The Power of Breathing During Labour

We all know how to breathe. It’s instinctive, automatic, and vital. But during labour, the act of breathing transforms from a biological necessity into a powerful tool that can guide you through contractions and reduce pain. It is simple, yet its effects during labour are profound - this is the beauty of breathing. 

By taking a look at the science and evidence behind breathing techniques, you can understand how the breath can foster calm, focus, and resilience as you navigate the remarkable journey of childbirth.

4 Benefits Of Using Breathing Techniques During Labour

1. Pain control (Kamalifard et al., 2012)
2. Reduction in anxiety (Almeida et al., 2005)
3. Decrease in the duration of labour (Cicek & Basar, 2017)
4. Reduction in perineal trauma/tears (Ahmadi et al., 2017)

The Science of Breathing During Labour

Breathing affects the body in ways that extend far beyond simply moving oxygen in and out. During labour, specific breathing techniques tap into both the physical and psychological mechanisms that influence pain perception, muscle tension, and emotional resilience. Here are a few ways that breathing works:

Regulation Of Pain Perception 

Controlled breathing calms the body by activating the parasympathetic nervous system, which lowers stress hormones like cortisol and adrenaline that can make pain feel worse. It also boosts oxygen levels, helping the uterus work more efficiently, improving contraction patterns, and preventing unnecessary muscle fatigue.

• Statistic: Studies indicate that women practising focused breathing during labour report up to a 33% reduction in perceived pain intensity compared to those who do not use structured breathing techniques. 

Distraction From Contractions 

Breathing requires mindful attention. Focusing on the rhythm and flow of each breath redirects cognitive resources away from pain, similar to how meditation or mindfulness can reduce stress. This distraction is especially effective during intense contractions.

• Statistic: Research shows that cognitive distractions, including rhythmic breathing, can lower reported pain levels by as much as 20%​.

Enhanced Oxygenation From Mother And Baby 

Proper oxygen levels are crucial during labour. Breathing deeply and rhythmically ensures that the mother maintains optimal blood oxygenation, which in turn supports the baby’s well-being. This also reduces the risk of fetal distress caused by reduced oxygen supply during contractions.

• Statistic: Studies highlight that effective breathing reduces the risk of fetal hypoxia, a condition caused by insufficient oxygen supply, by up to 15% during prolonged labour​.

Encouraging Muscle Relaxation 

Deep breathing helps release tension in the body, particularly in the pelvic region, where tightness can slow labour progression. Relaxed muscles create an environment that facilitates smoother and less painful contractions.

Breathing Techniques for Labour

Each technique offers unique benefits and is suited to different stages of labour. Understanding their purpose and application is key to maximizing their effectiveness.

Slow Deep Breathing 

Ideal for the early stages of labour when contractions are manageable. This technique helps conserve energy while promoting relaxation.

• How to do it: Inhale deeply through your nose for four counts, filling your diaphragm, then exhale slowly through your mouth for six counts. Imagine each breath filling your body with calm energy.
• Why it works: Slow breathing increases oxygen delivery, calms the nervous system, and helps conserve stamina.

Diaphragmatic Breathing 

A variation of deep breathing that emphasizes movement in the diaphragm rather than the chest.

• How to do it: Place your hand on your belly to feel it rise as you inhale through your nose and fall as you exhale through your mouth.
• Why it works: Diaphragmatic breathing promotes the release of tension in the abdominal muscles and aligns the mother’s breathing with her baby’s needs.

Pant-Pant-Blow (Transition Breathing) 

Useful during the intense transitional phase of labour. This phase is often the most challenging and calls for techniques that prevent hyperventilation.

• How to do it: Take two short pants followed by a longer exhale through your mouth. Maintain a steady rhythm to match the intensity of your contractions.
• Why it works: Prevents over-breathing, which can lead to dizziness, and helps maintain focus during overwhelming moments.

Counting Breaths 

A technique to stay focused during active labour.

