired emotional relationships between the mother and infant [6]. in their study, firuzbakht et al. showed the effect of childbirth preparation classes and exercises on reducing the rate of episiotomy [7]. the study of sharifizad et al. demonstrated that complaints of episiotomy pain and postpartum hemorrhage were significantly lower in the natural delivery group than in the cs group [29]. the results showed that yoga exercises had a significant effect on the birth weight of nulliparous women’s infants and the mean birth weight of the infants in the yoga group was higher than that of the control group. field et al. showed that the infants’ weight was higher in the yoga and massage therapy groups than that of the control group, which was statistically significant [16]. in their study on the effectiveness of yoga on pregnancy outcomes (gestational age and infant weight), narendran et al. acknowledged that the birth rate of infants with an abnormal weight was significantly lower in the yoga group than in the control group [23]. it should be noted that one of the factors affecting the birth weight of the infant is the regular repetition of yoga exercises during pregnancy, which is one of the reasons for the difference in the results of different studies. the results of the present study showed that the mean and standard deviation of gestational age at delivery in the yoga group were higher than those of the control group, showing a significant difference between the two groups. in the study of rakhshani et al. [20] and field et al. [16], delivery at a low gestational age was less in the intervention group, which was statistically significant [20]. yoga exercises had a significant effect on the apgar score in the first to fifth minutes of labor in nulliparous women. there were significant differences between the first apgar scores of the infants in the control group and the yoga group and between the second apgar scores of the infants in the control group and the yoga group. in the study of rakhshani et al., the number of infants with a low apgar score and the rate of delivery at a low gestational age were lower in the intervention group than in the control group [20]. gehan et al. also showed in their research that exercise during pregnancy in nulliparous women led to a significant statistical difference between the intervention and control groups regarding the apgar score in the first and fifth minutes [30]. in the study of mohyadin et al. [25], jahdi [17], and chuntharapat, no significant difference was observed between the yoga and control groups regarding the infants’ apgar scores in the first and fifth minutes [19]. the reasons for the differences between these studies were the differences in the nature, type, intensity, and frequency of yoga exercises in pregnant women during the pregnancy period. the limitations of this study, which were not under the researchers’ control included the small sample size, unrecognizable emotional and mental conditions unexpressed by the participants, the stress and anxiety of the pregnant women during childbirth, and environmental factors (such as disturbing noises which were minimized in this study). it is suggested that further research be done with larger sample sizes, other factors affecting the delivery and neonatal outcomes be taken into account, and other scales be used. the results of the present study showed that yoga exercises could lead to a normal birth weight and improve the infant’s apgar score and reduce emergency cs, labor duration, induction of labor, and preterm labor. therefore, they can be used as part of the care protocol along with childbirth preparation classes to reduce the complications of pregnancy and delivery. therefore, yoga exercises can be part of the usual midwifery nursing care. since these exercises are low cost and uncomplicated, they can be used by nurses, midwives, and gynecologists for willing nulliparous pregnant women. when women are at risk for preterm labor based on the presence of risk factors, give advice on modifiable risk factors. explain options with a woman who is nearing prolong pregnancy, including induction of labor. midwifery led care is associated with the best outcomes for low risk deliveries assess the baby’s apgar regularly for prolonged second stage of labor, consider the options of cesarean section versus assisted vaginal birth avoid routine episiotomy avoid routine preterm labor the effect of reducing the rate of cs is introduced when yoga exercises are performed during pregnancy. determining the extent of adverse neonatal and delivery definition of failed induction, compared with shorter time intervals and different access to cesarean delivery in yoga further empirical research is needed to reach a consensus on the starting criteria (both in terms of definition and support). the data that support the findings of this study are available from [leila dehghankar] but restrictions apply to the availability of this data, which were used under license for the current study, and so are not publicly available. data are however available from the authors upon reasonable request and with permission of [leila dehghankar]. cesarean section qinxian j, zhenguo w, li z, jenae d, peijie c. effects of yoga intervention during review for current status. am j perinatol. 2015;32(6):503 14. google scholar tafazoli m, bageri m, boskabadi h, setayesh y. the comparative study of the impact of antenatal training care infants to fathers and couple on the father’s participation after birth. int j pediatr. 2013;1(1):31 8. google scholar cunningham f, leveno k, bloom s, hauth j, rouse d, spong c. williams obstetrics. 23rd ed: mcgraw hill; 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the creation of new software used in the work st, and fm, fg; have drafted the work or substantively revised it ld and ly. all authors have read and approved the manuscript. correspondence to leila dehghankar. the ethical principles observed by the researchers included obtaining permission from the ethics committee of qazvin university of medical sciences (code: ir.qums.rec.1397.184). this study was registered in the iranian registry of clinical trials (number: irct20180623040197n2). in addition, written informed consent from all the participants were obtained and they were granted the right to withdraw from the study at any time. the principles of anonymity and confidentiality were applied and the participants were provided with the results upon their request. not applicable. the authors declare no competing interests regarding the present study. springer nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. open access this article is licensed under a creative commons attribution 4.0 international license, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the creative commons licence, and indicate if changes were made. the images or other third party material in this article are included in the article's creative commons licence, unless indicated otherwise in a credit line to the material. if material is not included in the article's creative commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. to view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. the creative commons public domain dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. reprints and permissions yekefallah, l., namdar, p., dehghankar, l. et al. the effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in iran: a clinical trial study. bmc pregnancy childbirth 21, 351 (2021). https://doi.org/10.1186/s12884 021 03794 6 download citation received: 21 december 2020 accepted: 12 april 2021 published: 03 may 2021 doi: https://doi.org/10.1186/s12884 021 03794 6 anyone you share the following link with will be able to read this content: sorry, a shareable link is not currently available for this article. provided by the springer nature sharedit content sharing initiative issn: 1471 2393 by using this website, you agree to our terms and conditions, your us state privacy rights, privacy statement and cookies policy. your privacy choices/manage cookies we use in the preference centre. © 2025 biomed central ltd unless otherwise stated. part of springer nature.

