Pratyahara during the Childbirth Process.

This article was published the Brtish Wheel of Yoga Journal Spectrum (Winter, 2017)

Pratyahara is the fifth of the eight limbs of yoga which together constitute the ashtanga yoga path as set out by Patanjali in the ancient Yoga Sutras.

It is known as the forgotten limb. Certainly there has been little written about it in the western yogic literature expert to acknowledge its mystery.

Pratyahara is the first of the four inward looking limbs and as such exists on the threshold of the outer and inner worlds.

It follows pranayama (or control of prana) and, by linking prana with the mind, takes it out of the sphere of the body. It is through the practice of Pratyahara that we enter the inner space.

Defined as “the conscious withdrawal of energy from the senses;” pratya means to ‘withdraw’, or ‘draw back’ and ahara refers to anything we ‘take in’ such as the various sights, sounds and smells our senses are continuously bombarded with – never more so than in today’s over-stimulated tech and social-media driven world.

Being the first of the eight limb’s internal practises – following pranayama and preceding meditation – this elusive state has inspired much discussion in the yoga community but very little in the birthing world. And yet pratyahara is the ideal birthing state and one which all pregnant yoginis should be working towards – especially if they are aiming for an uninterrupted birth experience.

In (Yoga Sutra 2.54-56) Patanjali states of pratyahara:
54:The senses retire from their objects by following the natural inward movement of the mind.
55: From this comes supreme mastery of the senses.

As the mind settles, it is no longer distracted by the outer world, attention, naturally, moves inwards towards it own source and the senses follow suite paving the way for a much deeper experience.

Says Swami Satchitananda:
“The senses are like a mirror, turned outward, they reflect the outside; turned inward, they reflect the pure light.” Swami Satchitananda describes the deeper experience to which Pratyahara is a gateway.

This limb of Yoga can sometimes seem inaccessible and esoteric but, like most of the internal limbs, it has degrees of depth. For example all practitioners experience pratyahara in savasana. Judith Lasater captures its essence in her description of the second stage of savasana: If the first stage of savasana is letting go of the body , the second is the : “withdrawing from the external world without completely losing contact with it. “This state is like lying at the bottom of a well: You still register input from your sense organs, but you don’t react to that input. There seems to be a space between the sensory stimulus and your response. Or, in everyday language, you are in the world but not of it.”

Pratyahara is essentially a state of non-reaction. It is a both a process and a destination that starts at the level of the body – with the closing of the eyes- and progresses through the layers of conscious awareness to its deepest manifestation which can leads directly to samadhi.

There are four main forms of pratyahara: 

indriya-pratyahara — control of the senses; The old saying “the spirit is willing but the flesh is weak” applies to those of us who have not learned how to properly control our senses. We are bombaered at sense level daily. Commercial society is dependent on it. The media thrives on it. Strong sensations dull the mind, and a dull mind makes us act in ways that are insensitive, careless, or even violent.

prana- pratyahara — control of prana; this is prep for Pratyahara and not relevant for pregnancy as withdrawing breath is contra-indicated.

karma-pratyahara — control of action; and reward for action. Karma-pratyahara can be performed by surrendering any thought of personal rewards for what we do, doing everything as service to God or to humanity. The mothers body as spiritual vessel in service to mother nature at that point.

mano-pratyahara — withdrawal of mind from the senses. This is the ultimate form of Pratyahara and describes the point where the senses withdraw inwards towards the nature of the mind. This is what arises in active labour during a physiological birth.

During childbirth, it is around 5-6 cms dilation, or the beginning of the active phase of labour, when a woman experiencing an uninterrupted birth will begin to enter pratyahara. At this point in the process, the birthing energies are gathering momentum, her body has become increasingly saturated with hormones of love and transcendence; oxytocin, endorphins which bring her relief from the immensity of the labour contraction-expansions experience. Like an ardent yogini she is deeply immersed in her pranayama as this is the only way she can stay present and surrender to the powerful sensations moving through her. If you ask her a question, you will receive, at best, a monosyllabic answer; at worst, a blunt profanity. She does not wish to be disturbed by the outer world any longer. She closes her eyes and seeks privacy. Between expansions, she often appears asleep. Actually she is awake and aware but so deeply located within herself she no longer notices anything outside her own internal experience.

