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Birth Doulas

Maximizing the Power of your Breath in Labor

By Meredith Ashton Cohen

I approached my first birth excited and engaged in the process and largely “muscled” my way through labor. I said to myself, “I am doing this!” and while my body progressed naturally (without intervention), I forced it along with gumption and energy to “make it happen.” My breathing was a series of pants and forceful exhales, I marched my feet through my contractions or forcefully swished my hips in the bathtub relying on rhythm to ease the intensity. My movement during labor came from my doula training and experience thus far, I knew how to “do birth” in my mind, but I failed to simply tune in to my body and respond accordingly. 

Meredith in labor with her 1st child.

As my second pregnancy progressed I picked up Marie Mongan’s Hypnobirthing book for the first time. I came to the breathing techniques chapter and read this passage, “…when your uterus surges, it rises. Slow breathing helps you to work in concert with that upward movement of the uterus as you breathe your abdomen up to the highest possible height–like filling an inner balloon. This maximizes the wave of vertical muscles, causing them to work more efficiently in drawing up the lower circular muscles, and thinning and opening the cervix. The assist that this gives to both sets of muscles shortens the length of the surge, as well as the length of labor.” (124)

Meredith laboring with her 2nd child.

Could I really create a shorter, easier labor/delivery by simply breathing? The scientific piece of aligning with my uterine muscles for maximum efficiency combined with the possibility of a shorter, easier birth intrigued me and I decided to put it to the test. For my second  birth the only thing I was going to do was breathe. I wasn’t going to waste any energy “doing birth” or “making it happen,” I was going to match my breathing with my contractions the best I could and surrender all else. Surrender every muscle and simply support my uterus to do its thing. 

The proof is in the pudding. I did in fact create a shorter, easier birth the second time around with a baby who was two pounds heavier. My second labor was five hours total (11 hours shorter than my first) and pushing went from 2.5 hours to ten minutes! I came away from my second birth experience with questions and curiosity about why the process worked so well. It was these questions that propelled me a little further into the anatomy of the uterus and science of labor. 

Below are two illustrations of the uterine muscle fiber patterns. As you can see, the myometrium, the muscular layer of the uterus, has three variations of muscle fibers; longitudinal, figure-eight, and circular.

During contractions, the muscle fibers at the top of the uterus (fundus) get shorter and thicker, while the muscle fibers at the bottom of the uterus lengthen and move up. This all corresponds with the baby moving down towards the birth canal. YouTube: Mini Lesson 002: The Uterus in Action illustrates this well. 

Since “Oxygen is the most important fuel for the working muscles in the uterus.” Hypnobirthing 123, the best way to support the uterus is to inhale as it contracts and take in as much breath as possible, as slow as possible–oxygenating muscle fibers and baby, followed up with a slow exhale. The way to do this and maximize lung capacity is through abdominal breathing. Abdominal breathing has many names: slow breathing, belly breathing, diaphragmatic breathing, Ujjayi/Yoga breathing, etc. The concept is the same, using the diaphragm to inhale and expand the belly and allowing the belly to shrink with the exhale, it is slow and controlled. This method of breathing fills the belly rather than causing the shoulders to move up and down. When breathing makes the shoulders move, it is shallow breathing that uses only the upper lobes of the lungs while abdominal breathing maximizes all five lobes of the lungs.

During labor, researchers suggest that breathing for pain relief works by interrupting the transmission of pain signals by providing something positive to focus on. It may also release endorphins, and help the laboring person reframe their thinking about labor to be positive, productive, and manageable.

Like most things from Mother Nature, one gift has multiple remedies. Breathing is no different. In addition to transforming how we engage in delivering our babies, Rebecca Dekker of Evidence Based Birth reports in her article Breathing for Pain Relief during Labor, “Electroencephalography (EEG) studies on this type of abdominal breathing have found that even just a few minutes of using this type of breathing alters your brainwaves in a positive way, increases your relaxation response, decreases your stress hormones, decreases your blood pressure, and increases your oxygen levels.”

Inside the birth community we talk about the importance of breath and breathing through labor, but I want to emphasize that when we use it to support the uterus, we transform it from a nice thought in to a powerful tool for faster, easier labors. And we are in the business of supporting faster, easier labors. 

Resources:

Evidence Based Birth, Breathing for Pain Relief during Labor

Stress Management: Breathing Exercises for Relaxation

Clinical Anatomy and Physiology of Female Reproductive System. Assessment and health promotion. 

Layers of myometrium showing the three layers of smooth muscle fiber

YouTube: Woman Explains Contractions with a Balloon

YouTube: Mini Lesson 002: The Uterus in Action

Take a Deep Breath

Hypnobirthing by Marie Mongan

About Meredith:

Meredith Ashton Cohen CD(DONA), is a birth doula who specializes in supporting unmedicated births using Hypnobirthing techniques to create efficient and positive outcomes. She is passionate about educating and “holding space” for each birthing person, baby, and birth partner to find connection during the pregnancy/birth process for a faster, easier, more comfortable birthing experience.