contact pulling down the moon 770 n lasalle suite 800 chicago, il 60654 1770 first street, suite 400 highland park, il 60035 info@pullingdownthemoon.com (312) 321 0004 text only: (312) 379 9576   m f, 9am 5pm call: (312) 321 0004 visit our shop written by: co founder of pulling down the moon, reg. yoga teacher, yoga swami reviewed for accuracy by: cassie harrison certified yoga instructor, certified prenatal yoga instructor yoga is an ancient practice shown to reduce stress and improve flexibility. for women who are struggling to conceive, stress is a common part of the process. at pulling down the moon, we maintain a wide range of fertility treatments that can support a woman’s goal of pregnancy, and fertility yoga is one of them. in one of the largest controlled yoga studies to date, fertility centers of illinois and pulling down the moon, collaborated in a study examining the impact of yoga practice on anxiety in fertility patients. using the state trait anxiety inventory (stai), a well established self report measure of anxiety, study results found that after the pulling down the moon six week yoga program, state (situational) anxiety scores were reduced by 20 percent in the yoga group vs. two percent in the control group; and trait (longstanding) anxiety scores were reduced by 12 percent in the yoga group vs. three percent in the control group. the study was presented at the american society for reproductive medicine’s annual meeting in october 2015. completing the yoga for fertility program was not only effective at lowering stress; it produced drastic results in a short period of time. we hypothesize this was potentially related to the following three factors: community support and reducing isolation, relaxation activation via vagus nerve stimulation, and utilizing key relaxation strategies of breathing and meditation. yoga for infertility focuses on reducing stress and feelings of isolation, increasing community support, and improving overall health. both stress and weight have been linked to problems with ovulation, which, in turn, lead to problems with fertility. thus, yoga can help. when you manage stress in a healthy way and tackle your weight control with exercise, you may find that your fertility improves. women who are trying to conceive will find several benefits from yoga exercises. keep in mind that yoga can’t replace medical treatments for fertility or acupuncture treatment, but it works well in conjunction with these. some benefits you’ll notice include: in yoga class, you will learn breathwork and relaxation techniques. since the stress and anxiety associated with trying to conceive without success is often close to that of serious medical conditions like cancer, this is an important benefit. ﻿ the poses in yoga open the muscles around the hips and pelvis. these are necessary for a healthy pregnancy. hormones and stress are closely tied. when you release stress, your hormone levels balance. regular yoga practice can be part of this picture. yoga improves circulation. this means that it increases blood flow to all of your body’s organs, including those associated with reproduction. not only that, but the university of washington indicates yoga increases hemoglobin levels in red blood cells. increased blood flow can stimulate the uterus and ovaries. these are the most important parts of the female reproductive system, and supporting their health is critical to conception. women who are undergoing assisted reproductive processes, such as ivf, have a higher rate of success when they participate in low impact yoga classes. fertility is a two way street. not only do women need to be healthy in order to conceive, but so do men. low sperm counts contribute to as many as 20% of couples experiencing fertility concerns, and yoga for fertility can help men, too. here’s how: the conscious breathing techniques in yoga and the postures that increase blood circulation throughout the body can all improve sperm counts in men. a higher sperm count increases the likelihood of the couple conceiving. stress hurts libido and sperm count, and both of these problems contribute to fertility issues. yoga reduces stress through mental relaxation and meditation practices. this, in turn, positively affects male fertility. ﻿ yoga improves the mood. a better mood can improve libido. when men have improved libido, the couple is more likely to get pregnant. men also need blood flow to the reproductive organs to be fertile. improved blood flow through yoga exercises is a benefit for men as well as women. it takes two to tango. one third of the time infertility is a female issue, one third of the time it is a male issue, and one third of the time it is either both partners or unexplained. doing all you can to improve your own fertility, can feel very supportive for female partners, particularly since they are the ones most likely to get pricked and prodded at the doctor’s office. ﻿ at pulling down the moon, we offer fertility yoga classes designed to address the specific concerns couples with infertility face. this is part of our holistic fertility approach that focuses on the whole body and mind. some specific yoga poses we recommend include: warrior ii pose goddess pose cobra pose legs up the wall pose butterfly pose to achieve this pose, stand in the mountain pose and then take a big step back with the left leg. press all four corners of the feet down, then raise the arms so they are parallel to the floor. bend the right knee, keeping it over the ankle, and roll the thigh downward toward the floor. draw in the abdominal muscles to engage the core, and stay in the pose for five breaths. standing poses help to stretch and strengthen the lower body and spine. in the goddess pose, squat so that your thighs are parallel to the floor with the feet pointing outward. raise your arms so your elbows are at a 90 degree angle, palms facing outward. hold for five breaths. squatting poses help send energy and blood flow down toward the groin and reproductive organs. for this pose, lay on your tummy on the mat. put your hands flat on the floor, then push our torso up, reaching your chin to the sky, while your legs stay pressed to the mat from the hips down. backbends can be mood elevators and heart openers. this inversion pose is highly effective at improving blood flow to the reproductive organs, enhancing circulation and can causing positive changes in mental perspective. lay on the floor and lift your legs so they are up against a wall. push your hips until they are also touching the wall so your legs make a 90 degree angle. extend your arms to the side. this is a simple but effective pose. sit with your legs pointed inward, feet touching in front of you, and knees to the side. grab your feet, then lean forward toward them. this stretches the hips allowing for greater blood flow in the pelvic organs, which is helpful for conception and pregnancy. it also improves nerve transmission to the nerve plexuses of the lower sacrum. from a yoga anatomy perspective, the hips are where we store a lot of emotion and disappointment. if you’re new to yoga, make sure you start slow and don’t push too hard into poses. this could lead to injury. intensity also won’t