There are three main breathing techniques we can use for breathing during labor! Each breathing technique is tied to a certain phase of labor. There are three stages of labor: the first stage is when the cervix is dilating, and what we usually think of when we think of labor with contractions; the second stage is pushing; the third stage is the placenta being born.
Each breathing technique can be modified depending on your preferences, but this is a general guideline on how to approach each stage.
Early to Active Labor
First Stage of Labor Breathing: Diaphragmatic Breathing
When we are having contractions, the breathing technique that we would recommend is a diaphragmatic breathing pattern. When you inhale, feel the belly and abdomen increase in pressure and stretch. Then, when you exhale, focus on release and letting go just a little bit. Every inhale, feel more pressure and stretching, and every exhale let go just a little bit more.
You’ll repeat this breathing pattern throughout the entire contraction. Then in between contractions, just breathe easy and rest. We can keep our nervous system in a parasympathetic state by having slow, controlled breathing. When we breathe quickly, or with our chest, we can arouse our nervous system into a fight or flight response, which could inhibit labor progress. So, we can focus on a 4-6 count inhalation, and a 4-6 count exhalation, with a small pause at the top of the inhale. We can practice calming our nervous system by focusing on this slow and controlled breathing pattern after exercise or exertion. So, you do your 10 squats, then focus on breathing to calm your heart rate and respiration rate.
We can practice diaphragmatic breathing techniques with different breathing drills, in a variety of positions that we may want to labor in. Breathing drills during pregnancy can also be a great way to prepare the pelvic floor for birth. We offer a monthly pelvic floor prep webinar with our in-house pelvic floor PTs, or you can sign up for a group session with our pelvic floor PTs to overcome any pains you may be having, learn how to breathe, and move the pelvis in prep for birth. We offer in-person and virtual sessions throughout the week.
Here is a video to explain diaphragmatic breathing.
The Second Stage of Labor: Open or Closed Glottis Pushing
The second stage of labor is pushing. When we are pushing, we can do two breathing techniques: open or closed glottis. Neither technique is necessarily better than the other, but you should get to choose which one you do. You may also notice that you do a combination of both! Think about when you use the restroom, you may notice that you do a combination of both breathing techniques while using the restroom. The same also applies to birth.
The glottis is the throat, so the difference between the two breathing techniques is whether or not the throat is closed or open.
Open glottis pushing involves exhaling out as you push, while closed glottis pushing is when you hold your breath to push. In both techniques, inhale as you feel the contraction building. As you inhale, feel the belly and the perineum expand and there should be an increase in downward pressure. Then the difference is in the active pushing portion.
Open Glottis: exhale to continue to bear down with the push. In this technique, the air is leaving the lungs as you increase muscular force downwards to push actively.
Closed Glottis: hold the breath to continue to bear down to push. In this technique, there is no air leaving the lungs as you increase muscular force downwards to push in combination with the increased pressure. This technique could be more stressful for you and your baby, as it is in a deoxygenated state. Ideally, you hold your breath for 6-8 seconds, not a full count of 10.
You can practice this breathing method when you use the restroom and explore both options!
The Second Stage of Labor: Crowning
The final part of the second stage of labor is crowning, or when your baby’s head is being born! We want to slowwwww the push down here so that baby can ease their head out to decrease the risk of tearing.
We can focus on little pushes by decreasing the length of our exhalations to small puffs, pants, or blows. Some helpful cues are to pant with your tongue out or blow out a series of candles. It can be helpful to have your provider let you know when to slow down, but you may intuitively slow the push on your own too.
There are a few different breathing techniques that we can use throughout labor, and we can practice them all before labor even begins! We can incorporate these breathing patterns into our workouts, when we use the restroom, and even just while sitting around. Learn more breathing strategies in our childbirth education courses, and in our upcoming pushing webinar!