11 Weeks Pregnant: Hypermobility and Pregnancy

September 1 – September 6: 11 Weeks 0 Days – 11 Weeks 6 Days.

When we measured hamstring flexibility in high school gym class, I blew past the end of the gauge on the sit-and-reach box (which was about the only thing I was good at in P.E.). At 19, when I first set foot in a Bikram Yoga studio, I was already one of the most flexible people in the room. I often had yoga teachers ask me if I was a gymnast or a dancer—I wasn’t; my bendiness is mostly genetic. Needless to say, I’ve always been flexible in certain directions; however, I don’t know if I’ve always been hypermobile.

Flexibility is mainly a function of how long and pliable your muscles are. Hypermobility relates to different tissues. If you removed all the muscles from a human body (don’t try this at home), the bones would maintain a skeleton shape because of tiny straps called ligaments that hold the bones together at the joints. Ligaments have some elasticity, but unlike muscles, they don’t contract and relax. If you work diligently to build flexibility in a muscle, you may quickly lose your flexibility if you stop your stretching regimen. However, if you stretch out your ligaments, they stay that way for a quite a while. Some examples of actions that stretch ligaments:

  • Twisting your ankle
  • Pushing your elbow to straighten as far as it goes
  • Making sudden stops or pivots while running
  • Sinking into yoga poses as deeply as you can rather than maintaining integrity

If the ligaments get so lax that the joints are no longer stable (e.g. the shoulder easily comes out of place in its socket), it is called hypermobility. For people who get to this point, it’s of utmost importance to strengthen and refine control of the muscles around hypmobile joints as a second line of stability.


A view of the pelvis from the front.

All of this matters when you’ve got a baby on board because pregnant women’s ligaments become more pliable. Especially during the first trimester, pregnant women’s bodies release elevated levels of a hormone called relaxin. Bear with me for some anatomy: everybody knows that the hip joint is where the thigh bone attaches to the pelvis, but the pelvis also has a couple less illustrious joints that maintain its structure and don’t move that much under normal circumstances. The pelvis is made of two large irregular bones called the coxal bones (the iliac bone labelled in the diagram is part of the coxal bone), which come together in pubic area in the front and wrap around the sides and to the back where they join the sacrum bone, which (along with the coccyx) is the bottom part of the spine. One of relaxin’s function is to relax the ligaments of the joint in the front of the pelvis between the two coxal bones—the pubic symphysis—and of the joints between the coxal bones and the sacrum—the sacroiliac (or SI) joints. It makes birth a heck of a lot easier if the pelvis is mobile.

Because relaxin is released systemically, not just to those few pelvic joints, it affects all the ligaments in the body. People who have tight joints tend to enjoy this period of relative mobility. By the time I got pregnant I’d already been working with a couple hypermobile joints (including my SI joints) for two years. I had worked with a physical therapist to rehabilitate my body enough that I could teach yoga regularly and practice a couple times a week on top of that, but there was definitely a limit on how much stretching I could do before destabilizing my joints. My favorite classes became the ones that prepped the body for inversions, because they usually focused on strengthening instead of stretching. I kept telling myself, Before I get pregnant, I have to get back into doing my physical therapy exercise daily, start doing Pilates three times a week, and maybe even get back into weight training to stabilize my joints. But I didn’t get around to it, and I got pregnant a lot quicker than I thought I would. When I found out I had a baby on the way, I knew I was in trouble.

I’ve never striven to be that mama who’s 36 weeks pregnant doing a one-legged wheel through an Instagram filter (No disrespect intended—you are amazing and gorgeous; thank you for sharing what’s most authentic to you during pregnancy). However, I visualized myself continuing to work through pregnancy. When I was a lifeguard in college, there was a diving coach who worked at the pool named Betty-Sue, or Anna-Jane, or something like that. She was tall and boisterous, had pixie-cut stark red hair (before it was cool), and a giant pregnant belly. Fueled by the only images we had of pregnancy childbirth—the hectic emergency situations portrayed on TV and in movies—the other lifeguards and I were horrified that she was still working. We were sure we’d have to deliver a baby on the pool deck, armed only with the three-minute section about emergency childbirth we’d discussed in our first aid course. Years later, I think back on that diving coach as a powerful role model. During pregnancy, I wanted to be out there fulfilling a purpose greater than my own needs right up until my contractions started.

