Ep 94: How Prenatal Yoga Can Improve Your Entire Birth Experience with Deb Flashenberg

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I am really looking forward to revisiting the topic of prenatal yoga on this week's episode! We explored some of the benefits of pre- and postnatal yoga back in episode 30, but today we are going to dive even deeper.

I'm joined by the wonderful Deb Flashenberg, founder and director of the Prenatal Yoga Center in New York City, to talk all about her work and this practice. Deb is also a labor support doula, Lamaze childbirth educator and mother of two. She has really thrown herself into the world of pregnancy & birth in support of her clients and has experienced the benefits of prenatal yoga herself.

Deb and I talk about her journey into teaching prenatal yoga and the philosophies that underpin her center & support. We discuss how yoga can create balance in the body during pregnancy and birth, how this can make labor and delivery smoother and the importance of learning to manage pain and discomfort. 

We also talk about bodily autonomy and how practicing prenatal yoga can help you get more comfortable advocating for yourself during pregnancy and birth. There is so much amazing stuff packed into this episode - I learned a lot myself and know all of you will too!

In this Episode, You’ll Learn About:

  • How Deb started teaching in prenatal yoga and how she has deepened her knowledge & practice over the years
  • What she means by "functional birth" and how prenatal yoga can help support you in having one
  • Why pelvic floor support is such a great area for pregnant & birthing people to explore
  • The three prongs of Deb's philosophy at the Prenatal Yoga Center and how she builds community among her clients
  • The importance of building a relationship with your body and its sensations, and how this relationship will help you navigate labor and birth
  • Why it's important for you to know how to manage the pain of contractions, whether you're having a medicated birth or not
  • How prenatal yoga can help you  build a better understanding of your body and prepare your mind and body for labor and birth

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I want this podcast to be more than a one sided conversation. Join me on Instagram where we can connect outside of the show! Through my posts, videos, and stories, you'll get even more helpful tips to ensure you have a beautiful pregnancy and birth. You can find me on Instagram @drnicolerankins. I'll see you there!

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Ep 94: How Prenatal Yoga Can Improve Your Entire Birth Experience with Deb Flashenberg

Nicole: In this episode, you'll learn about one of my favorite things: prenatal yoga.

Nicole: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OB GYN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now let's get to it.

Nicole: Hello, welcome to another episode of the podcast. This is episode number 94. Thank you for being here with me today. So I'm super excited to be talking today about prenatal yoga. I talked about it back in episode 30 of the podcast, and I definitely suggest that you listen to that one as well. But in this episode, we're talking about it again from a different perspective. I have Deb Flashenberg on the podcast, and she is the founder and director of the Prenatal Yoga Center in New York City. Along with being a prenatal yoga teacher, she's also a labor support doula, a Lamaze childbirth educator, and a mother of two. After the challenging birth of her first child, Deb became incredibly interested in pelvic health and she has also since earned her pelvic floor yoga certification. And for the past four years, she has also enjoyed being the host of the podcast, Yoga Birth Babies, where she speaks with some of the world's leading experts in pregnancy, birth, breastfeeding, and parenthood.

Nicole: She was actually kind enough to invite me to be a guest on her show as well. Now, Deb and I have a great conversation about her unique prenatal yoga center methodology that combines using the yoga poses, interweaves childbirth education into the yoga classes, and of course, includes community. We talk about how her methodology emphasizes setting the birthing person up for what she calls a functional birth, where there is a focus on creating balance in the pelvis, pelvic floor and soft tissues in order to help encourage the baby to be in the best and most optimal position. And then also how to incorporate safe yet strong sensations into yoga so that you can explore coping skills as well as stress management as a result. And that is really just the beginning of what we talk about. There is so, so much more great information in this episode.

Nicole: You're really going to enjoy it. Now, before we get into the episode, let me do a quick listener shout out. This is from graduate five six, seven, eight, nine nine. And the title of the review says a great listen. And the review says, Dr. Nicole is knowledgeable and always has a very fair and even approach to how she explains things, great interviews and topics. Well, thank you. Graduate five, six, seven, eight, nine, nine, for that lovely review. I kind of want to ask people sometimes like, how do you come up with the name that you use? It's always interesting to see the names for the reviews, but I appreciate that kind review. You mentioned that I have a fair and even approach. I also have a fair and even approach in my online childbirth education class, the Birth Preparation Course. The Birth Preparation Course is of course my signature online childbirth education class that ensures you are calm, confident, and empowered to have a beautiful birth. I've had over 650 women enroll in the Birth Preparation Course, and I would love to have you as well. You can check out all the details of the course at drnicolerankins.com/enroll. All right, let's get into this great interview with Deb Flashenberg from the Prenatal Yoga Center.

