Pregnancy

Breathing Techniques For Labor, Childbirth, & Pain Management

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Overview

Pain is expected in childbirth, but did you know that relaxation and specific breathing techniques for labor can help you manage it better?

During the third trimester of pregnancy (or even earlier), you can start learning breathing techniques to help you with pain relief throughout the various stages of labor and delivery.

By the end of your pregnancy, you’ve probably completed your birth plan, packed your hospital bag, furnished the nursery, shopped for your baby’s clothes and essentials, and chosen a name for your baby.

A childbirth class such as Lamaze can help you get ready for your little one’s delivery.

In these classes, you’ll learn about many aspects of childbirth, including wellness, pain management, and techniques for breathing and relaxation that might make labor easier for you.

Learn more about effective techniques for relaxation and breathing during labor as you continue reading below.

Benefits Of Breathing Techniques For Labor

  • Breathing exercises have been used for thousands of years in yoga as a way to manage the body and mind. Today, science has shown that certain breathing techniques offer multiple health benefits.
  • These breathing techniques give you something to focus on and help redirect the mind away from perceived pain. Learning breathing techniques and keeping a steady rhythm can help you stay calm and relaxed by soothing your nervous system.
  • These breathing techniques might help you respond more positively to the onset of pain. Each time you breathe deeply, it sends a message to your brain to relax and calm down. Then, the brain sends this calming message to various parts of your body. In turn, you’ll feel your body relax. Signs of stress such as fast breathing, high blood pressure, and increased heart rate will decrease as your body relaxes.
  • Rhythmic breathing can give you a sense of control over the pain.
  • Because you stay calm, the steady supply of oxygen and energy can provide you more strength throughout labor than if you’re panicked.
  • You’ll find more purpose with each contraction, which could make each one more productive.
  • These techniques, such as yoga breathing, can also provide you with more energy and strength to help you during the difficult parts of labor.

Here are some techniques to help you find pain relief during labor:

Yoga Breathing (Pranayama)

  • Pranayama or yoga breathing helps you create a state of union within yourself first.
  • The more you practice yoga breathing, the more vital energy will move inside you. This can help you feel stronger, healthier, and more inspired.
  • You can channel that energy into helping you stay calm and strong even during the most painful moments of labor.

Here are some pranayama exercises you can try during labor:

  • Box Breathing
  • Ocean Breathing
  • Alternate Nostril Breathing
  • Mindful breathing

Lamaze Patterned Breathing For Pain Management & Labor

The Lamaze breathing technique keeps you focused on your breathing. This can keep your mind off the birthing pains you experience during labor.

Lamaze is based on the idea that you can decrease your perception of pain through controlled breathing.

Your childbirth educator or certified Lamaze instructor will teach you the different breathing patterns used in the different stages of labor.

First Stage Of Labor

Start of Contractions: Relaxing Breath or Cleansing Breath

During early labor, your contractions will be weak and sporadic. At this point, you start to feel some pain in your pelvic area. That’s because your body prepares to bring the baby out of your womb.

This stage can last for around 12 to 13 hours for your first baby and seven to eight hours for your next child. But the actual length of labor will be different among pregnant women.

  • Do the cleansing breath or relaxing breath by taking a deep breath at the beginning and end of each contraction.
  • Breathe as normal when the contractions stop.
  • Always remember: the goal is for you to relax.

Organizing Breath

As labor progresses, you’ll feel stronger contractions because your cervix begins to open to around 4 cm.

  • Each time you feel contractions happening, take an organizing breath.
  • Do this by inhaling slowly and taking a deep breath through your nose when the contraction starts.
  • Then, slowly breathe out through your mouth.
  • This releases the tension you feel from your head down to your toes.
  • When the contractions start again, take another organizing breath and focus on relaxing a different part of your body.
  • As the contractions continue, find another part of your body to focus on relaxing.

Pregnant women usually stay at home during this stage of labor. But make sure to time your contractions.

You’ll know if it’s time to go to the hospital when you enter the active labor stage, and your contractions last for 60 seconds and come five minutes apart.

Active Labor: Light Accelerated Breathing

If you can’t talk properly during a contraction, then you’re probably moving into active labor. Your cervix will open from 4 cm to 7 cm at this point.

