Pregnancy is an incredible experience that will take your breath away. Literally.
While many of us can relate to the image of a pregnant mama huffing and puffing toward the end of her term, breathing difficulties can actually occur as early as a few weeks after conception. In fact, shortness of breath, or dyspnea, is a common symptom of early pregnancy, with 70 percent of us experiencing it in the first trimester.
Yogis are particularly in tune with their breath, often making them especially aware of breathing alterations during pregnancy. The yoga tradition holds that the breath is the external manifestation of our internal life force energy, or prana. It makes me wonder whether this may be why we feel so exhausted during the first few months of pregnancy. There are no words to describe how mind-numbingly tired I felt in the beginning of my recent pregnancy. It was a wonder I could wash my face, let alone get up and go to work.
Among the placenta’s many incredible functions, it helps babies to breathe in the womb. In fact, the placenta is sometimes even called the “fetal lungs.” But at this early stage in pregnancy it is not fully formed—not until 13 weeks is it totally operational. Until then, we have to share our breath with our babies. From a yogic perspective, this is the equivalent of sharing your prana with another being!
Luckily, we humans have been sharing our breath with our growing babies for as long as we’ve been having them. And although it may make for an uncomfortable nine months, it is well worth it in the end when your little one takes their first breath. In the meantime, there are techniques to help the breath flow more easily.
First, let’s look at some of the causes of breathlessness throughout pregnancy.
How breath changes throughout pregnancy
Depending on the trimester, there are different things that can make breathing a challenge. In early pregnancy, shortness of breath is often the result of hormonal changes that happen prior to conception.
One of the key hormones in pregnancy is progesterone. Progesterone production gradually increases from ovulation throughout pregnancy. Among its many functions, it is a respiratory stimulant, which causes us to breathe more quickly during pregnancy, leading us to take more breaths, which produces more oxygen for the baby.
In later pregnancy, breathlessness often has a different cause. Around week nine, the uterus begins to grow and presses into the internal organs, which in turn are pushed upward. Back pain is incredibly common at this point in pregnancy, partly because of all the shifting going on inside. Back pain and trouble breathing may be linked to efforts to avoid pain, like rounding or hunching forward, or muscle strains, which make getting a full breath challenging. One 2017 study estimated that 50 percent of pregnant people will experience back pain at some point and that almost half will experience it most acutely in the second trimester.
One structure being compressed and relocated during the great organ migration is the diaphragm. The diaphragm is our main breathing muscle. It is a pancake-like, dome-shaped muscle that sits at the base of the rib cage, dividing the upper and lower portions of the body. When we inhale, the diaphragm contracts and moves down, pulling oxygen into our lungs like a vacuum. When we exhale, it relaxes, parachuting upward to squeeze the breath out of the lungs. According to one 2015 study, in pregnancy the diaphragm moves upward five centimeters as the uterus grows.
Even though the diaphragm moves to create more space in the abdominal cavity, by the third trimester (around weeks 28 and 29) the uterus begins to press directly into it. This makes getting a full breath especially challenging during the last few months of pregnancy—thus that widely recognizable image of the very pregnant woman huffing and puffing.
Luckily, there are some things we can do to help us breathe more easily during pregnancy.
How to cultivate more breath
One of the surest ways to breathe easefully is to make more space in the body! This can be facilitated through simple daily adjustments—such as sitting up taller and being more conscious of your posture when standing, along with more specific movements such as stretching your arms overhead. Axial extension is the anatomical term for spinal lengthening, and it is especially important during pregnancy as the body begins to adjust to accommodate baby. While our specific physical needs change throughout pregnancy, the need for length remains important throughout.
Avoiding overexertion and taking more breaths is also helpful. It can be challenging to maintain the pace of some of your activities prior to pregnancy, such as fast vinyasa classes or running. Allowing more breaths per movement and taking breaks can help. However, unless a healthcare provider has advised otherwise, you do want to keep moving! Continuing to move your body throughout pregnancy improves breath and keeps you cardiovascularly fit.
Relaxation techniques such as a longer savasana, prenatal massage, meditation, and acupuncture can also be incredibly helpful during pregnancy. The calmer the nervous system, the deeper the breath. And, of course, yoga, as it combines movement, axial extension, relaxation, and breathing techniques.
With all of this in mind, you might try the following sequence the next time you find yourself competing for air with your unborn one.
And when experiencing breathlessness, please always check first with your care provider in order to rule out any underlying causes, such as asthma, anemia, or heart issues.
Breathe again sequence
This prenatal sequence can be done day or night or both. It is short enough that you can even run through each pose twice. And again, please check with your care provider before engaging in any type of physical activity during pregnancy.
1. Hero pose (virasana) with arms overhead and thumbs hooked
This lengthener will put your body in traction and open space in your spine. The best news is that you don’t have to be on your mat to practice this! You can do the arms any time—whether sitting, standing, or even lying on your back.
From a kneeling position, place a block horizontally between your ankles on either its low or medium setting. Bring your knees together and sit on the block. On an inhale, reach your arms overhead and hook your thumbs together. Ground your sitting bones into the block and begin to reach up through your entire body, from foundation (shins and sitting bones) to fingertips.
Hug your front ribs in toward your back body as you reach your sternum toward the ceiling. Keep your arms very straight by hugging your outer upper arms in toward your ears while simultaneously pulling your thumbs away from each other. This will help to engage your inner upper arms (in particular your biceps) and open space at your neck and shoulders.
Isometrically pulling your thumbs apart is also a way to support the changes in the wrists and hands that occur in pregnancy. As the joints become more flexible, carpal tunnel syndrome and wrist pain can be common, and some people also experience swelling in their hands and wrists. This simple isometric movement can help to maintain strength in your hands and space in your wrists.