As the active phase peaks in transition, with expansions occurring every 2 minutes, each lasting a minute or more, she has completely surrendered to the power of her body and is oblivious to the world around her.

Spiritual midwife Marian Littlejohn writes: “I breathed deeply through the 12-hour experience of birthing my firstborn son. I knew I had tapped into a secret and powerful source of love and energy within myself.”

It is the ideal vision of birth towards which we strive. For many – a transcendental experience; the point at which the mother herself is born; a stronger, wiser, more compassionate and aware woman. This is the yoga of childbirth – and every woman’s birth rite. It is what in Pregnancy Yoga we are preparing for.

The reality however is that most women do not experience the transformative depths of pratayahare in labour – or the labour trance – as it is commonly known. Some experience a watered down version; many do not experience it at all – especially if they have had intervention of any kind.

Research carried out in a recent study on childbirth pain found that women were essentially in one or other of two mental/emotional states during the childbirth process.
A): A state of mind characterised by focus, open and accepting of the inner experience, including pain. This state tended to be accompanied by a more positive reporting of the labour experience. B) A state of mind characterised by distractedness and thought processes featured pain catastrophising, self-judgment and a negative evaluation of pain. The study found that although these two mind states appeared to be distinct, women could shift between them during labour.

Birth is experienced usually as both a positive and empowering event and as a painful, undermining and frightening one – depending on your beliefs, behaviour patterns and the coping and support systems that you have in place.

In my own four births I have oscillated between both the mind body states described above – depending upon what was going on – but I have also experienced the deep and blissful state of pratyahara – and emerged dedicated to the practice of yoga as birth preparation.

The key is knowing not to attach any significance to the negative mind-state and allow it, like a brief storm, to pass. “Dig deep!” the midwives say in those moments, but you have to know where to dig. This is where pratyahara practice comes in. Every time we experience a mindful and self-aware moment we strengthen the neural pathways that create more mindful moments. We literally use our mind to change the architecture of our brain.

So why do some women experience pratyahara and others not at all? And how can pregnant women help themselves to prepare for the experience – which Mother Nature provides for a purpose greater than pain relief. For it is in this deep state of withdrawal of the mind, at the end of the active phase of labour, that the ancient knowledge of birthing stored in the primitive brain is accessed and initiated – bringing the baby through to birth. From this deep state of pratyahara a powerful involuntary second stage emerges.

The central obstacle to pratyahara in labour is the modern birthing context; the clinical birth experience. It renders this kind of experience virtually impossible. The hospital environment, the interruptions, the checks and examinations. the public and intimidating aspect of it all threaten to undermine the hormonal blueprint of labour which is a blueprint for maternal transcendence.

The solution is in the practice of pratyahara itself – which is as much a process as it is a destination.

Pratyahara can be a natural turning inwards of the mind but it can also be a conscious choice to turn away from distraction and stay focused inwards moment to moment – despite the interruptions. This is the essence of mindful awareness. The sense perceptions are still there but we train ourselves not to react to them. You may experience pain, despondency, fear, even terror but if you have learned to recognise all these emotions and intense sensations as movemnets of energy just passing through; if you have understood that you can reside in your awareness without neding to react to them – and even if you do – not attaching to your reaction then you will be better able to weather the storm you encounter – however

I like Desikachar’s translation of the pratyahara sutra because it is a bit more proactive. It demonstrates a commitment on the part of the practitioner to disregard the distractions and be faithful to their focus – in this case remaining surrendered to the experience in the body.

Desikachar 2.54:
The restraint of the senses occurs when the mind is able to remain in its chosen direction and the sense disregard the different objects around them and faithfully follow the direction of the mind.

