Breathing During Labor

For a discussion about how to breathe during pushing, skip to the bottom of the page!

For more information about how to prep your body for birth, see our post HERE

BREATHING DURING LABOR

We constantly are talking about important breathing properly is. Believe it or not, breathing can also be used as a form of pain relief during labor. One 2011-12 survey study found that the most common non-drug form of pain relief during labor was breathing techniques, with 48% of respondents reporting that is their preferred method.

There are reasons why breathing techniques are so commonly taught to pregnant women. Breathing techniques are used around the world for stress and anxiety relief. Researchers believe that focused breathing activates certain mental processes in your brain, stimulating the release of endorphins, which are natural pain relieving hormones. This could help you to redirect your thoughts about labor to being more positive and manageable.

One of the most highly regarded breathing techniques is diaphragmatic breathing. We talk about this one a TON. It is a key component of activities such as yoga, meditation, and tai chi. Studies have shown that even just a few minutes of this type of breathing can modify your brain waves in a positive way. In addition, it helps to decrease your blood pressure and stress hormones, increase your relaxation response, and increase your blood oxygen levels.

For a proper breath, you want to start by taking a long, slow breath in through your nose. When you INHALE your stomach should RISE while your ribs should EXPAND to the sides. That is why strong abdominal muscles are so important— we need strong abs to get rib expansion and back body diaphragm expansion. Focus on drawing air into the bottom ribs and relaxing your belly. You can also visualize your diaphragm lengthening downward (toward your feet) as it fills with air while your pelvic floor nicely relaxes. To exhale, pretend you are blowing out birthday candles by lightly pursing your lips and exhaling slowly. As your diaphragm rises your pelvic floor will follow by reflexively contracting. Visualize on your exhale that you are scooping out the air in your body making a hook shaped pattern with your belly.

Take caution not to breath exclusively into your BELLY. During pregnancy, a forward-expanding belly in the absence of any rib cage movement puts extra pressure on already taxed core. What ALWAYS helps is to re-focus on your bottom ribs. Here are the steps to feel and help promote awesome rib cage movement:

1. Place both hands at your sides with your fingers in front (just below where the underwire of a bra) and your thumbs wrapped around back of your rib cage and INHALE

2. You should feel your bottom ribs rise”up and out” under your fingers

3. You may even appreciate that your ribs expand BEHIND your body (your rib cage is a 360 degree canister! It has a front, sides, and back!)

4. Try “square breathing”: inhale x 4 sec, hold x 4 sec, exhale x 4 sec, hold x 4 sec

5. On your exhales, feel your ribs come back IN and DOWN toward your pelvis. You can even give a little extra over-pressure with your hands to help feel like your ribs are REALLY coming back down.

HOW TO PUSH

• Create downward pressure with abdominal contraction while EXHALING (blowing the petals off a flower)

  • This downward pressure will push the baby toward the outside world

• You have to actively focus on relaxing your pelvic floor during this process, as if you were pooping

  • Because the downward pressure you’re creating does not meet any resistance (i.e. pelvic floor tension) your baby can smoothly make an exit with no high-pressure strategies needed (such as closed mouth/red-faced pushing)

• If your pelvic floor refuses to relax, it is going to take you generating WAY more pressure to get the baby out 

  • Hours and hours of heavy pushing are what can lead to pelvic organ prolapse and perineal tears, not to mention horrific hemorrhoids! 

• Learning how to push with keeping your pelvic floor OPEN and WITHOUT holding your breathing will potentially spare you (and your baby!) a lot of trauma during the birthing process

We need to be able to turn our abdominals on independent of our pelvic floor for POOPING and BIRTHING. When something (or someone!) is trying to exit our body… we want to generate downward pressure that is NOT met with resistance at the bottom of the pelvis. If your pelvic floor refuses to relax see our post Relaxing your Pelvic Floor!

The moral of the story:

• Work on your diaphragmatic breathing

• Learn how to contract and relax your pelvic floor independently of your abdominal muscles

• Learn how to contract and relax your abdominals independently of your pelvic floor

• Practice the coordination needed for birth:

  • Gently contract your abdominals while exhaling through pursed lips (“blow out the birthday candles”)

  • During this abdominal contraction, think about relaxing and letting that pelvic floor relax and GENTLY descend down away from your body

  • This is ultimately the proper way to push, you create pressure from above while relaxing from below and let things gently exit the body!

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