Breathing And Relaxation For Labour

         

Ignore Fear Tension pain Syndrome

The uterus is made up of strong muscles whose action causes it to open and let the baby pass first through its opening (cervix), then through the vaginal passage, into the doctor,s hand. Child birth therefore depends largely on the efficient working of the muscles of the uterus and the vagina.

Muscles on our body are of two types, the voluntary muscles and the involuntary muscles.. The voluntary muscles are those over which we have direct control, the muscles of the arms and the legs for instance. Involuntary muscles are those over which we have no direct control, like the muscles of our heart and uterus.

If a women is tense during labor, her uterine muscles will also get tense and perform with great difficulty, because tension in the body is infectious, it passes from one muscles to other. If however she is relaxed, her uterine muscle will work unhampered, and with each contraction they will get closer to complete dilatation of the cervix., so that the women will have a shorter, less painful labor.

This is called the ignorance, fear,tension, pain syndrome. That is ignorance of how the body functions in child birth causes fear of the unknown. Fear causes tension, which in turn leads to rigid abdominal muscles, more pain and longer labor.  Whereas, if you eliminate ignorance by  understanding the physiology of birth, you eliminate the fear of the unknown. Without fear, tension will be absent, leading to easy muscle action, so that your body functions as nature intended it to, without being hampered by tension.

Quick Relaxation in Labor

There are certain points in the body where tension tends to accumulate. If you work at relaxing these points you will quickly achieve relaxation.

1 . Relax your forehead. Stop frowning.

2 . Relax your jaw. A relaxed jaw is a relaxed vagina.

3 . Relax your shoulders.

4 . Relax your elbow. Loosen them and move them away from the body.

5 . Relax your hands.

6 . Relax your feet.

If you find it difficult to relax any of these points, have your partner massage them for you. For instance your partner can massage your shoulders, face or feet, to help you relax. Practice this relaxation daily, so that you use it  with ease during labor.

Each time a contraction is over, go into this relaxation. During a contraction, the uterus is partially deprived of blood and oxygen. Relaxation after the contraction sends a plentiful supply of life giving fluids to uterus. When the body is relaxed, the muscle in the body use  a minimum of energy and oxygen, the blood flow in the body is efficient and a rich supply of oxygen- enriched blood reaches the uterus and the baby, ensuring a healthier and alert baby. Also, using rest of periods between contractions to your maximum advantage will not allow tension to build  up  and accumulate in your body, keeping you relax right through.

When a contraction occur, concentrate on keeping your face relaxed. If you keep your face relaxed , automatically the rest of your body will also remain relaxed. Tension anywhere in the body will show on the face.

Breathing for Labor

Properly regulated breathing during labor will help take away the pain in labor. Breathing has to be practiced regularly before delivery, so that you can sip  into breathing effortlessly when you go into labor.

Conditioned Reflex

Reflexes are instantaneous and involuntary responses to stimuli. There are two types of reflexes. The inborn reflex e.g  blinking to protect eyes from the blow or the conditioned reflex of feeling hungry at mealtimes. Breathing regularly practiced for labor establishes a pathway to the brain which associates breathing with labor. When labor actually sets in  the brain determines the response of breathing.

Breathing Focus

Breathing during labor  brings about a focus of activity of one part of the brain, from where it has a tendency to develop and spread. For instance a pupil paying attention to what a teacher is saying is not aware of noise in the street, because the attention he is paying to the  teacher's lecture localizes the focus of activity in his brain  and becomes surrounded by a zone of inhibition into which all the stimuli from the surrounding noises drain.  In the same way a toothache, which is hardly noticed when one is busy with some important  activity, becomes stabbing during inactivity.

The aim of preparation for labor by learning breathing patterns is to reinforce to its maximum the inhibition of the brain, by bringing about a focus of  breathing activity during labor. The strength of inhibition brought about by your focus on  breathing activity will depend on your strength of your focus on your breathing patterns. This in turn will depend on the work and practice you have put into  the development of this focus. The success of your labor is therefore in your hands.

Breathing Patterns 

Deep cleansing Breath

Before any kind of breathing is practiced, first take a deep cleansing breath. That is you fully fill and empty your stomach. Breathe in deeply through the nose  and sigh out through the mouth. Take this breath at the beginning and at the end of a  breathing practice.

                       

Waist-Level breathing

Place your hands at your waist below your breasts. Breathe in deeply through the nose up to your hands, and breath out slowly through your mouth, as though you are trying to flicker the flame of a burning candle held in arm's length, with the air that you are exhaling. Practice a few times.

Now do your quick relaxation, then practice this breathing for thirty seconds, beginning and ending with a deep cleansing breath.

