1. Extended exhale (4-6 breathing)
Breathe in through the nose for four counts, out through the nose for six. Continue for five to ten minutes. The ratio matters more than the numbers: as long as the out-breath is longer than the in-breath, the parasympathetic nervous system engages. Start here — it is the safest, simplest and most effective of the five, and it is the one to use in labour too.
2. Diaphragmatic breathing with a hand check
Lie on your left side with a pillow between your knees. Place one hand on your upper chest and the other on your ribs. Breathe so that the ribs expand sideways while the chest stays relatively still. Anxiety produces shallow upper-chest breathing; this retrains it. In late pregnancy the uterus limits downward movement of the diaphragm, so think of breathing wide rather than deep.
3. Slow counted breathing (resonance breathing)
Breathe in for five counts and out for five, about six breaths a minute. Ten minutes. This rate aligns breathing with the natural rhythm of blood pressure variation and produces the strongest measured effect on heart rate variability. Use a metronome app or simply count. Good for pre-sleep wind-down rather than mid-night waking.
4. Alternate nostril breathing, without retention
Sit up. Using the right thumb and ring finger, close the right nostril and breathe in through the left; then close the left and breathe out through the right. Continue, alternating, for five minutes. Crucially: no holding the breath at any point, which is the modification that makes this safe in pregnancy. Calming and good for a racing mind before bed.
5. Humming exhale (brahmari, gentle version)
Breathe in through the nose, then hum quietly on the out-breath, letting the hum stretch the exhale naturally long. Six to eight rounds. The vibration is soothing and the hum makes the long exhale effortless — useful when counting feels like work. Keep it soft; this is not a performance.
Set up sleep so the breathing can work
- Left side-lying with a pillow between the knees and one under the bump. Add a pillow behind your back to stop rolling.
- Prop the upper body if reflux wakes you. An extra pillow or a wedge helps more than antacids.
- Last meal two to three hours before bed, and keep it light.
- Fluids front-loaded — drink well through the day, taper in the evening to reduce night trips to the bathroom, but do not restrict to the point of dehydration.
- No screens for an hour before bed, and keep the room cool.
- Calf stretches before bed to reduce night cramps.
What to avoid
Breath retention (kumbhaka), kapalbhati, bhastrika and any forceful or rapid breathing practice are not appropriate in pregnancy. Stop any technique that makes you dizzy, breathless, nauseated or tingly, and never practise while standing.
When it is not just poor sleep
Speak to your doctor about loud snoring with gasping or pauses, which may be sleep apnoea and is linked to blood pressure problems; severe restless legs, often related to iron deficiency; persistent insomnia with low mood; or intense itching keeping you awake, which needs a cholestasis check.