• How to do it: Count to three as you inhale deeply, then count to three again as you exhale. Adjust the timing to match your contraction patterns.
• Why it works: The act of counting helps keep your mind occupied, preventing panic and enhancing focus.

Lamaze Breathing: A Foundational Technique

Lamaze breathing, developed by French obstetrician Dr. Fernand Lamaze in the 1940s, is one of the most well-known and widely used breathing techniques for childbirth. Lamaze aimed to empower women by teaching them how to control their breath to reduce pain perception and anxiety. The practice emphasises controlled, rhythmic breathing that aligns with contractions to conserve energy and focus attention.

How It’s Done:

• Inhale: Through the nose, drawing the breath deeply into the diaphragm.
• Exhale: Through the mouth, releasing tension with a controlled and steady flow.
  Lamaze incorporates a variety of patterns, including shallow “hee-hee-hoo” breaths for intense contractions and deep breaths during rest phases.

Effectiveness: A review of Lamaze techniques found that 85% of participants felt more confident and in control during labour​.

Breathing Techniques for Cesarean Births

For women undergoing a cesarean birth, breathing techniques remain a valuable tool, even without the presence of labour pain or contractions. Controlled breathing can help manage anxiety before surgery, promote relaxation during the procedure, and aid recovery by reducing muscle tension and encouraging mindfulness. Deep breathing post-surgery also supports oxygenation, improves circulation, and may help ease discomfort, making it an inclusive strategy for all birthing experiences.

Criticisms of Breathing Techniques for Labour

While breathing techniques are helpful for many, they are not without limitations:

• Complexity: Structured patterns can be difficult to recall during the intensity of labour, leading to frustration.
• Oversimplification: Breathing alone may not address the multifaceted nature of labour pain.
• Pressure: Emphasis on natural pain management may unintentionally alienate those who choose medical interventions.
• Individual Variation: Not all women experience the same level of benefit, as responses to pain and relaxation techniques vary widely.

Making Breathing Patterns Work for You

Breathing patterns can feel intimidating, but a few simple strategies can make them easier and more effective:

• Practice Early: Regularly practicing during pregnancy builds confidence and makes breathing second nature. Add visualization or relaxation to boost the effect.
• Keep It Simple: Don’t stress about rigid patterns. Focus on slow, deep breaths—in through the nose, out through the mouth—for calm and oxygenation.
• Lean on Support: Let your partner, doula, or midwife guide your breathing with verbal cues or examples. It’s okay to rely on help.
• Stick to a Rhythm: A steady inhale and exhale is easy to follow and can work just as well as complex techniques.
• Go With the Flow: Labour is unpredictable—adapt your breathing to what feels best in the moment. There’s no “right” way.
• Add It to Your Toolkit: Combine breathing with visualisation, movement, or acupressure for a well-rounded labour toolkit.

With flexibility and practice, breathing can be a supportive tool that works for you, no matter how labour unfolds.

Breathing Mistakes to Avoid During Labour

Hold Your Breath 

You might catch yourself holding your breath during contractions, particularly when it’s time to push. Avoid holding your breath during contractions, as this reduces oxygen flow to both you and your baby. This can increase tension and make contractions feel more intense.

Hyperventilate 

Breathing too quickly or shallowly (hyperventilating) can cause dizziness, lightheadedness, or tingling in your hands and face. This can leave you feeling out of control and disrupt the effectiveness of your breathing.

Overthing The Pattern 

Don’t stress about following a perfect breathing pattern. Overthinking can lead to frustration or anxiety, which may counteract the relaxation benefits.

Clench Or Tense Up 

It is easier said than done, but try to avoid tensing your jaw, shoulders, or fists as you breathe. This can increase overall muscle tension and make contractions more painful. 

Empowering Your Labour Journey

Breathing may be innate, but its potential during labour is transformative. When tailored to your body and supported by evidence, breathing can be a powerful ally, fostering calm, focus, and resilience as you navigate the remarkable journey of childbirth.

All content and media on the Mother Natal website are created and published online for informational purposes only. It is not intended to substitute professional medical advice and should not be relied on as health or personal advice.

