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Building a Happy Baby: A Guide for Parents.London: UNICEF UK; 2018

Measuring the benefits of free pregnancy yoga classes

02 February 2019
Volume 27 · Issue 2



Antenatal yoga is known to have many benefits, including increased comfort in labour, decreased pain in labour and decreased length of labour.


To identify the impact and benefits of free yoga sessions on women's pregnancy experience and birth outcomes.


A structured service evaluation was carried out, consisting of a small-scale audit of birth outcomes of primigravid women who had attended six or more yoga sessions, and a survey of women who had attended.


Women found the classes to be beneficial, and reported the breathing and relaxation to be invaluable. The social aspect of the classes enabled women to make friends and build support networks. The birth outcomes audit was small scale and did not account for confounding variables such as demographics or mobility in labour. Of the women audited, 83% had a spontaneous vaginal birth, and the average length of labour was 5 hours and 45 minutes.


Yoga classes have had multiple benefits for women during pregnancy, labour and birth, and beyond.

Antenatal yoga has numerous benefits for women, including increased comfort in labour, decreased pain in labour and decreased length of labour (Chuntharapat et al, 2008; Jahdi et al, 2017). Furthermore, antenatal yoga has been shown to decrease incidences of anxiety and depression (Newham et al, 2014; Satyapriya et al, 2013). In 2016, there were no yoga or similar classes running in Aneurin Bevan University Health Board in South Wales, and options for implementation were explored. Since this study, sessions have also been started in Hywel Dda University Health Board due to a change in job role, enabling more women across Wales to benefit.

An Iolanthe Midwifery Trust award enabled the author to train as a pregnancy yoga instructor in June 2017. It was decided that free yoga sessions would be offered to all women in the Health Board, and that classes would be held in the evenings to make them more accessible to women who continued to work during pregnancy. Classes would be held in the main antenatal clinic area as this was available in the evenings and free to use. Women were informed of the classes by their community midwives, and details were also shared via health board social media pages.

Yoga classes commenced in July 2017, with 20 women attending the first session. The classes continued to be well attended, and within a few weeks the number of weekly classes doubled to meet the demands of the women. Feedback from the women was excellent, and it was quickly recognised that the classes were providing women with many benefits.

In May 2018, further funding was gained via the Chief Nursing Officer's Betsi Cadwaladr Scholarship to enable two more midwives to receive yoga training. Classes have since started in the north of the Health Board at a second hospital as a result, meaning that there are now four yoga classes per week in the area. Additional midwives being trained will also reduce class cancellations due to trained midwives being on annual leave.


Permission was sought from the Health Board's research and development department to undertake a structured service evaluation that investigated both birth outcomes and women's views on the free pregnancy yoga classes. For the purpose of the birth outcomes audit, enrolment forms for the classes were counted to ascertain how many individual women had attended the sessions between July 2017 and July 2018. Demographic details on the enrolment forms were used to distinguish between primigravid and multigravid women, and class registers were then used to count the number of sessions that each woman had attended.

In order to gain women's opinions on the classes and how useful they found them, an online survey was compiled, considering multiple factors. The survey was short to aid completion rates, and a variety of free text, yes/no and multiple choice questions were used. Women were asked questions about the provision of the classes, what they valued most and found most useful.


The details of all primigravid women who attended six or more yoga sessions throughout their pregnancy were included in the audit, with the exception of those who had an elective caesarean section. The survey was shared on a closed Facebook group that was created by the attendees. The group had 125 members, and was used for the women to keep in touch between classes and to share birth stories. The survey was kept open for 1 week (20–27 June 2018) and was completed by 52 women, which equated to 41.6% of the group's members. Of the women who completed the survey, 46% (n=24) were antenatal and 54% (n=28) were postnatal.


Class provision

The survey included questions on the provision of the classes, in the hope that this could aid decision-making regarding further classes. It was decided to run the sessions in the evenings to make them more accessible to women. Of the survey respondents, 86% stated they would have been unable to attend the sessions if they were held during working hours (Monday-Friday, 9 am-5 pm). Women were also asked how they found about the classes, and were provided with a number of options as well as an ‘other’ category.

As evident in Figure 1, the majority of women (n=20; 38.5%) were informed of the classes by their community midwife. Leaflets in booking packs and maternity notes had informed 17.3% (n=9) of women about the service, with posters in either hospital or GP settings informing 21.5% (n=11) and 9.6% (n=5) of women. Responses in the ‘other’ category included recommendation from friend, recommendation from physiotherapist and Health Board employees who heard about the classes through their role. These data demonstrate the importance of continuing to advertise the classes via a variety of sources.