Nicole: Thanks so much, Deb, for agreeing to come on to the podcast and reaching out. I am super excited to talk about prenatal yoga. I love yoga myself, and I'm getting more and more like into it. So delighted to have you here.

Deb: Thank you so much for having me. I really, really appreciate it.

Nicole: Why don't we start off by having you tell us a little bit about yourself and your work and your family.

Deb: Absolutely. Thank you. So I have been the founder and director of Prenatal Yoga Center for we're heading somewhere over 18 years, almost 19 years. And I started it in my twenties. Well, before I knew what it would be.

Nicole: Oh, wow.

Deb: I know. I had my own kids and it was, I kind of stumbled into it. I was a former singer dancer and I started doing yoga and I started with the practice that I didn't really end up liking it as Bikram yoga, just wasn't my thing. And someone mentioned prenatal and I thought, well, that's a great idea. And so I just jumped into it, but my passion for it actually changed not from having my own kids, but from witnessing birth. That's really, when things turned around to one of my, uh, one of my students asked me if I want to come watch some births.

Deb: And again, as a singer dancer, most of my friends were not having babies in their twenties. And when I went into a hospital and it was very, I'm going to put in quotes, like typical hospital birth, from what I later learned, it was just a shocking experience that I felt like what I was starting to work with. My students in the yoga room, wasn't really translating to what they were encountering in birth. And so that just sparked a fire of trying to find a bridge between what I was teaching, what was happening. So I became a doula and that gave me the opportunity to understand birth on a different level, as a witness, to watching people, watching the variety. I mean, you know,

Nicole: Right, right, right.

Deb: So many different varieties. And, and that's really where the trajectory started. Then I became a Lamaze teacher. Um, I studied pelvic floor health, and then eventually like nine and a half years later, I had my first child. And then I had been, and that was a bit of a train wreck. It was a very long, long, long challenging birth. And then I learned from that and that affected my work. And then I had another, and it was so much different. My first I pushed for like five hours. And my second one, I pushed for six minutes.

Nicole: Oh, wow.

Deb: I know. Very different. But a lot of that informed what I teach and, and my passion for helping, helping people have a birth they can walk away from feeling good about no matter if it was what they envisioned, if they feel seen and heard and they really trust their body, I think it can really make a difference a hundred percent.

Nicole: Yeah. That's why it's usually not about a specific type of outcome. Yes. You know, it's perfectly reasonable to want that, like whatever you want, but really underneath most birthing people just want to feel respected and heard. And like their wishes were, were like they were involved participants in their birth.

Deb: And that's what I didn't see at that one turning point with that one birth I was, was talking about when I was watching this hospital births, is the person really was treated like a vessel. And not really, no one really took care of that person and the baby wasn't with the person after. And it just made me realize that's not how we should be birthing and that's not how people should be respected.

Nicole: Absolutely not. And unfortunately that still occurs to some degree today we've gotten better, but it still occurs. Hence why I do this work. So I would be delighted to be put out of business one day in terms of like having to do this sort of work and I'll always keep catching babies. But, um, yeah, unfortunately that's still still the case we have some work to do in that regard. It's interesting to me though, that you got a lot of people who I talked to got interested in prenatal yoga after their own personal experiences, but that didn't happen for you.

Deb: No, you know, I, I was really, I kind of went backwards. A lot of people said, you know, I, I jumped into this because at the time I started this back in 2001, so this was a while ago. There wasn't a lot of prenatal yoga. And I thought, well, that's an underserved population. Why not get into it? And my passion actually became as a birth advocate that no seeing birth and seeing what was happening and then seeing what could happen and what we could do in the yoga room. That's really what sparked it. But things did change actually, after I had my first, I really, my whole approach to prenatal yoga changed. I always worked with yoga, working with coping skills, yoga, learning, how one can move. But a turning point was when I had my son and it was such a long, challenging birth. I stepped back and I thought, okay, what happened? Like I was not expecting that. I thought this is what I do. Like as a Lamaze teacher, as a doula, like as a dancer, my mom told me how great her births were. So it was literally expecting this baby to like fall out. And when it didn't, I had to step back and say, okay, what, what was that about? And in discovering that and working with a physical therapist, because you pushing for five hours, it's going to do a number on your abs and pelvic floor. And it certainly did. And I worked with a PT and we talked about, and you're like, things were just really tight. And then I'm like, okay, that makes sense. I was spinning like five, six days a week. I did not really adjust, even though I think I knew too, I had a hard time accepting it and I didn't adjust my yoga practice enough. I didn't adjust the weights, the intensity and everything was tight. My psoas was tight, my pelvic floor was tight.