help your stress levels, which you need to control while trying to conceive. also, in the luteal phase, which is the time between ovulation and confirmation of pregnancy or the time after embryo transfer, avoid yoga poses that put pressure on the lower abdomen. ﻿ if you are looking for fertility yoga classes, pulling down the moon has them. by participating in our classes, you not only receive fertility specific yoga instruction, but you also have access to all of our fertility treatment options, including fertility nutrition counseling, fertility enhancing massage (fem), fertility life coaching, and acupuncture for fertility. once you successfully conceive, we offer prenatal yoga classes and postpartum treatments to help you throughout your pregnancy and birth journey. this is why our holistic approach to fertility, conception, and pregnancy makes sense. if you are ready to get started and get to know our team, our six week yoga for fertility class could be a good starting point. book your appointment today! view profile: yoga director at pulling down the moon cassie, a certified yoga instructor trained at urban breath yoga in saint louis, specializes in personalized instruction. she holds certifications as a prenatal yoga instructor with 95 hours of training from amala school of prenatal yoga and in yoga for fertility from pulling down the moon. she prefers small class sizes and incorporates kriya yoga, including hatha yoga, which engages the body, breath, and mind. cassie's primary focus now is yoga for fertility, offering support in preparing the body and managing the stress of fertility journeys. her personal experience with holistic approaches like acupuncture, nutrition, and chiropractic care helped her conceive two sons. cassie teaches yoga for fertility to provide a supportive community for others on their fertility journeys. < older post newer post > fill out our form below and we will be in touch. we are open 7 days/week. thank you for contacting pulling down the moon. we will get back to you as soon as possible. oops, there was an error in sending your message. please try again later. chicago (river north) 770 n la salle dr #800 chicago, il 60654 see clinic hours highland park 1770 1st st ste 400 highland park, il 60035 see clinic hours send us a message info@pullingdownthemoon.com call us today 312 321 0004 copyright ©2021 pulling down the moon holistic health | all rights reserved

an official website of the united states government official websites use .gov a .gov website belongs to an official government organization in the united states. secure .gov websites use https a lock ( lock locked padlock icon ) or https:// means you've safely connected to the .gov website. share sensitive information only on official, secure websites. primary site navigation logged in as: corresponding author: maria muzik, md, ms, department of psychiatry, university of michigan depression center, 4250 plymouth road, ann arbor, mi, 48109 2701, 734 232 0205 (phone) or 734 846 8027, 734 615 8739 (fax), muzik@med.umich.edu issue date 2012 nov. prenatal psychopathology may have an adverse impact on mother and baby, but few women receive treatment. we offered a 10 week mindfulness yoga (m yoga) intervention to psychiatrically high risk pregnant women as alternative to pharmacological treatment. participants (n=18) were primiparous, 12 26 weeks pregnant, and scored positive (>9) on the edinburgh postnatal depression screen at baseline. in addition to a baseline diagnostic assessment, women completed self ratings on depression, mindfulness, and maternal fetal attachment before and after m yoga. findings suggest that m yoga was feasible, accepted and effective. symptoms of depression were significantly reduced (p=.025), while mindfulness (p=.007) and maternal fetal attachment (p=.000) significantly increased. overall, this pilot study is the first to demonstrate that m yoga may be an effective treatment alternative or augmentation to pharmacotherapy for pregnant women at high risk for psychopathology. keywords: yoga, mindfulness, depression, pregnancy, maternal fetal attachment psychopathology during pregnancy in pregnancy is a serious health concern [1 3]with perinatal major depression (mdd) impacting 1 in 5 women, and [4], perinatal anxiety affecting 1 in 10 women [5]. co occurrence of mdd and anxiety is high and treatment is complex with modest success rates [5, 6]. hormonal changes, genetic predisposition and social factors can set up an expectant mother for many debilitating symptoms, including persistent depressed mood or irritability, feelings of being easily overwhelmed, and decreased ability to cope with stress [7]. untreated antenatal psychopathology bears major health risks for both mother and unborn child such as poor weight gain, preeclampsia, premature labor and trouble bonding with the unborn baby [2, 3, 8 10]. thus, from a public health perspective, development of feasible treatment modalities for pregnant women suffering psychiatric conditions is critical. unfortunately, few women suffering from perinatal mental health disorders receive treatment, leaving them and their children exposed to the negative impact of psychiatric illness during this vulnerable period [11 14]. while antidepressant medications have been proven effective to treat antenatal mood disorders [15], many pregnant women are reluctant to take these drugs due to concern for their infant’s safety [16, 17]. in fact, up to 50% of women taking antidepressants prior to conception choose to discontinue medication, creating risk for relapse of symptoms during their pregnancy [15]. many women prefer psychosocial treatments, but face psychological and practical barriers to treatment initiation and adherence while pregnant [18]. when traditional treatments are rejected or feared, there is evidence [19] to suggest that women may feel more comfortable with the options offered by complementary and alternative medicine (cam), including herbal medicine, relaxation techniques, and mind body work. despite limited empirical research, cam methods are becoming more popular [20] among pregnant women, suggesting that pregnancy may be a time when cam is more acceptable to the average women, possibly serving as a gateway to effective treatments for women who may have never considered cam before becoming pregnant. yoga is an ancient practice that originated in india thousands of years ago, and involves meditative focus combined with physical poses. kabat zinn [21] defines the practice of mindfulness as being fully present in the moment, without judgment or correction, starting with simple awareness of one’s body and thoughts. inherently, the human mind judges each experience we have as positive or negative, while striving for a particular outcome and becoming disappointed if that outcome is not achieved. mindfulness practice gently pulls the mind out of this pattern by observing each experience with an attitude of curiosity, non judgment, and patience, focusing on what is happening in the present moment, instead of worrying about the future or regretting the past. yoga alone has been shown to have many positive health effects, from reducing stress and improving chronic pain to decreasing