Patterned Breathing Exercises For The First And Second Stages Of Labor

Breathing Exercises

Understanding patterned breathing

The main goal of patterned breathing is to have a calming and relaxing effect. This can differ from woman to woman. Some women prefer breathing deeply, using their diaphragm to fill their abdomen with air, while other women prefer light breathing, inhaling just enough air to fill their chest. Often, different patterns of breathing are used during the different stages of labor. Many use their breathing to focus on making each contraction a productive component of the labor and birthing process.

Benefits of patterned breathing during labor

In addition to helping you cope with contractions, patterned breathing during labor can help maximize the amount of oxygen available to your baby and conserve your energy. When you are tense or frightened, your breathing can become rapid and shallow. This is termed ‘panic breathing’ and it results in limited oxygen getting to both you and your baby and can make you feel pretty exhausted rather quickly. Patterned breathing, also known as rhythmic breathing, aims to not only to counteract this reaction but to also improve your birthing experience.

Patterned breathing for the First Stage of labor

Slow breathing

When contractions are intense enough that you cannot walk or talk through them without pausing, it is time to begin slow breathing. If, at any point, you don’t find slow breathing helpful any longer (i.e. you become tense and/or can no longer relax during contractions), switch to another pattern.

Slow breathing involves:

  • Focusing your attention
  • Taking an organizing breath, which is basically a large sigh, as soon as the contraction begins and release all tension as you breathe out
  • Slowly inhale through your nose and exhale through your mouth, again letting the air come out as a sigh; pause until the air seems to ‘want’ to come back in again
  • With each exhale, focus on relaxing a different part of your body

Light accelerated breathing

At some point, depending on the intensity of your contractions, you will probably want to switch to light accelerated breathing during the active phase of labor. This type of breathing involves rapidly breathing in and out at a rate of around one breath per second, keeping your breathing light and shallow. Your inhalations should be quiet but your exhalations should be audible. If you switch to light accelerated breathing:

  • Take an organizing breath, as you have done with slow breathing
  • Focus your attention
  • Inhale slowly through your nose and exhale through your mouth. As the contraction increases in intensity, accelerate and lighten your breathing, all the while trying to match it to how quickly the contraction peaks (in a shorter amount of time or more slowly). Keep your shoulders and mouth relaxed.
  • As your breathing rate increases towards the peak of your contraction, breathe in and out lightly through your mouth, at a rate of about breath per second.
  • As the contraction subsides, gradually slow your breathing rate, switching back to breathing in through your nose and out through your mouth
  • When the contraction ends, take a finishing breath – exhale with a sigh

Variable Breathing (also known as Transition Breathing)

Variable breathing is a variation of light breathing and is sometimes referred to as “hee-hee-who” or “pant-pant-blow” breathing. It combines light shallow breathing with a more periodic more pronounced or longer exhalation. This type of patterned breathing is good to do in the first stage of labor if you are feeling overwhelmed, exhausted, or unable to relax.

  • First, take an organizing breath, as with the other patterned breathing exercises mentioned above
  • Focus your attention on something, such as a picture, or someone, such as your partner
  • During the contraction, breath through your mouth in light shallow breaths at a rate of 5–20 breaths in 10 seconds
  • After every second, third, fourth, or fifth breath, blow out a longer breath – this breath may be verbalized with a “puh” or a “who” sound
  • When the contraction ends, take one or two deep relaxing breaths with a sigh

There will be times during the first stage of labor where you will want to push or bear down but it is not the right time. During these particularly difficult moments, you might want to hold your breath but this is something you should avoid. Breathe in and out constantly or raise your chin and blow and pant. This is so you don’t add to the pushing that your body is already doing.

What is the Second Stage of labor?

Once your cervix is dilated to 10 centimeters, you enter into the Second Stage of labor. This stage consists of pushing and ends with the delivery of your baby. Up until this point, your body has been doing all the work. Now, you will start pushing when you feel the urge. The Second Stage can last between 20 minutes and 2 hours.

Patterned breathing for the Second Stage of labor

The breathing pattern used once the cervix is fully dilated and the Second Stage of labor has begun is called ‘expulsion breathing’.

  • As with the breathing patterns in the First Stage of labor, take an organized breath (a big sigh) as soon as the contraction begins. As you breathe out, release all tension, going limp all over, from your head down to your toes.
  • Focus on the baby moving down and out, or on another positive image
  • Let the contraction guide you; breathe slowly, but accelerate or lighten your breathing to maximize your comfort. When you cannot resist the urge to push, take a big breath, tuck your chin to chest, curl your body and lean forward. Then bear down, while slowly releasing air by grunting or morning, or alternatively you can hold your breath. It is important that while bearing down, you relax the pelvic floor to help the baby to come down.
  • The urge to push come and goes in waves during the contraction. After 5 or 6 seconds, release your breath, and breath in and out. When you again feel the urge to push, bear down once more. Continue in this way until the contraction ends. Use the breaks in between pushing to breathe deeply, in order to provide oxygen to both your baby and your body.

Do I still need to learn patterned breathing techniques if I am planning to have an epidural?

Yes, you do! Most labor and delivery departments will not accept you until your contractions are around 5 minutes apart for over an hour. So, you will want to have breathing and stress release exercises to do before you get to that point. In addition, sometimes an epidural doesn’t work, wears off quickly, or only works for just one part of the body -or sometimes labor comes on so fast that there is no time for an epidural-, so you need to be prepared for all of these scenarios. If you decide to have an epidural, you should wait at least an hour from the time you are fully dilated before you start pushing, unless you get a strong urge to push or your baby’s head is visible.

Melody Watson
Melody Watson holds Bachelors degrees in Biochemistry and Microbiology. She works as a medical writer for a medical communications agency in Berlin, Germany, where her work ranges from medical translation to writing publications for medical journals. Melody is passionate about promoting science, including evidence-based medicine, and debunking pseudoscience.

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