#144 | Restrengthening from Within through Yoga with Deb Flashenberg of The Prenatal Yoga Center

January 19, 2022

How is yoga like birth? They both ask us to get uncomfortable and sit with that discomfort. How long can we sit with it? Where does our mind go when we get uncomfortable? How quickly do we reach for distraction? Yoga prepares us for birth not only physically but also by integrating the mind/body connection and strengthening our intuition and our physical body. Today, Deb Flashenberg of the Prenatal Yoga Center in NYC speaks with us about how to get safely uncomfortable and learn to use your body, breath and mind to get to the to other side, whether on your yoga mat or at your birth.  We also discuss postpartum recovery, and the importance of recovering physically from inside to outside, such as when it comes to diastasis recti and posture. 

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View Episode Transcript

I think yoga is a great opportunity to be safely uncomfortable. And I feel like we can look at birth that same way that for the most part, you can have really big sensations even call it pain. But most of the time when we have these big sensations in our lives outside of birth, it means that something's wrong. And it's not that anything's wrong, but it's an opportunity to work with your body and your breath and your mind, your mind is a very strong part. And use these tools to recognize I can be uncomfortable, but I can also find calmness and stillness.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hi, I'm Deb Flashenberg, I'm so excited to come and chat with you guys. I'm the owner of the prenatal yoga center. And I'm founder I'm also a Labor's doula ad loss teacher and a mother of two. And with all of that experience and all that knowledge, I'm really excited to talk about the yoga practice and the facets, the different facets about how we can use our practice, to explore and examine fears that we may have around birth, and then tools that we can use in our practice, to help us get to the other side. And I can get rid of those fears. But we can definitely have tools for when they arise.

Deb, I'm really happy that you're here today. I've been wanting to do an episode on yoga for the longest time because I've been teaching HypnoBirthing since 2007. And my clients hear me talking every I can't help but talk about yoga in every class. And I'm very excited to hear about your perspective, because my perspective is in teaching HypnoBirthing the whole goal of yoga, the way I would describe yoga is to be able to be calm in what's potentially a difficult moment or a chaotic moment. It's to be calm and in control. And we just do that with physiology, focus and breath. And those are exactly the tools we're teaching in HypnoBirthing. So it's impossible not to see the the alignment between the two. So can you talk a little bit about your own perspective to you? What does yoga have in common with giving birth? Let's start with that.

I think it's it I see everything through the lens of birth. So let's just say that, that I can't see something about don't think about how it can relate to birth. So I think yoga is a great opportunity to be safely uncomfortable. And I feel like we can look at birth that same way that for the most part. You can have really big sensations even call it pain. But most of the time when we have these big sensations in our lives outside of birth, it means that something's wrong. You know, you break your arm, whatever it is, you're hurt yourself. And that's usually an indication that something's wrong. But you can be in a yoga class and experience really big sensation. And it's not that anything's wrong. But it's an opportunity to work with your body and your breath and your mind, your mind is a very strong part. And use these tools to recognize I can be uncomfortable, but I can also find calmness and stillness that actually came up in class I just finished teaching about a half an hour ago, a student came in and she is 40 years old. And she shared that her care provider is saying we're getting concerned about your blood pressure. And she said, I don't know if it's white coat syndrome that as soon as I heard that, and every time they took my blood pressure, I got more freaked out. And and we've talked it's not they checked, it's not preeclampsia, so we talked a lot about they're going to check her blood pressure regularly now. And that's just going to make her more tense. And we talked a lot about finding the calm within the storm. And I kind of feel like that's what you're you're also alluding to. And so through class, we looked at a myriad of different coping skills and seeing what fit her and then we went into poses that had a lot of sensation. And we asked the whole class can you start to let yourself raise that threshold of reaction? Yes, something might be uncomfortable. Your toes, your feet, your hips, whatever. But can we start to use these skills to find calmness, even though the situation happening in our body in our mind and maybe even around us? Let's face it, a lot of hospitals can feel very overwhelmed But can you find that internal calmness because it's not something that someone can necessarily give you like, How bad is it if you're trying to relax and relax, just relax, like, let's say that your face is not helpful. And I think as a hypnobirth teacher you could relate to is the idea of practice, the more we can come on the mat, and we can keep practicing and finding that progress, the quicker we're going to drop into. Here I am, I'm in my skill. Okay, I've been working on a certain breathing. I started, I dropped into it. So I very much see how yoga can help us prepare, both physically and mentally for birth and however birth unfolds. Whether it's a vaginal birth was a surgical birth, having those tools of finding communists can be incredibly beneficial.