the incidence of symptoms associated with psychiatric illnesses [22 26]. in addition, mindfulness practice alone has been shown to successfully decrease perceived stress and depressive symptoms while increasing energy and psychological well being [27 29]. in the united states, yoga is frequently taught in gym like settings, resulting in an epidemic of classes that omit mindfulness and concentrate on yoga as “exercise” and “yoga and mindfulness” are not synonymous for a beginning yoga student. thus, the intentional combination of yoga and mindfulness practice can be powerful, increasing stress tolerance and sleep quality and decreasing psychological distress and chronic pain intensity [30 33]. mindfulness and yoga are natural partners during times of stress and physical pain, and may be particularly useful as the body progresses through the normal physical and emotional changes of pregnancy. research on the impact of mindfulness yoga on pregnant women is limited, but encouraging. several studies support the acceptability of prenatal yoga among women seeking treatment for antenatal depression [34 37]. mindfulness practice and yoga have been shown to decrease the perception of pain during labor, reduce physical discomfort during pregnancy and significantly reduce stress [36, 38, 39]. in addition, vieten and astin [29] found that a prenatal mindfulness based intervention alone significantly reduced anxiety and negative emotions. to date, no research has examined yoga as a treatment for antenatal psychopathology. only one study [40] examined the impact of mindfulness yoga (m yoga) on the emotional and physical distress of healthy pregnant women in the united states, finding that an intervention combining iyengar yoga and mindfulness based stress reduction (mbsr; [41]) significantly decreased emotional stress and physical pain. however, since women meeting criteria for current psychopathology were excluded in this study, it is unclear whether benefits of m yoga are limited to healthy women or can be generalized to pregnant women with psychiatric illness. the present study is the first attempt to close this gap in the literature; we explore the feasibility, acceptability, and efficacy of m yoga in reducing symptoms of depression among pregnant women with current and lifetime psychiatric diagnoses in an open trial format using a convenience sample. we hypothesize that prenatal yoga will improve antenatal depression through the following mechanism: m yoga will enhance women’s mindfulness and maternal fetal attachment, which in turn will lead to an empowered and positive feeling towards pregnancy and motherhood and subsequently contribute to reduced symptoms of depression. all study procedures were approved by the institutional review board of the university of michigan medical school. informed consent, including an explanation of potential risks and benefits, was obtained from all subjects prior to data collection. participants were recruited through a university based perinatal psychiatry clinic and flyers posted in the community. women were invited to participate in a free 10 week prenatal “mindfulness yoga” class to improve wellbeing and decrease stress. forty nine were screened for eligibility within a 4 week period in the fall of 2009, and 22 were found eligible for the study. eligible women were primiparous, age ≥18, english speakers, scored ≥9 on the epds depression screen [42], not taking psychotropic medications and ≤ 26 weeks gestation. exclusion criteria included patients with active substance abuse, psychosis and suicidality. women in psychotherapy, practicing yoga or those with medical problems (pre existing or pregnancy related) were not excluded from the sample. each eligible woman underwent a psychiatric diagnostic interview [43] at baseline to assess both past and present dsm iv diagnoses. of the initial 22 women entering the study, two dropped out after attending only one class; one due to transportation problems and the other due to back problems unrelated to yoga; thus only 20 women participated in the intervention. lastly, for the final outcome measures, two more women did not complete surveys after the last yoga class (premature delivery; relocation) reducing the sample size to n=18. women enrolled in the study were predominantly caucasian, partnered, college educated and carried low socioeconomic risk (table 1). half of the sample had an active axis i diagnosis at baseline according to dsm iv tr [44], and over 85% had a lifetime psychiatric diagnosis (table 1). depression symptom severity at baseline was assessed using the beck depression inventory ii (bdi ii) [45]. nine participants were also engaged in outside psychotherapy while undergoing the m yoga class. there were no adverse events related to study participation. participant demographic and mental health baseline characteristics axis i diagnosis assessed with scid, 73% of participants had more than one diagnosis note: income is measured in categories 1 21 in 4k increments: 18 = 85 89k, 12=55 59k minorities included: 2 latinas, 1 african american, 1 bi racial, 1 native american, 1 other the m yoga open feasibility trial was facilitated by two instructors, both master’s level clinicians, certified in prenatal yoga and experienced in mindfulness techniques. each 90 minute session focused on a variety of poses, taught specifically for the pregnant body, with awareness of the baby and modified for any level of experience or gestational age. classes met once weekly. two 10 session mindfulness yoga classes ran consecutively, each with 10 participants who completed the full series of sessions; one class took place during evening hours and the other during the day. both classes received the same intervention, taught by the same instructors, and only differed by time of day delivery. materials used during m yoga, such as mats, bolsters and straps, were provided by the research study. the m yoga curriculum differed from typical prenatal hatha yoga classes by highlighting mindfulness practice, with targeted instructions, reminders, and readings. participants were taught mindfulness techniques including breathing, guided visualization and relaxation. the instructors consciously made it a part of class to continually remind women to focus inward toward the sensations of their body, listen to the feedback of body during asana, and be aware of how their bodies are changing to support their growing baby. a significant aspect of the intervention was being “mindful” of the baby, to sense its unique persona, which in turns facilitates the attachment process. in addition, having the word “mindfulness” in the title of the class/study continually brings that awareness to the forefront. sessions opened with a 10 15 minute check in, allowing each woman to share how she was feeling physically and emotionally with the group. teachers customized the poses and instruction to address participants’ current issues, cultivating a supportive atmosphere. for example, if irritability was an issue, instructions included finding compassion towards oneself as the body experiences the hormonal changes of pregnancy. if heartburn was an issue, poses can be taught with an emphasis on creating