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So much has been written about Lamaze Breathing Techniques; So many "Lamaze" classes are run only on the basis of teaching specific breathing patterns to mothers. But, really what is "Lamaze Breathing" all about? Is it required that you attend a class to just learn breathing patterns? The answer is - No. You are already breathing! You will adjust your breathing to the needs of labor, much like you adjust your breathing to climbing stairs or walking fast. That said, slower, deeper breathing as a tool to connect with yourself and your baby during pregnancy. And, slower, deeper breathing to focus into and manage the labor pain, is a valuable tool to have.

When I work with women in Lamaze classes, I look at breathing as a way of connecting themselves to their bodies - a sort of breath awareness. Is the mom stressed? Is she able to relax enough to breathe into her body and into her womb, to her baby? What are the sensations she feels as she lets her body relax and becomes aware of her breath as a life-giver? Is there silence around her? Or is she suddenly becoming acutely aware of sounds around her? Is she able to tune out the sounds of everyday, such as honking and cell-phones? This concentration and focus she has while she breathes is powerful because it lets her take some time in her everyday life, where she can pay attention to all the physical, emotional and spiritual changes that are happening inside of her. Finding a place of peace and stillness, can be crucial as she tries to accomplish this wonderful work.

How does this slower, deeper, more conscious breathing help the mother during pregnancy? Once the mother has worked on her breath awareness on a regular basis during her pregnancy, she finds that it becomes a skill. Penny Simkin talks about "checking in" daily with the body, as well a completing a "roving body check" to find and consciously ease tensions in any part of the body where the mother finds it. I find it very interesting when we do this activity in our Lamaze class, and how mothers and fathers alike are able to consciously find and release the tension in their bodies (and minds) thorugh the simple act of deep breathing! And, it does not take more than 5-6 minutes to do this! When a woman takes time out to "practice" deep breathing and relaxation regularly, she can then use it to relieve or lessen stress, when she has any anxious or stressful moments. It is not about prescriptive breathing - this breathing becomes her "pattern" to relieve stress and provides her with a "comfort" tool.

How does this translate into a helpful labor tool? Labor is a stress on the body. If mother is encouraged, she will moan, groan, sway and use various positions to comfort herself during labor. She will change her breathing pattern and her using rocking and other forms of movement, until she finds her own unique rhythm in labor. As her contractions increase in intensity, she will be helped by nature's narcotics - endorphins - to manage the pain as well. In addition, breathing both during and after contractions will send good oxygenation to her uterus and her baby. Through all of this, the mother will find that breathing can become a wonderful tool to bring herself to a different space of body awareness - to acknowledge and manage her pain - not to run away from it! For most women, this deeper breathing will be effective when used in conjunction with other pain relief modalties such a massage, touch, shower, heat, tub, etc. The wonderful part is that, its rhythmicity will allow it to easily become a ritual for her to manage each contraction!

A word of caution: Unlike what is taught in many "Lamaze" classes, breathing exercises and realxation exercises should not be the only feature of the class. As Judith Lothian says, " Lamaze classes prepare women for a safe, healthy birth by providing the most current, evidence-based information about birth, simplifying birth, and helping women navigate the maze of modern obstetrics. Be wary of “Lamaze” classes that spend a lot of time practicing relaxation and breathing and little or no time building your confidence or discussing how to keep things simple and how to have the safe, healthy birth you want in the birth setting you have chosen."

In the end, there is no "right" or "wrong" way to breathe. Panting, saying "hee hee" or "ha ha", timing your contractions and accordingly modifying your breathing are less likely to be useful when used as a prescription. The only "right" way to breathe is whatever feels right to you! When used with visualizations and other comfort measures, it will let you do whatever you need to do to bring your baby out. The only thing you will need from others is support, encouragement, patience and respect, while you respond to your body's cues as your birth your baby.

How did "breathing" help you in labor? Do write back with your comments and questions.

Happy Birthing!

In 1996, the World Health Organization called for the elimination of unnecessary intervention in childbirth. However, there were few resources to assist maternity care providers achieve this goal. In 2012, three major midwife organizations in the USA (ACNM, MANA and NACPM) came together to create a Physiologic Birth Consensus Statement, to help define normal physiologic birth, and systematically identify factors that would help to provide optimal outcomes for mother and baby.

So, what does this statement put forward?

"A normal physiologic labor and birth is one that is powered by the innate human capacity of mother and fetus."

This birth is more likely to be safe and healthy because there is no unnecessary intervention that disrupts normal physiologic processes. Normal physiologic childbirth

• is characterized by spontaneous onset and progression of labor
• includes biological and physiological conditions that promote effective labor
• results in vaginal birth of infant and placenta
• results in physiological blood loss
• facilitates optimal newborn transition through skin-to-skin contact and keeping mother and infant together in the postpartum period
• supports early initiation of breastfeeding

What disrupts normal physiologic childbirth?

• induction or augmentation of labor
• an unsupportive environment: bright lights, loud voices, lack of privacy, multiple care providers, lack of supportive companions
• deprivation of food and drink
• routine IVs
• artificial time constraints, driven by careprovider or institutional policies
• pain medication, epidurals, etc.
• routine amniotomy and episiotomy
• immediate cord clamping
• seperation of mother and infant
• any situation in which the mother feels threatened or unsupported

While sometimes interventions can save lives during childbirth, why is it so important to try and support an intervention-free physiologic birth, as much as possible?

• Normal birth has both short term and long term benefits for the mother-baby dyad
• The hormones that are released during childbirth, facilitate cardio-respiratory transition and thermo-regulation of the newborn, successful lactation and enhanced bonding
• Normal birth enables the woman to emerge from the experience feeling physically and emotionally healthy and powerful as a mother

Together, these outcomes are beneficial to family and society.

As midwives, we believe that providing excellent antenatal care, information and education to the mother and her family about pregnancy and childbirth, providing continuous and unlimited labor support, physically and emotionally supporting her through the continuum of labor, birth and the post-birth period allow for the best outcomes for both mother and baby. We support normal birth!

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