Yes, exactly. To that point, the founder of HypnoBirthing. Miki mungkin, used to have a tagline at the bottom of every email she ever sent out. And of all the things she could have said to the world about birthing, she chose to talk about conditioning. And what the tagline said was, the dogs would not have salivated if Pavlov had only rung the bell once or twice. Yeah. So her biggest message to the world was about practice and conditioning. Go ahead, Trisha.

I just wanted to take it one step further, as far as how physical activity and getting into discomfort through physical activity relates to birth, not only is it important to learn how to practice that state of calm, but even further, you have to learn how to not want to flee. The situation like can you stay in the moment? In the discomfort? How long can you tolerate discomfort without not just in common it, but without trying to distract yourself from it? Yeah, because that's what happens. So often, when we feel a contraction coming on, or we feel discomfort in any form of exercise, whether it's yoga, or any type of other physical conditioning, we just want to get past it as quickly as we can. Or the more you can sit with it, and not try even little things like fixing your hair, you fix your ponytail, when you know something gets uncomfortable, or you adjust your pants or you like pull your sports bra, all of those things are little moments of distraction, that take us out of the moment out of the calm out of the strength out of the focus, and block our progress forward.

I completely agree. And I also think that's important. We think about parenthood, how many times get a mom of do how many times I want to flee at moments when, sir, you know else, it drives me a little Batty, I can't, I can't, I can take myself out for a second, take a breath. But sometimes you just have to be in it, you have to get to the other side, I call that hitting that wall of like that crisis of confidence. You can be in the middle of that contraction, and there's no getting out of it, you have to get to the other side, what you choose down the road, that can change, but there's no getting out of it. And like I said, when we when we distract ourselves, it's going to take us out of all the calmness, all the foundation that we built, if we keep, you know trying to change that channel too quickly, and the mental strength that you're building. And so that's why the practicing the practice, practicing the practice, in every moment of discomfort, wherever you are, it doesn't matter in yoga class, in parenting in birth in driving your car and talking to a friend. Where do you go in that moment when it gets uncomfortable? Do you sit with it? Or do you? Yeah, quickly move on love. I love that point you're making because of my yoga practice. The yoga instructor I follow that I love so much. In fact, I just finished a practice right before we jumped on the call is Brian cast, who's out in California and I do his streaming classes now. But he you know, sometimes he'll challenge us if we're holding a pose even a really simple pose. Even if we're holding down dog for a long time, he'll say, can you challenge yourself just start to fidget so much and you realize you're shifting your weight on your feet, your you're repositioning your hands and when you practice not fidgeting, when you practice stillness, it is a whole it's like going up a pyramid. It is significantly harder than that step before where you're doing a little bit of fidgeting. I think you're right. You just have to sit with that. And what do you do in that uncomfortable? Minor uncomfortable moment, right? Focus, breathe, what else do we have?

I feel like the breath is the foundation and then all of our other skills are just different takes on it one of my favorite to work really fine in that parasympathetic nervous system. So a three count into the six count out. So we slipped more into that rest and restorative. And I find that when we can use the breath, we can train our mind that okay, maybe today it's maybe I can try the elongated exhale. So having several tools. I think it's important because if we only rely on one, what if it's just not working in that moment? I think having a few practice techniques can help us if that if we're only depending on Okay, usually might use my mantra but I gotta keep fidgeting. All right, what if I try a different topic?