Count the number of waist level breaths practiced, excluding the deep cleansing breath. The number should be between 4-6. It is more than six you are breathing too fast. Slow down your breathing accordingly.

Chest Level Breathing

Place your hands at your chest, below your collarbone. In  addition, you can have your partner place one hand at the bra level on your back. Now breath in and breath out through your mouth up to your hands, a shallow slow, and gentle breath. So that your mouth does not get dry, place the tip of your tongue on the roof of the mouth. Practice a few times.

Do your quick relaxation. Practice this breathing for thirty seconds, beginning and ending with a deep cleansing breath.Count the number of chest level breaths practiced without the deep cleansing breaths.The number should be between 10-12 breaths. If you exceed twelve breaths, slow down your breathing.

Jaw level breathing "OUT"

The jaw level breathing entails simply saying the word 'OUT' with a stress on the 'T'. Do not worry about your breathing, it will take care of itself as you say the word. Practice a few times. Do your quick relaxation.  Practice the breathing for thirty seconds, beginning and ending with a deep cleansing breath. You can get between twenty and twenty-five breaths in thirty seconds not counting the deep cleansing breaths. If you exceed twenty five breath slow down your breaths.

Precautions

If you ever feel dizzy while doing the breathing practices, cover your nose and mouth with your palm and blow out once. Then breath normally.This will reestablish the proper balance of oxygen and carbon dioxide in your body and relieve dizziness if it is experienced.

Now you are ready to do a breathing practice. Let us imagine you are having a contraction which slowly builds up to a peak and then tapers away.

Breathing Practice 1

Your partners says                                     You do                                                       Duration

Contraction begins             A deep cleansing breath & waist level breathing               15 Sec

It's going stronger              Chest Level Breathing                                                        15 Sec

Still Stronger                     "Out Breathing"                                                                  15 Sec

It's going away                   Chest Level Breathing                                                       15 Sec

Further Away                     Waist Level Breathing                                                        15 sec

It's Gone                             Deep Cleansing Breath   

    

Practice this a few times with verbal instructions.

Then practice with pressure on the wrist. At the inner wrist the nerves are sensitive, and by exerting the pressure on them, we acquaint the nerves with the message that the greater the pressure the shallower the breathing. For instance when you walk you do not breath as shallow as you do when you are running.

In the labor the pressure will not be given on the wrist in this manner. When labor begins, the nerves ends on uterus will send similar messages to the brain as contractions progresses. The brain will automatically respond to greater discomfort with shallower breathing, due to the earlier practice with pressure on the wrist. 

Your partner should hold  your wrist, and exert pressure in accordance with the verbal instructions :

                          

Contraction begins    -   Exert a firm grip on a waist

Its getting stronger   -    Exert a little more pressure

Still stronger            -     Still more pressure

It's gone away          -     Reduce the pressure slightly

Further away            -     Return to a firm grip on a waste

It's gone                   -      Release pressure totally

Practice five rounds of breathing practice once daily. Before you begin do your quick relaxation. After each breathing practice, repeat the relaxation. During the breathing practice keep your face relaxed.

Concentration Breathing

Chose a spot above a eye level, concentrate on it Imagine you see their the image of something beautiful, like a beautiful sunset you might have seen recently or a favorite picture. Concentrate on the image, and leave your mouth open slightly. Breath through your mouth naturally.

Breathing Practice 3

Your Partner says                    You do                                                                  15 Sec

Contraction begins         Deep cleansing breath & Chest level breath                     15 Sec

It's getting stronger         "OUT" Breathing                                                             15 Sec

Still stronger                   Concentration Breathing                                                  15 Sec

It's going away                "OUT" Breathing                                                             15 Sec

Further away                   Chest level breathing                                                       15 Sec

It's gone                           Deep Cleansing Breath

Breathing practice will be used when contractions are stronger. It is to be done with pressure on the wrist as in breathing practice 1.  Do five seconds of breathing practice 2 along with five rounds of breathing practice 1. Remember to do your quick relaxation before you begin, and repeat the relaxation after each breathing practice. You can practice on waking in the morning or before sleeping at night.

In labor you will do whatever breathing you feel like doing. What you eventually use will depend on whether you are naturally a deep or shallow breather; whether your labour is artificially induced or a natural labor.

As a Distraction Breathing

Concentration breathing can be used as a distraction breathing.

If you are been given an internal examination, take a deep cleansing breath, and go into concentration breathing, leaving your pelvic floor muscle  relaxed as when passing urine.

If you are distracted by another patient or a member of the staff or by relatives, go into your concentration breathing.. It will remove you from your  immediate environment and you will not feel disturbed.You can couple your concentration breathing with the other breathing levels, that is as you do waist level, or chest level or OUT Breathing, you can concentrate on your image at the same level.