Deb: I'm sure that then torqued things internally. Um, I'm sure my, and I know I had sacroiliac issues. So add all that up. And the baby, while his spine was forward, his head was asynclitic. And that, again, it doesn't surprise me knowing that things weren't soft and supple and balanced. So after going through that and understanding it better, that changed how I approached yoga and how I work with the students. It's not just about modified practice. It's how can we take this practice to try to create balance in the soft tissue in the bony pelvis so that baby can be well aligned. So as the uterus pushes the baby down, the baby's in a good position to help open the cervix. Well, so everything shifted with that. And I became really into an advocate of body work. And again, that's when my second pregnancy, I did things completely different in six minutes, that baby's coming out.

Nicole: And it's interesting, you know, I never say that people who have it, um, given birth can't understand, or can't help people who are giving birth, but I can cause they certainly can. But I think almost universally going through the experience will change yo,u open up new perspectives on things.

Deb: I, I agree, you know, I teach a lot of prenatal yoga teacher training and I've always had like, I've taught for years without having had my own baby, but it did give me a different perspective. And I try to come at that because people would say like, how can you teach prenatal yoga without having a baby? And I tried to do enough births as a doula to see enough variety. You know, I did over a hundred births before I had my own. I definitely saw the variety of births and recognizing that what I feel is not what someone else is going to feel, but it definitely gave me a different perspective. You're absolutely right.

Nicole: Yeah, for sure. For sure. So obviously you've had a ton of training and in terms of being a yoga teacher and certifications and all of that kind of stuff, I do like to put that out there for folks that, um, just tell us a little bit about what your training is in this field.

Deb: Sure. Yeah, I've done a fair amount. So I started my first yoga teacher training was in 2000 and then I, and I was a bit of a yoga teacher junkie that way. I'm like, oh, what are dreams? I'm very much about education. So, and I was also a dancer before singer dancer. So I had a fair amount of body awareness. And then after that I did my prenatal yoga teacher training in 2001. And then I think it was 2004. I did two other yoga teacher trainings. And throughout that time I was still practicing yoga. Um, I study mainly Iyengar and Vinyasa. So I did my Om yoga teacher training with Cindy Lee. I did a Vinyasa teacher training with Sheba Ray. This is back in 2004. And then I believe I got my doula certification in maybe 2005, maybe 2004 as well. I was, I didn't have kids. I had a lot of time

Nicole: If we only remembered too, like you don't even know, that's how much time you had before you had kids.

Deb: Oh yeah, it was all about what I wanted to do. It was very nice. And then I'd got my Lamaze certification somewhere in that maybe like 2008. And then I did a pelvic floor teacher training a little bit later and I also went to this place called the Farm Midwifery Center. And I did, um, yeah, with Ima and

Nicole: Correct.

Deb: All of those latest down there. And I did a little midwifery, uh, assistant training program. So yes, I've, I've continuously added on, um, I've studied spinning babies, so, oh. And I finished, um, a birthing from within training a couple of years ago. So I like trainings. I feel like if I can continue to educate myself, I have just a new perspective to bring to my students.

Nicole: Yeah. I think the only thing you haven't done is go to medical school.

Deb: I actually considered it. I was at a birth, it was a, is a precipitous birth and doulas shouldn't do this, but I asked, I accidentally caught a baby. Like it was not, it was not planned. Right.

Nicole: I, it was either you catch it or the baby was gonna hit the floor kind of thing. Yes.

Deb: Yeah. I walked into the, into the, her house holding a sandwich and I hear the, husband say like she's in the bathroom. And she says, I think something's coming out. And I'm like oh, and he's calling nine one one and I'm supporting the head in the perineum, so, right, right, right.

Deb: And for like a hot second I thought, oh, do I want to do this? Or am I going to be a midwife. And I thought, no.

Nicole: That is funny. So why don't we have, why don't you, um, tell us a bit about your Prenatal Yoga Center Methodology. I'm guessing its going to combine some of all of the things that you've talked about.

Deb: You are absolutely right. So I based it on, I call the three-prong theory. It is strongly about the yoga asana and that has so many layers. So the yoga poses, what can they do? They can teach us coping skills. They can teach us ownership of our body. They can teach us, uh, listening to our body because I feel like so many people say, oh, listen to your body. But if you've never had that conversation and you don't know what sensations are just strong and what feels dangerous, then how, how do you decipher that? So it's a lot about using what your body is sharing with you to make decisions. And then we also can use the poses to create balance. Balance the round ligaments, balance the uteral sacred ligament, balance the ligaments that help support the pelvic floor, balance the pelvic floor itself, the bony pelvis.

