Sunday, August 11, 2013

Fundamentals of Relaxation Part 5 - Breathing

In spite of the new technology associated with labor and birth, women are still fearful.  Fear may come from hearing stories, reading articles, or simply by not knowing the full truth about the events of the birthing process.  An important aspect of relaxation for fear is breathing.

Any source that addresses fear, stress or anxiety will also address breathing.  Breathing is an effective and easy way to reduce stress and fear by decreasing the body’s reaction to the stress.  Slow, rhythmic breathing has been shown to lower blood pressure, reduce heart rate, and reduce the secretion of stress hormones such as cortisol. Relaxed breathing also balances O2 and CO2 levels and decrease muscle tension.

Behaviors for coping with severe fear of childbirth or SFOC were related to six domains of childbirth education relaxation: concentration or focusing, support from family or doula, breathing, relaxation and perception of control.  Since breathing helps to maintain focus and relaxation and hence perception of control, breathing seems to be a foundational skill to learn.

For decades, Lamaze has taught patterned breathing to offset the intensity of the contractions. Since Lamaze has become as synonymous to breathing as Kleenex is to tissues, many expectant parents come to childbirth class, regardless of the method, to learning breathing.  While Lamaze still offers instruction on breathing, it is not so much how one breathes as that one does breathing effectively.

In a 2011 article in the Journal of Perinatal Education, author Judith Lothian gives these guidelines for using breathing in labor:

  • Breathing is easily subject to conscious control. Therefore, controlled breathing is easy to learn.
  • Slow, deep breathing is particularly effective. The “right” way to breathe is whatever feels right. There are no rules related to how many breaths per minute, whether to breathe through the mouth or nose, or whether to make sounds. The key here is that the breathing is conscious, not automatic.
  • As labor contractions get stronger and the work of labor gets harder, speeding up the breathing and making it shallower is sometimes, but not always, more effective.
  • Focusing on something, either with eyes closed \or open, can help maintain the rhythm of the breathing.
  • Using conscious breathing in everyday life, either to relieve stress or to increase body awareness and mindfulness, is excellent practice for labor. It is an excellent life skill.
  • Conscious breathing works best in combination with many other comfort strategies. In Lamaze classes, women no longer spend large amounts of time practicing breathing. Women move, change position, slow dance, sway on birth balls, learn massage, and identify the countless other ways they normally relax and find comfort. Each of these comfort strategies can be used in combination with breathing.
  • In restrictive environments, breathing may be one of very few comfort strategies available for women in labor. It is one coping strategy that cannot be taken away.

Lothian, J. (2011) Lamaze Breathing: What Every Pregnant Woman Needs to Know.  Journal of Perinatal Education.  20(2), 118-120.

Salomonsson, B.  (2013). Self-efficacy in pregnant women with severe fear of childbirth.  Journal of Obstetrics, Gynecologic and Neonatal Nursing. 42(2): 191-202.

Turankar, A. et al (2013) Effects of slow breathing exercise on cardiovascular functions, pulmonary functions and galvanic skin resistance in healthy human volunteers – a pilot study.  The Indian Journal of Medical Research.  May 137(5): 916-21. 

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