If you are wheeled into the operation theater and want to take your attention off the frightening equipment around you, concentration breathing will help.

When an injection is been given, or when the drip is been fixed on your arm, do the concentration breathing.

Not Pushing Breathing

The old wives' tale that says that one must push the moment labor begins, is false. Physically pushing out the baby should done only at birth. Before birth, both lips of the cervix have to move away from the baby's head.

Just before the birth of the baby, while one lip could have moved away, the other would still be covering part of the baby's head. If you push pre maturely, it could cause the baby's head  to hit against the unopened lip of the cervix, causing swelling and tenderness.

You might experience a desire to bear down and push the baby out, in the middle of the concentration. It is important to immediately inform the staff how you feel, and not bear down until the staff or the doctor says that you can do so. To avoid bearing down  do the following breathing:

2 shallow pants. Blow

2 shallow pants. Blow

2 shallow pants. Blow

If the urge to push is very strong, you may need to blow out several times in a row, That is 

2 shallow pants. Blow. Blow. Blow

Occasionally, some women who have had induced labor have used this breathing during labor.

Transition

 (Transition from the first stage of labor to the second stage.)  

Transition is an intense period before the birth of a baby. The cervix dilates to a total of ten centimetres to permit the passing of the baby's head. During transition the cervix could be about eight centimetres dilated. That is, the dilatation of the cervix is soon going to be complete, and the expulsion of the baby through the vagina is going to begin. There is soon going to be a  transition from the first stage of labor to the second stage.  The transition can last for ten minutes to an hour or more. It is a sign that  you are almost their.

You might just sail through the transition without feeling a thing. On the other hand you might  feel cold or hot or nauseous during this phase.  This is the time you need the quiet presence of your partner.

During transition your contractions are closest together.  They could come two minutes apart  and can be sharp long ones, lasting a whole minute The 'OUT' and concentration breathing should be most suitable at this stage.  After transition, the contractions again become five minutes apart.

Typical of this stage is the  premature desire to push the baby out. If you push before the cervix is fully dilated, the cervix can become swollen and tender and actually close instead of opening up. The transition can also be characterized  by a negative chance of mood. You might suddenly feel angry or discouraged or helpless or need a pain killer. You might be angry with the hospital set up  or your partner.You might feel discouraged that  having baby in labor  for hours, nothing is happening. You might feel helpless at your situation and your inability to run away from it. A combination of strong contractions and a negative mood swing might tempt you to  ask for a pain killer. This is also the time when  you might be offered a pain killer. Medication at this stage is best avoided, as it can slow down  the birth process and require the use of instruments at birth, that is the use of forceps or use of vacuum extraction.

On other hand if left to her self, the 'physiological' fear experienced by a mother can result in a sudden expulsive reflex, called this the "fetal ejection reflex" If your partner reminds you,'this must be the transition and therefore a sign that  you are at the end of the labor'. It helps some women find the hand squeeze comforting at this stage, whereas others do not like being touched. The unobstructed presence of a partner is most welcome at this stage. This is the time when a women internalizes and knows she has to make a go of it  all by herself. She is with the process her body is undergoing. It is a short and intense phase.

Pushing

When dilatation of the cervix is complete to ten centimetres or five fingers, and the baby is being pushed out  through the birth canal or vagina. The second stage of labor has begin.

At this stage you will be taken to a delivery room. The delivery room has a special table on which you will be made to lie, with your legs apart. Your legs may be supported by a stirrups. Alternatively you will be told to place your legs bent at the knees and your feet placed flat on the table.

When your doctor tells you to push, you do the breathing described below.

During practice, either lie down using two pillows under your head or sit with your back supported by the wall and your legs stretched out in front of you, then take :

One waist level breath (inhale through the nose  up to your waist) and blow out through pursed lips)

A second waist level breath.

During the third waist level breath, after inhaling exhale your breath out very slowly.

While exhaling your breath, release your pelvic floor  as when passing urine. DO NOT physically apply pressure downwards as when you are constipated. This kind of pressure will naturally be applied at actual birth, when the mother will feel natural urge to do so.

During practice and at the time of birth, while exhaling. If you run out of breath, quickly inhale and repeat a long slow exhalation. Continue repetition until the contraction lasts during birth, and four times approximately while practicing. That is :

Take one waist level

Take a second waist level

Take a third waist level. and exhale it out very slowly, (releasing the pelvic floor, like when passing urine, at the same time.

When you run out of breath, breath in and continue exhalation (and release the pelvic floor). Continue repeating this process till the contraction are gone. Do your quick relaxation in between contraction.

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