Figure 1. Where did you hear about the yoga sessions? ABUHB: Aneurin Bevan University Health Board

Most (n=36; 69.2%) women began attending yoga classes between 14 and 20 weeks' gestation. A further 19.2% (n=10) started attending between 21-27 weeks', and 11.5% (n=6) attended between 28-34 weeks'. Women were also asked how satisfied they were with the classes using a five star rating. Overall, 80.8% (n=42) awarded the classes five stars, 17.3% (n=9) awarded four stars, and 1 woman awarded three stars. The average star rating of the classes was 4.8.

Likert scale questions were used to ascertain how women felt about the time and venue of the sessions. All women agreed that the classes were at a convenient time, and 92.2% (n=47) felt that the venue was convenient.

Benefits of classes

Women were asked how they would describe the benefits of the classes to a friend or relative, and the free text responses were analysed for themes. Breathing, relaxation, socialising and meeting friends, labour techniques, and pregnancy information were identified as themes within the free text responses. The word cloud (Figure 2) shows the most common responses to the free text question.

Figure 2. Word cloud of common free text survey responses


Postnatal women were asked whether breathing exercises had been helpful during labour and birth, and 96.5% (n=27) agreed with the statement. This demonstrated the value of breathing exercises for labour and birth, and shows that they were an important element of the classes.

When asked how they would describe class benefits, 61.5% (n=32) of women overall mentioned breathing. Multiple responses commented on the usefulness of breathing exercises during labour:

‘Breathing techniques were amazing during labour.’

‘The breathing techniques taught were brilliant for the first stage of labour and the afterbirth too, keeping mum and baby calm.’

‘Better breathing practices during delivery.’

Some respondents felt that the breathing exercises had helped with labour pain, showing that they were beneficial not just for keeping calm but also for coping with contractions:

‘Breathing techniques help with labour pain.’

‘Helps you to understand breathing techniques which help with labour pain.’

Women also commented that they found breathing exercises to be of benefit during pregnancy as well as for birth, again demonstrating their value:

‘During pregnancy if ever I found I couldn't sleep, the breathing seemed to have a calming influence to help me sleep.’


Numerous (n=42) responses acknowledged the relaxation that took place during the classes, both formally and informally. The classes ended with a 10-minute guided relaxation, which women found useful:

‘Relaxation techniques can be used after birth, which is great when over tired and not able to switch off.’

‘Learn relaxation techniques for labour.’

‘Relaxation techniques were incredibly useful.’

Women also commented on the relaxed atmosphere of the classes and how they felt after completing them:

‘Relaxed sessions providing pregnancy related yoga and techniques to utilise for labour.’

‘A rare hour where you can focus on yourself.’

‘Relaxing, reassuring, lovely friendly environment.’

One respondent also commented that attending the hospital regularly for classes helped with relaxation:

‘Going to the classes at the hospital meant less stress when going in for labour.’

The relaxation script included elements from the Building a Happy Baby leaflet written by UNICEF (2018) as part of the Baby Friendly Initiative. All women were provided with this information by their community midwife during the antenatal period; however, women commented on this aspect of the relaxation during the classes, mentioning:

‘Relaxing time to connect with baby.’

‘A time that is just for you and baby.’

‘The yoga classes gave me an hour a week to chill and focus purely on myself and the baby.’

Women appeared to value the relaxation aspect of the classes, with 19.2% respondents (n=10) stating that this was the most useful part of the sessions. This again highlighted that women valued the holistic aspect of the classes as well as the exercise.

Socialising and meeting friends

Women demonstrated through the survey results that they valued the opportunity to meet other local pregnant women. Of the respondents, 26.9% (n=4) found this the most useful element of the sessions, and numerous comments were made in the free text responses:

‘A great way to meet other pregnant women.’

‘Chance to meet some new mummy friends.’

‘Good to get out and meet new mums.’

Many women also referred to making friends and supporting one another through pregnancy and beyond;

‘Nice to share experiences and advice with other ladies.’

‘Helpful to talk to other mums to be about pregnancy issues.’

‘A brilliant way to interact with other pregnant mums and an informal place to chat and get advice.’

‘We make friends with other mums to be so we have a network.’

‘I made lots of friends who I'm still in touch with even after giving birth.’

‘The friends I have met have become lifelong friends.’

‘The friendships have proved invaluable to me, we have helped each other through sleepless nights, crying poorly babies, long days and some even longer nights.’

