"Bring the shoulders toward the hips. On your next exhale, round the spine," Jennifer Knight said in a light and calming voice as she pattered barefoot around five women on yoga mats. "Now, wrap your arms around your belly and hug your baby."
Knight owns the Yoga Tree yoga studio on Hill Road, where she leads two prenatal yoga classes a week. The women in the class are in various stages of pregnancy--one hardly showing, another only hours from her due date.
The pale green room filled with the sound of deep breathing against a backdrop of ambient music. The women moved gingerly from cat-cow poses to downward dog, to Warrior One, Two and Three.
Knight started practicing yoga when she got pregnant 13 years ago. It taught her to be conscious of her breath, bringing her a feeling of calm and control--helpful for when labor began. Prenatal yoga also reduced aches and pains from pregnancy, and she learned exercises that helped minimize contractions.
"After that, I was like, women need this tool," Knight told Boise Weekly. She started Yoga Tree in 2008 with a heavy focus on prenatal yoga, which she's taught for nine years.
Sitting in her small office connected to the yoga studio, Knight is the picture of health and vitality. An intense smile rarely leaves her face and brunette hair sweeps from shoulder to shoulder as she talks. Her white desk has nothing on it but a new iMac and a glass of water. She finds talking about the benefits of prenatal yoga delightful.
"It helps alleviate concerns [a woman might have] about the body being able to do birth, and it helps take away the fear and stress of everyday. Not only does pregnant mama work, but she's constantly thinking about what's going on. As that baby develops in her body, the energy is equivalent to running a marathon inside of her," Knight said. "The yoga class is her time to just be pregnant and focus on mommy and baby."
When she was pregnant in the early 2000s, Knight could not imagine her OB/GYN recommending yoga, but that's not the case today. Saint Alphonsus Medical Center is at the launchpad of a new referral program for prenatal yoga.
Dr. Mary Janowiak--an OB/GYN at St. Al's--helped bring this to fruition. She did prenatal yoga with her last baby and thinks it's all those head and hand stands at 36 weeks that flipped her baby head-down; otherwise she would have needed a caesarean section. Within the next month, she'll be handing a card to her patients referring them to prenatal yoga at the Yoga Tree, or the Birkeland Maternity Center in Nampa.
"Pregnancy is an ideal time to make some behavioral changes. We hope to make a lifetime-worth of healthy changes and habits in our patients," Janowiak said. "Since women see their doctors monthly throughout their pregnancy, it's a great way to hold them accountable."
Above all, Janowiak wants to promote exercise during pregnancy, and prenatal yoga is a safe, multi-beneficial way to do that.
Her colleagues agree almost all pregnant women can do yoga. She said it's especially good for women who want a natural childbirth, "or for women who don't want a natural birth, but get to do it as a surprise."
The relationship between the yoga instructor and the doctor will take time to establish, but they won't share medical charts. Instead, the yoga instructor, like Knight, will tell a doctor, like Janowiak, if her patient attended class and how often. Then it's up to Janowiak to follow up and see if the classes help.
Knight, whose Yoga Tree studio is the only one in Boise where Saint Al's will refer patients at the start of the program, said she's excited to create evidence-based research on prenatal yoga through her budding relationship with the hospital.
But despite the referral, yoga classes aren't something most health insurance carriers will cover. Some insurance companies allow yoga to be paid for from a health savings account, but full coverage for alternative or holistic medicine is years away--though practitioners are hopeful that coverage for complementary medicine and alternative methods like yoga will one day be rolled in with the Affordable Care Act. In the meantime, the Yoga Tree charges $50 a month for unlimited classes.
While the practice of therapeutic yoga is nothing new, the referral program at Saint Al's is unique. St. Luke's Hospital has been offering prenatal yoga classes on its campus for more than 10 years, but its physicians don't have an official referral program. They also offer a couples take on prenatal yoga, allowing dads to come along.
Right now, the referral program at Saint Al's only works for pregnant women, but Dr. Janowiak said yoga can help people who suffer from obesity, back pain, asthma and more.
For John Dillman, 69, yoga helped him almost halt the progression of his Parkinson's Disease. Dillman didn't get a referral from his doctor, but he tried yoga after his disease made him give up telemark skiing, mountain biking, rock climbing and kayaking.
"When I was first diagnosed [three years ago], I got really depressed," Dillman said. "I started reading all these books about what happens to people when you've got Parkinson's and it made it sound like I was going to be laying in a bed in a few years, dying."
Dillman stopped reading everything about Parkinson's and started doing yoga almost daily since July 2012. He struggled at first, with two broken feet and a torn hamstring, but he feels like the classes have renewed his lease on life.
"A person with Parkinson's isn't just someone who shakes and walks really slow through an airport. They've got all kinds of mental issues," Dillman said. "I've had tremendous improvements, both physically and mentally. My focus is better. My attention span is better."
Dr. Janowiak said she hopes an expansion of yoga offerings will benefit the overall health of the population.
"We're all concerned about the direction our country is going," she said. "Having one more program [like the one at Saint Al's] to emphasize health is better than just taking care of people when they get sick."