  • During active labor, start with an organizing breath. Keep breathing slowly through your nose and out of your mouth, but speed up as the contractions increase.
  • Relax your shoulders and switch to light breathing as the contraction peaks.
  • Instead of breathing in through your nose, you breathe in and out through your mouth. Take one breath per second.

Variable Or Transition Breathing

Even in active labor, contractions can go from strong to weak. So, you might need transition breathing at this point.

  • Continue light breathing until the contractions wane. Then, go back to taking an organizing breath.
  • Find a focal point and focus your eyes there. It can be a part of your body, a picture, your doctor, your partner, or even a spot on the ceiling.
  • As the contractions resume, take one or two quick breaths through your mouth every second.
  • Count your breaths. Blow out a long breath every fourth or fifth breath, but continue with the quick breaths.
  • Take a relaxing breath as the contractions wane.

This technique is also known as pant-pant-blow breathing.

If you want, you can verbalize quick breaths with a “hee” and long breaths with a “hoo.”

So, transition breathing can go like this: hee-hee, hee-hee, hoo, hee-hee, hee-hee, hoo for up to 10 seconds.

Second Stage Of Labor

The second stage is known as the hardest, most painful in labor. It occurs as the cervix opens from 7 cm to 10 cm.

Contractions come every two or three minutes and will last for around 60 to 90 seconds.

Expulsion Breathing

Labor pain is at its hardest during this stage, but remember that it will be over soon, mama.

  • Start with a relaxing breath.
  • Don’t think about the pain. Instead, focus on the baby moving down and out.
  • Instead of shallow breaths, take a slow deep breath with each contraction.
  • But you can also find your rhythm. The type of breathing you pick at this point should be something that you’re comfortable with but lets you remain focused on getting the baby out.
  • If you feel the need to push, first take a deep breath and slowly release it through your mouth as you bear down.
  • When the contraction stops, relax. Take two calming breaths.

It’s important to also listen to your doctor’s instructions even as you focus on your breathing.

Third Stage Of Labor: Birth And Delivery

Towards the end of the second stage, your doctor will see the top of your baby’s head through the opening.

At this point, your healthcare provider will tell you to push as hard as you can and get the rest of the baby’s body out.

How do you breathe while in labor and pushing?

Continue with rhythmic breathing until you deliver the baby.

  • Once the baby is out, your pelvic muscles will continue to contract. This will push the placenta out, but the movement will no longer be as painful as the contractions before delivery.
  • As the contractions wane, take a few deep breaths to let your body relax.

During your childbirth classes, you’ll be able to practice these breathing exercises with your childbirth instructor. You can discuss other comfort and relaxation strategies that you might also want to try.

Fourth Stage Of Labor: Recovery

Postpartum breathing will be easier. But make sure to take deep breaths to help your body begin its recovery process from the fatigue you experienced during labor.

Contractions will continue inside your body as your uterine and pelvic muscles begin to go back to their original positions pre-pregnancy.

Doctors recommend breastfeeding as soon as possible because this helps the uterus contract and decreases postpartum bleeding.

Encourage your baby to latch on and try suckling even if your milk flow isn’t strong yet and you’re both still trying to figure out how breastfeeding works. You can also use a breast pump to help establish your milk supply.

What Is A Belly Breather? Paced Breathing For Pain Management

This is another type of breathing pattern that’s slightly different from the Lamaze technique. This slow and diaphragmatic breathing technique, also known as belly breathing, can be used during active labor.

In normal breathing, you take around 12 to 14 breaths per minute. But in paced breathing, you slow it down to just five to seven breaths per minute.

Should you hold your breath when pushing during labor?

Here’s how you can use this breathing pattern during labor:

  • When the contraction begins, take a deep breath. Completely fill your lungs with air.
  • Hold your breath and slowly release after eight to nine seconds.
  • Find a focal point and fix your eyes on that spot while you continue inhaling and exhaling slowly.
  • At the start of each contraction, you can visualize massaging your uterus by placing your hand on the lower part of your belly and stroking gently while moving up.
  • Let your hands slowly move down as you exhale.
  • Breathe normally when the contraction ends.
  • Repeat the cycle for each contraction.