more space between the chest cavity and throat. each class included seated, kneeling, standing, and restorative poses. the instructors demonstrated each pose while including descriptions of kabat zinn’s [46] seven qualities of mindfulness: allowing presence, non judging, patience, beginner’s mind, non striving, acceptance and letting go. for example, “practice the pose for your body without judgment” and “bring your attention to your breath, always practicing with awareness of your growing baby”. see table 2 for more examples. techniques supported women’s comfort with their changing body, prepared the body and mind for the birthing experience, and focused awareness on the fetus. to ensure women’s safety, modifications for all poses were offered and participants were reminded throughout the practice to listen to the body’s cues, for example, when to move deeper in a pose and when to slow down. classes ended with a 15 20 minute restorative pose, including a full body relaxation exercise, along with a reading from a text such as everyday blessings: the inner work of mindful parenting [47]. finally, sessions concluded with a 5 10 minute informal interaction while participants prepared to leave. instructors and participants did not interact outside the class context, and we did not facilitate peer interactions among participants outside the m yoga class. women were encouraged to also practice at home, but compliance was not assessed. examples of m yoga instructor’s language participating women underwent an initial psychiatric interview, and completed self report questionnaires about depression, mindfulness, and maternal fetal attachment, at baseline and after the final yoga class. the structured clinical interview for dsm disorders (scid i n p) [43] is a clinician based diagnostic interview deriving a dsm iv axis i diagnosis [44], administered prior to the intervention. the scid modules assess the presence of current and past psychopathology, specifically mood disorder, psychotic symptoms, eating disorders, anxiety disorders, and substance disorders. available data suggest good inter rater reliability for major depressive disorder (α= .61 .80) and ptsd (α= .77 .88) and is seen as the “gold standard” among diagnostic interviews [48, 49]. the edinburgh postnatal depression scale (epds)[50] was used to determine eligibility; a cut off score of ≥ 9 was used [42]. items are scored on a 4 point scale (0 3), ranging from 0 30 [51]. available data suggest good reliability (α = .87) and positive predictive value (83%)[51]. the beck depression inventory (bdi ii) is a 21 item survey designed to measure the severity of symptoms of depression, such as loss of interest, guilty feelings and worthlessness [45]. items are scored on a 4 point scale (0 3), ranging from 0 63, with higher scores indicating greater symptomatology. a score of 0 13 indicates minimal depression, 14 19 mild depression, 20 28 moderate depression and 29 63 severe depression [52]. in this study, we sorted subjects into two groups, mild depression (range 6 13; n=10) and moderate depression (range 14 33; n=12). among psychiatric samples, the internal reliability of the bdi ii has ranged from a =. 89 to a =. 92 [45]. the five facet mindfulness questionnaire revised (ffmq revised) assesses for elements of mindfulness in five areas: observing (paying attention to stimuli), describing (labeling the sensation of stimuli), acting with awareness (purposefully attending to stimuli), non judging (not criticizing one’s inner experience), and non reactivity (allowing thoughts and emotions to come and go, without reaction) [53]. items are scored on a 5 point scale (1 5), ranging from 39 195, with higher scores reflecting greater mindfulness. the ffmq revised has shown good internal consistency in several samples, with chronbach’s alphas ≥.80 [53]. the maternal fetal attachment scale (mfas) is a 24 item scale that assesses for maternal fetal attachment during pregnancy, made up of five factors, role taking (“i picture myself feeding the baby”), differentiation of self from fetus (“i enjoy watching my tummy jiggle as the baby kicks inside”), interaction with fetus (“i poke the baby to get him/her to poke back”), not attributing characteristics to the fetus (“it seems the baby kicks and moves just to keep me from resting”) and giving of self (“i feel all the trouble of being pregnant is worth it”) [54]. available data suggests good reliability, with subscale cronbach’s alphas ranging from .52 .73, and a total score alpha of .85 [54]. women completed a brief survey regarding acceptability of the intervention. women with and without current psychopathology did not differ on demographic characteristics (table 1). thus, we did not control for demographics in all subsequent analyses. the eighteen participants attended on average 7.83 sessions (sd=1.62); eleven (55%) participants attended at least 8 or more groups, and 3 (16%) only attended 5 groups. overall, women felt m yoga was a helpful coping strategy and benefited the child as well (“yoga helped me to cope with a high risk pregnancy and my son is the most calm and gentlest of souls. the stress reduction really helps the baby, too”). social support of group was highlighted (“hearing from the other moms made me feel much less alone,” and “i really benefitted emotionally from sharing with the other participants and benefitted physically from breathing and relaxation exercises.”) teaching content and instructors were perceived positively (“the breathing and mindfulness exercises allowed me to have the delivery i wanted. it was perfect.” or “i loved all of it the readings were excellent and the instructors have a true passion for helping pregnant women”.) we calculated the correlation coefficients from pre to postintervention for all measures (table 3), demonstrating a negative correlation between baseline depression symptoms (bdi ii) and post intervention mindfulness skills as well as negative correlations between both baseline mindfulness and maternal fetal attachment with post intervention depression symptoms (bdi ii). futhermore, we calculated the stability coefficients from pre to postintervention for mindfulness (r(18)=.85, p<.001), maternal fetal attachment (r(18)=.62, p<.01), and depression (bdi ii) (r(18)=.64, p<.01). postintervention bdi ii depression scores were significantly and inversely related with baseline mindfulness (r(18)=−.470, p<.05) and maternal fetal attachment (r(18)= −.549, p<.05); these associations were even stronger for concurrent postintervention mindfulness (r(18)= −.547, p<.05) and maternal fetal attachment (r(18)= −.591, p<.05). correlations between pre and post group measures p<.05 and p<.01 eighteen women provided post intervention assessments. using paired t tests, we explored changes on all outcome variables from pre to post intervention (table 4). as 9 women were enrolled in outside psychotherapy, we investigated treatment effects based on psychotherapy; psychotherapy enrollment did not affect m yoga outcomes, and thus was not controlled for in analyses. there was a significant reduction in depressive symptoms as measured by both the bdi ii and epds. mindfulness skills (ffmq revised) total score improved significantly