Deb: So creating balance, especially that psoas it's like a little runway for the baby, balance that psoas, so the yoga asana has so many layers, but then because I have the doula background and the childbirth, that background, we interweave those themes throughout class. So that it's not just when the parent shows up for their childbirth class and they're taking notes. We keep putting little bits of childbirth ed into every class. So they just keep layering their knowledge. And then the final prong is community. Especially when you're pregnant, things are just changing, who knows what's going on in your life outside. It can feel pressure from not having like your friends don't have a baby, or maybe you're the last of them to have a baby or maybe there's fertility issues, or maybe your partners are unpartnered. There can be so much. And then to come together as a community of everyone kind of going through the same thing can feel really reassuring and it's a safe place to open up and get support. So those three pieces create our methodology and they show up in every class.

Nicole: I love that. That is really, really awesome. And I really, um, especially like the first part about, we tell people to listen to their body. But if you haven't like had practice or experience with what that practically means, then yes, it's kind of hard to just show up in the moment and be like, hey, listen to your body. So, and yoga, definitely. I know from my own personal experiences, uh, taught me how to like know when to push myself a little bit more when to back off how to navigate that. So that is, I really, really like that.

Deb: I'm glad. It's a lot of people they'll start feeling sensation and just immediately like, oh my gosh, I'm feeling something that must be wrong or you're feeling something. And it's just your body giving you feedback that those are your quads working. Yeah.

Nicole: Okay. Yep. Exactly, exactly. And I, I can imagine, and we'll get to this, that's going to impact like the immediately, my mind went to aha. Understanding the sensations that you have when it's time to push. Yes. Yeah, yeah, yeah. For sure. All right. Now I know one of the things you mentioned when we communicated before was setting the pregnant person up for a functional birth. So what do you mean by a functional birth?

Deb: So what I mean is that we have the power of the uterus pushing the baby down. And so I'm sure all your listeners know this, but you know, the, the cervix opens up in mind.

Nicole: I mean, actually not everybody knows, you know, I, you know, so, so yeah, let's talk about it. Not everybody, I don't think even in our society, we get a lot of education about how our bodies work. So,

Deb: All right.

Nicole: So lots of folks come in thinking that you're going to have three contractions and a baby's get a fallout and it's like, mm, doesn't quite work that way.

Deb: No. It's not like the movies.

Nicole: No, not at all. So let's go for it.

Deb: Alright. So the way I visioned this is that this cervix is like a turtleneck sweater and the baby's head is pushing it open. And so you have the uterus pushing the baby down and the baby's head is slowly opening the cervix. And if the power of the uterus pushes the baby down, the baby's head is well aligned on the cervix. And again, please correct me because you're really the expert. And if it's pushing it down evenly, the cervix opens more evenly. But a lot of that has to also do with the baby position. So the baby is

Nicole: Yep. You got it.

Deb: See? I learned a thing or two. I like that. Thank you. So if baby is say posterior, that means, um, the spine is towards the pregnant person's back then the forehead's trying to push the cervix open and that doesn't mold like the back of the head or the baby has what my son had, asynclitic meaning the ear was closer to the shoulder. So the side of his head was trying to push it open. So if we don't have the baby well aligned, it doesn't matter how strong that uterus is. What does, I mean, you can pick it up or add Pitocin to keep pushing that baby down, but when baby's well aligned and the uterus is functioning well, and they work as a team, uterus and baby, the body opens up the baby drops and navigates through the pelvis and, and birth is, I don't want to say easy. That's why I use the word functional. There's less, there's less issues or stalling. So that's what I think of as a functional birth when the body and baby work well together.

Nicole: So y'all, that was a perfect explanation.

Deb: Okay.

Nicole: Like, a hundred percent spot on, like it does it necess- and this is one of the reasons why, like, if you have a C-section the first time, because the baby didn't fit, definitely try the second time. Cause it may not have been. It's not that there's something wrong with your pelvis. It really is an alignment issue where ideally you want the baby to come kind of straight down, like Deb was saying, but if it's tilted one way or another, or looking a certain direction, it makes it more challenging and actually millimeters of space can make a difference.

Deb: Yeah. Cause there's not that much space. I mean, for, you know, let's think about how wide those sit bones can get. Like there's every bit helps.

Nicole: Every little bit helps. And then that's why something like yoga or spinning babies. I actually want to reach out to her or someone from that organization to talk about spinning babies, but getting babies in a, in a good position can help, um, facilitate birth for sure. So that like exactly what you said is spot on.

Deb: Oh, thank you. Thank you. Yeah. So we include, and a lot of the spinning babies, I haven't done my spinning babies certification yet. That's my, like, I am so excited to someday do that, but I, I do know a fair amount of their methodologies that I include some of that in class. So when we can create that balance in the pelvic floor, really try to help set the person up that the psoas is balanced and everything's more balanced, then we're really trying to stack the cards in the right way to help that baby kind of like, I wish it was like a water slide, but kinda like a corkscrew. Yeah.