Needless to say, giving up a big chunk of my teaching was a tough choice, but it came down to the question: “Would you rather have the physical integrity to hold and carry your future child or to continue to practice contortion?” For me, there is no contest. As soon as I found out I was pregnant I stopped practicing yoga in public classes. My home practice has consisted almost exclusively of low lunge, legs up the wall, and savasana. Within a week of finding out I was pregnant I gave a month’s notice on the public vinyasa classes I’d been teaching. In that month it became clear that I’d made the right choice. After sitting cross-legged for long periods my ankles feel kinked. If I go to my full depth in a forward fold (let alone doing it repeatedly in a series of several sun salutations), my SI joints ache like never before until I can do some of my rehab exercises. After samokonasana (side splits), I feel pins and needles in my pubic symphysis for the rest of the day. Even in gentle back bends I feel sharp discomfort in my upper abdominals. Twists make me nauseous. In short, vinyasa yoga is not therapeutic for me at this time. I’ve had several pregnant women practice in my vinyasa classes into the third trimester, but it just isn’t meant to be in my body.

Last week, was my last week teaching vinyasa. I’m continuing to teach Seniors’ Yoga, yoga and meditation to people with chronic pain, and a couple private classes, which has been lovely and soothing for my body this week.

For others who have (or think they may have) hypermobile joints (during or not during pregnancy), here are some yoga-related insights I’ve gleaned from living in a similar body:

  • The cues in yoga classes don’t always apply to you. For example, a common cue in yoga is to tilt the pelvis forward (or reach the sit bones upward) during forward folds. If you’re already flexible this may destabilize the SI joints. Ask an anatomy-focused teacher for tips to suit your specific body after class, or sign up for a private session!
  • Yoga not just about softening and relaxing. The dialog around softening to intensity is one of the reasons yoga is so healing, but when you have hypermobile joints, there’s an art to it. With practice, you can learn to completely relax and release in one area while engaging the muscles to stabilize another. For example, in frog pose, can you soften your inner thighs and groin while engaging your core so your spine doesn’t hammock down? At first it can be like patting your head and rubbing your belly. Anusara-inspired yoga teachers often include great cues about stabilizing the joints.
  • Being hypermobile doesn’t necessarily mean you’re flexible. For one, muscles can automatically tighten up to protect hypermobile joints. Also, sometimes areas of immobility can actually contribute to hypermobility. For example, due to very mild scoliosis my upper back is less mobile than average. Above and below that immobile area, I have developed hypermobile joints that have compensate so I can approximate fun, sexy positions like wheel pose. Relying on hypermobile joints to achieve yoga poses is not a sustainable practice.
  • The posture should be steady

    The posture should be steady, comfortable, and grounded in joy – Patanjali (This photo was taken long before I was pregnant)

    You may not be able to feel your edge. You can easily and comfortably press hypermobile joints into unstable positions that may continue to stretch or damage surrounding ligaments. Because the ligaments are long, you don’t feel pain until the joint is really out of place. The cue, “Breath into the discomfort” in the absence of cues and enforcement of alignment did not serve me as a developing yogi. When I didn’t feel discomfort in a pose, I’d go searching for it. In some directions, the only discomfort available was achieved by destabilizing my joints. I used to hold resting pigeon 6 minutes each side per day because it was so beautifully intense—as if it was stretching the fibers of my soul. Turns out it was so intense because the way I was sinking into it was pulling apart the tissues that stabilized my SI joint. That sounds like it would be painful, but it’s important for other bendy yogis to know that it never felt bad or destructive to me; it felt transcendental. Now, my personal rule of thumb is that the stretching part of a pose should be comfortable and pleasant. Don’t worry, in most styles of yoga, there’s still tons of uncomfortable strength work as an arena to develop equanimity.