over the intervention. this result was mainly driven by significant results on the non judgment subscale. finally, maternal fetal attachment (mfas) significantly increased overall and on all five subscales. intervention effects p<.10, p<.05 and p<.01 while conventional treatments for psychopathology are well researched and many are widely accepted, pregnant women may be reluctant to utilize standard treatment modalities due to possible risks to the unborn child. it is crucial to explore more acceptable treatments. our findings suggest that the m yoga intervention is acceptable to the target population. we found that m yoga reduced depressive symptoms in pregnant women. given small sample size, we did not have adequate representation of mildly, moderately or severely depressed women and thus were unable to make inferences about the efficacy of m yoga based on depression severity. however, we speculate that m yoga may prove beneficial if offered as adjunctive treatment mode in combination with traditional pharmacotherapy or psychotherapy for pregnant women struggling with symptoms of depression. future studies should include a sufficiently large sample with a wide range of depression severity in order to make definite conclusions. as predicted, the intervention appeared to positively impact participants’ mindfulness skills, helping them to experience the present moment with an attitude of curiosity instead of judgment. this was expected as the intervention specifically targeted the capacity for mindfulness through selected readings and the guided focus on body awareness. finally, it appeared that a potentially positive impact of m yoga was in the maternal fetal attachment domain, with improvement in overall total score as well as all five subscale scores. the mfas measured how often mothers engage in behaviors that indicate interaction and connection with their unborn child [54], meaning that women who completed the intervention became more comfortable assuming the role of a mother, enjoyed interaction with the fetus and were more likely to engage in healthy behaviors because of the pregnancy. this increase in fetal attachment suggests that m yoga provided a supportive environment in the transition to motherhood, as well as an opportunity to engage in healthy behaviors for the group as a whole [55]. the improvements in maternal fetal attachment were independent of depression symptom level and current psychopathology. limitations of this study include the small sample size, the homogeneity of the sample population and the lack of a control group. in addition, we relied upon self report of symptoms rather than interviewer rated assessment of some key outcomes (bdi ii). finally, we did not measure symptoms of anxiety, which would have been useful considering that nearly half our sample (45.5%) met criteria for an anxiety disorder at baseline. however, the majority of our participants (54.5%) met criteria for past mdd and all participants scored ≥9 on the epds at baseline, indicating they were at risk for developing mdd during pregnancy, we feel that depression is an appropriate primary outcome variable. despite a small sample size, data collected provides a solid foundation for future research in terms of documenting feasibility and acceptability of this intervention. it is notable that we were able to recruit our sample very quickly due to tremendous response and in fact were required to turn away several women after meeting our recruitment goal. verifying our results with a larger, more diverse sample will be important; given the interest we observed during the recruitment phase, obtaining such a sample appears realistic. our sample consisted primarily of white, highly educated, partnered, and financially comfortable women open to alternative treatments for psychopathology. while we attempted to make the classes accessible to women of different socioeconomic backgrounds and employment status by offering classes during the day and evening, enrollment in the classes was determined in part by distance traveled and was thus limited to women who had reliable transportation. more research is needed to explore the effects of m yoga on pregnant women who are unpartnered, under age 25, from diverse ethnic backgrounds and with fewer resources (education, income, etc). finally, the lack of a control group does not allow us to separate the effects of m yoga and the social support created by meeting weekly with other pregnant women and two familiar instructors. future research would benefit from recruiting a group who practices yoga at home using a dvd or a group that meets weekly for group exercise such as walking to use as a control in order to determine which mechanism has the greatest impact on outcomes. this study builds on the work of beddoe et al [40], vieten & astin [29] and battle et al [35], demonstrating the feasibility and acceptance of mindfulness yoga during pregnancy, yet for the first time targeting a high risk population with historical and active psychiatric disorders. our work provides promising first evidence that mindfulness yoga may improve depression symptoms, promote a mindful stance towards pregnancy and enhance mother’s attachment towards her child, which in turn, is a long term gain promoting child wellbeing. m yoga instructors: marlene mcgrath, msw and barbara brooken harvey, msw inward bound yoga, ann arbor, mi usa no writing assistance was used. funding source: integrative medicine seed grant, department of family medicine university of michigan, grant # 314249/g008549, ann arbor, mi usa conflict of interest statement the authors declare that they have no conflict of interest. maria muzik, email: muzik@med.umich.edu. susan e. hamilton, email: sueileen@med.umich.edu. katherine lisa rosenblum, email: katier@med.umich.edu. zahra hadi, email: zahrahadi@gmail.com. connect with nlm national library of medicine 8600 rockville pike bethesda, md 20894

a complete neurological exam and medical history are needed to diagnose ms. neurologist oliver tobin, m.b., b.ch., b.a.o., ph.d., answers the most frequently asked questions about multiple sclerosis. so people who are overweight have a higher chance of developing ms and people who have ms who are overweight tend to have more active disease and a faster onset of progression. the main diet has been shown to be neuroprotective is the mediterranean diet. this diet is high in fish, vegetables, and nuts, and low in red meat. so this question comes up a lot because patients who have multiple sclerosis can sometimes get a transient worsening of their symptoms in heat or if they exercise strenuously. the important thing to note is that heat does not cause an ms attack or ms relapse. and so it's not dangerous. you're not doing any permanent damage if this occurs. exercise is strongly recommended and is protective to the brain and spinal cord. scientists do not yet know which stem cells are beneficial in ms, what route to give them or what dose to give them or what frequency. so at the moment, stem cell treatments are not recommended outside of the context of a clinical trial. neuromyelitis optica spectrum disorder or nmosd and mog associated disorder can give features similar to