Yoga in pregnancy and for older adults: safety points to know

This review covers what official sources say about yoga in pregnancy and in older age, focusing on safety.

1. Introduction

Physical activity is encouraged for most pregnant women and older adults. Yoga is one option, and official sources add precautions for both groups. The US NIH centre NCCIH says pregnant women, older adults and people with health conditions should talk with their provider and yoga instructor first ^[1].

2. Yoga in pregnancy

NCCIH states that with appropriate precautions yoga can be safe during pregnancy, and that a health care provider should check whether exercise is safe for you ^{[1, 2]}. It notes that a 2022 analysis of 29 studies found pregnancy yoga reduced anxiety, depression and perceived stress, and was linked to shorter labour and more normal vaginal births, but the programmes varied and more rigorous research is needed ^[1].

The NHS says exercise in pregnancy is safe for you and your baby, and describes moderate activity as being able to talk but not sing. It lists yoga as an example of activity that can count towards the 150 minutes of moderate activity it recommends each week ^[3]. The CDC also lists some forms of yoga among suitable activities ^[4].

Precautions in pregnancy

• Avoid hot yoga, because of the risk of overheating ^[1].
• Avoid long periods lying on your back. NCCIH says to avoid poses with long stillness or lying on the back, the NHS says not to lie flat on your back for more than a few minutes in later pregnancy, and the CDC says to avoid it after the first trimester ^{[1, 3, 4]}.
• Tell your instructor you are pregnant, drink enough water, stay cool and wear suitable clothing ^[3].
• Stop if you feel uncomfortable, too hot or unwell ^[3].
• Ask your midwife which activities are safe if you have a health condition ^[3].

3. Yoga for older adults

NCCIH reports that adults aged 65 and over have a higher rate of yoga-related injuries treated in emergency departments ^[1]. It recommends starting with gentle or seniors yoga to get individual guidance and learn correct form, and describes chair yoga as a gentler option for people with limited mobility ^[5]. Older adults with medical issues should consult both their provider and the yoga teacher before starting ^[5].

Research suggests better balance with yoga in healthy people, and newer studies support benefits for older adults living in the community ^{[1, 5]}. The National Institute on Aging lists yoga among balance exercises that may help prevent falls ^[6]. Its safety tips include moving slowly, keeping a sturdy chair, person or wall nearby, wearing stable shoes or going barefoot for grip, and checking with a doctor or physical therapist if unsure about a movement ^[6].

4. Poses and conditions needing extra care

NCCIH says beginners should avoid headstands, shoulder stands, the lotus position and forceful breathing ^[1]. People with knee or hip injuries, lumbar spine disease, severe high blood pressure, balance problems or glaucoma may need to avoid or modify poses ^[1]. Tell your teacher about any of these conditions.

5. Choosing a class

Ask about the instructor's training and experience, and tell them about your health conditions and injuries ^[1]. Learning without supervision has been linked to a higher risk of injury ^[1].

6. Practical tips for exercising safely

Both the NHS and the National Institute on Aging give plain advice that applies to yoga as well as other activity. The NHS says moderate intensity means you can talk but not sing, and that if you are new to exercise you can start with about 10 minutes a day and build up gradually ^[3]. It says it is better to do some activity than none, and that total activity can be split into shorter sessions ^[3]. It also advises avoiding exercise on an empty stomach, which could make you faint ^[3].

The CDC says pregnant people should be under the care of a doctor who monitors the pregnancy, and should ask that doctor whether or how to adjust activity ^[4]. The National Institute on Aging advises warming up and cooling down with light activity, staying hydrated unless your doctor has told you to limit fluids, and talking with your doctor if you are unsure about an activity ^[6].

NCCIH notes that yoga use among US adults aged 65 and over rose from 1.3 percent in 2002 to 6.7 percent in 2017, so many older adults already use it ^[5]. A gentle or seniors class is therefore a sensible starting point ^[5].

7. When to see a doctor

Speak to your doctor or midwife before starting, and again if your health changes. Stop if you feel uncomfortable, too hot or unwell ^[3]. The National Institute on Aging advises stopping aerobic exercise if you feel dizziness, chest pain or pressure, or nausea ^[6], and it is sensible to apply the same caution to a demanding yoga session and ask a doctor for advice. Do not use yoga to delay care for a medical problem ^[1].

If you are pregnant and have light bleeding or spotting, call your maternity unit or get urgent help ^[7]. Get emergency help if you are pregnant and bleeding with severe tummy pain, pain in your shoulder, feeling sick, faint or dizzy, or if the bleeding is heavy ^[7].

In an emergency, call your local emergency number (112 in India, 911 in the United States).

8. Conclusion

Yoga can be a gentle activity in pregnancy and older age when precautions are followed. Avoid hot yoga and long periods lying on the back in pregnancy, and choose gentle, supervised classes in older age. Your doctor or midwife should be asked first, because programmes vary widely and more rigorous research is needed.