Yoga practice teaches us that there is a clear pathway to pratyatara and it is asana and pranayama; movement and breath. The more we experience pratyahara in practice, the more we glimpse what yoga is really about. Similarly during labour we should use adapted asana and pranayama to elicit pratyahara. and remain there as best we can – until the birthing momentum takes over.

Without breath awareness and movement and with the mat replaced by the hospital bed, the incense replaced by the smell of bleach and the candle light by bright overhead lighting, pratayahara will be much harder to achieve. If on a primal level you do not feel safe; the body does not lie: adrenaline courses, our muscles contract, our vessels constrict and our breath is restrained. The mind races with all sorts of fearful thoughts.

It takes real commitment and focus to establish pratyahara in the most un-condusive setting. The practices in themselves will need to be strong. We can support ourselves further by staying away from hospital as long as possible and when we are there using props to create Shanmukhi Mudra; covering our eyes, wearing headphones to block ears and making sure our birth partners are our mouthpieces.

Like most things in Life; the more you practice, the better you get. With Yoga the fruits of your practice are manifold as the real light of yoga reveals itself. As your baby nears his/ her birth date, you have a body that is strong and supple, a breathing practice that is confident and enduring and a mind that knows how to be steady in the face of disruption, intervention and emotional turmoil. Then with a little grace from the godforce – you will carry yourself to the state of partyahara and then you will be carried safely to Motherhood and your baby to birth.


Yoga Practices to Encourage Pratyahara

Ujayi breathing

It has a soothing effect on the nervous system, calms the mind, slows down the heart rate and lowers the blood pressure. As we focus on the sound of our breath, it becomes easier to increase our concentration during the practice enabling it to become a moving meditation.

Yoga Nidra (yogic sleep)
Yoga nidra is a powerful yoga technique, which helps one to achieve deep relaxation and awareness of ones own body through yogic sleep. It as a systematic method of inducing complete physical, mental and emotional relaxation, while maintaining awareness at the deeper levels as well.

Shanmukhi mudra/ Yoni mudra (sealing the senses)
Swami Sivannda said of this mudra it resembled the tortoise withdrawing in on itself. In this way it invokes the sate of pratyahara.
To practice Shanmuki / yoni mudra, close your ears with your thumbs, cover your eyes with your index fingers, close your nostrils with your middle fingers and press your lips together with your remaining fingers. Then release the middle fingers gently to inhale and exhale while you meditate.

Practise Shanmukhi Mudra after pranayama as it uses the fingers to block the sensory portals and encourages attention to move within. It resembles life in the womb.

Shanmukhi is called to Six Faces Goddess, the serpent deity.

In the context of Mudra, Shanmukhi is referred to 6 openings through which we sense the external world or, through which our awareness scattered out. These 6 openings are 2 ears, 2 eyes, nose, and mouth.

Nada Yoga – the use of sound
Described in the Hatha Yoga Pradipika as one of the most powerful and fruitful meditation techniques to still the mind, the primary stage of nada yoga is pratyahara, withdrawing the senses inward and picking up and then focussing on an internal sound, that might be your heartbeat, a hum, or a bija mantra.

Chanting Aum
My personal favourite. So powerful a practice for labour as it opens the throat, deepens the breath and expands the lower body with its vibrations. Inhale deeply, then exhaling notice the sound “A” rising easily from the chest. Meeting the roof of the mouth it becomes “au,” reverberating through the cranium. As a finale the mouth closes with the buzzing sound of “mmm.” Repeated with correct intonation aum is said to echo to the core of our being cleans cells, balance energy centres, calming the mind and awaken the spirit.

Nadia Raafat

Childbirth educator, doula and yogini Nadia Raafat is  devoted to preparing women for child-birth and motherhood with the teachings of yoga, tantra, mindfulness and embodied birth prep.
She has helped hundreds of women to manage pregnancy stress and birth with confidence through her online Yoga and Mindfulness for Birth programme.