Comfort measures for labour and birth: breathing, movement and more

Preparing for labour should be a time of anticipation and excitement as you get ready to meet your baby. While contractions can be intense, it is important to remember that the sensations of labour are a normal and healthy part of the birth process. They are purposeful (your uterus needs to contract efficiently for your baby to be born) and they are intermittent, meaning you will have breaks between contractions to rest and recover.

As labour progresses, contractions will generally become stronger, closer together and more intense. Understanding what is happening and knowing how you can respond can help you approach labour with confidence.

There are many different ways you can support yourself through labour. There is no single right approach, so the key is to explore your options during pregnancy and find what works for you.

Breathing through labour

Breathing effectively and efficiently can be beneficial in many aspects of life, including exercise, yoga, swimming and meditation. You may already practise meditation or yoga, but if not, pregnancy is a great time to experiment with different techniques. During labour, conscious breathing can help you relax, maintain focus through distractions and regain a sense of control during physical or emotional stress.

Labour can be a long process, particularly for first-time mothers, so learning different breathing techniques for different stages of labour can be helpful.

One technique to explore is diaphragmatic breathing, where you consciously expand your diaphragm down towards your baby. This can encourage relaxation and help create a calmer internal environment.

Conscious breathing is free, can be used anywhere and at any time during labour, has no side effects for you or your baby, and can complement other coping strategies such as movement. Your partner can also become involved by breathing alongside you, counting your breaths or simply holding your hand.

The best breathing technique is ultimately the one that works for you.

Early or latent labour

During early labour, slow breathing may help you relax and establish a calm rhythm.

As a contraction begins, breathe in slowly through your nose, fully inflating your lungs while relaxing your shoulders, chest and ribcage. Then breathe out through your mouth, consciously releasing tension and relaxing your mouth, jaw and forehead. You may also like to vocalise as you breathe out.

You can practise this slower breathing for up to 90 seconds, which is approximately the length of a strong contraction.

Your partner can support you by breathing with you, counting your breaths, massaging you or simply holding your hand while you focus on relaxation.

Active labour

As contractions become more intense, you may find that light breathing works better than slow breathing.

Focus your attention on the beginning of the contraction and take short, shallow breaths through your mouth, aiming for around five to 10 breaths every 10 seconds. Keep your shoulders and mouth relaxed and maintain a steady rhythm until the contraction ends.

When the contraction finishes, allow yourself to relax completely. Use the break to change positions, have a sip of water or do whatever you need to prepare for the next contraction.

If you feel lightheaded or dizzy while practising light breathing, keep your inhalations quiet and breathe through your nose. This allows your body to adjust to how much air you need rather than forcing air in.

Keep water and lip balm nearby to help with dry lips and throat.

You may also enjoy vocal breathing, using a word, phrase, chant, song or even your baby's name to help establish a rhythm. Your carers and birth support people can join in and help create a positive environment.

You may find that a combination of longer, relaxing breaths and shorter, lighter breaths works best for you.

Breathing while pushing and birthing your baby

When it is time to birth your baby, you will usually feel an uncontrollable urge to push. This is a natural and healthy part of the birth process.

Trust your body and follow its urges to push, breathing in whatever way feels right for you.

As your baby’s head begins to crown, your midwife or healthcare team may ask you to breathe lightly, puff or pant rather than taking strong pushes. This can help your baby’s head advance more slowly and allow the perineum (the skin between the opening of the birth canal and the anus) to stretch as your baby is born.

Focusing on something or someone during this intense stage can also help you stay calm and maintain your breathing rhythm.

There is no single right or wrong way to breathe during labour. If controlled, conscious breathing works well for you in other areas of your life, it may become a valuable coping tool during labour too.

Keep moving

Movement can be a powerful way to respond to your body’s needs during labour. Walking, standing, kneeling, sitting, stretching, dancing or simply rocking can help you find positions that feel comfortable and allow you to work with your contractions.

Moving and changing position can also help your baby move down and rotate into your pelvis. This can help your uterus work efficiently and may support the progress of labour.