I think of all the techniques between breathing physiology, whether it's facial relaxation or physiology within the body elsewhere, and focus, I personally think the hardest to practice and to teach is focus. But we're lucky as human beings, we're the only mammals who have developed a prefrontal cortex. And because of the law of substitution, our conscious mind can only hold one thought at a time. So if we are willing to put in the work, to practice focus, it is powerful in childbirth. Because if you truly achieve focus during labor, nothing touches you you're impenetrable. You have that thought you have that visualization. Yes, breathe, yes, keep your physiology relaxed, but you're untouchable. And I just find that to be the most fascinating and challenging aspect of really preparing for a calm physiological birth, even before focus is awareness. So so much of the time, we're not even aware that we're not focused. So true, right? You're, you're just your mind is just doing its monkey mind. It's like you don't even you don't even have the awareness to

know that your focus comes in the physical practice. It's so specific. I think when I come on the mats, my own practice, I count my mental vacation, that no matter you know, I'm stepping out from my busy life. And when I'm on the mat, and I'm aware of the awesomeness of what's being asked of me of the small details, like you said, you can only think of one thing at a time. So if I'm in where's my, where my feet? Where's my breath? What am I doing with my hips, like really coming into that physical awareness, it gives me such mental space from the rest of my day. So I emerged. That's why I think the yoga practices, it has so many facets that I love. But it's different than what I'd put in the category of exercise. Yes, it's great exercise. But when I do what I put in my category of exercise, honestly, I'm hoping to be done with it as soon as possible. But I still do it. And you know, my husband's like, you're on your bike every day, you must like it. I'm like, It's a habit. But what I like, is the yoga practice, because it's not about trying to escape it and be done with it. It's actually more of an invitation inward of awareness to close off the external monkey mind and all the external responsibilities.

So so let's talk about yoga and pregnancy. What let's get a little practical with it, like, what should women be doing? How is this going to help?

So we talked about the coping skills, the way that I like to approach the asana practice, it's not, I think there's several things one, you can look that the practice can look at, where there's aches and pains, and work with that. But I also have been the last few years doing a lot of spinning babies, and I'm actually doing their parent educator training, which I've been in that mindset for years. So my first birth was very long, about 42 hours. And I was I didn't do what I would tell my students to do, I like did the opposite. I was I had tension in my pelvic floor, my So as was a hot mess, everything was brother on even. And the birth took a really long time, my son came down and said, It's in clinics. So it took a really long time. So since that experience, my focus changed to how can we use the practice of prenatal yoga, to create alignment internally, through the soft tissue to the ligaments through the bones. So that baby can descend and rotate without obstacle. So the way that I like to approach prenatal yoga, it's yes, it's the the shapes of the asana. But when I'm taking the poses to do, it's a lot about creating balance balancing. So as balance in the pelvis balance in the pelvic floor balance in the pelvic ligaments, ideally, we're hoping that again, this comes back to the yoga practice, that we've built a trust to listen to how someone wants to move. And if we can build that on the mat, then we can hopefully find that in the practice, then if things in the birth, so we build it on the mat, that you can find it in the birth argument. That's that up. So if they can find it, they can trust how their bodies working, and they're listened to body throughout the birth, then we let that go. If we start to see, oh, okay. It may look like baby is not sending Well, or maybe baby hasn't engaged or maybe we've hit kind of a stall, then we can start to pull out some of those principles. So I'm always looking at what can we do to soften and release the so as what can we do to find back rib mobility? I don't think it's one or two specific poses that I'm teaching necessarily. It's more the approach and the awareness of how their bodies moving

to have you know how someone can be in a yoga pose. And let's say imagine someone in pigeon pose and they're lying down and they're doing that incredible deep hip release. I'm not necessarily talking pregnancy But you know how sometimes in a yoga practice, someone can burst into tears? And it's not because of any physical sensation, but it's because of something they're accessing within their body? What's your theory? On how yoga can touch that part of us? And what's your theory on how emotions are physiologically within our body?

I'm not sure. To be honest, I think that we do hold a lot within ourselves. And I think sometimes it's the opportunity to release and feel vulnerable, that these sensations are coming up.