One respondent commented that the classes had helped with her mental health:

‘The friendships made with other mums will be long-lasting. Ultimately it's these friendships that help you through the harder aspects of pregnancy and parenthood and I feel that has helped me to maintain my mental health.’

Women who attended the classes established a popular closed Facebook page where they asked for advice and support, and shared birth stories. When asked whether yoga had helped them to meet other pregnant women, 94.2% (n=49) agreed, and 92.3% (n=48) felt that yoga had enabled them to make friends, which is reflected in the free text responses. Respondents were asked whether they interacted with other ‘yoga mums’ outside of classes; 63.5% (n=33) said that they chatted to other yoga mums outside of classes, and the same percentage said that they met up with other mums outside of sessions. The responses above show that the classes were valued as an opportunity for socialising as well as for exercise.

Labour techniques and sharing of information

Free text responses made reference to labour tips and techniques that were shared during classes. Women used the classes as an opportunity to ask questions about labour, and to ask for advice about coping techniques, pain relief and birth plans. Free text responses indicated that this was of value to the attendees:

‘The opportunity to have some fun yet informative “me and bump” time that doesn't feel like yet another appointment.’

‘Great to get some questions answered.’

‘Opportunity to ask questions to other pregnant mums.’

‘Allows you time to share tips and techniques with other mums-to-be.’

Respondents were asked whether yoga helped them to feel more prepared for labour and birth, and 94.2% (n=49) agreed. Almost all (n=50; 96.2%) respondents felt that the yoga sessions helped them to learn more about labour and birth, demonstrating that the classes were valued for information as well as exercise.

Postnatal women were asked if yoga classes had enabled them to feel more ‘in control’ during labour and birth, and 92.9% (n=26) agreed. The same percentage felt that yoga helped them to feel more prepared for birth, and 82.1% (n=23) felt that yoga had aided them with birth positions specifically. When asked whether yoga had helped women to have more positive birth experience, 89.3% agreed, with the other 10.7% of respondents selecting ‘neutral’. These responses highlight the value of the yoga sessions both in preparing for labour and birth, and in helping women during their birth experience.

Women in this study valued the relaxation techniques taught during yoga sessions, saying that it helped them to connect with their babies

Sessions run by a midwife

It was felt by 93.1% of respondents (n=49) that having the sessions run by a local midwife was beneficial. This was also reflected in the free text responses:

‘The chance to speak to the midwife about anything was very comforting.’

‘Helpful tips from a midwife and the chance to ask questions.’

‘The interaction with an actual midwife is great because she can answer any questions we may have.’

Women also commented that the sessions helped them to discover more about the local maternity service

‘Extremely beneficial, not only for yoga but finding out essential information, ie about parent craft class—I wouldn't have heard of it any other way.’

Responses also indicated that women felt they gained a lot of information from the classes, both via the midwife and from each other:

‘It's also a great place to learn a lot from the midwife that takes the class.’

‘Informative and friendly midwife there to give advice.’

‘Allows you to share tips and techniques with others in the class.’

‘Learning through social conversation about birth and other people's pregnancy stories.’

When asked whether yoga had helped women to find out about what the local maternity service offers, 90.4% (n=47) agreed. This demonstrates that women found the classes helpful for sharing information about the service, both formally and informally.

Common pregnancy complaints

Free text responses highlighted the value of the yoga exercises in relieving some of the common complaints of pregnancy:

‘Advice for comfortable positions to sit in and exercises to do if suffering with aches and pains in pregnancy.’

‘Really good for targeting certain pregnancy aches and pains.’

‘Learn different yoga positions for various pregnancy problems eg hip pain, back pain, heartburn.’

‘Helped relieve hip and lower back pain, and helped me to sleep better.’

‘Stretches to help relieve back pain.’

‘It was good to learn positions that could help with different pregnancy symptoms (heartburn/SPD [symphysis pubis dysfunction]/cramps).’

It is possible that these exercises to relieve common complaints of pregnancy could reduce referrals to GPs for women who are struggling with symptoms. One respondent also felt the classes helped her to cope with a common pregnancy condition that the classes did not intentionally target:

‘Motivated me to leave the house when I was suffering with hyperemesis.’

Audit of birth outcomes

A total of 215 women attended classes between July 2017 and July 2018, with the majority of women attending more than five classes throughout their pregnancy. When considering birth outcomes, details of all primigravid women who attended a minimum of six classes were analysed. Birth outcomes were audited for a total of 42 women, including onset of labour, mode of birth and length of labour.