Nicole: I mean, yeah, it's true. Yeah. Honestly, it really is true. Yeah. It definitely helps. It definitely helps. And is something that these types of, um, position changes and movement and getting ready for this, that is, this is something that's definitely lost or not very present, uh, as much as it needs to be in traditional hospital birth. Um, I think midwives for sure have more knowledge of, of that, but in like physicians, it's not something we even get really a lot of training on. It's like if the baby's in asynclitic or posterior, we just are like, okay, I guess we can turn it or not, but not understanding how we can have the, the birthing person can move her body to help facilitate those changes. It's not something that we get a lot of training on, unfortunately.

Deb: I love that you do know that to help people because there's, as you said, a lot of care providers don't and then a baby was too big, but was baby too big. Yeah. So I love that you're putting out there.

Nicole: Yeah and I think we're getting better, like the hospital where I work, um, all of the nurses are trained in spinning babies and um, more hospitals are understanding these things and these techniques. And I can't say that I necessarily understand how to do them. And then I walk in the room and like a leg is here and it's like, oh, I see we're doing some, some maneuvers to try to get this baby in a better position, but they certainly work. And the risk is very low. So, um, something we need to know more of for sure.

Deb: Oh, I love that. You're putting it out there. Thank you.

Nicole: Yeah. Yeah. So we also, and we'll get to maybe some of the pelvic floor work things, but first I want to get to, how do you use yoga for things like you mentioned coping skills and managing stress. And then I think we talked a bit about how it helps you understand like, or get autonomy over one's body, but maybe like elaborate on those things a bit.

Deb: So sure. So the coping skills, I'm not afraid of safe sensation. So I want the students because labor hopefully is safe or, you know, we'll have safe sensations and that's definitely parenthood. You know, it's a lot of sensations mentally. So if we can not be afraid of the body and safely move through poses, that gives strong feedback. It's an opportunity to sit with that discomfort. And a lot of people have, and I put myself in there in that category, it can be hard to sit with discomfort. We don't want to put ourselves in strong uncomfortable situation. And when we can be in that discomfort, it can teach us all right, what are my habits? Okay. I tend to tighten, my shoulders are tight, my jaw and I hold my breath. Well, that's not really going to help, but that's my habit. So that's one of those like learn about yourselves.

Deb: And then when I can see that I can start to think, all right, instead of tightening, can I then find something to help me breathe? Maybe I'm going to find a focal point and breathe to that. Or maybe my focal points internal, or maybe it helps my open my throat and make sound, or maybe I go to a mantra or maybe I want to like push on my thighs and give a little tactile feedback. So we explore all the, these coping skills while being safely uncomfortable. Cause you can talk about them in a childbirth class just theoretically, but when you're actually uncomfortable, you can really learn about them. And I always tell my students, even if you're planning on taking pain medication, that's fine, but you don't get it at your first contraction. You have to get to a point.

Nicole: Yes. Yes. I tell everybody, you must understand some basics about managing contractions because the epidural, doesn't not at your house. So yeah.

Deb: You don't walk into the hospital, hand over your insurance card and be like, and here's my back. Okay.

Nicole: Exactly.

Deb: There's some space. So no matter where someone wants to get to, I just want to give them a variety of skills to get them to wherever that is. And then for the stress again, I think it's helpful to connect to breath and build confidence when we're one of the more confidence in their body. That's going to take the stress down. And as we talked about the autonomy, learning about your body, knowing that you can say no to something, I always offer the students saying like, I'm just making these suggestions, but I want you to make the decisions on how you want to move your body. And if they can do that on the yoga mat, then hopefully that can build up to asking like, do I need this? Or no, I don't want to do this. Or can you explain to me all of the options? Because I think sometimes it's easy to get, just put yourself out there. You know, when you walk in to a hospital to saying, sure, whatever you tell me, I'll do it. Now. My son just had surgery and I kept my mouth quiet. And I'm like, why are you saying, why aren't you saying something? I knew a fair amount. And it was yet hard for me to speak up for him. And so I can imagine them being in labor, it's hard to speak up for yourself. So we're trying to do it on the mat to bring forward.

Nicole: I mean, you're just going to have I'm I'm having like 50,000 like quotable moments from this episode. I love it. This is just, I mean, it's perfect. All of everything that you said it is great. Like, I love that safe sensations, um, concept because contractions, most people will experience them as painful, but they're not dangerous. And you need to understand that it's time limited on the other side of it is something great. You need to get through this, this limited period. So understanding those coping skills and understanding like, is this something that's dangerous versus something that's not, I just, that's a really, really great and important concept and obviously very helpful to help people, um, during birth. And then of course like the, the stress and the, the breath work and, um, autonomy is a big thing. Like, uh, there's, there's a difference between like being empowered.