Trisha, do you have a theory on that? Well, I don't know if I necessarily have a theory on why yoga triggers the release, I think it happens in any form of exercise. I mean, I've I've experienced it happening in vigorous high intensity exercise, even more so than your I've experienced it in yoga, as well. But so I don't know that it's yoga specific. But what I do know is that emotions do get trapped in the body. And if we don't find a way to release them through physical movement of any kind, and they become physical ailments, and not just emotional, I don't have a theory on the specific mechanism of release. But I know that it is very important to release them through physical activity.

And I think yoga gives us a permission as we're talking about to be present. And I think when we're in our daily life not being present, those emotions can get stuck because we're distracting ourselves. I think, because we're within ourselves. And we're having to be with ourselves. And if there's something in there, it can more likely bubble up and release because we're sitting with our own honesty and authentic space. And I think that's where yoga where I could see it being released more because we have to face what's coming up. We're not we can't go to our phone and, and distract ourselves and I don't want to feel this. This is too uncomfortable. And fidget we're sitting within ourselves. And that's where I think it probably makes sense that it's being out it's being released.

We’ll have to get an energy practitioner to talk about it.

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So Deb, we know you do a lot of work with postpartum and I haven't given much thought to yoga postpartum other than just getting your strength back and your posture back and feeling strong again. But can you talk to us a bit about what you're seeing on the postpartum side?

Yeah, I'll say that a lot of it again changed after my first child because my birth was so hard and there was so much healing, I don't think I recognized even though I had been working with new parents for about 10 years at that point, I don't think I really understood the emotional side of parenting and the exhaustion that can come and how I feel a lot of people, including myself during pregnancy, can stay pretty strong, and then postpartum. Our bodies have gone through such a shift, and such an emotional shift and such an identity shift, that people come back to postpartum. And they're really looking to find a sense of who they are, again, they're looking to re strengthen. They're looking at their relationship to themselves in the world and their identity and their partner and their new roles and respond ability, sometimes they're processing a birth that didn't unfold as they wanted it. Sometimes they're just trying to wrap their head around this brand new responsibility. Remember, with my son, I, one of my favorite things in the morning is to be to I was living in New York at the time, just go down, go to doors over grab a bagel, and coffee. And that would take no time at all. And then once he was born, the idea of getting out of the house, like within five minutes, it was like a half an hour ordeal just to get two doors down. And so that shift of or that loss of freedom, in a sense, can really hit people very hard. The idea of isolation, when a student comes in, I might have been the first adult they talked to in hours with their child, so postpartum, it's so much more than build the strength, which I'd love to talk about in a moment. But it's really holding that container for so much emotional change that the new parent is is having. And again, I'm not a therapist, I'm not trying to give advice, but I am just trying to create a safe space for somebody to show up and share if they need or get the support from the community members around them. So I really respect that emotional place, and that those huge changes. You don't

have to be a therapist, you don't you know, when you said you might be the first person they speak to an hour as you might be the first person they speak to in weeks at a time of having an actual authentic conversation and an empathetic listener. Yeah, I run Postpartum Support Groups every week of the year and the support the women even give each other even taking me out of it when they get into conversations. You know, when you're listening to an empathetic group of people, they use the words over and over it is life changing. Why because it is so isolating, and to feel seen and to feel heard, is everything it transgresses the isolation, it transgresses the exhaustion? And did you want to get into the physical like the? That's more physical?

