Heartburn, Rib Pain, and Breathlessness in Pregnancy: A Deeper Look

First A Few Terms You’ll Hear Me Use In This Blog:

Because I tend to teach in anatomical language, I want to offer a few simple clarifications to help you track what’s happening in your own body with more precision:

• Posterior — means the back side of your body. So when I say “posterior ribs,” I’m talking about the part of your ribcage that wraps around toward your spine.
• Lateral — refers to the sides of the body. Your lateral ribs are what you might think of as your side waist or side body—the places that often feel tight or pinched as your pregnancy progresses.
• Diaphragm — the dome-shaped muscle that lives just beneath your lungs and above your abdominal organs. It plays a major role in how we breathe, how we digest, and how the body manages internal pressure.
• Thoracic cavity — the upper part of your trunk, essentially everything enclosed by the ribcage. When I talk about thoracic mobility, I’m referring to how well your ribs, spine, and surrounding tissues can move to support breath and spaciousness.
• Esophageal sphincter — the small muscular valve at the base of the esophagus that helps keep stomach contents from rising upward. When there’s too much pressure or twisting in the ribcage, this valve can become compromised, contributing to heartburn or reflux.

There’s a particular cluster of sensations that many women experience as their pregnancy progresses. None of them are uncommon, but they are often misunderstood. A sense of fullness beneath the sternum. The feeling of not being able to take a satisfying breath. A vague achiness that settles into the back of the ribcage. A burning discomfort that rises up the chest, especially in the evenings.

We tend to name these things separately: reflux, heartburn, rib pain, shortness of breath. But in practice, they often show up together. And what I want to name here is that more often than not, they’re coming from the same root cause. A loss of mobility in the diaphragm and a narrowing of the upper abdominal space.

When there isn’t enough movement through the thoracic cavity (especially in the lateral ribs and back body) then the diaphragm cannot descend fully. The stomach becomes compressed. The lungs can’t inflate completely. The esophageal sphincter may begin to torque under pressure. And what we experience, then, is not simply reflux or a high baby or tight shoulders. It is the biomechanical consequence of compression.

This Isn’t Just About Food

Yes, digestive changes in pregnancy are very real. And yes, hormonal shifts do influence sphincter tone. But what we see so often is that the symptoms attributed to eating too late or choosing the wrong foods are actually originating from restriction in the soft tissue structures of the ribcage.

When the diaphragm is unable to function like the piston it was designed to be—rising and lowering with each breath—we lose the internal massage that helps maintain pressure balance throughout the abdominal cavity. If there’s torsion through the esophagus, or if the stomach is being pushed up under the ribcage without room to descend, heartburn becomes a logical consequence.

And I want to be clear that this isn’t always just about fetal position either. Yes, your baby might feel high. But the deeper question to ask is: why is there no space for them to move lower?

Because when the posterior ribs are fixed forward, or the lateral rib cage is not expanding, or the soft tissue surrounding the diaphragm is unable to yield, then both mother and baby are left without room to move.

So we don’t begin by fixing reflux.
We begin by restoring motion and making space.

If you’re ready to explore this kind of movement, one that works with your breath and tissues rather than against them, Prenatal Movement, Redefined was designed for just that. These are not flows or stretches. They are physiologically respectful, breath-led practices that help your body find space again, from the inside out.

Where We Work First: Breath, Ribs, and the Upper Abdominal Wall

The goal here is not to stretch the diaphragm, but to restore its capacity to move. We do this by bringing awareness, and then expansion into the places where there has been restriction. That often means starting with the side body, the back ribs, and the soft tissues of the breast and thoracic fascia.

A few of the ways we begin this work include:

Breathwork in supported sidelying

Not passive. Not collapsed. But supported in such a way that the belly is cradled and the top ribs have the opportunity to lift and widen. This allows the diaphragm to lengthen and descend without force. The breath begins to return not just as a function, but as a form of internal spacing.

Myofascial work through the breast and lateral ribs

This is subtle work, often done with a soft ball, a dog toy, or even balled-up socks, and can be more powerful than we expect. Tractioning the tissue of the breast upward, or simply lifting and creating gentle space, can influence both the posterior thorax and the organs tucked beneath.
I’ve seen heartburn shift just from this alone. Not always immediately, meaningfully, and consistently.

There’s a full breast myofascial class available inside Born Through Movement if this is something you’d like to explore more fully.

Side-body wall reaches for upper rib expansion

With knees wide and hands crawling up the wall like little spiders, we use the arms not to pull but to coax more length through the side ribs and upper abdominal wall. This is especially helpful for women who feel like their baby is in their lungs, because the lungs themselves are mostly posterior. Creating more space behind, not in front, is often the missing piece.

Gentle thoracic rotation for re-patterning breath

For those with the strength and coordination to load tissues gently, we incorporate rotational work with a stretchy band. Not for the sake of building strength, but to restore the spiral dynamics of the thoracic cage. Rotation is breath. Rotation is digestion. Rotation is space. And that includes space for the stomach to descend and the esophagus to untwist.

When We Say Heartburn, We’re Often Naming Compression

One of the most overlooked aspects of heartburn is that it is not just a digestive symptom. It is often a respiratory one. The esophageal sphincter sits right at the base of the diaphragm. When that area becomes crowded (either because the diaphragm cannot move or because the stomach is being pushed upward into it) we get reflux not because of acidity, but because of spatial distortion.

Which means: if we change the shape, we change the sensation.

So many women are told to manage reflux with antacids or small meals or sleeping at an incline. And I’m not saying those tools can’t be helpful. They absolutely can. But they are often treating the end result of a mechanical pattern that has not yet been addressed.

The real work is not just in soothing the burn.
It’s in asking:
Where is there compression in my system?
Where have I lost space?
And what would it feel like to move from that place again?

This kind of question is at the heart of what we explore inside Born Through Movement—a full study of birth biomechanics for women who want to understand their design, not just get through labor.

Movement as a Way Back to Breath, Digestion, and Ease

This work is about bringing movement back to the places where movement has been lost. Not through aggressive stretching or force, but through consistent attention to the thoracic system.

When you create space in the side ribs, the baby often finds more room.
When you release the breast fascia, the stomach has a little more give.
When you re-pattern your breath, the esophagus gets to reorient.

And from there, you often sleep more comfortably.
You digest more easily.
You breathe more deeply.
And the whole system begins to settle.

Want to keep working with these concepts in your body?

If you're craving movement that makes space for your breath, supports your changing structure, and actually prepares your body for birth, not just with strength, but with softness and coordination then come join me for Prenatal Movement, Redefined.

This isn’t traditional prenatal yoga.
These are breath-driven, fascia-aware, trimester-conscious practices that meet you where you are, and guide you gently toward where your body is asking to go.

Whether you're in your first trimester or nearing the end, these sessions are designed to restore space, reduce discomfort, and bring clarity to how you move through this season.

Want the deeper study?

If you want to understand the "why" behind fetal position, the biomechanics of the pelvis, and how your own breath, fascia, and tissue yield shape the way your baby moves through you—Born Through Movement is where I teach all of it.

This course is for those who want to study the design of the female body, not just get through birth.
It’s movement-based, but also deeply anatomical.
It’s rich with layered teaching, self-palpation tools, and practices for every trimester—including strategies to help resolve common aches, optimize position, and reorient your own awareness of the pelvis from the inside out.

Whether you’re preparing for your first birth, seeking a VBAC, or supporting other women as a doula or midwife, this course is a full study of how birth is designed to work... when we make space for it.