Techniques for First-Stage Labor
Purpose of Breathing
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.
Rhythmic breathing promotes physical relaxation by reducing muscle
tension, and promotes emotional relaxation by reducing anxiety.
Breathing techniques provide a means for distracting the woman from the
pain of labor, giving her something to focus on other than the
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
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
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
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.
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
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
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.
to use: When deep breathing no longer seems enough to help with
Helps with relaxation, distracts attention from contraction.
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.
to use: When Hee-Hee Breathing isn’t enough.
Helpful during transition. Or, when you’re feeling light-headed from using
light breathing pattern.
of patterned hee-hee-blow:
Provides a rhythm to breathing. Helps to avoid hyperventilation. The blow
breath helps to release tension.
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.
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.
Distraction. Woman focuses on partner and on counting the breaths.
To: Take in a big deep breath. Exhale out in four short, light, puffing
breaths. So, it’s IN-out-out-out-out.
to use: anytime in active labor; alternative to light breathing or hee-hee-blow breathing.
Similar to patterned hee-hee-blow.
May be especially helpful fsor women with asthma.
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
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.
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.
by Janelle Durham, 2002 - 2008
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