Nicole: Obviously we can all be empowered with information, but just knowing or taking that next step of actually using it. And in our system, it can be hard. There's definitely a power dynamic where doctors have more, I shouldn't say more, but they certainly have like the, the, they hold a lot of the keys, so to speak and it can, it can be challenging. So it's a muscle, it's a thing. It's something that you have to practice. So I just love it.

Deb: Oh, I'm so glad. Thank you.

Nicole: Yeah. Yeah. Um, okay. So let's talk about pelvic floor work and giving listeners some like concrete things. What are three things maybe that they can do to help facilitate that a vaginal birth and push more effectively where there are, or it doesn't have to be pelvic floor, I guess, yoga or what, what are some concrete things you recommend?

Deb: Let's talk about that a lot. I am a big fan of bodywork. So if anyone's not really sure about what's going on in their pelvic floor, because we want the pelvic floor to be kind of like Goldilocks just right. You don't want it too tight, just right. I think that checking of the pelvic floor PT can be really helpful. So a lot of people don't know like, is it too tight? It's too loose? A lot of times people get pregnant, they think, oh, I better just tighten everything up, but sometimes you can get too tight on the pelvic floor. So I think of the pelvic floor kind of like a trampoline, you want to have it have give and support. So we want do a pelvic floor to be able to stretch open as well as support the pelvic organs. So we do a fair amount of pelvic floor balancing where for some people it's just about the inhalation and that's going to help the pelvic floor stretch.

Deb: And for other people, it's about the exhalation. We work on the engagement of the toning, but I really try to have people think about what's the state of their pelvic floor. So not to get too, too crazy into it, but just some general guidelines. If it hurts something going into the vagina, or when you're touching around the pelvic floor, it's very painful. That can be a sign the pelvic floor is overly engaged and we wouldn't want to add more tightness, especially if we want the muscles to soften and open to let a baby out. So we work on certain yoga poses that can help gently stretch through the pelvic floor. We do a lot of softening breath, but on set for some people, they do need tones. So we work on an exhale to engage the pelvic floor, but I always remind people, check with the pelvic floor PT, if you can, just to know what the state of your pelvic floor is, so that you know how to work it. We also do a fair amount of breath work with the transverse abdominis. Those are the ones that wrap around like a corset and you can use them for pushing, which is great. So that it doesn't just come from your face and shoulders.

Nicole: Yes, absolutely.

Deb: So, yeah, so we do all that. We do all that transverse abdominis work and really it's, it's quite easy. It's really using the exhalation to train and tone those muscles. If people try to overly engage, they actually tend to get their obliques engaged more than the TA. And I think a lot of times people think of core work and they like go for the burn, working the transverse abdominis doesn't have that same burn. So for listeners, just think about like, if you had like a little cocktail star, you're blowing out a candle, you just keep exhaling and exhaling and exhaling until you're really scraping the breath out, then take your deep inhale. And that's the TA muscles are contracting around as you exhale. And then you can use those muscles to help push baby. And especially if someone's going to be taking pain medication and they're numb, if they don't have that relationship and train those muscles, then you're ask them to push with their abs. Like, but I can't feel them. So, so that's hard.

Nicole: Yes, yes, yes. For sure. For sure. Yes, absolutely. Yeah.

Deb: So that's what we do. We'd work on balance in the pelvic floor. We work on the TA muscles and we work on breathing and I think all of that can help with a vaginal birth. And it can also help if someone has a surgical birth, because at least they've trained their transverse abdominis to have some support. So afterwards they can find those muscles again.

Nicole: Yeah. I had two C-sections and I, I think my muscles just kind of got it. Like, I wish I would have done some of this training ahead a time cause they're just, they're not friends anymore. Like they're all spread out, whatever it is, what it is. But so yes, if you can do some of this work ahead of time, it can help you either way and just really be more in tune with like, um, your body and how to most effectively use it, I think is just really, really important. And I love talking to a pelvic physical therapist. We so under utilize them in general. Um, and there can be some challenges. They certainly are. There can be some challenges because of insurance and things like that. But I think more and more it's being like accepted and covered and you're right. Like if things are too tight, then you don't want to go around doing tightening things cause you need to loosen up and those muscles need to relax a bit for a baby to come out. So all great, great, great advice. Thank you. Um, now how have you been able to make changes and keep this prenatal yoga accessible and keep the classes and the community, all of those things and still make it work during COVID?