Yeah. So I'm always checking in with them about their abs and pelvic floor. And what drives me a little crazy is that they'll have their six week checkup and like, I'm good to go. I'm like, what? Trisha talks about this all the time, the whole workshop around it, I did her oh my gosh, no, when you're ready emotionally or physically, yeah, for models, usually. And you know, so they get the good to go. And what we know is that if their abs or their pelvic floor have had some change in damage, then they could be jumping back into an exercise routine that actually inhibits healing. So I do a lot of a huge exercise, or I'll just put it out there as much as I love yoga. I'm also a huge exerciser. So I'm always doing like strength training, and I'm looking at what like, they're like, Oh, we're gonna do this core stuff. And I'm watching the teacher teach this core stuff. And I'm like, I'm Hope there's no new parents doing this. Because you're doing like full Jackknife setups like Oh, which is fine if the if we have that integrity in the front body. But if someone got that you're good to go at six weeks, and they have some sort of weakness at the linea. Alba, that the diathesis. By pushing into their abs, they can be making the situation a longer healing process. If someone's doing a lot of jumps and heavy lands are holding their breath, their pelvic floor has some vulnerability, they can be making things worse. So I really put it back onto the student to take a moment like, how are my abs? What is going on my pelvic floor, because most OB Joanne's or even midwives, that's not their training. They're not trained necessarily, like they may do the, I'm going to insert two fingers, go ahead and squeeze Oh, I don't feel a lot. Just do your key goals. There's so much more to pelvic floor work, then squeeze it up, like much more, or, Oh, you're good to go. And they never checked that linea alba. And then they're trying to do crunches and crunches and situps. Like, why is this getting? Why isn't this getting better. So I really try to introduce them to learning about their own body, and what's going on, I'm always offering them go see a pelvic floor PT, if it's within your means, go work with someone that knows about this. And then we in class are going to I separate things. If you have diathesis. If you have pelvic floor issues, we're going to shift things a little bit for you. And then I teach them how to check their own diathesis. And then a lot of it is about strength and about re supporting. The postpartum body often has a lot of weakness and tightness in that whole posterior chain. So we're working on that we're working on the glutes, the adductors, the abductors, the hamstrings, areas that in yoga tend to get stretched a lot but not strengthened. So it's a little bit of a different focus than your typical yoga class. We're really building the glute strength, the glute lead the max minimus like that whole pelvic area. So yeah, we do a lot of strengthening.

Let's touch just a little bit more on the diastasis. Because I think that's a big worry for a lot of people and there seems to be so much discussion around it probably because it's more it can be more severe than a lot of practitioners realize. And women aren't aware of it. But I also want women to know that it is static. Okay, so from I've spent studying with Dr. Sarah Duvall, and her statistics, I believe she got these Diane lay that at full term, every pregnant body is going to have dialysis, which just means you have it.

I did not know these guys. So we think everyone has to think of think of your rectus close together when you're not pregnant, some postpartum what's our rectus you're sick, your six pack muscles like the most superficial, your rectus abdominus. So So you have these muscles that go up and down your six pack. And the connective tissue is called the linea. Alba. Now we need to have separation of them because the baby has to go somewhere. And in fact, if people that have super strong core that don't allow baby that the belly to expand, you're more like those people are more likely to have a breech baby. Because if the belly is so tight, how has that baby go and head down? We need to have expansion. So everyone's going to have it to some degree. Now, what can change? There's variations of people's genetic makeup, how much collagen they naturally have, what are their habits? How are they breathing, what's their posture, like, all of these can affect how that heals. And some people can have people, everyone has to ask this and some people are going to continue to and some bodies just naturally heal. I believe this statistics, I can double check that I believe this statistics are 39% of postpartum folks at six months are going to still have they asked us this, and I believe it's 32 at 12 months. So if we look at our posture, if you're constantly it's a rib flaring, like you're pushing your front ribs out, then that's putting a lot of pressure of that connective tissue in the front. And that can inhibit healing. If you've jumped back into your yoga practice, and you're doing a ton of up dog, a ton of big back bends, then we're again pushing from the inside into that connective tissue. If you didn't big twists, or maybe you're doing plank, and you and your front body is not able to handle that load, and your your coning or I caught the shark fin that can inhibit healing. So some of it can be our habits. And then some of it can be our genetics. So I ask people just to be mindful of what's happening in that center line. And it's not as much about how far that gap between the rectus in the six pack. It's about the tension of that connective tissue. So some people might have a bit of a distance a gap. But when they use their abs, if they palpate it, then they've got some tone, I call it the spring back that you're pressing against a trampoline. And then some people have what I call a marshmallow, I'm sure there's more technical name, or you just kind of keep going in what she like a marshmallow. So it's about looking at the load our body can handle and then also having respect that it can take a while for us to come back. I think that's a very long winded answer. I hope that answers the question.