You can continue to move during the pushing stage too, finding positions that feel effective and comfortable for you.

Some positions you might like to try include:

• squatting
  
• lunging
• walking
• standing
  
• rocking
• using an exercise ball or birth ball
  
• kneeling on all fours
  
• slow dancing
  
• laying on your side
  

You can alternate between positions throughout labour and respond to what your body is telling you. Your partner can support you with movement, love and encouragement.

A warm bath or shower can also give you an opportunity to relax, feel buoyant and move freely.

For more information on movement, see our blog on Positions and movement for an active birth.

Massage and touch

Massage and touch can be effective ways to help you cope with contractions while also helping you feel loved, supported, reassured and encouraged.

Your partner can play an important role in providing massage, giving them a practical way to feel involved in your labour.

Touch can stimulate the release of oxytocin and endorphins. Oxytocin supports strong contractions, while endorphins act as natural pain relievers to help you cope with the intensity of labour.

Massage can be firm or gentle, depending on what feels right at different stages. You might prefer firm pressure during a contraction and lighter touch between contractions.

You can have massage anywhere that feels comfortable, including your upper or lower back, feet, hands, head or shoulders.

Warm water, heat and cold

The warmth and buoyancy of a bath can provide a relaxing change during labour. Try different positions to find what feels comfortable. The ideal bath temperature is around your normal body temperature, approximately 37°C, to prevent overheating. Ideally, stay in the bath for no longer than 90 minutes at a time.

Showers can also be helpful, particularly if you direct the showerhead onto your lower back during a contraction. Your partner may be able to join you for additional support if there is enough room.

Some St John of God Health Care (SJGHC) hospitals have access to a bath for pain relief during labour. However, certain medical and labour conditions, including continuous fetal monitoring, may mean that you cannot use the bath. Note: SJGHC hospitals do not perform waterbirths.

Heat and cold packs can also provide comfort at different stages of labour. Heat can be particularly helpful for relieving pain in your lower back and abdomen, while a cold pack can provide relief during the second stage of labour when you are working hard during pushing.

Other ways to create comfort

Sometimes it is the small things that can make a big difference. Consider what helps you feel comfortable, safe and focused. It might help you to make a list from A to Z of your comfort measures for reminders when labour begins.

• Music can provide a welcome distraction. You might enjoy dancing through contractions or listening to soothing music to help you relax.
• Stress balls can give you something physical to focus your energy on during a contraction.
• Meditation can help calm your mind. Learning and practising meditation during pregnancy can make it easier to access this relaxation response during labour. Apps such as Mind the Bump, Gentle Birth, Insight Timer and Calm Birth may help you get started.
• Clothing should be whatever makes you feel comfortable and supported. Wear what makes you feel good.
• Food and fluids are also important. Think of labour like running a marathon and, where appropriate, eat small, high-protein and carbohydrate snacks regularly, including a little sugar. Remember to drink water as you need it.
• Affirmations can help you stay positive and focused. You might decorate your birth environment with positive birth statements or words that encourage you through labour.

Find what works for you

Every woman and every labour is different. What feels comforting at the beginning of labour may not feel right later, and you may move between different techniques as your needs change.

The most important thing is to know your options. Practising breathing, movement, meditation or other comfort measures during pregnancy can help you discover what works for you and your birth team.

Your partner and support people can also play an important role, whether that’s through massage, helping you change positions, breathing alongside you, holding your hand or simply offering encouragement.

There is no perfect way to labour. Listen to your body, trust yourself and use the tools that help you feel calm, supported and in control.

You are strong, capable and preparing to do something incredible - meet your baby!

Further information

For further details about antenatal exercise classes available through your local women’s health physiotherapist, speak with your obstetrician or a midwife at your hospital.

References

Lamaze International, How Should I Breathe During Labor?, https://www.lamaze.org/Giving-Birth-with-Confidence/GBWC-Post/how-should-i-breathe-during-labor

Balaskas, J. (1983), Active Birth, Allen & Unwin Pty Ltd, Australia

www.lamaze.org