I have had the absolute joy of giving birth three times. Although I have other secret weapons for labor and delivery, I believe this one is the most important for managing pain, preventing panic or anxiety, and maintaining adequate oxygenation, no matter what type of birth you are planning.
The secret weapon is simple: Your breath.
Over my almost 20 years of practice in physical therapy and women’s health, I have found that the breath is the first line of defense in promoting women’s well-being. Female well-being is perhaps most important during birth. The best vehicle I have found for helping moms harness the grit to give birth (because girls, you ALREADY have the grit, you just need to fully develop it) is yogic breathing.
First: Practice and know Yogic breathing for labor and delivery.
In my own clinical practice I teach expectant (and veteran) moms a concise ‘breathing through birth practice’. It focuses on alveolar ventilation, which is crucial during labor to prevent oxygen deprivation to you and your baby. It also minimizes the “fight or flight” reaction which can cause a mother to panic or have such anxiety that it interferes with healthy birth outcomes. Plus, good breathing will give you a laser-like focus and resolve during the most intense moments (that is also good for later, when your sweet little one gets into trouble).
During labor, I encourage moms to focus on the rate and rhythm of the breath. Slow down your respirations per minute (which is typically around 12 per minute).
Second: Your birth coach should also know the breathing routine.
Even though I teach labor and delivery coaching, I still needed suppport from my husband (and fantastic birth coach) during my sons’ births. Practice your breath routine for the moments where you may forget or lose focus during hard labor or transition (which we all do). This means your husband, doula, and anyone else supporting you during birth. You don’t want them to give you different cues for breathing at critical moments.
Although I cannot teach you the complete breathing program, here are a few tips to remember in practicing breathing for labor and delivery. Remember, the breath not only affects your health, it directly influences your unborn baby’s health as well. Good breathing habits during labor can be one of the key determinants in having the birth you imagine.
Tips for a Better Birth through Breath
1. To learn how to breath, you first must know what improper breathing looks like.
Your belly gets big in the last trimester, and it gets tough to breathe. During my first pregnancy I thought belly breathing might be impossible as I journeyed into my third trimester. And here I was, a breathing “expert!” However, I soon found out that it was a myth.
You CAN belly breath all the way through pregnancy. It just takes practice.
A belly breath is also called a diaphragmatic or abdominal breath. Abdominal breathing is not only possible, it is absolutely necessary. Abdominal breathing helps you maintain your focus and prevent hypoventilation (too little oxygen to you and baby), especially during the most difficult parts, like transition (right before pushing begins).
Poor breathing, also called, shallow, thoracic, chest, or clavicular breathing, “looks” like this:
- On inhale, the chest will heave upwards and expand with little or even reverse (pulling in) expansion in the belly area. A poor breather will breathe through the mouth instead of the nose. The muscles of the neck may pop or stand out when she inhales. The inhale will be short and not very long.
- On exhale, the belly will expand instead of relaxing in a passive drawing in action.
This type of breath does not allow for proper oxygen exchange because it only utilizes the upper portions of the lungs and does not allow for use of the respiratory diaphragm.
2. Know what a proper breath looks like.
The gold standard breath needed during labor and delivery is the belly breath, also called the abdominal or diaphragmatic breath.
- On inhale, the belly expands naturally and without force. This is because the diaphragm must descend and therefore must push the abdominal contents outward. No muscles in the neck, face, or shoulders need to be used to take a breath.
- On exhale, the belly naturally and passively retracts as the diaphragm returns to its original position.
A 2011 review of randomized studies in the International Journal of Obstetrics and Gynecology discourages the use of valsalva (breathing holding) during the pushing phase, citing reduced maternal satisfaction and increased urodynamic (bladder) problems. This means you want to avoid holding the breath at any time during labor and delivery, especially the pushing phase.
During the abdominal breath, primarily breathe through the nose. Avoid adding mouth breathing until an abdominal breath is perfected. Mouth breathing alone can increase anxiety and chest breathing by causing a sympathetic nervous system response. This puts the nervous system in a “fight or flight” condition and can cause hyperventilation, an imbalance of O2 and CO2 in the mother and baby.
After perfecting abdominal breathing, a mom can learn how to breathe through both the nose and mouth at the same time.
More Tips for Best Breathing:
- Watch a baby breathe. Mimic their gentle abdominal expansion during inhale and passive relaxation during exhale. Repeat.
- Slow down your respirations, or breaths, per minute. Try to reduce it to below 12 respirations per minute.
- Equalize your inhale to your exhale. Start with a 3-6 second inhale and a 3-6 second exhale. During my own births, I focused on a long (up to 12 seconds for each inhale and 12 seconds for each exhale), rhythmic (often synchronizing my breath to the music I brought to the birth room) breath.
3. Start a yoga practice.
If you are pregnant and not already a yogini (woman who studies or practices yoga), now is the perfect time to begin. With your doctor or midwife’s approval, you can begin practicing yoga with the help of this post.
Even if you only practice the breath without the poses, yogic breath harnesses the power to prepare you for labor and delivery.
I work with moms on yogic breath practice, starting with abdominal breath during their first trimester. Each 3-4 weeks I add a new technique. By the 37th week, moms can be experts of the breath.
A yogic breathing practice can help you exercise control over their body during birth through the following:
- Decrease fatigue (especially important for labor)
- Increase mental focus (important for entering into the “zone” of concentration)
- Manage pain (perhaps most important, especially since there is such a fear surrounding natural childbirth)
- Control nervous system and hormonal/endocrine regulation (related to depression prevention and birth outcomes)
- Help with easier pushing phase during delivery