Breathing Techniques For Labor

For some women, relaxation is sufficient for dealing with the sensations of labor. Others need additional coping strategies. This article will cover specific breathing patterns. The following subsection will present additional tools that con provide comfort during labor. To be properly prepared, you should learn all of these techniques. Then you can use those tools that you need during your unique labor situation, modifying them as you desire.

Breathing in a rhythmical pattern maintains a constant, balanced exchange of oxygen and carbon dioxide to ward off hyperventilation and to ensure a good oxygen supply to the working uterus, the placenta, and the baby. In addition, the focusing required to maintain slow or patterned breathing techniques may reduce your perception of pain. According to the gate control theory, pain sensations must travel up to the brain through a limited number of pathways. If the laboring woman keeps her mind busy with concentrating on a specific breathing pattern, focal point, or visualization, the gate closes, allowing fewer pain sensations to reach the brain. Thus, the perception of the contractions will be diminished. In other words, you distract yourself from perceiving the intensity of the pain. It is an experience similar to having a headache but for getting about it while watching an exciting or engrossing movie. When then movie ends, the headache returns. Athletes frequently continue to play through an injury, and do not perceive the intensity of the pain until the game is over and they begin to focus on it.

Another method of utilizing the gate control mechanism is to physically simulate specific points on the body. Examples of this include the use of heat, cold, massage, and acupressure, which will be discussed in the following sections in this article.

Breathing Basics

Several elements are the same for all the breathing patterns presented in the following pages. They are:

  • As each contraction begins and ends, you should take in a smooth, deep breath through your nose, then let the air out like a sigh through your mouth. This is known as a relaxing breath, and it is your cue to relax your body. This breath gives you a good boost of oxygen for the baby and for the uterus at the start of the contraction, and it is a signal to your labor partner that the contraction has begun or ended.
  • You can focus your eyes on some object or spot in the room for the duration of the contraction. This object or spot is called your focal point. If you practice at home with a particularly pleasing object—such as a picture of a baby, a pleasant scene, a religious symbol, or the object that you visualize in your Special Place—take it with you to the birthing room. A focal point gives you something outside of yourself on which to concentrate and thus helps to lessen your awareness of the strength of your contractions.
         Some women prefer to keep their eyes closed during contractions because it helps them to be in tune with their bodies. It also helps them to block out their surroundings when performing a visualization.

  • When practicing a breathing pattern, have your partner give you the verbal cues “Contraction begins” and “Contraction ends“. During labor, you will automatically transfer your practiced responses from the verbal cues to the physical sensations of the uterine contractions.
  • Have your partner call out the passing seconds in 15-second intervals. This will help you gauge the duration of each contraction when you are in labor.

The practice steps for the breathing patterns are:

  1. Have your labor partner say, “Contraction begins“.
  2. Take a relaxing breath and release the tension from your body.
  3. Concentrate on a focal point, if desired.
  4. Begin the breathing pattern.
  5. Have your partner “time the contraction” by calling out in 15-second intervals.
  6. Have your partner say, “Contraction ends“.
  7. Take a relaxing breath and totally relax your body.

Rest for a few seconds, then repeat the steps.

Breathing Patterns

Now that you are familiar with the elements common to all the breathing techniques, you can begin to learn the individual patterns. Keep in mind that every person’s breathing rate is different and that the patterns should be modified for your personal comfort. Before you begin, determine your normal resting rate of breathing by having your partner count your breaths for 1 full minute. During your practice cessions, you can either take air in through your nose and let it out through your mouth, do all nasal breathing, or do all mouth breathing. If your nose is congested, you may find mouth breathing easiest.

When you go into labor, do not use the special breathing patterns until you really need them. As long as you can walk and talk through your contractions, you will not need to do anything special except stay relaxed. As the contractions become stronger, begin slow paced breathing. Continue using this pattern for as long as possible. Many women find that slow paced breathing is the most effective in keeping them relaxed. The faster patterns require more energy and make relaxation more difficult. The longer you can comfortably wait before starting the special patterns, the more energy you will save.

MoaningIf it feels better for you to make noise, try humming or moaning in low tones during your contraction. Low pitched sounds will help to keep you relaxed. Many women have found that moaning is one of their best comfort tools.

