Breathing often reflects our state of relaxation or excitation. When at rest, breathing is usually slow and rhythmic, (such as when asleep). When tense, breathing may be erratic, or we may hold our breath. Controlling breathing may help you become aware of your state so you can stay relaxed. Breathing techniques are helpful to many women in labor. 

The theory behind childbirth breathing patterns is based on the concentration required to focus on your breathing. During a contraction, your thought process is redirected from a pain response such as tension and breath holding to a learned relaxed breathing response. The successful development of a relaxed response to painful stimuli is most effective through a lot of practice.

Allow your body to relax as completely as possible and work with the contractions while using the breathing and relaxation techniques. There is no right or wrong way to breathe. The breathing techniques are only guidelines and should be adapted to your individual preference and comfort.

Guidelines for Breathing Techniques

Begin focusing on your breathing when you feel you need help relaxing or can no longer walk or talk through a contraction. For many women, this may be hours into labor. Your breathing should be at a comfortable rate and not cause you to feel short of breath or light-headed.

Your breathing style should be your own. The breath may be taken in and out of your nose or mouth, or in your nose and out your mouth. The key is to have the breathing feel natural, relaxed and even. 

Each of the breathing techniques has two common features: a cleansing breath and a focal point.

Cleansing Breath

The use of a cleansing breath before and after every contraction is important. It is an exaggerated, deep breath, usually done by breathing in through the nose and out through the mouth. The purposes of this breath are to:

• Allow for increased oxygen to the baby
• Internally signal you that a contraction is beginning and to remind you to begin concentrating on breathing, focusing, and relaxing.
• Externally signal your partner and anyone else assisting with the labor that a contraction is beginning. They can then offer assistance, such as a back massage or verbal encouragement.
• Allow for blowing off residual tension after a contraction is over.
• Give your baby a boost of oxygen at the end of the contraction.

Focal Point

The use of a focal point will help enhance your relaxation and increase your concentration during a contraction. An internal focal point, such as a peaceful scene or serene setting may work well for some; others may find that they need to concentrate on an object in the room or the partner's eyes. This focus may change during labor, as contractions gain strength. Practice using different focal points that enhance your contraction and help eliminate distractions. (Note: a clock is not used as a focal point).

• Allow the breathing to continue on its own quietly, easily, and evenly. Concentrate on letting yourself completely relax and let your body go limp with each exhale. Picture a rag doll.
• Your body may begin to feel warm and heavy.
• When ready to rouse yourself, breathe in deeply, stretching arms and legs, as you exhale.

Slow Paced Breathing

• Take a "cleansing" breath at the beginning of a contraction
• Continue to breathe evenly in and out with slow,easy abdominal breathing.
• Pace is approximately half your normal respiratory rate.
• You may use Attention Focusing strategies such as:
  • Inhalation/exhalation through nose
  • Inhalation/exhalation through mouth
  • Counting rhythms, imagery, affirming phrases, etc.Movement, stroking, massage, tapping, etc.
  • A visual focal point
• As contraction ends, take a "cleansing" breath, breathing out slowly, and relaxing completely.

Modified Paced Breathing

• Easy, rhythmical breathing with a frequency of approximately twice your normal respiratory rate.
• Relaxed movement in chest and abdomen with more use of intercostal (chest) muscle.
• Use as needed for more challenging contractions
• Use same steady rate throughout contraction or use attention focusing strategies as needed.

Patterned Paced Breathing

• Even, rhymthmical breathing approximately twice your normal respiratory rate.
• Breathing pattern does not change rate or volume of air exchange.
• Pattern 3 breath/1 "blow"
• Use Attention Focusing strategies as needed.

Variations of Patterned Paced Breathing

• Pattern can be from 1 breath/1 blow to 6 breaths/1 blow.
• Can use Patterned Paced breathing in 1 breath/1 blow (He/Who)
• Try pattern of 5/1, 4/1, 3/1, 2/1, 1/1, 2/1, 3/1, 4/1, 5/1
• Combine paced breathing techniques in one contraction.
• Use attention focusing strategies as needed.