Practice passive diaphragmatic breathing.
We all prepare differently for baby's arrival and truly there's no right or wrong way to get ready for the big day. Often times, this preparation takes the form of reading and attending childbirth prep classes, registering for baby items and setting up the nursery. These are all important ways to prepare mentally and emotionally, but I want you to consider preparing your body as well and the physical work that comes with labor.
Rest assured, this preparation applies whether you're preparing for a planned cesarean or striving for a vaginal delivery. Optimal fitness will aid in tolerance of and recovery from all forms of delivery. If you're exercising already, that's wonderful! If you're not, it's not too late to get started!
To begin, try these simple breathing exercises that will help you achieve strength and balance in mind and body.
1. Passive diaphragmatic breathing
A great way to reduce stress and anxiety, this practice can be incorporated into daily living throughout all stages of pregnancy and into postpartum. Diaphragmatic breathing will provide numerous benefits when utilized during labor and delivery as well, including muscle relaxation and creating an overall sense of calm as it works to reduce feelings of "fight or flight."
To practice, begin in a comfortable seated position, upright, but not stiff in your posture. Relax through your jaw and tongue while lifting through your spine. Practice lengthening your neck and releasing your shoulders.
With one hand on your belly and one to your chest, notice the movement of your abdomen with each inhale and exhale. Actively breathe into the belly while inhaling (allowing belly to expand). On the exhale, gently hug your belly back toward your spine while visualizing a wrapping motion of your deep abdominal muscles as they hug side to side.
You may repeat the sequence 10 to 20 times daily, focusing on relaxing the muscles of your rib cage and spine while gently activating the deep abdominal muscles to facilitate expansive breathing. For more on this breathing practice, see here. You can give the practice a try alongside this video.
2. Active diaphragmatic breathing
Sit-ups? Crunches? Leg-lifts? Planks? Can you do what you've been doing for core exercises now that baby is on board?! Well, that all depends, but there are some things I'd like you to avoid!
Core strength is very important in pregnancy as it helps to reduce muscle imbalances throughout the body, reduces common aches and pains and the risk of abdominal separation. With that said, proper core strengthening considers the needs of the pregnant body and means leaving behind those traditional "ab workouts" (such a crunches and sit-ups).
If you're beyond the first trimester, this is a great time to transition to more beneficial, safer core exercises such as Quadruped also called, Opposite Arm and Leg Extension or Bird-Dog.
You can practice safe core training through the use of diaphragmatic breathing simply by making the breath a bit stronger, called Active Diaphragmatic Breathing. To give this a try, add an audible sound such as "Shhh" or "Ssss" through pursed lips on your exhale while gently hugging your belly and baby back toward your spine and up toward your diaphragm.
You can follow alongside this video to practice.
3. Core + pelvic floor connection
"Are you doing your kegels?!" Good news! You will never hear me ask a student this question and I'm not really asking you either!
Why? Well, because many of us are walking around with pelvic floors that are already too tight. As you can imagine, attempting to strengthen an already tight pelvic floor with hundreds of kegels each day does not help in preparation for labor and delivery.
Now this does not mean we should ignore the pelvic floor. In fact, it's quite the opposite. If you have a history of or are currently experiencing pelvic floor pain or dysfunction ie: urinary incontinence, I would definitely recommend seeing a Women's Health Physical Therapist in pregnancy. These specialists can help you to prepare for labor and delivery through education and manual therapy.
While I won't advise in performing hundreds of kegels, I will encourage you to connect to your pelvic floor through the use of your breath and movement. When you practice your diaphragmatic breathing, notice if you can feel the pelvic floor relax and contract with the breath. Pay attention and aim to incorporate a lift of the pelvic floor while you're exhaling. On the inhale, aim to fully relax and release the pelvic floor.
As with much of life and within our own bodies, we are striving to find balance. In the case of the core and pelvic floor, it's finding the balance of strength and relaxation, the ability to contract and release. Tuning into these sensations of relaxation and contraction in unison with your breath can be powerful preparation for the effort of labor and delivery as you and baby work together to bring your little one earthside.
You may be planning for a scheduled cesarean, trying for a vaginal birth after a cesarean (VBAC), hoping for a vaginal delivery... independent of this, pregnancy places stress on the pelvic floor from the downward pressure of an increasing belly. Having the ability to relax and contract your core and pelvic floor will aid in postpartum recovery based on your unique delivery experience.
Practice these foundational exercises daily to gain a greater connection to your evolving body in pregnancy and to set you up well for returning to fitness.