Regardless of the childbirth method you choose, all methods focus on the importance of your breath and relaxation. When you breathe, you are giving oxygen to your muscles and allowing your body to work effectively with the contractions. Furthermore, you are providing the baby with the oxygen he so vitally needs. A typical response to a strenuous or scary situation is to hold your breath, however, that action greatly interferes with labor and can leave the baby in distress. If you are holding your breath, the oxygen supply to the baby is diminished. Therefore, proper breathing through labor is essential. There are various methods of breathing through labor.

The Bradley® Method focuses on deep abdominal breathing with relaxation. This breathing is meant to be used throughout labor and birth. Simply listen to the quiet, steady rhythm of your breath as you breathe deeply. Notice how the tummy expands outwardly as you breathe in, and relaxes as you breathe out. This type of breathing is slow and very relaxing and sets the stage for your ability to relax through the contraction. For Bradley® instructors in your area contact The Academy For Husband Coached Childbirth or 1-800- 4-A-Birth.

The Lamaze method uses breathing patterns for various responses to labor. Below are the typical breathing patterns (various childbirth instructors may use different terms for each). These techniques are designed to maintain oxygen flow and keep Mom focusing on her breath rather than contractions. For a Lamaze certified childbirth instructor in your area, contact: Lamaze International or 1-800-386-4404.

All breathing begins with a Deep Cleansing Breath

• Inhale-through the nose (if possible), keeping shoulders relaxed
• Exhale-through the mouth, letting go of all the tension in your body

SLOW-PACED BREATHING

• Rate is approximately half the number of breaths you normally take per minute; not less than 3 or 4 breaths per minute
• Aids relaxation and provides optimum oxygenation
• When doing the more advanced breathing techniques, return to slow-paced breathing when able

Procedure:

• Deep Cleansing Breath
• Inhale (through nose if possible) to a count of 4 - In two, three, four
• Exhale through mouth to a count of 4 - out two, three, four
• Repeat the inhale/exhale throughout the contraction
• When contraction ends, Deep Cleansing Breath

MODIFIED-PACED BREATHING

• Rate is slightly faster than your normal breathing rate; not exceeding twice your resting rate
• Allows you to be more focused and alert

Procedure:

• Deep Cleansing Breath
• Inhale through nose to a count of 2 - In two
• Exhale through mouth to a count of 2 - Out two
• Repeat the inhale/exhale throughout the contraction
• When contraction ends, Deep Cleansing Breath

PANT-BLOW BREATHING

• Same rate as modified-paced breathing
• Blowing softly at regular intervals creates a rhythmic pattern
• The pant is an in breath and an out breath (touching the tip of your tongue to the roof of your mouth will help keep your mouth moist)
• Patterns may vary: pant - 2 -3 - 4 - blow, or pant - 2 - 3 - blow

Procedure:

• Deep Cleansing Breath
• Take upper chest, shallow breaths follow by relaxed exhales
• At regular intervals, add a slightly emphasized exhalation (a sigh)
• The importance is to keep facial muscles relaxed
• When contraction ends, Deep Cleansing Breath

Many ICEA certified childbirth educators teach these techniques as well as a more basic breathing as in the Bradley® Method. The theory behind this is "freedom of choice based on knowledge of alternatives." If you are taught several methods, you can choose which one best suits your needs and desires. You can find an ICEA Certified Childbirth Educator through ICEA.

Work on practicing your breathing with your partner. In labor, you may have a tendency to breathe too quickly which may lead to hyperventilation. By having your partner breathe with you and guide your breath through the contractions, you are most likely going to avoid hyperventilation during labor. Once you learn to listen to your breath and use your breath effectively, you will notice how relaxed your body is and how well your labor flows.

Breathing During Second Stage ~ Pushing

Renewed energy and enthusiasm occur during the Second Stage. It is Mother Nature's way of helping laboring mothers get through the final time before the birth of their baby. However, some mothers feel ready to push before their cervix is ready! If you or the mother you are supporting feels the urge to push and her care giver has not given her the OK to push, repeated puffing air in and out as if she is blowing out a candle will help her to gain control during this difficult time.

Regular and rhythmical breathing during pushing allows a mother to push longer while maintaining good oxygen flow to the baby and reducing fatigue. All pushing contractions should begin and end with a cleansing breath. You may use these three methods of breathing during pushing.

Spontaneous Pushing
The urge to push is a relentless urge to push ~ it is nearly involuntary. To push spontaneously, many women find that holding their breath during pushing increases the intensity and strength of the push. Remember, it is important to come up for air! Spontaneous pushing is most often used during early Second Stage/Pushing as it is probably the least effective of the three. It is good however, to learn from and to begin listening to how your body will be pushing out your baby.

Slow Exhalation Pushing
Working with the urge to push and producing a push that is slow and easy, Slow Exhalation Pushing is alot like blowing up a new balloon. During a contraction, a mother inhales and exhales slowly through pursed lips in much the same way as if she were blowing up a balloon. This is often preferred to breath holding when the baby indicates (via an electronic fetal heart monitor) that he/she may not be tolerating Stage 2 well. This may also be preferred when the mother and care giver are trying to avoid an episiotomy, since the push from Slow Exhalation Pushing is so gentle.

Directed Pushing
Directed Pushing is the most commonly used type of pushing in the United States. Again during a contraction, a mother inhales and then holds her breath while a support person counts a quick count of 10. This is not 10 actual seconds (it is actually about 6 clock seconds)! However for clarity at a time when mothers do not process information well, a count of 10 is helpful to her. At the end of the count of 10, she exhales and inhales rapidly again, holding for another count of 10. This cycle is repeated until the contraction goes away.

Remember, it is not so much what type of breathing technique you do, it is that you are breathing. Finding a pattern that is relaxing and feels good for you can help make your labor easier!

References:

1. Bobak, I., Jensen, M. Maternity & Gynecologic Care: The Nurse and the Family. (1989) St. Louis: Mosby Publishers.
2. Nichols, F., Humenick, S. Childbirth Education: Practice, Research & Theory (2000) Saunders & Co.
3. Whitely, N. A Manual of Clinical Obstetrics (1985) Philadelphia: J.B. Lippincott Company.
4. Reeder, S., Martin, L., and Koniak-Griffin, D. Maternity Nursing: Family, Newborn, and Women's Health Care. (1997) Philadelphia: J.B. Lippincott Company.