Three ways beyond exercise to promote a healthy core during pregnancy.

The body’s “core” is a system of muscles that support the spine and pelvis, with the ceiling being the diaphragm and the bottom of the cylinder being the muscles of the pelvic floor. The shift of the pelvis and the separation of abdominal muscles during pregnancy can result in weakness and instability. This may lead to pain in the lower back and pelvis during pregnancy. Women without any contraindications are advised to counteract the instability and weakness by strengthening abdominal, back, butt and pelvic floor muscles through exercise

However, beyond exercise, pregnant women shouldn’t overlook these 3 strategies to encourage a healthy pregnant core.

Tip 1 for a healthy pregnant core: perform diaphragmatic (belly) breathing

Why? The diaphragm is a thin muscles that separates the chest from the abdomen, forming the roof of the core. A 2013 article in The Journal of Multidisciplinary Healthcare discusses the functional relationship between the diaphragm and the pelvic floor, indicating the diaphragm has a role in core function and pelvic stability. The diaphragm and pelvic floor muscles should work together, meaning as the diaphragm contracts and moves down during an inhale, the pelvic floor muscles should relax and lower. The opposite is true on an exhale, with the diaphragm relaxing and rising while the pelvic floor is contracting and rising

How to perform diaphragmatic breathing: Women should lie on their back with knees bent or for pregnant women beyond 16 weeks, sitting is appropriate. Inhale slowly to the count of 3, letting your belly expand outward. Exhale slowly to the count of 3, allowing your belly to relax. Repeat this 5 times. As the belly grows this will become more difficult and “chest breathing” will become more natural, however women can still be deliberate about the mind body connection between the diaphragm and pelvic floor. This type of breathing may also be useful in the first stages of labor as a relaxation technique and is a safe postpartum exercise to begin rebuilding the core after baby.

Tip 2 for a healthy pregnant core: Rise up with a side roll

Why? There are three groups of muscles that make up the abdomen. During pregnancy the rectus abdominis group (6-pack muscles), can separate due to increased hormones and tension placed on the abdominal walls due to the growing baby. A study by Sperstad JB, Tennfjord MK, Hilde G, et al. 2016; found that approximately 33% of women at 21 weeks pregnant will experience separation and that number rises to 60% when looking at women 6 weeks postpartum.This separation is called Diastasis Recti Abdominis. Anything that increases the pressure within the abdominal wall can widen the separation of the muscle (sneezing and coughing included). One factor that women can control is the pressure exerted on the abdominal wall while rising up from a lying position.

How to create less pressure while rising:  Women can rise up to sitting or standing by performing a side roll, rather than coming straight up and putting excessive pressure on the abdominal walls. From lying on the back, first bring knees to a bent position then roll to the side. Using both arms, push the body up. If lying in a bed, then drop both legs over the bed and stand. If coming up off of the floor, push up on both arms and then come into a kneeling position to rise and stand.

Tip 3 for a healthy pregnant core: Avoid bearing down or breath holding

Why? As already discussed, increased abdominal wall pressure can lead to further separation of the abdominal muscles.

How to avoid bearing down or breath holding: women should exhale through any strenuous movements that might cause her to bear down or hold her breath. This might include bowel movements, lifting objects or other children, and movements during exercise.

Although these 3 strategies work to improve core function and decrease abdominal wall pressure, more research needs to be done on the risks and preventative factors related to pelvic and back pain, as well as abdominal separation during pregnancy.