  • You may not have the strength to do the poses that most people don’t have the flexibility to do. The typical class that works up to wheel as a peak pose focuses on flexibility. This isn’t enough prep for me. Because I have the hypermobile segments in my spine, it takes an incredible amount of core/abdominal/back muscle control and strength for me to bend evenly in my spine instead of just collapsing into those “easy” joints. To do wheel comfortably, I need to spend a good chunk of time priming the strength component of the pose. (Actually, this is good advice for anyone. Doing wheel without engaging the abdominals to control the back bend is a really effective way to develop painful hypermobility issues).
  • Typical sequencing may not work for you. For me: Ashtanga and other sun-salutation-heavy styles—yuck, too repetitive and extreme-to-extreme to keep my joints in place. Sequencing that’s so focused on the peak pose that is sacrifices balance—ick, imbalanced muscle groups can easily pull unstable joints out of alignment. Hamstring stretches until the sacred cows come home—my SI joint says no thanks. Yin yoga—Oh God no. Those long holds are designed to get into your connective tissues, that’s the whole point of them. I don’t need my ligaments to be any longer than they are. It’ll be different depending on what you’ve got going on in your body. It’s okay if not all styles of yoga resonate with you. It’s okay if no style of yoga resonates with you.
  • Yoga is not a cure-all. Anyone who tells you otherwise probably has a financial interest in you continuing to practice yoga exclusively. There’s a glaring (but sometimes hard-to-accept) difference between a practice that’s therapeutic and one that’s only tolerable; just because you can do all the typical yoga poses doesn’t mean they’re improving your physical state (or improving your ability to sit in meditation). Check in with your body. You may have incorporate other types of exercise or therapies into your regimen to restabilize your joints. I’m not qualified to give medical advice, but for my body, seeing a physical therapist who could specifically evaluate what was going on in my body, give me physical hands-on adjustments, and assign homework exercises to keep those adjustments in place worked better than anything else. Pilates with an experienced teacher is also great. Since I’ve been pregnant I’ve been taking Preggo Pilates with Stephanie Forster. Update: Nearing the end of my second trimester, I swear even more vehemently by prenatal pilates. When life has painfully kinked my joints, pilates has snapped me back into place.
  • There are seven other limbs of yoga, all of which you can still practice, even with hypermobile joints. Let your asana be a practice that serves you—not a practice that adheres to what other people tell you that you “should” be doing (Prenatal yoga is such a staple in San Francisco that not one doctor, midwife, or acquaintance could resist telling me I should try it even after hearing about my joint issues. You know your body. You know what’s right—that knowledge just may be hiding under a couple layers of ego). I’ve been using the Hypnobabies home-study course (see my review of it here) as a form of meditation and connection to my baby.

Having hypermobile joints can leave us feeling lonely and judged because there are relatively few of us out there, people don’t have much compassion for us (“You’re too flexible? I’d love to have your problem!”), and sometimes we’re even shamed for succumbing to our challenges (yoga teachers may tell us to “let go of our ego” when we’re sinking too deep into yoga poses rather than helping us find alignment in the lax joints we have a hard time sensing). My hypermobile sisters and brothers: know that you are not the only one. It’s okay to have the body you have—just because certain things don’t work for you doesn’t mean your body is bad or wrong or broken. If a teacher makes you feel that way, it’s a sign they don’t have the knowledge to help you; find a new teacher. Your body is perfect, and there is a practice out there that will be therapeutic for you. Trust that if you let go of dogmas around asana, put the other principles of yoga to work, and get a little one-on-one help from an experienced teacher or therapist, you will find your way.

24 Weeks Pregnant: Horizontal Growth Spurt

December 1 – December 7: 24 Weeks 0 Days – 24 Weeks 6 Days.

