Background & Literature Review

The Maternal Brain

Pregnancy and the postpartum period involve significant neurological adaptations that help prepare a mother for caregiving and the transition to parenthood. Research using neuroimaging has demonstrated structural and functional changes in several brain regions responsible for emotional processing, stress regulation, and internal body awareness. These regions include the amygdala, hippocampus, insula, and prefrontal cortex.

Together, these brain areas form a network that helps regulate emotional responses, interpret internal bodily signals, and coordinate behavioral reactions to stress. During pregnancy and postpartum recovery, these systems undergo substantial recalibration as hormone levels shift and the brain adapts to new physiological demands. 

(Cárdenas et al., 2019; Cleveland Clinic, 2024)

Understanding these neurological changes is essential for recognizing how brain function, emotional regulation, and physical recovery are closely connected during the transition to motherhood. 

The Nervous System 

The central nervous system (CNS) and autonomic nervous system (ANS) work together to maintain balance in the body by regulating physiological and emotional responses to internal and external stressors. The CNS integrates sensory, emotional, and cognitive information, while the ANS controls involuntary functions such as heart rate, digestion, endocrine signaling, and muscle tone.

During the perinatal period, this regulatory system must adapt to major hormonal, physical, and psychological changes.

Stress activates the HPA axis, leading to the release of cortisol. When stress responses become prolonged or dysregulated, the body may remain in a heightened sympathetic (“fight-or-flight”) state, which can reduce parasympathetic (“rest-and-digest”) activity.

Autonomic dysregulation can influence many aspects of daily functioning. Individuals may experience increased anxiety, reduced pain tolerance, difficulty with decision-making, and decreased ability to engage in daily occupations and responsibilities. Postpartum stressors—especially when combined with prior trauma, anxiety, or complex birth experiences—may further weaken physiological resilience.

Because the nervous system plays a central role in emotional regulation and physiological stability, strategies that support nervous system regulation may improve both physical and emotional postpartum recovery.

(Amabebe & Anumba, 2018; Cárdenas et al., 2019; Cleveland Clinic, 2022; Cleveland Clinic, 2023; Ortiz et al., 2020 Porges, 2025)

Pelvic Floor Dysfunction & Stress

The pelvic floor is closely influenced by nervous system activity. Elevated cortisol and chronic stress can increase sympathetic nervous system activity, which may contribute to increased pelvic floor muscle tension and reduced relaxation capacity. 

When the body remains in a prolonged stress state, pelvic floor muscles may respond by tightening rather than relaxing. This can contribute to symptoms such as:

• pelvic pain

• urinary urgency or frequency

• constipation

• difficulty coordinating pelvic floor muscle function

Research suggests that stress-related nervous system activation may influence pelvic floor behavior more strongly than other skeletal muscles because the pelvic floor plays a role in survival-related functions. 

Despite the growing recognition of this relationship, the connection between nervous system regulation and pelvic floor function remains underexplored in research. This highlights the importance of educational programs that help individuals understand how stress, emotional regulation, and physical function are interconnected.

(Porges, 2025; Wang et al., 2024; Pan et al., 2019)

Impact of Cognitive Awareness Interventions

Mindfulness and breathing-based practices can influence emotional regulation by directly interacting with physiological systems such as respiration, the autonomic nervous system, and stress hormone activity. 

Diaphragmatic breathing, in particular, stimulates the vagus nerve, which increases parasympathetic nervous system activity and helps reduce physiological stress responses. These breathing patterns can also influence brain activity, emotional intensity, and cognitive processing by synchronizing with neural rhythms involved in mood regulation.

The diaphragm, abdominal muscles, and pelvic floor work together as part of the body’s core stabilization system. When breathing practices are combined with mindfulness, they can reduce pelvic floor muscle tension and improve emotional regulation. Research has demonstrated that individuals who practiced diaphragmatic breathing experienced both lower perceived emotional stress and reduced pelvic floor tension. 

Higher levels of mindfulness during pregnancy have also been associated with:

• greater parasympathetic nervous system activity

• lower prenatal and postpartum emotional distress

• improved emotional regulation

• more positive infanct social-emotional outcomes

These findings suggest that increasing cognitive awareness of bodily states—through practices such as breathing, mindfulness, and interoceptive awareness—can support both emotional and physical well-being during the perinatal transition.

(Braeken et al., 2016; Golec et al., 2025; Kabat-Zinn et al., 2013; Loucks et al., 2022; Porges, 2011; Peper et al., 2016; Peper & Cohen, 2017; Sharp et al., 2024; Schulz & Vögele, 2015)