Re-establishing Healthy Breath Patterns Postpartum

Since my baby is now 3.5 months, I officially survived the fourth trimester- whew! Getting through this period is a step worth celebrating for moms. Babies are waking up to the world and moms are adjusting to a whole new one. A lot happens in the fourth trimester - and for me a lot of healing needed to happen, including correcting my breath patterns.

My labor was longer and more draining than I anticipated. I needed an induction and laboring with pitocin is no joke. After pushing for four hours my little man finally arrived. While I celebrated that the hard work of labor was behind me, the real work of healing had just begun.

I had a second degree tear that didn’t heal well, which meant that by my 6 week postpartum visit I had already been seen by a visiting nurse (offered for free by grant in the state of Maine) and had two follow ups with my midwife. Managing pain felt like a full time job on top of caring for my baby. That said, I know I was lucky. Having these extra visits is well above the normal one postpartum 6 week visit that many women can expect. And I had additional tools: my mom was here to help with the baby freeing me up to nap, I had nourishing food from friends, and a husband with two weeks leave. Plus, a colleague was able to come give me acupuncture when I was at my worst. And still, I felt like I had been hit by a bus.

At 8 weeks I was able to start pelvic floor physical therapy. Having worked with pregnant patients for years I understood ahead of time how critical a physical therapist’s role is during the postpartum phase. Not only did I get to share my story, but I was able to have a second set of eyes and ears to validate my experience and help me understand how to pick up the pieces and start to heal.

The first step for me was re-establishing proper breathwork. Because my labor had been difficult my body responded by tightening up. The assumption is that our pelvic floor is weak after delivery and that the key is getting the tone to return. I needed circulation of blood flow, but not toning. So exercises were not a good start.

I had to rebuild the foundation of breath before I could get functional movement back. With a newborn I had pushed through a lot of discomfort to help soothe, feed, and care for him. That meant doing a lot of guarding to help minimize my pain. To correct the guarding, I needed to concentrate on sending breath to my lower body and break out of the cycle of shallow breathing.

Placing my hands on my pubic bone helped me to feel the air travel to the area I needed blood flow most. Targeted gentle stretching with concentrated breathing helped establish a better routine with breath and movement. Then I could integrate healthy breathing into daily activities like lifting my baby into his crib.

While I have preached the benefits of diaphragmatic breathing before, I didn’t realize how easy it is to fall out of the habit until my postpartum PT evaluation. Re-establishing healthy breath was step one of my pelvic floor PT recovery. It was the foundation I needed to get back on track.

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