Breathing Techniques for First-Stage Labor

Purpose of Breathing Techniques.

• Provide oxygen to mom and baby. If the muscles are well-oxygenated, they can function more effectively, so there will be less pain. If baby has plenty of oxygen, his heart rate will look great.
• Relaxation: Rhythmic breathing promotes physical relaxation by reducing muscle tension, and promotes emotional relaxation by reducing anxiety.
• Distraction: Breathing techniques provide a means for distracting the woman from the pain of labor, giving her something to focus on other than the contraction.

When to Use Breathing Techniques. No special breathing techniques are necessary in early labor, when you’re still easily distracted from focusing on contractions. Begin using techniques when you can no longer walk and talk during contractions.

Always use the most basic technique possible (those near the top of this list), using the least effort required to manage each contraction. This helps prevent fatigue, and helps avoid the sensation of having already used all the techniques early on, leaving you with no new resources later in labor.

The Cleansing Breath

• How to: At the beginning of each contraction, take a deep breath in through your nose, then exhale through your mouth, loud enough that others can hear the exhale. When a contraction ends, take another deep cleansing breath, perhaps also yawning or stretching to release tension.
• Benefits: Welcoming breath gives both mother and baby an extra boost of oxygen, serves as a signal to relax and focus, and informs partner and support people that a contraction has begun. Closing breath serves as a release, informs support people that contraction has passed, and serves as a reminder to relax between contractions.

Slow, Relaxed, Abdominal Breathing

• How to: Inhale slowly through your nose, allowing your belly to expand first, then your chest. Exhale slowly through your mouth, pursing your lips. Breathing should be slow and relaxed, about half your normal rate. 6-9 breaths per minute.
• When to use: Use it through as much of labor as possible. Some women use it for their entire labor. Other women find that at some point in labor, they can no longer relax with this technique, and use other patterns and variations described below.
• Benefits: Relaxing, slow, and effortless. Many women find that breathing slowly can induce a sense of peacefulness and safety that helps to release tension.

Light Breathing, a.k.a. Hee-Hee Breathing

• How to: Inhale and exhale through the mouth. Lips are relaxed, with a slight smile. On exhale, make a soft “hee” sound. To avoid hyperventilation, focus most of your attention on this exhale – let the inhale happen easily. Breathing is shallower than in slow breathing. Frequency: Approximately one breath per second.
• When to use: When deep breathing no longer seems enough to help with contraction.
• Benefits: Helps with relaxation, distracts attention from contraction.

Hee-Hee-Blow Breathing

• How to: Similar to hee-hee breathing, except after two to five of those light exhales, do a slower exhale, blowing all the air out of your lungs, and letting yourself relax deeply with that deep exhale. Repeat the cycle. Find the number of breaths that work best for you. Some women do two hees, then a blow, others like 4 hees.
• When to use: When Hee-Hee Breathing isn’t enough. Helpful during transition. Or, when you’re feeling light-headed from using light breathing pattern.
• Benefits of patterned hee-hee-blow: Provides a rhythm to breathing. Helps to avoid hyperventilation. The blow breath helps to release tension.

Variable Hee-Blow Breathing

• How To: Partner randomly chooses a number of breaths to be done before each blow: 2, 3, or 4. For example, he holds up three fingers, mom does three hees, then he closes fist to show her to blow, then he holds up two fingers, etc.
• When to Use: Best as a “take-charge” routine during transition. The birth companion can use when the mother is feeling out of control and panicky. Establish eye contact with her, and guide her through breathing until she is focused again.
• Benefits: Distraction. Woman focuses on partner and on counting the breaths.

Slide Breathing

• How To: Take in a big deep breath. Exhale out in four short, light, puffing breaths. So, it’s IN-out-out-out-out.
• When to use: anytime in active labor; alternative to light breathing or hee-hee-blow breathing.
• Benefits: Similar to patterned hee-hee-blow. May be especially helpful fsor women with asthma.

Practicing Breathing Techniques before Labor

Deep, abdominal breathing can be practiced any time: while driving, reading, or watching TV, at work, at times of stress, etc. It is beneficial not only during labor, but in all of life.

It’s also important to practice the other techniques until you become comfortable with them, and can use each for two minutes without feeling out of breath. If you begin to feel lightheaded or dizzy, take a deep cleansing breath, and start over again. If necessary, rebreathe your air by cupping your hands over nose and mouth, or breathing into a paper bag. Practice in various positions: sitting, side-lying, standing, hands-and-knees.

To help yourself remember to practice breathing techniques, set up cues. For example, every time you’re at a red light, do hee-hee breathing. During TV commercials, do hee-blow.

Tip: if your mouth feels dry, try touching the tip of your tongue to the roof of your mouth.

Breathing Techniques for Second-Stage Labor

How to Avoid Pushing, if necessary.

How to: Lift your chin, and arch your back a little. Either: Breathe deeply, relaxing your body. Or: Pant, blowing lightly. Some people recommend visualizing a feather, and blowing just enough to keep the feather bouncing up and down in the air above your lips.

When to use: If you are experiencing the urge to push, and your caregiver has told you that it is too early to begin pushing, or that there is some need to stop pushing temporarily.

Benefits: This won’t prevent your uterus from pushing, and it won’t take away the urge to push. However, it does keep you from adding your voluntary strength to a pushing effort.

Breathing for Birth

Breathing the baby out: Breathe in deeply, then on exhale, gently push downward with abdominal muscles, while visualizing the baby moving down and out. It may help to grunt or vocalize while exhaling. Continue this pattern through the contraction.

Pushing the baby out: During a contraction, when the urge to push becomes irresistible, then hold breath for five to seven seconds, while pushing. Then breathe deeply in and out again until the urge to push becomes strong. Repeat through contraction.

“Purple” pushing: In the past, some caregivers recommended holding your breath and pushing for as long as possible before coming up for air. However, this can cause a reduced oxygen supply to the fetus, and is not recommended.

Compiled by Janelle Durham, 2002 - 2008

Relaxation Techniques

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