The labor breathing techniques of our mother’s day, “ha ha heeeee, ha ha heeee,” make decent material for sitcom births, but are in fact rarely seen today. I’m not sure exactly why the use of breathing techniques for labor has fallen from it’s once revered place. I do know that many women seek out instruction in breathing techniques for labor and expect them to be part of the curriculum of childbirth classes. I also know many expectant grandmothers who tout how useful they are and earnestly encourage their daughters to be sure to learn their breathing techniques for labor.
Are breathing techniques for labor beneficial?
When I became a certified childbirth instructor, I was taught the importance of encouraging natural instinctive breathing during labor rather than contrived breathing techniques. Because the breath center is typically involuntarily regulated, it takes a keen intention to focus on conscious control of the breath. Asking a laboring mother to focus on an unnatural breathing pattern requires her to activate the frontal cortex of her brain. The labor process itself creates changes in our brain chemistry which favor a quieting of this concentrating, focused part of the brain, allowing women to enter an altered mental state where time becomes distorted and women fall comfortably into the repetitive nature of labor. These changes are helpful! Too much emphasis on keeping the mind focused on breathing impedes us from experiencing the trance-like state which allows women to birth instinctively, often having powerful experiences in this state.
There is also wisdom in the body’s innate breath regulation. It is important that we draw in more air when working hard. The body regulates oxygen and carbon dioxide levels very well when left to its own unconscious control.
I have had the opportunity to be with hundreds of women through birth. I agree completely that breathing techniques for labor are rarely needed. When I am with women who allow the mind to slip away into a labor-induced fog, finding their way instinctively through birth, their breathing rarely needs adjustment and they are not in need of a coping technique. Birthing without breathing techniques works beautifully for the majority of women, most of the time. But every birth is different. Some births make sudden shifts in intensity, some are very fast and powerful, and sometimes there are moments of real fear or doubt during birth. In these situations, and others, labor breathing techniques can be a wonderful resource. Here is my guide to various breathing techniques for labor, the benefits of each technique, and when they may be used.
7 labor breathing techniques and their uses
The breath is connected to our emotional state. Deep breathing is a calming breath. The body naturally falls into deep breathing just before drifting off to sleep or during relaxation exercises such as the loving touch birth relaxation technique.
Deep breathing is a wonderful breathing technique for the latter part of early labor when distraction alone is no longer an effective way to work with contractions, but the labor pattern is not yet considered active. Contractions at this stage are very painful, but do not necessarily elicit responses such as vocalizing or rocking. Deep breathing as labor intensifies helps mom remain confident and calm and helps her find her rhythm or get into a zone. For some women, deep breathing is a fabulous tool throughout active labor as well. It is often combined with the use of water therapy. Deep breathing is also a great breathing technique for labor after discussions or procedures that distract mom. A period of deep breathing helps her settle back into the labor process. A modification of deep breathing is to simply focus on slowing down the rate of breathing. This is useful anytime mom’s breathing becomes rapid or fast and shallow and she is at risk of panicking, feeling overwhelmed, or hyperventilating.
The cleansing breath is a breath in which you release all of your air completely. Typically, some air is retained after each breath. With a cleansing breath you release this normally held air as well.
Cleansing breaths are particularly useful as you sense that a contraction is approaching, or as one ends. Coinciding with the breath, you also release all body tension, allowing your muscles to be soft and relaxed. Doing this before a contraction helps you remain open and loose during a contraction rather than bracing yourself, and at the end of a contraction, a cleansing breath helps you release any tension that entered as you went through the peak intensity. Cleansing breaths are useful throughout the active stage of labor, and anytime one needs to release strong emotions or regroup.
Pursed Lip Breathing or Straw Breathing
Pursed lip breathing is sometimes called straw breathing because you can imagine that you have your lips pursed around a straw in order to blow forcefully through the straw. Pursed lip breathing is useful during a very intense, fast birth. The intensity of the blowing is a helpful coping tool and the tight posture of the lips will actually cause resistance in the pelvic floor which may help slow the decent of the baby. This technique is rarely needed with first babies but is often helpful during transition or pushing with subsequent babies.
Hee breathing is similar to pursed lip breathing in that it is an intense breath useful for coping with the strongest stages of labor. The difference is that unlike the tight posture of the pursed lip breathing, the upward corners of the mouth formed when making the “hee” sound will encourage a nice release of the muscles in the pelvic floor, thereby encouraging opening of the pelvis rather than resistance. This is a great breath for handling intensity while also encouraging decent of the baby.
When using “horse lips” you loosly puff lips and allow them to flap as air is exhaled. Horse lips are useful anytime mom is resisting an urge to push while also helping her cervix, pelvic floor, or perineum open for birth. The most common times for its use are either when mom has a strong urge to push when there is still a centimeter of cervix left or to back-off from the strong desire to push with force as the baby’s head is crowning.
Patterned breathing is a pain coping technique using the principle of distraction. Bringing intense focus to the breath helps distract from the pain of childbirth. Patterned breathing can be initiated on your own or with the help of a coach with whom you can make eye contact and follow along. Patterned breathing can be a helpful breathing technique if someone feels panicked. This is a surefire way for birth companions to step in and take a strong coaching role to get mom through an intense moment.
Patterned breathing can also be a way, unfortunately, to try to force moms to control their vocalizations. If what you really want is to let out a loud bellowing vocalization, or even a primal scream, I say go for it! Show the world your birthing power! Vocalization is usually a more empowering and natural response to labor because you are embodying the elemental force of birth rather than attempting to control or keep-at-bay the incredible energy of contractions. Whatever feels best for you is the best thing to do! Use patterned breathing if it helps you, but not to please others.
Re-breathing is a technique that allows you to re-breath the air you have just expelled, thereby taking in a higher ratio of carbon dioxide to oxygen. You simply place something over the mouth to catch the exhaled air, and then draw this exhaled air back in with the inhale. Your own hands or your partners hands are usually enough. A bowl or a cupped sheet of paper can also be used, as can the classic paper bag. In the hospital an Oxygen mask is usually available, though for re-breathing you do not connect it to an oxygen source, but rather just use the mask to catch your exhaled air. Re-breathing is used when mom is hyperventilating. Sometimes hyperventilation can be controlled by slowing the breathing rate or being sure to fully exhale before breathing in. Those techniques are usually preferable to re-breathing. Sometimes those techniques alone don’t work, and re-breathing is very helpful. Signs that you may benefit from re-breathing include tingly finger tips, tingly lips or face, and feeling light headed. Try to slow your breath along with the re-breathing technique.