Patterned Breathing During Labor

Patterned Breathing During Labor: Techniques and Benefits

Patterned breathing refers to the act of breathing at any number of possible rates and depths. Some women prefer breathing deeply, using their diaphragm to fill their abdomen with air. Other women prefer light breathing, inhaling just enough to fill their chest. The goal is to find breathing patterns that have a calming and relaxing effect. Your breathing should be at a comfortable rate and should not cause you to feel short of breath or light-headed.
The more you learn about labor and birth, the more you will see how different patterns of breathing are used at different stages. You will learn about using breathing to focus on making each contraction a productive part of the birthing process. Whether pregnant or not, patterned breathing is helpful in coping with various types of pain, discomfort, anxiety, and fear.

Benefits of practicing patterned breathing

  • Breathing becomes an automatic response to pain
  • The mother remains in a more relaxed state and will respond more positively to the onset of pain
  • The steady rhythm of breathing is calming during labor
  • Provides a sense of well being and control
  • Increased oxygen provides more strength and energy for both the mother and baby
  • Brings purpose to each contraction, making contractions more productive
  • Patterned breathing and relaxation can become techniques for dealing with life’s every day stressors

How to practice patterned breathing

Traffic jams, headaches, and household chores provide opportunities to practice different breathing techniques and make them part of your routine.  To simulate labor, some childbirth educators suggest holding an ice cube in your hand while practicing effective breathing techniques.

How to begin

At the beginning and end of each contraction remember to take a deep, cleansing, relaxing breath. This not only helps sharpen your focus but also provides more oxygen for your baby, your muscles and your uterus.
Breathing patterns for the first stage of labor:

Slow Breathing

Begin slow breathing when contractions are intense enough that you can no longer walk or talk through them without pausing. Use slow breathing for as long as you find it helpful. Switch to another pattern if you become tense and can no longer relax during contractions.

  1. Take an organizing breath, a big sigh as soon as the contraction begins. Release all tension (go limp all over – from head to toe) as you breathe out.
  2. Focus your attention.
  3. Slowly inhale through your nose and exhale through your mouth, allowing all your air to flow out with a sigh. Pause until the air seems to “want” to come in again.
  4. With each exhale, focus on relaxing a different part of your body (see Relaxation Techniques).

Light Accelerated Breathing

Most women feel the need to switch to light breathing at some time during the active phase of labor. Let the intensity of your contractions guide you in deciding if and when to use light breathing. Breathe in and out rapidly through your mouth at about one breath per second. Keep your breathing shallow and light. Your inhalations should be quiet, but your exhalation clearly audible.

  1. Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over – from head to toe) as you breathe out.
  2. Focus your attention.
  3. Inhale slowly through your nose and exhale through your mouth.  Accelerate and lighten your breathing as the contraction increases in intensity. If the contraction peaks early, then you will have to accelerate early in the contraction. It if peaks more gradually, you will work up to peak speed more slowly. Keep your mouth and shoulders relaxed.
  4. As your breathing rate increases toward the peak of your contraction, breathe in and out lightly through your mouth. Keep your breathing shallow and light at a rate of about one breath per second.
  5. As the contraction decreases in intensity, gradually slow your breathing rate, switching back to breathing in through your nose and out through your mouth.
  6. When the contraction ends, take your finishing breath—exhale with a sigh.

Variable (Transition) Breathing

This is a variation of light breathing. It is sometimes referred to as “pant-pant-blow” or “hee-hee-who” breathing. Variable breathing combines light shallow breathing with a periodic longer or more pronounced exhalation. Variable breathing is used in the first stage if you feel overwhelmed, unable to relax, in despair, or exhausted.

  1. Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over – from head to toe) as you breathe out.
  2. Focus your attention on your partner or a focal point, such as a picture.
  3. Breathe through your mouth in light shallow breaths at a rate of 5-20 breaths in 10 seconds, throughout the contraction.
  4. After every second, third, fourth, or fifth breath, blow out a long breath. You might try verbalizing this longer exhale with a “who or “puh.”
  5. When the contraction ends take one or two deep relaxing breaths with a sigh.

Breathing to avoid pushing at the wrong time

There will be times throughout both stages of labor when you will want to push or bear down, but it is not the right time. Most women want to hold their breath during these, particularly difficult moments. Avoid holding your breath by breathing in and out constantly or by raising your chin and blowing or panting. This keeps you from adding to the pushing that your body is already doing.

Breathing patterns for the second stage of labor

Expulsion Breathing

Used once the cervix is fully dilated and the second stage of labor has begun.

  1. Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over – from head to toe) as you breathe out.
  2. Focus on the baby moving down and out, or on another positive image.
  3. Breathe slowly, letting the contraction guide you. Accelerate or lighten your breathing as necessary for comfort. When you cannot resist the urge to push (when it “demands” that you join in), take a big breath, tuck your chin to chest, curl your body and lean forward. Then bear down, while holding your breath or slowly releasing air by grunting or moaning. Most important of all, relax the pelvic floor. Help the baby come down by releasing any tension in the perineum.
  4. After 5-6 seconds, release your breath, then breathe in and out.  When the urge to push takes over join in by bearing down. How hard you push is dictated by your sensation. You will continue in this way until the contraction subsides. The urge to push comes and goes in waves during the contraction. Use these breaks to breathe deeply providing oxygen to your blood and baby.
  5. When the contraction ends, relax your body and take one or two calming breaths.

Tips to help alleviate dry mouth during labor

  • Touch the tip of your tongue to the roof of your mouth just behind your teeth as you breathe. This slightly moistens the air you breathe.
  • With your fingers spread, loosely cover your nose and mouth so that your palm reflects the moisture from your breath.
  • Sip fluids or suck on ice chips between contractions.
  • Periodically brush your teeth or rinse your mouth with mouth wash.

Want to Know More?

Get the Fetal Life App for Apple and Android endorsed by the American Pregnancy Association. It features meal recommendations, kicks counter, blood glucose tracking, and more.

Compiled using information from the following sources:
The Birth Partner Second Ed. Simkin, Penny, P.T., Ch. 4.
Pregnancy, Childbirth, and the Newborn: The Complete Guide Simkin, Penny, P.T., et al, Ch. 7.
Birthing from Within. England, Pam, CNM, MA, and Rob Horowitz, Ph.D., Ch. 38.