It was discovered that 83% of primigravid women who had attended more than six yoga sessions during their pregnancy had a spontaneous vaginal birth, 10% had an instrumental birth, and 7% had a caesarean section. NHS Maternity Statistics 2016-17 (NHS Digital, 2017) have been used for comparative purposes, due to the size of the review and quality of data. The review includes mode of birth statistics for 430 439 women, subcategorised by parity. The most common mode of birth for primiparous women in the review was instrumental, with 56.8% of women having either a forceps or ventouse birth. A further 33.9% had a caesarean and just 28.4% had a spontaneous vaginal birth, a significantly lower number than in the yoga group. It must be noted that the yoga audit was small scale, did not account for confounding variables, and did not include elective caesareans; therefore, direct comparisons and firm conclusions cannot be made. That said, the spontaneous vaginal birth rate for primiparous women in the yoga group is almost three times higher than in the NHS maternity statistics review (NHS Digital, 2017), suggesting that pregnancy yoga attendance may influence mode of birth; research of a larger scale would be needed to further support this.

Length of labour in the women audited ranged from 8 minutes to 23 hours and 18 minutes, with the average length of labour being 5 hours and 45 minutes. A study by Albers et al (1996) investigated length of labour in low-risk births and found that length of labour among primiparous women was 7 hours and 42 minutes, and 5 hours and 42 minutes amongst multiparous women. Although the data obtained in the yoga audit included both high- and low-risk births, length of labour was significantly shorter than the average for primiparous women in Albers et al's (1996) study, and was just longer than the average for multiparous women. Again, the size and quality of the yoga birth outcomes audit must be considered, and direct comparisons cannot be made.


Pregnancy yoga is known to have many benefits for women, as demonstrated in the literature reviewed. Women's responses highlighted the value of providing pregnancy yoga sessions in the Health Board. Women found out about the classes from a variety of different sources, demonstrating the value of advertising the sessions in a number of ways. The majority of respondents felt that the classes were held at an appropriate time and venue, and would not have been able to attend the sessions if they were held during working hours. Furthermore, women shared their views on the benefits of the classes. It was felt that the social interaction with other women was the most useful aspect of the sessions, and this was reflected in the free text responses. Women found the friendships invaluable, and these have continued into the postnatal period and beyond. Women also valued the breathing and relaxation exercises, the chance to spend time with their babies, and the sharing of information and advice, both from each other and from the midwife running the session. It was noted that the yoga exercises have been shown to be beneficial to women in helping to relieve common complaints of pregnancy (Chuntharapat et al, 2008; Jahdi et al, 2017); however, only 3.85% of women felt that the yoga poses were the most useful aspect of the classes, demonstrating that the holistic aspect of the classes was far more of value to women that the exercises. The audit of birth outcomes suggests that pregnancy yoga attendance may influence mode of birth and length of labour; however, further research of a better quality and using a larger sample size would be required to confirm this.


  • Continue to provide free pregnancy yoga sessions in the Health Board, and continue to ensure that all women who wish to attend are able to do so
  • Continue to share details of the classes in a variety of ways
  • Continue to enable the social interaction of women at the classes
  • Consider the value of informal midwife contact and casual sharing of information led by women rather than midwives
  • Recognise the value of pregnancy yoga for relieving common complaints of pregnancy, and the potential impact for reducing referrals to GPs, physiotherapists and other health professionals
  • Recognise the value and usefulness of breathing exercises for labour and birth, and consider sharing these techniques outside of yoga session as well as within them
  • Carry out further research on a larger scale to explore the effect of pregnancy yoga on birth outcomes.
  • Key Points

  • Women appreciated the fact that the classes were free, ran by a midwife and held in the evenings
  • Breathing exercises proved to be invaluable for women during their births and beyond
  • The taught relaxation techniques and the relaxed class atmosphere were valued by the women
  • Women appreciated the opportunity to meet other local pregnant women and have formed lifelong friendships and support networks
  • The spontaneous vaginal birth rate amongst a small group of primigravid women who regularly attended pregnancy yoga sessions was 83%
  • The average length of labour among a small group of primigravid women who regularly attended pregnancy yoga sessions was 5 hours and 45 minutes
  • CPD reflective questions

  • Which element of the classes do you feel contributed towards the improved birth outcomes for primigravid women?
  • How do you think you can incorporate the useful elements of the classes into your service?
  • How do you think informal midwife contact can be provided in your setting?