Remain in this active shape for 10 full breaths. Your inhales create more length, while your exhales maintain your connection to the ground and lower belly support. After your last breath, lower your arms, pause, and then repeat with the opposite thumb clasp.
2. Cat/cow (bitilasana/marjaryasana)
Most of us can do this yoga class staple throughout our entire term. It offers myriad benefits—from igniting the breath through movement, to opening the front body on the cow tilt, to core support for the front body and a stretch for the back body in cat.
Come to hands and knees. I suggest placing a folded blanket under your knees and shins for padding, as joint sensitivity is common during pregnancy, and using props can provide comfort. Align your wrists under your shoulders and your knees under your hips.
On an inhalation, lift your chest toward the ceiling. Try to keep your low back supported by lengthening your tailbone toward the back wall. This is unlike a typical cow tilt, in which the low back is allowed to extend with the rest of the spine. Instead, aim to keep your lumbar spine neutral. As the belly grows throughout pregnancy, it often causes instability in the lower back and we can mitigate this by providing extra lumbar length in backbends. Keeping space more “even” throughout the torso by avoiding overarching can also help us breathe more fully and completely, as we feel more “room” to do so.
On an exhale, round your back and imagine drawing your baby up toward your spine. This will help to engage your core, which needs all the extra tone it can get to support the growing uterus and baby.
Continue dynamically on the breath—inhaling to arch your spine and exhaling to round—for a total of 10 rounds.
3. Low lunge
Props: Blanket and 2 blocks
There is a deep connection between the psoas, the deepest hip flexor, and the breath, as the origin of the psoas is right near the diaphragm.
When we are afraid or stressed out, the body’s natural response is to curl inward into a fetal position like our babies, contracting the psoas. This can compromise our ability to take a full breath. Low lunge can help counteract this, lengthening the front body from the back thigh to the chest.
Place a folded blanket in the middle of your mat (for your knees) and two blocks on their medium setting at the top of your mat. Start on hands and knees with your hands on the blocks. Step your left foot around your left hand and block, coming into low lunge.
Keep your torso lengthening with the support of the blocks. Ground your left heel into the floor and isometrically pull your shin back, which will help square your pelvis toward the top of your mat and keep your pelvic floor engaged.
Reach your chest forward with every inhale and very gently hug your navel toward your baby on the exhales. You can also reach your arms up if you like.
Remain for 15 breaths. To come out, press into your blocks and return to hands and knees before switching sides.
4. Supported fish pose (matsyasana) with the arms overhead
Props: 2 blocks
Deep backbends are generally considered to be contraindicated during pregnancy because of the body’s changes, some of which are caused by the hormone relaxin. Most lumbar spines have good range of motion when bending backward, but become even more mobile with relaxin. Also, a growing belly often prevents us from being able to lie comfortably on our backs for very long, making certain backbends inaccessible after the second trimester. Lastly, too deep of a belly stretch creates the possible risk of placental abruption (with the placenta detaching from the uterus). Supported backbends like this one can be an accessible way of achieving spinal extension and chest opening, both of which are major components of an easeful breath.
Set two blocks side by side at the rear of your mat—with the block closest to the mat edge on the highest horizontal setting and the other block on the medium horizontal setting. Lie on your back so that your shoulder blades rest on the lower block and the higher block supports the back of your skull. Start with both knees bent and your feet on the floor.
If your low back is feeling tender, keep your knees bent. Otherwise, try straightening your legs. Keep your legs together and active by hugging your ankles together and pressing your thighs toward the floor. Have your arms by your sides and your elbows softly bent for a few breaths.
You may opt to stay here in this more restorative version, or, on an inhale, you can slowly reach your arms overhead behind you. Try to keep your front ribs down as you bring your arms overhead. The ribs act as a brake and prevent your arms from going too far back. Once your arms are overhead, traction your body by reaching your heels toward the front of the room and your fingers to the back wall, breathing length into your body with each inhale. On your exhales, as the belly deflates, you can imagine hugging your baby toward your spine.
Hold the shape for 20 breaths. At the end of your last breath, lower your arms by your sides and let your legs flop open if you’d like. Remain here for a few minutes if it feels good. To come out, bend your knees and roll to your left side off the blocks, resting your ear on your left arm like a pillow. Press into your right hand to come up to sitting.
5. Alternate nostril breathing (nadi shodhana)
Props: 1-2 blankets
Some forms of breathing practices, or pranayama, are generally contraindicated during pregnancy. These include those that involve holding the breath, as well as any breath that pumps the abdomen. The following form of pranayama, known as nadi shodhana, is great during pregnancy. It is known for balancing our energy and helping us feel centered.
Find a comfortable seat on a folded blanket. You may need more than one blanket if you have trouble sitting up tall. Assume deer seal, or mrigi mudra, with your right hand: Curl your index and middle finger toward your palm, leaving your ring and pinky fingers pointing upward and your thumb stretched out to the side.
Place your thumb very lightly on the cartilaginous bulb above your right nostril and your ring and pinky fingers against your left nostril. Close your left nostril with your fingers and on an inhale, breathe in through your right nostril. Close your right nostril with your thumb and open the left to exhale through your left side. Now inhale through your left nostril and then gently close your left nostril and release your thumb to exhale through your right nostril.
That is considered one full round. Repeat two more times.
Though it may be uncomfortable at times, breathlessness is a normal part of pregnancy, and there are lots of ways to get your breath back during pregnancy. Just remember that any changes in the body are not only temporary, but for a great cause—your amazing baby! Spending time moving your body and making space is both helpful for your breath and an opportunity to connect with your developing little one.
Pretty soon you’ll be losing your breath for another great reason—chasing after baby! So use this time now to cultivate your breath.
Photogprahy: Kyle Rebar