multiple sclerosis. these are more common in people of asian or african american ethnicity. and your doctor may recommend blood tests to exclude these disorders. well, the first drug approved by the fda for treatment of multiple sclerosis was in 1993. since then, over 20 drugs have become available for treatment of ms. and the potency of these drugs has increased over time to the point where we can almost completely suppress the inflammatory component of the disease. this would not be possible if patients like you did not enroll in research studies. there are many different types of research studies, not just drug trials, but also observational studies, as all of these enhance our understanding of the disease, hopefully to lead to even better cures for multiple sclerosis. well, the most important thing about having a diagnosis of multiple sclerosis is that you are at the center of your medical team. a comprehensive ms center is the best place for management of multiple sclerosis, and this typically includes physicians with expertise in multiple sclerosis, neurologists, but also urologists, physiatrists or physical medicine and rehabilitation providers, psychologists, and many other providers who have specialty interest in multiple sclerosis. engaging this team around you and your particular needs will improve your outcomes over time. there are no specific tests for ms. the diagnosis is given by a combination of medical history, physical exam, mris and spinal tap results. a diagnosis of multiple sclerosis also involves ruling out other conditions that might produce similar symptoms. this is known as a differential diagnosis. brain mri scan showing white lesions associated with multiple sclerosis. during a lumbar puncture, also known as a spinal tap, you typically lie on your side with your knees drawn up to your chest. then a needle is inserted into the spinal canal in your lower back to collect cerebrospinal fluid for testing. tests used to diagnose ms may include: in most people with relapsing remitting ms, the diagnosis is straightforward. diagnosis is based on a pattern of symptoms related to ms and confirmed by test results. diagnosing ms can be harder in people with unusual symptoms or progressive disease. additional testing may be needed. brain mri is often used to help diagnose multiple sclerosis. our caring team of mayo clinic experts can help you with your multiple sclerosis related health concerns start here there is no cure for multiple sclerosis. treatment typically focuses on speeding recovery from attacks, reducing relapses, slowing the progression of the disease and managing ms symptoms. some people have such mild symptoms that no treatment is necessary. multiple sclerosis research laboratory at mayo clinic during an ms attack, you may be treated with: there are several disease modifying therapies (dmts) for relapsing remitting ms. some of these dmts can be of benefit for secondary progressive ms. one is available for primary progressive ms. much of the immune response linked to ms happens in the early stages of the disease. aggressive treatment with these medicines as early as possible can lower the relapse rate and slow the formation of new lesions. these therapies may reduce the risk of lesions and worsening disability. many of the disease modifying therapies used to treat ms carry serious health risks. selecting the right therapy for you depends on many factors. factors include how long you've had the disease and your symptoms. your healthcare team also looks at whether previous ms treatments have worked and your other health issues. cost and whether you plan on having children in the future also are factors when deciding on treatment. treatment options for relapsing remitting ms include injectable, oral and infusions medicines. injectable treatments include: interferon beta medicines. these medicines work by interfering with diseases that attack the body. they may decrease inflammation and increase nerve growth. interferon beta medicines are injected under the skin or into muscle. they can reduce the number of relapses and make them less severe. side effects of interferons may include flu like symptoms and injection site reactions. you'll need blood tests to monitor your liver enzymes because liver damage is a possible side effect of interferon use. people taking interferons may develop antibodies that can reduce how well the medicine works. oral treatments include: infusion treatments include: natalizumab (tysabri). this is a monoclonal antibody that has been shown to decrease relapse rates and slow down the risk of disability. natalizumab is designed to block the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. it may be considered a first line treatment for some people with relapsing remitting ms or as a second line treatment in others. this medicine increases the risk of a potentially serious viral infection of the brain called progressive multifocal leukoencephalopathy (pml). risk increases in people who are positive for antibodies that cause the pml jc virus. people who don't have the antibodies have extremely low risk of pml. ocrelizumab (ocrevus). this medicine is approved by the fda to treat both the relapsing remitting and primary progressive forms of ms. this treatment reduces the relapse rate and the risk of disabling progression in relapsing remitting multiple sclerosis. it also slows the progression of the primary progressive form of multiple sclerosis. clinical trials showed that it reduced the relapse rate in relapsing disease and slowed worsening of disability in both forms of the disease. ocrelizumab is given via an iv infusion by a medical professional. side effects may include irritation at the injection site, low blood pressure, a fever and nausea, among others. some people may not be able to take ocrelizumab, including those with a hepatitis b infection. ocrelizumab also may increase the risk of infections and some types of cancer, particularly breast cancer. alemtuzumab (campath, lemtrada). this treatment is a monoclonal antibody that decreases annual relapse rates and demonstrates mri benefits. this medicine helps reduce relapses of ms by targeting a protein on the surface of immune cells and depleting white blood cells. this effect can limit nerve damage caused by the white blood cells. but it also increases the risk of infections and autoimmune conditions, including a high risk of thyroid autoimmune diseases and rare immune mediated kidney disease. treatment with alemtuzumab involves five consecutive days of infusions followed by another three days of infusions a year later. infusion reactions are common with alemtuzumab. alemtuzumab is only available from registered healthcare professionals. people treated with the medicine must be registered in a special medicine safety monitoring program. alemtuzumab is usually recommended for those with aggressive ms or as second line treatment if other ms medicines didn't work. physical therapy can build muscle strength and ease some of the symptoms of ms. these treatments can help relieve some of the symptoms of ms. therapy. a physical or occupational therapist can teach you stretching and strengthening exercises. the therapist also can