Slow Paced Breathing

Slow paced breathing is the first, and possibly the only, breathing pattern that you will use in labor. It is done by breathing at approximately half your normal rate. (see Figure 5.1). When doing slow paced breathing, breathe in a relaxed and comfortable manner.

Figure 5.1. Slow paced breathing.

Modified Paced Breathing

If and when slow paced breathing no longer keeps you relaxed and comfortable, you can switch to the next breathing pattern, modified paced breathing. Modified paced breathing is more rapid than slow paced breathing, but no faster than twice your normal breathing rate. (See figure 5.2). Since it is a more fatiguing pattern, you should return to slow paced breathing when possible.

Figure 5.2. Modified paced breathing.

If you use mouth breathing, you can reduce dryness by placing your tongue behind your lower teeth. Strive for light, effortless, quiet breathing, taking in and letting out the same amount of air. At first, making a hee or ha sound when you exhale may help you to get the rhythm correctly. Later, your breathing should be quiet.

Do not go for speed. Rather try to develop a slow, even rate. Try breathing in a 4/4 rhythm by mentally counting your breaths up to 4 and then starting again. Or, pace yourself by mentally reciting a nursery rhyme, such as “Jack and Jill went up the hill to fetch a pail of water“.

When you are in labor, your breathing will accelerate naturally in response to your contractions. You might find yourself using slow paced breathing at the beginning of a contraction, gradually increasing the rate as the contraction builds, and then slowly decreasing the rate as the contraction subsides. (See Figure 5.3). This pattern is called accelerated-decelerated breathing.

Figure 5.3. Accelerated-decelerated breathing (slow paced and modified paced breathing)

Breathing too fast is not only exhausting, but could make you hyperventilate. Hyperventilation is the result of exhaling too much carbon dioxide. You may feel dizzy, or have numbness or tingling in your fingertips, nose, or tongue. To combat this, breathe into your cupped hands or a small paper bag to rebreathe the same air and slow down your breathing rate.

Patterned Paced Breathing (Pant-Blow)

The last breathing pattern is designed to help with the long, strong, and often erratic contractions of transition. You should wait to use it until you find modified paced breathing no longer effective. It is the most tiring pattern and will prove exhausting if you use it too early.

Most women prefer mouth breathing with this pattern. As with the other breathing patterns, begin with a relaxing breath. You may need to make the relaxing breath short if the contraction peaks quickly. Otherwise, the contraction will get ahead of you and may cause you to lose control. If the contraction peaks immediately, skip the relaxing breath and start the breathing pattern at once.

The patterned paced breathing pattern is composed of 3 to 6 shallow breaths or pants followed by a short blowing-out breath through pursed lips. Do not forget to inhale before you blow out! The blow should be only a short accent; do not overemphasize it by breathing too slowly. When practicing, position your hand about 12 inches from your mouth and blow at it as if you were blowing out a candle. You should feel the blow lightly. During labor, repeat the pattern until the end of the contraction. Work for a light, even rhythm.

When practicing, try several of the variations. These include 3 pants and 1 blow, 4 pants and 1 blow, 5 pants and 1 blow, and 6 pants and 1 blow. (See Figure 5.4). Decide which is the most comfortable for you and practice it for use in labor.

Figure 5.4. Patterned paced breathing (pant-blow)

You may find yourself moving in rhythm with your breathing when you practice this pattern. This uses extra energy unnecessarily. Instead, try to keep your shoulders and face relaxed and quiet.

You can also practice a more complicated form of this breathing pattern—increasing and then decreasing the number of pants before each blow. This demands even greater concentration. For example, during a contraction, do 2 pants and 1 blow, then 3 pants and 1 blow, then 4 pants and 1 blow, then 3 pants and 1 blow, and finally 2 pants and 1 blow. You can design your own combination of pants and blows.

Blowing for Premature Urge to Push

If, during a contraction, you feel a strong urge to push, blow out repeatedly and forcefully until the urge passes. It is difficult to bear down or push effectively when you are blowing out strongly. Remember to breathe in air before you blow out. When the urge to push is gone, return to the breathing pattern you had been using. (See Figure 5.5).

Figure 5.5. Patterned paced breathing with blowing for a premature urge to push.