Learning to Breathe Postpartum
After your child is born, you may find that you suddenly have to readjust to many new body mechanics, including learning to breathe again. Many pregnant people can struggle to regain control over their breathing mechanisms, and can find it difficult to reconnect to their diaphragm–muscle that helps us draw in air even when we aren’t conscious of its hard work.
Many people develop a rib flare during pregnancy to compensate for core instability and to feel like they have more “room” to breathe. With ribs in this hyperextended, position, it becomes harder to engage the full range of motion of the diaphragm. Many pregnant people develop a ribcage positioning pattern in which their ribs can feel a little “stuck,” making it harder to feel like you’re taking the deepest breath possible. This hyperextended “stuck” rib cage also makes it more difficult to engage your core, as you are putting the core muscles on a stretch. Additionally, your rib cage often widens during pregnancy by 2-5 cm. The combination of this new, widened rib cage, alongside a more flared rib position, may make it difficult to feel like you’re taking the deepest breath possible.
You’ve just had your baby, you’re exhausted and adjusting to one of the biggest transitions in your life. Maybe you’ve noticed that your body feels a little awkward, and returning to the breathing pattern you had pre-pregnancy feels challenging or impossible. What can you do?
Find the bucket handle and the pump handle
The motion of the ribcage is often discussed in terms of a bucket handle and a pump handle. Your bottom ribs, or floating ribs, tend to move out towards the side of your body on the inhale, similar to a bucket handle. You can feel this more by cupping your rib cage in a C-shaped grip, with your thumb towards your back body and the rest of your hand cupping your ribs in the front. You can also use a band to wrap around your ribcage as well. Can you feel the ribs expanding out towards the side on the inhale? Accessing more of that lateral breathing will help support diastasis healing and postpartum core rehab.
The other movement of the ribs is more of an up and down movement, like a pump handle. It’s important to note that this motion comes from both the front and back body. It sometimes helps to pay attention to your sternum, connecting both sides of your ribs. Can you feel it rise like a pump handle on the inhale, and then fall back down on the exhale?
Ideally, diaphragmatic breathing looks like this 360 degree expansion, with the ribs moving laterally as well as up and down.
What could be impacting your ability to find full rib cage expansion?
If you’re early postpartum and feeling like you cannot access this sensation of 360 diaphragmatic expansion, you’re not alone. There are many things that are occurring in early postpartum life that could make it hard to access full range of motion of the diaphragm, including:
Postural dynamics, including forward head and rounded shoulders
Pelvic positioning (either anterior pelvic tilt or posterior)
Lack of core stability
What can you do
Finding an expansive diaphragmatic breath is an important part of postpartum rehab. It impacts the ability to find your core strength, as well as support proper pressure management techniques in order to support your pelvic floor. So what can you do?
Sometimes it’s helpful to go into exaggerated postures in order to develop a felt sense of their impact on their body. Here’s one common pregnant and postpartum posture: bring your pelvis all the way forward so that your lower back arches. Extend your rib cage up and open. Try to take a deep breath here. You may find that your abdominal muscles feel too stressed, and that there’s no room for the diaphragm to expand.
Now play with a more optimal posture. In sitting, find pelvic neutral, with the sensation of your sit bones connecting to the chair or the ground. Your front hip bones and your pubic bone should be sitting on the same frontal plane, with neither too far forward or back.
Come sense into your ribs. Align your rib cage over your pelvic. Tuck your ribs down, and sense into a heavy sternum. You may find from just this adjustment that you can feel your core a little bit better.
Now, try to take a deep diaphragmatic inhale. Go slowly, through your nose, and count to five. It sometimes helps to look in the mirror to see what’s happening. Do you see a lot of movement in the shoulders and neck? Try to soften it. Find that lengthening quality in your front, sides, and back body, right underneath your rib cage. Hopefully you’ll now find that it feels like there’s more “room” for your breath.
Neuromuscular patterns that were codified in pregnancy are sometimes challenging to unlearn. Playing with posture and 360 degree diaphragmatic breathing can make it easier for you. If you’re finding that certain areas of your body feel “too tight” to find that 360 breath, you benefit from pelvic floor physical or occupational therapy, which will help you strengthen, lengthen, and coordinate the right muscles in order to access the deep breath you’re looking for.
This article was written by Mirah Sand OTR/L. They are a pelvic floor occupational therapist who is certified Pregnancy and Postpartum Corrective Exercise Specialist, and has received advanced pelvic health training through Herman and Wallace Pelvic Rehabilitation Institute.