October 13, 2009

Breathing for Labor, A Yogic Point of View

I am going to go out on a limb and say: “I strongly believe the best breathing for labor is deep-belly breathing!” There, I said it. This may upset some, or contradict what others believe and what some childbirth educators are teaching. However, from my experience as a labor support doula, this is what I have seen work best. The days of the Lamaze hee-hee-hoo breathing is (thankfully!) falling into the past. Now, I say this with great respect to Lamaze International, being a member and certified Lamaze teacher myself. When I took a certification course 3 years ago, my teacher explained that Lamaze no longer teaches that method.

The reason I like deep-belly breathing is because it helps move the body into the action of the parasympathetic nervous system. The autonomic nervous system (ANS) is divided into two parts: the sympathetic nervous system (the fight-or-flight response), and the parasympathetic nervous system (the rest-and-relax response). The body responds to the parasympathetic nervous system by slowing the heart rate and decreasing blood pressure while increasing the release of endorphins.

I admit that my experience can be considered biased, since my doula clients are also primarily my prenatal yoga students – these women already have a relationship to deep breathing. One reason prenatal vinyasa yoga is so conducive to teaching expectant moms how to connect to the breath is because it encourages them to link breath and movement. This helps to create a mindful connection to the breath; even if they are in a stationary position, they will have a memory of their own relationship to their breath. When the mother is dealing with the growing pain of a contraction, she has the imprinted memory of connecting to her breath and trying to relax her mind and body.

There may be times during labor – the transition period, resisting the urge to push, the pushing stage, or as the baby’s head is crowning – when deep breathing is challenging. The breath may end up short and shallow, blown out, or what I call “defused breath.” However, if the intention is still to try and take a deep breath, even though it may not come to fruition, the mother gains the benefits of it, as opposed to consciously taking shallow breaths that may not be as helpful, and may cause additional tension.

I have found that patterned or coached breathing, which can have a positive effect by creating a helpful distraction, can also cause short, shallow breathing, and potentially hyperventilation, muscle tension, and anxiety. I believe there are more beneficial ways to distract from the sensation of the contraction. Some women like to count their breaths: 4 counts to inhale, 4 counts to exhale, and so forth. This type of breathing is often used in yoga, called sama vritti pranayamaor even-fluctuation breathing . The individual still receives the helpful effects of deep breathing while finding a distraction or focal point within the breath.

Another benefit to the deep-breathing method is figuring out what part of the breath you need to facilitate. By this I mean that you can use the breath differently depending on the task at hand. When faced with a challenging situation where you may need a little more energy, focusing on the inhale can provide you with more energy or prana. This is called the inhalation, (puraka) which stimulates the body. The other side of the breath is the exhalation (rechak), which cools and relaxes the body and mind. Particularly in labor, this may be useful in reminding moms that instead of tightening their body when feeling a lot of sensation, they can use the exhalation to try and surrender to the discomfort. *Please remember that in traditional pranayama there would be a third part to the breathing, the breath retention (kumbhaka), which is not appropriate during pregnancy.

I also teach a variation of viloma breathing, or 3-part breathing, in class. One of the PYC teachers, Michelle, reported that she used this technique while in labor with her daughter. Here, the pranayama is executed by breathing into the belly, then drawing a little more breath into the ribcage, allowing the ribs to widen all the way up to the collarbone. Exhale from the top downward, let the air out from the ribcage, allow the ribs to slide closer together and the belly to deflate, gently drawing the navel towards the spine. The benefits are similar to those of other deep-breathing techniques which, while calming the mind and relaxing the body, slow the heart rate and have a calming effect on the central nervous system. They also oxygenate the blood and purge the lungs of residual carbon dioxide.

Another technique to explore is exhaling with vocalization. hmmm…ahhh…oooh…shhhh Again, this encourages a commitment to a long, deep inhale and long, slow exhale. The benefit of adding a vocalized sound is that the listener can hear the quality of the voice and notice if the throat is constricted or open. (This goes back to my favorite saying: “Open throat, open vagina”!)

However much I believe in the benefits of deep breathing, it is really up to the individual to discover what breathing techniques are most effective at a given moment. You may find yourself jumping between several techniques and discovering usefulness for each at different times of your labor. The most important thing is to commit to your breath and trust that it will help you.




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