No, it's very good, because I think people have a lot of questions about that. And that the the main thing that I want to make sure people understand is that it is normal to have it it is part of the physiologic process of pregnancy and postpartum recovery. And exercise and re strengthening is the method for healing it. But you have to do it in a way that isn't overly aggressive, because you can then make it worse if you have a severe case of it. So people need to be aware and they need to have somebody who is helping them understand. Yeah, and they're there. I think it's important, they learn how to check it themselves. That way, they're not always saying, Oh, I can't do this until I see my care provider or PT. If they can check themselves, they're going to be able to trust their body.

And just learning to listen to their body in the moment because I do I do feel that people are can get overly paranoid about oh, yes, it's a separation. I feel like I see a lot of that just over analyzing it over worrying about it. It's become like a real thing.

I think the trap that most people fall into, if not most Americans just most people is that when we want to get back in shape or we want to get in shape. Our focus is always around the major muscle groups. You know, we want toned arms want toned legs and toned glutes, but postpartum. As you're saying we have to learn about the fascia. We have to learn about the interior muscles, we have to re gain our strength in the right order. So it's not just like go back to your workout and be careful. That's what most people think. Go back to your workout. Just be careful It's like, you might not be ready for that level of workout when you're hitting those macro muscle groups yet, you really have to make sure everything on the interior is knitting back together and strengthening back together and in that order, and then it'll get easier and you can be more productive anyway, when you get back to those larger muscle groups.

How would people know how do people know if they're going too far? How do they know if those inner fascia and ligaments are healing? Or they're being too aggressive? And I think the answer to that is probably their level of discomfort during exercise or the pain they might experience afterward, the recovery time, how long does it take you to recover after.

And the thing is, if they go back too quickly, then the healing process getting back to what someone loves is just going to take longer. So say someone is a runner, and they go back too quickly, and their pelvic floor is like, go thank you. And then they maybe then it would prolapse, then it's going to be such a longer road than if maybe they took the extra couple of weeks. And I say this with a big open heart. Because I certainly was one that when I wanted to jump back, but my body in every possible way was like you can't do that my brain was like, let's do it. And I was like, hold the horses, you cannot do it. So if we can give ourselves that grace period of respect, and slowly coming back and listening, then I think we can get back to what we love quicker. But also, going back to what Cynthia was saying. It may not be kind of the sexier muscle groups like the arms and the legs. A lot of it has to do with the back body, which we don't often think about if we can get that posterior chain strong again, that's going to help our posture and how many people are thinking like, oh, do I have too much rib flare? Probably not. But we can get that balance in the posture better and better aligned, it's going to help us fro
m the inside out. So that we we're not dealing with pelvic floor dysfunction. We don't have as much diathesis and then we can get to the sexier parts that people think about.

Yeah, and there's also always those opposing muscles so that I think we have to keep in mind. We're overworking the back muscles. The shoulders are hunched, we're carrying our babies. Maybe we're breastfeeding We're wearing our babies we're we're slouched over all the time, we just round the back body, which puts so much on those back muscles and then the front muscles have no choice but to get soft and not to be in use. So just it's like this dance between the muscles on the back of the body and the muscles on the front of the pod.

Yeah, we need to strengthen imbalance. Same thing we didn't three NATO strengthen a balance.

Deb, can you speak to us a little bit about how you bring your yoga practice into your doula work what is like the most important thing that you carry with you from your work as a yoga instructor and bring into the birth with you.

I think it's about the opportunity to trust yourself. We can allow ourselves to be our best teacher, that we can look within ourselves and find a sense of resilience that maybe we didn't know and trust that we can get past that obstacle and I feel like that can come very much into birth and parenthood.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

Don't let anyone say Oh, it's just about the baby. It's all that matters. You have a healthy safe baby because that's really invalidating.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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