Deb: Well, that's the power of Zoom. We, we S you know, I was listening to NPR really early as, as COVID started. So we heard about things happening in China and around January. And I told my husband like, oh my God, what happens if it gets here? And so, as things started to escalate, I already figured out how to move everything. I had all my software ready. I had the whole platform ready to go. So the studio had its last in-person class on March 13th. And on March 16th, we were already holding classes online. I actually was doing some hybrid. I was doing some online and in-person because some people were already even before everything closed, not comfortable coming in. So I just shifted gears. Um, we still it's so community-based still because we always start class with circle time where everyone still says their name, they still, I call them the name cause now their names there. Um, they still say how far along they're in, their aches and pains,and what's going on. So we're still communicating with each other. They're not just showing up as a box on the screen. I'm still having conversation. I still know what's going on in their lives and their bodies. So we keep it going online. In fact, it's been beautiful because in the past we were just within our four walls in New York City. But now we have people coming from all over and it's, that's exciting. Like we have people from other countries and we have people I know it's so cool. Different time zones. It's just, I really love knowing that the community is expanded because people, whether COVID is happening or not, people are still having babies and they still need support as you well know. And they're still probably feeling isolated, like really isolated. So we just make ourselves available to listen and support. And it's been, it's been really nice.

Nicole: Oh, that's great. So you were like, I'm ready. Like let's, let's, let's go.

Deb: I made a corner of my basement, my little yoga studio. I would love to actually get it back into my studio, but we're making it work. Has, you know, today actually marks seven months of teaching in my basement. So that's crazy. Isn't that crazy? I look forward to actually seeing people face to face.

Nicole: Yeah. Yeah. I can totally understand that. So just to wrap up, um, what would you say is the most, let's say what's the most frustrating part of your work?

Deb: Oh, that's good. Um, oh, I was actually thinking about this this morning. It's hard for me because I am not a doctor and I want to stay within the scope of my work. It's hard for me to keep my mouth closed. When I know there is some outdated practices that are going on, you know, I, I'm not their doctor. They didn't hire me. I don't have a medical degree, but when I hear certain things happening or certain labels being placed on people, like I have a student who just, she literally just turned 35, like a month ago. She's like, I am now, you know, a geriatric pregnancy. My, my care provider wants me to be induced early. I'm like, is there any other factor I should know of? And she's like, no, it's just, I'm 35. And that's hard for me, like 30 a month into 35. Doesn't mean you're uterus closes up and needs a walker, you know? So like,

Nicole: And this term, geriatric pregnancy is so offensive. I hate it.

Deb: I mean, I had my daughter at 40. So I definitely, it was quoted that, but it's hard for me to hear, to hear certain things that I know have some outdated information. I had a student say that her care provider often does episiotomies. And I'm like, really? I'm like,

Nicole: But why? Because it's not necessary.

Deb: I can. So that's where I I'm frustrated. Cause I have, I do need to stay within my scope. I offer an offer, you know, like, oh, if you're interested, there's some, there's a podcast on this or I'm happy to refer you to some other information, but it's not for me to really say.

Nicole: Mm, yeah, that's tough. I can imagine that. And you want to be like, yeah. I mean, we each have to stay in our own lane, so to speak. So you can't give medical advice, but yeah, I can see how you can say, well, you know, maybe that's not, um, typical, maybe you want to look at some other options, you know, those kinds of things. That can be hard. So I can definitely understand that. So then I guess on the flip side, what is the most rewarding part of your work?

Deb: It's when people come back and say that they had an amazing birth, that's just, I just love hearing that. Yeah. I know. I wasn't really any part of that. Like, I don't want to take anything, but to know that they were able to use skills that they learned or they felt confident or they felt heard whatever it was, anything that they came back and they said, I really had a great birth. That just, I'm just, touched.

Nicole: Yeah, you are of course a part of it.

Deb: Like, I don't want to take any or, you know, acknowledgement of that. Like I'm just offering the skills, they can choose how they then choose how they use it. So I, I'm just thrilled that people do get something out of the work.

Nicole: Yeah. Yeah. And I think there's a difference between, I've certainly heard people be like, you know, like taking credit for a birth experience and it's like, no, that's not what, that's not what it is. It's a different feeling. It's like, you're just grateful to be a part of it actually. Um, whatever part, big or small that you played in it. And it really does like warm your heart when you see somebody smile and you can feel that energy, that they feel really good about their experience. And if you had a part to play in it, then it really does feel good. Absolutely. Yeah. Yeah. For sure. Okay. So what is your favorite piece of advice that you would like to pass along?

Deb: Oh, okay. I would say think early, think long, and hard about your birth team. That's going to make a huge difference.

Nicole: We got that. We needed to say that again because cause that's so important folks.

Deb: So you have to think of the person that you're choosing is going to play a huge role in how the birth unfolds and do your philosophies match how you envision your birth is, is your care provider agreeing with that? You know, I have a lot of people that would say like, oh, you know, he, or she's really great. And I was with them for, you know, my pre pregnancy stuff. And so why not stay, but if you're not high risk, you shouldn't be with that. You know, they're going to treat you that way. So think long and hard about who you invite and who you hire into cause they're hired, you know, into your birth experience. It makes a huge difference.