Eight weeks ago I was wondering when my bump was going to pop. Well, it’s here!

24 Week Bump

Filling out my maternity clothes.

Over the last two weeks I had a horizontal growth spurt. So far in my second trimester I’ve been gaining a pound a week or less, but in the last two weeks I put on around 5 lbs. At least some of that gain was to my thighs and butt, but I’ll consider that stored energy for the baby when she’s so big that there’s barely any room in my stomach for food (although, if I start feeling like I’m going to split my maternity pants, maybe I’ll lay off the butter and bacon).

What I love most about the bump: Seeing evidence that my baby is growing. I’ve been feeling her kick more and more, too, which is so cool.

Other bump advantages:

  • Filling out my maternity clothes instead of swimming in them. My “I ate a seed” shirt finally makes sense.
  • Being recognizably pregnant. Growing a human is hard work, and it’s nice to be acknowledged for it! I love telling people, “It’s a girl!”
  • Getting special pregnant lady treatment, like being allowed to use a restroom that’s not normally for customers or having three grocery store employees desperately (but ultimately unsuccessfully) trying to help me find the perogies I’m craving. Sometimes people do go a little overboard. I can still pick stuff up off the floor on my own, carry quite a reasonable amount of weight, and walk a modest distance. I appreciate the thought though!

Bump Inconveniences:

  • Before I was pregnant: if I had to fit through a tight space, I’d turn sideways and squeeze through. Now: if I can’t fit through facing forward, I probably can’t fit through facing sideways either. I clipped my belly pretty hard on a door handle trying to sneak into a meeting room one day this week.
  • Putting socks and shoes on is awkward. I can’t really bend my knee into my chest any more, and it’s hard to tie my shoe with my ankle crossed over the opposite knee.
  • I don’t think my feet’s integrity has caught up with the extra weight I’ve gained. By the end of some days this week, my tootsies were aching, especially if I’d been wearing non-supportive shoes. I think a key to my third trimester will be finding supportive (but hopefully still attractive) slip-on shoes. Any suggestions?

My biggest bump challenge: Now that the baby is bigger she is starting to press up against my stomach, which is causing heartburn. One day this week the heartburn was intense and relentless. It feels like the baby may have turned upside down so she can kick up against my stomach (in the long run, this is a good thing as the ideal position for birth is when the baby is upside down—most hospitals will do an automatic C-section if the baby is feet down). I’ve been managing the heartburn with food and lifestyle choices so far (sipping almond milk, going for walks after eating, sleeping on an upward slant). The next thing on my list of things to try is papaya, which several reputable sources have recommended. That said, I’ve Googled, “Are Tums safe during pregnancy?” several times, so my resolve may be wavering.

Identity shift: I couldn’t categorize this as good, inconvenient, or bad because even when change is wonderful, healthy, and productive, it’s hard! With the physical changes in my body, Richard sees me differently. I’m no longer just a wife and a woman, I am a mother and the carrier of his already-beloved daughter. He cares for me in ways he didn’t before, and seems to have a heightened protective instinct for me and the baby. Obviously this shift in both of our identities is amazing, necessary, and there are parts of it I love (like having Richard make me snacks), but I still have a sense of melancholy around losing my old, simpler identity. Also, these new roles entail all sorts of a scary responsibility and stir up a deep-seated evolutionary need to not mess up, which can degrade into self-doubt and self-judgment. The questions around my future work situation contribute to the feeling of getting a total lifestyle makeover. More and more I’m willing to dive wholeheartedly into this new adventure and see myself as a mother (the books I’ve been reading have helped), but there are still moments when I just want to be a woman and a wife. I guess that’s what babysitters and date nights are for!

23 Weeks Pregnant: To Work or Not To Work?

November 24 – November 30: 23 Weeks 0 Days – 23 Weeks 6 Days.

