Two New Students, One General Class: Hypertension and Early Pregnancy

Restrict:

• Breath retention (kumbhaka) of any kind and forceful breathing (bhastrika, kapalabhati). Breath holding against a closed glottis or a forced exhale raises intrathoracic pressure and produces transient sharp rises in systolic pressure; forceful abdominal pumping adds further pressure swings.
• Long-held inversions (shoulderstand, headstand, and long unsupported legs-over-head). They produce marked central pressure and blood-pressure shifts and are poorly tolerated in uncontrolled or labile hypertension. Legs-up-the-wall for one to two minutes with quiet breathing is a restful supine position, not a loaded inversion, and is acceptable.
• Long static holds with straining or breath-holding to "get deeper", and any posture where he grips, clenches the jaw or holds the breath. Teach him to exit a posture rather than strain.

Keep and emphasise:

• Standing poses with steady, unheld breath; gentle forward folds with support; supine rest; savasana with the chest open.
• Slow breathing with a longer exhale than inhale (roughly 1:1.5, e.g. 4 in / 6 out, no hold). Prolonged exhalation is associated with parasympathetic dominance and lower heart rate and blood pressure.
• Rate the effort, not the pulse. He is on antihypertensive medication; beta-blockers in particular blunt the heart-rate response, so a pulse check will under-report his effort. Use a 1-10 perceived-exertion scale instead.
• Watch for postural dizziness on standing (medication-related orthostatic drop) - cue slow transitions, head below heart only briefly.

At 14 weeks she is in the second trimester: the uterus is above the pubic bone and she is likely to feel well, which is precisely when over-enthusiasm is a risk.

• No breath retention and no forceful breathing. Retention and hyperventilation-type practices alter maternal CO2 and, in principle, placental blood flow; they are conventionally avoided in pregnancy. Keep her on natural, slow breathing.
• No deep closed twists and no strong abdominal compression (no nauli, agnisara, kapalabhati, deep parivritta postures, boat with strong gripping). Twisting is restricted to open, short-radius twists from the sternum.
• Supine lying limited in duration. From roughly 20 weeks the gravid uterus can compress the inferior vena cava in supine (supine hypotensive syndrome), so establish the habit now: side-lying or a bolster under the right hip for rest. She can lie flat today, but do not build long supine sequences into her practice.
• Prone postures (bhujangasana, dhanurasana) need props under the chest/pelvis now and are dropped later.
• Avoid end-range stretching and overheating. Relaxin increases joint laxity; protect knees, hips and the lumbar spine by staying at about 70% of range. Room temperature moderate, no hot yoga.
• Pelvic floor and hip work are welcome; so are supported standing poses, cat-cow, side-lying rest and gentle squats with support.
• Ask her to report any bleeding, fluid loss, dizziness, calf pain or painful contractions and to stop immediately; she should reconfirm with her obstetrician as the pregnancy progresses.

Use whole-class layering rather than individual corrections:

1. Before class, in the two minutes while people settle, speak quietly to Ravi and Meera separately: tell them you will be giving "options" to everyone and that if they ever hear you say "option A", that is their version. This converts a public correction into a private contract.
2. Teach in two tiers out loud: "If your hamstrings are tight or your blood pressure is up today, take option A with the blanket; otherwise option B." The whole class hears choices, not a diagnosis. Regulars can choose A too, which removes any stigma.
3. Never call out a condition by name. Say "if you are working with a health consideration, stay with the supported version and keep the breath smooth" - and use the same sentence every time, so it becomes house style.
4. Use the props visibly for everyone - put a blanket under the whole front row, hand straps out generally - so modification is normal, not remedial.
5. Position yourself so you can see both without standing over them, and check in with a glance and a nod rather than a verbal correction.
6. Close with a general statement about progressing gradually and speaking to you after class, and be available at the door so either can raise a concern privately.