Nicole: Absolutely. When I can't say that enough, it's one of the things that, um, like the two biggest influences will be your, the philosophy of your care provider and the philosophy of the hospital where you give birth big, um, influence on your birth. So lovely, lovely, lovely advice. So Deb, where can people find you? Because I know they're going to go looking after they hear this episode.

Deb: I kind of feel like I'm everywhere. I'm so the main place, my website, prenatalyogacenter.com and again, all our classes are on zoom, so everyone can come to class. Um, but then if you have people that are interested in teacher trainings, I've been doing, I'm doing those pretty much nonstop. I have some smaller teacher training programs that people can just do like five hours online. It's called one of them is called Who's Afraid Of The Pregnant Yogi. Cause we have a lot of teachers that don't know how to work with pregnant people. So I've got a class for that. Um, I've got another one for teaching the postnatal student. Of course I'm on Instagram. Um, I think it's @prenatalyogacenter. And then I have my own podcast, Yoga Birth Babies. So I'm kind of everywhere.

Nicole: I love it. I love it. Well, thank you so much for agreeing to come on. This was such a really informative conversation. I know I learned a lot. I know the listeners will learn a lot and you also have a very soothing voice by the way.

Deb: Oh, thanks. Maybe that's my performing background. Yay. I am using my degree.

Nicole: Great. There you go. Thanks so much. Take care.

Nicole: So, wasn't that a great episode? I really enjoy talking to Deb and I'm super excited that she also had me as a guest on her podcast as well do, check out her podcast again. That is Yoga Birth Babies. Now after every episode where I have a guest on, I do something called Nicole's Notes and here are Nicole's Notes with my top three takeaways from my conversation with Deb. Number one, I really love the concept of learning safe sensations and how to manage discomforts by using yoga as a way to do that, to kind of push your body a little bit, to understand what's safe, to understand, not safe.

Nicole: Everyone needs to learn how to manage discomforts and pain of labor without medication like we talked about in the episode. And I just think this is a really smart and easy way to do that. So love, love, love that. Number two. So, so important that you understand that you have autonomy over your body. You can ask for explanations, you should know that you have options. You can decline things if you want, you should expect some privacy during your labor. Now I know there are a subset of people or some people who will say, well, I'm just fine. It was just like doing what the doctor says. And that's certainly fine, if you want to take that approach, you know, everybody is free to do what they feel works best for them. I think some of that may be rooted in kind of societal expectations of women that we just sorta do what we're told in a way specifically when it comes to the doctor, being an authority person and being able to tell you what to do. And again, I'm not saying that you have to push back against that. If you feel comfortable going with, you know, I'm just going to do what the doctor says, that's fine, but I want to be clear, but that it does not have to be that way. You have options, you have choices and you can certainly take a different approach. And it doesn't have to be like antagonistic or like argumentative or anything like that. It can certainly be like a nice, smooth flowing relationship, but you have autonomy ultimately over what happens in your body. And it's just really important that you remember that. And then the final thing I'll say is emphasizing the importance of your birth team in my free online class, on How To Make A Birth Plan That Works.

Nicole: I teach how to have the most influential factors in your birth are your doctor's philosophy towards birth and the philosophy about birth of the hospital, where you plan to give birth. Those two things will have a huge impact on your birth experience. And in that free online class, I give you questions to ask. So you can really understand those two things before you get to the hospital. So do check out that free class. It's How To Make A Birth Plan That Works. You can register for it at drnicolerankins.com/register. It's an on demand class that's available several times a day. So do check that out for sure. All right. So that is it for this episode of the podcast, be sure to subscribe on Apple podcast, Google Play, Spotify, wherever you are listening to me right now. And of course I would love it if you leave a review in Apple podcast in particular helps the show to grow, helps other women to find the show. And so I really, really appreciate it. And then of course I do those shout outs from reviews as well. And if you want to have some fun between episodes, then come follow me over on Instagram. I'm there @drnicolerankins. I post every day, they're helpful pregnancy tips, inspirational quotes, fun questions. I've also been doing live Q and A sessions lately. And people ask me some really interesting questions there. I think because I asked the questions in an anonymous fashion in those polls and my Instagram stories. So people feel comfortable asking just about anything. So this has become one of my favorite things to do, to do those live Q and A sessions over on Instagram. So join me over there again. That's @drnicolerankins. Now next week on the podcast, we will be talking about hypnobirthing. So do come on back next week. And until then, I wish you a beautiful pregnancy and birth. Thanks so much for listening to this episode of the All About Pregnancy & Birth podcast. Head to my website, drnicolerankins.com to get even more great information, including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class on How To Make A Birth Plan That Works as well as everything you need to know about my signature online childbirth education class, the Birth Preparation Course. Again, that's drnicolerankins.com and I will see you next week.