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When I went into labor in March of 2020, the admitting nurse was screening for Covid so she asked me if I was experiencing shortness of breath…
Ma’am, I’m 40 weeks pregnant, of course I am.
Which leads to the question: Why am I so out of breath and what can I do to fix it?
I'm Katie of Body in Motion Pilates and I'm here to help you have a more comfortable pregnancy, efficient birth, and resilient recovery.
When we become pregnant, and we grow and grow, we tend to find that we are starting to run out of breath. There are a handful of physiological reasons for shortness of breath to occur during pregnancy, such as increased blood volume but what I’m here to talk about are the mechanical reasons.
As the belly increases, the infrasternal angle also increases. That is the angle your ribs make when they meet at the base of your sternum. When we breathe, our diaphragm descends and that causes a 360-degree widening of our ribcage, and that includes an increase in our infrasternal angle. But when the ribcage is already wide from being pregnant, there's nowhere for the ribcage to go. You're already in the inhaled state, and now we're trying to get an even deeper breath and you can’t because you’re already expanded.
If you are a chest breather, you can really start to feel stuck because you're already in this lifted-up position and it's hard for you to then get a deep breath to get more air in there.
Another common breathing pattern is belly breathing. There’s definitely a time and a place for it, as it’s great for relaxation. However during pregnancy, there's already a lot of extra pressure in your abdominal cavity from your growing baby, so why would we want to increase the pressure even more?
So really, the best way to breathe when we're pregnant is what's called 360 breathing or also called lateral thoracic breathing, but that's a mouthful. For 360 breathing, what we want to encourage is not only the ribs opening side to side on the inhale but also being able to get into the ribs in the back expand as well.
Breathing into our back ribs is really hard to do when your belly is pulling your center of mass forward which in turn can lock down your entire back, especially the lower thoracic and lumbar spine.
To get the rib and spine muscles to open up, we want to follow the three steps that we use for every movement pattern we’re trying to adjust.
The first step is to reset the ribcage to get these muscles to recognize that they can stretch and move.
Then we want to realign our ribcage over our pelvis. Pregnancy tries to change our posture either we get super lifted in the ribcage or we get rounded forward in the chest to counterbalance the weight shift forward. Either way, we’re no longer stacked.
And then finally, we want to reload the auxiliary breathing muscles - AKA any muscle besides the diaphragm that helps us breathe.
Watch those 3 steps in action!