I’ve seen a number of patients recently who are being challenged to breathe better by their pregnancies. The hormonal changes of pregnancy affect breathing rate and lung resistance, while the physical changes of pregnancy (as the uterus rises up in the abdomen) also affect lung capacity and the angle of the lower ribs.
It is well know that good breathing can improve our sense of wellbeing and calm anxiety and stress. This is because if we oxygenate our system well, we balance blood gases and this in turn can calm the “fear/fight/flight” side of our unconscious (sympathetic) nervous system. The first step towards doing this for ourselves is often to breathe out slowly and steadily, and thereby make it easier for us to take on oxygen efficiently in the next in-breath. So good breathing starts with good exhaling; it’s much more relaxing than breathing in – try it!
Many pregnant women find they are short of breath, typically in the first and third trimesters. In the first trimester, rising progesterone levels dilate the smooth muscle of the lungs to facilitate better elimination of carbon dioxide, but the increased metabolic demand of the growing fetus may still outpace this effect. So it is quite common to find women breathing more rapidly in early pregnancy to accommodate this.
In the third trimester, the growing baby tends to push the abdominal organs up against the diaphragm, which often rises up to 4cm to accommodate this growth. To compensate, usually the lower ribs flare to increase lower lung capacity and meet the body’s oxygen demands. But I have seen a number of women who have habitual tension in these lower ribs and struggle to make this change. It can even be quite painful as the tissues are resisting quite significant internal forces. This stage of pregnancy often brings reflux for similar reasons; here the diaphragm may not be accommodating change well and not closing off the upper sphincter of the stomach effectively. Any reflux sufferer knows how unpleasant this can be.
Rather than leaving it till late in pregnancy to engage with breathing patterns, it’s well worth trying to optimise breathing early on as it can have a profound effect on your wellbeing and even your sense of personal space. Feeling crowded by work pressures when you are tired and taxed by a growing baby is no fun. Learning to breathe well can make quite a difference to how you feel, it can help create a sense of space and ease that will stand you in good stead throughout the pregnancy and prepare you to labour and nurse well too.
Many of us constrain our breathing and sustain quite high levels of tension through all the layers of tissue in our rib cages, from the outer muscles and ribs even to the lungs themselves. You can assess your own breathing and tension by just watching your breath quietly and noticing how you feel as your inhale and exhale. What is easy and what feels strained? Once you’ve done this for a minute or two, then try exhaling for a little longer and allowing your in-breath to follow gently into the space you have created. Notice how your diaphragm expands and contracts, drops and rises. Quite mesmerising if you get absorbed by the rhythm of it! And a useful way of connecting with yourself, which is beneficial for all of us sometimes. And some of us most of the time!
Here’s a great summary of the science behind breathing changes in pregnancy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818213/
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