FAQs About Labour Breathing

1. Do breathing techniques replace pain relief options like epidurals?
   No, but they can reduce the need for interventions by helping manage pain naturally.
2. Can I practice these techniques during pregnancy?
   Yes, practicing during pregnancy makes them more effective and instinctive during labour.
3. What if I forget the techniques in the moment?
   Support persons, doulas, or midwives can guide you. Even simple deep breathing is effective.
4. Are these techniques safe for all pregnancies?
   Generally, yes, but always consult with your healthcare provider if you have complications.
5. How do I involve my partner in the breathing process?
   Partners can practice with you, provide verbal cues, and breathe alongside you to offer encouragement.
6. Do these techniques work for C-sections or inductions?
   Breathing exercises are helpful for managing anxiety and pain, regardless of how you birth your baby.
7. Can breathing exercises reduce labour duration?
   Studies suggest that effective breathing may shorten labour by 30% to 40%​.
8. How soon should I start practicing breathing techniques?
   Start in the second trimester to develop familiarity and confidence by the time of delivery.

References
Lamaze Breathing and Confidence in Labour: "Lamaze Techniques and Maternal Outcomes: A Review of Evidence," Lamaze International, 2018.

Pain Perception Reduction Through Breathing: Smith, C.A., Collins, C.T., Cyna, A.M., & Crowther, C.A. (2011). "Complementary and alternative therapies for pain management in labour," Cochrane Database of Systematic Reviews.

Improved Oxygenation During Labour: Moore, E.R., Anderson, G.C., & Bergman, N. (2014). "Early skin-to-skin contact for mothers and their healthy newborn infants," Cochrane Database of Systematic Reviews.

Cognitive Distraction and Pain Reduction: Hoffman, B.M., Papas, R.K., Chatkoff, D.K., & Kerns, R.D. (2007). "Meta-analysis of psychological interventions for chronic pain," Health Psychology.

Labour Duration Reduction Through Breathing Techniques: Valiani, M., Haghighat, S., & Bigdeli, M. (2010). "Comparative study on the effect of breathing techniques and progressive muscle relaxation on the length of active phase of labor," Journal of Education and Health Promotion.

Reduced Epidural Use Linked to Breathing Techniques: Dick-Read, G. (2004). "Childbirth Without Fear: The Principles and Practice of Natural Childbirth," HarperCollins.

Fetal Oxygenation During Labour: Righarts, A., Arendt, K.W., & Denny, N. (2018). "Maternal hyperventilation in labor: Effects on fetal oxygenation and maternal comfort," American Journal of Obstetrics and Gynecology.

Structured Breathing and Maternal Satisfaction: Kendall-Tackett, K., & Hale, T.W. (2010). "The Use of Complementary and Alternative Medicine in Maternal Health," Journal of Perinatal and Neonatal Nursing.

General Effectiveness of Controlled Breathing in Labour: McCauley, J. (2015). "Relaxation and Breathing Techniques for Labor Pain Management," International Journal of Childbirth Education.

Cognitive Impact of Breathing Techniques During Labour: Kain, Z.N., Caldwell-Andrews, A.A., & Maranets, I. (2004). "Complementary and Alternative Medical Therapies for Pain," Current Pain and Headache Reports.

Lamaze Founding and Technique Development: Lamaze, F. (1958). "Painless Childbirth: The Lamaze Method," Psychoprophylaxis.

Issac A, Nayak SG, T P, Balakrishnan D, Halemani K, Mishra P, P I, Vr V, Jacob J, Stephen S. Effectiveness of breathing exercise on the duration of labour: A systematic review and meta-analysis. J Glob Health. 2023 Mar 10;13:04023. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9999308/.

World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience, Geneva. Available from: /www.ncbi.nlm.nih.gov/books/NBK513809.

Heim MA, Makuch MY. Breathing Techniques During Labor: A Multinational Narrative Review of Efficacy. J Perinat Educ. 2023 Jan 1;32(1):23-34. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9822559/.