Since I stopped teaching vinyasa yoga at the end of my first trimester, I haven’t been working as much (more details on this to come—my hypermobility issues have been one of my biggest pregnancy challenges, and, as per the advice of a book I read I read to inform my last memoir-writing project, I’ve been letting those particular emotions age before blogging extensively about them). With Thanksgiving this week, I worked much more than usual filling in for colleagues who were out of town. This had me dropping my Richard off at his shuttle stop in the morning, then whisking Foxy off a friend’s house for the day, sitting with protesting joints in rush hour traffic during my long, rainy commutes, and missing my freedom to snack and rest the way my pregnant body wants to.

Working itself felt wonderful—having a sense of purpose that is my own is important to me, and my body has been cooperative during my second trimester. However, the experience left me wondering if I could maintain that schedule and add in arranging care for a baby, pumping breast milk at work, making a healthy dinner at the end of the day, interacting meaningfully with my family, and still practicing self-care.

I think equally good arguments can be made for providing a child a rich environment at home or immersing her in a social setting at daycare. If I work, I’ll feel bad about missing out on knowing and experiencing my children as much as I can, and if I stay at home I’ll feel bad for letting down womankind and sabotaging my career. Unless I change careers: after childcare, doggy daycare, and the cost of commuting, working would not put me that far ahead financially. Richard makes enough for us to get by and is supportive of me doing whatever I think is best for our family. So the question really comes down to how I want to spend my days. Lately, deliberating over my future work situation has started to feel like this:

Obviously “to work, or not to work?” is a false dichotomy. Work is a multi-dimensional spectrum with varying hours (full-time, part-time, temp, contract, etc.), activities (office job, teaching movement, manual labor, etc.), and location (work-from-work, work-from-home, traveling, etc.). It’s hard to know ahead of time where on the spectrum is best for me. A few pieces of advice I got this week gave me a little clarity:

  1. I put a dent in reading Baby 411 over the long weekend, and have been enjoying how the authors provide information to help parents make informed decisions without undertones of guilt and shame (My reviews of pregnancy books reflect my distaste for books that purport that there is only one right way to do things). In Baby 411, the authors say that whether you decide to stay at home or work, run with it—you can always reassess down the road. No matter what decision you make there will be people who judge you; it’s probably because they’re insecure about making a different decision than you did, and feel the need to justify it.
  2. I gave my e-mail to two or three pregnancy-related businesses, and now my inbox in inundated with baby spam. However, when this article about what NOT to worry about during pregnancy popped up in my inbox, I eagerly clicked the link and read it. In support of the sentiments in Baby 411, one of the quotes is: “No matter what decisions you make, someone will always disagree. Try not to let the negative comments upset you, and if you’re really worried about something, talk with your doctor or a nonjudgmental friend.” Who wants to be my go-to nonjudgmental friend?
  3. Someone I recently met quipped, “People always say they need to work to make money for their kids. Kids don’t understand money, they only understand love. They only want you.” Of course, if kids are going hungry because there isn’t enough money to buy food, they’re going to understand that something is wrong; however, this statement resonated with me with respect to my own situation.
  4. According to Baby 411 the old adage is true: research shows that quality time is more important than quantity time when is comes to parents and children.

Combining the ideas above, my take-away is to guiltlessly work as much (or as little) as I need to stay connected to my career, stay sane, and make any supplementary income we need to get by, but not so much (or so little) that I’m too drained to spend quality time with my family. Unfortunately this is still a pretty vague statement. How many hours should I work? What type of job? Is it worth missing out of my baby to be stuck in traffic on a long commute? What about a short commute? Should I find a job I can do from home? Should I hire a nanny or use a daycare center? What about the dog? I wish I could end this post with a concrete realization, but I don’t think I’ll get any clear answers until after the baby is in my life (and maybe not even then!). All I can do is start with a work schedule, and refine it as gracefully as possible through trial and error. In the meantime, I’m going work on the “guiltless” part: discovering and accepting what I think is best for my family, regardless of others’ judgments.