Take a Breath: Birth Matters February 2019
By Laura Maxson, LM
There is nothing more basic than breathing. We’ve been breathing all our lives mostly without giving it a second thought. That can change as pregnancy progresses.
Even in the early weeks, the body demands more oxygen and begins to make room with some changes in the lungs. The diaphragm moves up a bit right away and some women can experience shortness of breath at this early stage. As the weeks progresses, the rib cage widens and almost like wings, the rib cage spreads itself up and out from the sternum. This gives the lungs more room as the baby grows and the uterus invades usual breathing space. Some women might feel discomfort as the ribs move and stretch, especially when there is a little foot up there helping stretch things out.
Since a pregnant person is breathing for both themselves and their baby, the body changes in several ways to help the breathing process be more effective.
From dilated bronchi to more efficient chemical exchanges in the alveoli of the lungs, the pregnant person breathes more efficiently. Breaths per minute might increase slightly, but most of the increase is provided by other changes in her body.
Although a person might feel short of breath at times, the amount of air that is moved with breathing is actually increased in pregnancy. Sometimes this can cause a person to suddenly feel more conscious of their breathing, leading to anxious feelings. If this happens, change position – sit up in bed or stand up, walk around, open a window and get some fresh air. Lifting the arms can also help lift the diaphragm and open the chest to give the feeling of a little more room.
Another cause of shortness of breath is the normal hemodilution that takes place around 28 to 32 weeks as the body increases its blood supply. Plasma quickly increases, but red blood cells take a month or so to grow, so for a few weeks there are proportionally fewer oxygen-carrying red blood cells in the blood supply. Shortness of breath upon exertion can also be a sign of anemia. Anytime there is pronounced shortness of breath or chest pain a care provider should be seen immediately to rule out rare but serious issues.
The same hormones of pregnancy that are busy helping grow a baby can cause an increased vascularity and general swelling of the tissues in the nasal passages. The chronic stuffy nose that results can be annoying and cause snoring and restless sleep. Nosebleeds can be common, too. A humidifier can be a helpful addition for sleep and can be useful after birth to ease stuffy noses for babies, as well.
Breathing is a big part of most labor coping techniques. Breath control and conscious breathing are a focus of almost all childbirth preparation. Some breathing methods are more involved than others, but most aim for a slow relaxing breath. Long, slow exhalations, often accompanied by a toning/ohming sound can make contractions much more manageable.
Deep cleansing breaths at the end of each contraction can help release any leftover tension in the body. When breathing becomes too fast, hyperventilation can result with tingling of the face and feeling faint. Temporarily decreasing oxygen intake by rebreathing exhaled air will take care of this problem. If the classic paper bag isn’t available, breathing into cupped hands placed around the nose and mouth, for several breaths usually works. During labor, many find that focusing on breathing is their number one coping mechanism for labor’s pain.
Any labor support person needing to deal with a momentarily panicked person in labor can usually help by simply getting in their face, eye-to-eye and modeling slow deep breaths. Soon they’re breathing along more slowly and the contraction is ending and everyone can regroup for the next contraction. When it comes time to push – soft, spontaneous grunts or bellow- ing roars – breath is important. Often quick and shallow pants can help ease out a crowning head.
When a person gets up for the first time after birth, they may suddenly become aware of their breath once again, as the lungs and diaphragm that have felt the firm pressure of a pregnant uterus for months are suddenly left unsupported. This change can leave a person feeling as though they can’t breathe properly, when in fact they are breathing just fine. Being prepared for this can help lessen the odd feeling.
That slow, deep labor breathing technique can also work wonders when coping with sore nipples, colic, teething, tantrums and teenagers. Breathing is powerful – keep it up!
Laura Maxson, LM, CPM, the mother of three grown children, has been working with pregnant and breastfeeding women for over 30 years. Currently she is the executive director of Birth Network of Santa Cruz County and has a home-birth midwifery practice. Contact her at firstname.lastname@example.org or email@example.com