Modified Paced Breathing

During the second stage of breathing, contractions will be stronger, and paced breathing might not be enough.

So, you can start with modified paced breathing:

  • Again, start with a deep relaxing breath.
  • As the contraction starts, you should breathe slowly. But change the pace as the contraction builds and peaks.
  • Even as you change the pace, your breathing should still be regular. For example, shallow inhalation should be matched by shallow exhalation.
  • You can still massage your belly. But if that feels uncomfortable, you can let your partner massage your back or thighs instead.

If you feel lightheaded or dizzy, take another deep relaxing breath.

Breathing Between Contractions

It might be tempting to push between contractions, but that’s not how it works. You have to wait until your cervix is fully dilated before you can try pushing and letting the baby out.

So, when the contractions stop, you should also relax. Take a deep breath before breathing normally and wait for the contractions to begin again.

What Works Best For You

Don’t worry if you find yourself forgetting about the breathing patterns you practiced because the pain might be too much for you to handle.

Just remember that it’s all about finding your rhythm and focusing on your breathing instead of the pain. Then, you can try different breathing techniques or create something comfortable for you.

The most important thing is for you to relax and stay calm. So don’t panic if you can’t remember any rhythm.

Try slow breathing, then increase the pace with the intensity of the contractions. If that doesn’t work, you can take rhythmic shallow breaths or create a combination of both.

Why Practice Breathing Patterns Before Birth

The relaxation and breathing techniques mentioned above aren’t the same as those we normally use in regular, involuntary breathing. So, it’s easy to forget them once you’re in pain during labor.

That’s why practicing is important. It’s also a good idea to do it with your partner or the person who will be with you during the delivery.

When To Start Practicing

Make time each day to practice the different breathing patterns to get ready for labor.

You can do this anytime during the third trimester, beginning the seventh month of gestation, so you’ll get the hang of these techniques and memorize how they’re done before labor starts.

Does Breathing Really Help Labor? Evidence That Breathing Techniques Actually Work

Several studies found evidence that these different techniques really work during labor.

Lower Rate Of Epidural Use

In a 2016 randomized controlled trial conducted in Australia, researchers found that the participants who completed a childbirth course had a significantly lower rate of epidural use than those who did not participate in the lessons. (1)

Better Maternal Vitality And Positive Outcomes

Pregnant women who participated in childbirth classes conducted in a 2010 study showed better maternal vitality (defined in the study as the opposite of depression and low energy).

They also had positive outcomes. The breathing skills they learned during the classes may have helped decrease the use of pain-relieving medication during labor. The women also reported a better mood compared with the group that didn’t join the classes. (2)

Lower Labor Pain Perception

In a 2004 randomized controlled trial, women who learned breathing techniques, received nurse-administered massage, and were coached during labor had lower pain perception and felt more relaxed than the control group. (3)

Relaxation Techniques For Labor

Have you noticed how pain can radiate to all parts of your body even if only one part (such as a toe or finger) is hurt or injured?

That can also happen during childbirth. As the muscles in your pelvic floor move to make room for your baby’s delivery, it might feel like your entire body is also in pain.

For help with pain relief during labor, start by practicing breathing and relaxation techniques.

First, understand that your pelvic floor muscles need to move and push the baby out. So, it would help if you let these muscles do their work and provide them with the energy they need.

But you might be wasting your oxygen and energy if other muscles in your body are also tight during the contractions.

So, it’s important to relax these other muscles and conserve your energy to focus on your baby’s delivery.

Other relaxation techniques for labor include muscle relaxation exercises and visualization.

Other Ways To Keep Calm And Relax During Labor

  • Meditation
  • Listen to some relaxing music
  • Empty your mind and focus on breathing
  • Find a comfortable position
  • Use a birthing ball for comfort
  • Choose a focal point
  • Dim the lights
  • Put some relaxing essential oils (rose, jasmine, sage, or lavender) in the diffuser
  • Gentle massage
  • Snacking or munching on something such as ice chips, with your doctor’s permission
  • Hypnobirthing (a type of hypnosis and relaxation technique)

REFERENCES

(1) https://pubmed.ncbi.nlm.nih.gov/27428108/

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208940/

(3) https://pubmed.ncbi.nlm.nih.gov/15605131/

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