Thursday, May 20, 2010

Labor & Delivery Tips, Part Two

As promised, I would like to elaborate on the breathing program I use for laboring women.

Here is last week's excerpt from Tip #2:

2. Practice and know Yogic breathing for labor and delivery. I have a concise Breathing Through Birth Practice I teach women. It helps with alveolar ventilation, which is crucial during labor; and, it minimizes the fight or flight reaction and helps a mother stay calm and focused. The birth coach should also know the breathing routine, in case you forget or lose focus during hard labor or transition. I will be sharing this routine with you in future blogs.

My complete breathing program will be shared in my upcoming book, Fit & Fearless Birth. However, here is a sneak peek of important points to prepare you for the breath program I use with women during labor.
  1. Know what an improper breath looks like. In order to learn to breathe properly - you first must recognize an improper breath. Our bellies get big in the last trimester, and it gets tough to breathe. I thought that belly breathing might be impossible as I journeyed into my third trimester. And here I was, a breathing "expert!" However, I soon found out that it was a myth. You CAN belly breath all the way through pregnancy. It just takes practice.

    Abdominal breathing is not only possible - it is absolutely necessary. Abdominal breathing allowed me to maintain my mental focus and prevent hypoventilation when my labor become difficult, especially during transition (ouch! - the part right before pushing).

    Shallow breathing is also be called thoracic, chest, or clavicular breathing, and looks like this:

    When the mother inhales the chest will heave and expand, with very little expansion in the belly area. She will perhaps also breathe through the mouth instead of the nose. The muscles of the neck may pop or stand out when she inhales. The inhale will be short and not very long. This type of breath does not allow for proper oxygen exchange since it only utilizes the upper portions of the lungs and does not allow for use of the respiratory diaphragm. It is very self limiting and quite self defeating.

  2. Know what a proper breath looks like. The gold standard breath needed during labor and delivery is the abdominal breath, otherwise called the diaphragmatic breath.

    The abdominal breath looks like this:

    It allows for descent of the diaphragm, or the main muscle of respiration/breathing. When the diaphragm works, the abdomen will naturally expand on an inhale. No muscles in the neck or shoulders will be used to take a deep, full, slow breath. The breath will happen through the nose, and there will be little to no chest rise on the inhale. It is important to avoid breathing through the mouth until an abdominal breath is perfected, as it can overstimulate the nervous system and create anxiety, panic, or hyperventilation.

    Tip: Watch a baby breathe! We can all be perfect baby belly breathers.
    To Practice: The abdominal breath must be mastered before progressing to the rest of my Breathing Through Birth Practice. Download a free abdominal breath instructional practice here.

  3. Start a yoga practice. If you are pregnant and not already a yogini (woman who studies or practices yoga), now is the perfect time to begin. Even if you only practice the breath without the poses, yogic breath harnesses the power to prepare you for labor and delivery.

    A good yoga teacher or therapist can teach you the ujyaii pranayama, or victorious/overcoming breath. This is an instrumental part of my prenatal breathing program. The breath is aptly named, especially for use during labor and delivery!

    The victorious breath I teach, however, is different from the one traditionally taught in yoga. Ayurveda teaches that ujyaii is a heating breath - and moms do not need to create additional heat that would increase maternal or fetal temperature. I teach "non-heating" victorious breath.

    Here is my method for using ujyaii during labor and delivery. To practice:

    • Begin by inhaling through the nose and mouth if possible. To avoid creating heat: inhale through a moistened mouth (wet the lips and teeth with your tongue first) as if sucking air through your teeth. Feel the coolness of that breath.
    • If you have mastered the abdominal breath, you will be able to take this cooling form of victorious breath without getting anxious. The depth of your inhale should last at least 5-6 seconds. Sip the breath in, don't gulp it. The inhale will sound like a "sss" sound. Work up to the longer breath, realizing that it will take some time to master. Be patient with yourself.
    • As you exhale, imagine you are fogging a mirror or making the "haa" sound. Some women prefer the imagery of making your breath sound like a distant ocean. Whatever imagery you prefer, practice this breath until your exhale matches the length of your inhale.
    • Now you can perform the breath entirely through the nose. If that is difficult, continue the mouth/nose method as above. The main point in practicing this breath is to not create the "heat" that the traditional victorious breath creates. The breath should not be vigorous or loud like an angry sizzling fire, but cooling and soft sounding, like a deep sleeping breath.

      This breath increases alveolar ventilation, promotes calm, can assist with improving mental focus, and can decrease sympathetic nervous system input (decrease anxiety, lower blood pressure, and pulse). All of these benefits work together to help you bring your baby into the world and have the birth you envision - one with less pain and without fear.
My complete Labor & Delivery Breath Practice contains a start to finish, step by step program for every stage of your labor. This practice is just a short excerpt from the complete practice.

I work with moms on abdominal breath from their first trimester, and build on that with a new breath technique every 3-4 weeks of pregnancy. By the time moms reach their 37th week, they can be experts of the breath, which will ultimately help them exercise more control over their body during birth through the following: 1) decrease fatigue (especially important for long or difficult labors), 2) increase mental focus, (important for entering into the "zone" of concentration) 3) manage pain, (perhaps most important, especially since there is such a fear surrounding natural childbirth) and 4) help with pushing during delivery.

*Photo was taken just a few days before going into labor with my second son.

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