show you how to use devices to make it easier to perform daily tasks. physical therapy and a mobility aid, when necessary, also can help manage leg weakness and help improve walking. bruton's tyrosine kinase (btk) inhibitor is a therapy being studied in relapsing remitting multiple sclerosis and secondary progressive multiple sclerosis. it works by altering the function of b cells, which are immune cells in the central nervous system. another therapy being studied in people with ms is stem cell transplantation. this treatment destroys the immune system of someone with ms and then replaces it with transplanted healthy stem cells. researchers are still investigating whether this therapy can decrease inflammation in people with ms and help to "reset" the immune system. possible side effects are fever and infections. a type of protein called cd40l found in t cells has been shown to play a role in ms. recent studies have shown that blocking this protein can help manage ms. a new medicine called a phosphodiesterase inhibitor also is being studied. this medicine works to reduce inflammation by changing damaging immune system responses seen in ms. researchers also are learning more about how existing disease modifying therapies work to lessen relapses and reduce multiple sclerosis related lesions in the brain. further studies are needed to determine whether treatment can delay disability caused by the disease. explore mayo clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. to help relieve the symptoms of ms, try to: many people with ms use a variety of alternative or complementary treatments to help manage their symptoms, such as fatigue and muscle pain. exercise, meditation, yoga, massage, eating a healthier diet, acupuncture and relaxation techniques may help boost overall mental and physical well being. according to guidelines from the american academy of neurology, research strongly indicates that oral cannabis extract (oce) may improve symptoms of muscle contractions and pain. there is a lack of evidence that cannabis in any other form is effective in managing other ms symptoms. daily intake of vitamin d3 of 2,000 to 5,000 international units daily is recommended in people with ms. the connection between vitamin d and ms is supported by the association with exposure to sunlight and the risk of ms. with time, you'll find what helps you cope with the stress of a chronic illness like multiple sclerosis. until then, you may find it helps to: ask your healthcare team about your ms, including your test results, treatment options and, if you like, your prognosis. as you learn more about ms, you may become more confident in making treatment decisions. keeping your close relationships strong can help you deal with multiple sclerosis. friends and family can provide the practical support you may need, such as helping take care of your home if you're in the hospital. and they can serve as emotional support when you feel overwhelmed by having ms. find someone who is willing to listen to you talk about your hopes and worries. this may be a friend or family member. the concern and understanding of a counselor, medical social worker, clergy member or ms support group also may be helpful. make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you. if your healthcare professional thinks you might have multiple sclerosis, you may be referred to a doctor who specializes in conditions of the brain and nervous system, called a neurologist. because appointments can be brief, it's a good idea to be prepared. here's some information to help you get ready. your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. list your questions from most important to least important in case time runs out. for multiple sclerosis, some basic questions to ask include: don't hesitate to ask other questions. be prepared to answer questions, such as: multiple sclerosis care at mayo clinic mayo clinic does not endorse companies or products. advertising revenue supports our not for profit mission. check out these best sellers and special offers on books and newsletters from mayo clinic press. your donation powers the future of medicine and helps save lives. 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supported by more and more clinics are offering deep breathing, meditation and yoga lessons before stressful appointments, but will they help women get pregnant? the data is mixed. by katharine gammon this story was originally published on feb. 10, 2020 in nyt parenting. when emily mccourtney arrived for her uterine evaluation at a fertility clinic in southern california, she was nervous about how it might feel. the ultrasound test, which involved threading a catheter through her cervix and filling her uterus with saline, would help her doctor spot any abnormalities that might affect her chances of becoming pregnant. half an hour before her appointment, mccourtney met with elaine wang, a wellness coach at the clinic, who explained what was going to happen on yoga mats in a back room. they practiced deep breathing exercises to help mccourtney decompress, then wang followed her into the exam room so they could practice her breathing during the procedure. “after that, walking away, i felt more relaxed than at any other time at this office,” said mccourtney, 35, who later conceived via in vitro fertilization and is expecting a baby in april. for most people, a visit to a fertility clinic involves more apprehensiveness than calm. checkups and procedures can be uncomfortable experiences, with lots of poking and prodding, and a more sterile than welcoming vibe. but more and more, a small but growing number of fertility clinics across the united states are hiring wellness coaches to guide women (and their partners) through their appointments, helping them relax with mindfulness techniques like breathing exercises, yoga, positive affirmations and guided imagery. wang, 45, who holds a master’s degree in dance and has training in physical education, yoga and social emotional learning, has been a wellness coach at west coast fertility center in fountain valley, calif., for three years. she remembered how out of control she felt   emotionally, physically and financially   during her own egg preservation treatments when she was 39, and wanted to help others navigate the process. few scientists have studied the mind body connection to fertility. but there is some, albeit limited, evidence that mindfulness training might reduce anxiety and depression among fertility patients, and possibly even increase their chances of becoming pregnant. it’s not entirely clear how such practices might help, however, and because evidence is mixed, much more research is needed. in southern california, wang works alongside dr. david diaz, m.d., founder and medical director of the west coast fertility center at fountain valley regional hospital and medical center. first, they identify the times when fertility patients tend to feel the most stress. that’s typically the day of egg retrieval, when the doctor guides a needle through the vagina and into the ovarian follicle to collect eggs, and the day when doctors transfer embryos back into a woman’s uterus.

 you know how they say “hard work pays off?”