Breathing techniques are important to learn and practice during the child bearing process. This activity can help the mother to have an easier session during delivery. The following is an educational brochure to highlight the different breathing exercises that can be used. Family members, friends and spouses can practice this exercises prior to the delivery date. Expectant mothers may also practice the techniques in pairs during training sessions. This will make it easier to apply during active labour. There are several types of breathing techniques. They include cleaning breath, paced breathing, open mouth breathing and finally silent breath in and loud out breathing.
The target population for this brochure are expectant mothers and their partners. Staff who provide pre-natal care are also included in this target. They have the potential to reach more people and have a greater impact. The support person should take this exercises seriously as they will be required to remind the patient on what to do during this period. It is therefore, important to provide an additional copy for the support person. Including them in the breathing techniques will also be good practice.
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Tips for Effective Application of Breathing Techniques
To avoid a dry mouth during the breathing exercises, one should place the tip of their tongue on the roof of the mouth just behind the teeth.
Sipping on small amounts of water will help to keep the mouth hydrated despite the frequent inhalation and exhalation. Chapstick can also lubricate the lips.
It is important to pause or take a break between breathing exercises in order to avoid feeling light headed.
If the mouth begins to feel too unclean ,brush your teeth or gargle the mouth with mouth wash.
Practice these breathing exercises before you need them in order to master the techniques that are unique to each type.
Always listen to the responses coming from your body and adjust your exercises accordingly.
Types of Breathing Techniques
The Cleaning Breath Technique
The cleaning breath technique is beneficial in increasing the efficiency of the lungs. It is one of the techniques that is foundational to apply during active labour. The technique promotes the functioning of the lungs and makes it easier for the diaphragm to maintain its elasticity and spring. The exercise is recommended during, before and after pregnancy as it boosts the quality of breathing.
The technique can be executed in two ways. First by inhaling through pursed lips. This exercise is carried out when the mouth is closed to concentrate on multiple inhalations, while only one exhalation will serve the session. This keeps the airways open for longer than the normal inhalation and injects more oxygen into the lungs. This is an ideal way to get extra energy to function. Pregnant women can benefit from this technique especially in the first and last trimester. The second execution of the technique is through deep breathing exercises. These are done while sitting down. Deep breathes are then taken in with effort being made to involve the stomach muscles. One should hold the breath until when there is a feeling of saturation. When it is impossible to inhale any further, then it is time to let out breathe. This is similar to the pursed lips technique because both result in increased oxygen uptake. The technique can be done prior to active labour while the contractions are still far apart.
Paced Breathing Technique
Paced breathing helps a woman in active labour to manage her pain. The breathing exercises can help in keeping the pain at a level that is tolerable for the labouring mother. This exercises are also called patterned breathing because of the alternating and programmed depths and durations of breathing rates. The breathing technique works by providing a calming and relaxing experience for the mother in active labour. The process is also used as a coping mechanism to tackle anxiety, depression, fear and panic. When the exercise is well done, it gives the labouring woman a sense of control over her experience. The woman can also pace her breathing to power each contraction and make it more productive.
Paced breathing can be done in a systematic way.The breathes should match the physical state and be adjusted during each changing stage of labour or pain A woman should begin her exercises by taking in shallow breathes. This can be practiced before delivery and applied in case of a physical disturbance such as a headache. Rickard et al. (2015), further argue that shallow breathes should also be let out after a duration of 3-5 seconds. When the slow breathes are no longer effective, then the pace is picked up. The breathing should now be deeper. It should mimic a big sigh. It is okay to make some sounds at this point. The long deep breathe should then be let out. The breathing should release the tension in the body. An indicator that it is being done well is that the entire body should be stiff as the breathe is exhaled.
The next elevated pace should be slow like the first one. One should take a slow shallow breathe through the nose and then let the air out through the mouth. This efforts should be targeted and focused on the air flow, such that the patient can consciously feel when the body is ready for another shallow or deep breathe. The exhaling process should also be done with an aim to control the body and relaxing a different sections every time.
The paced breathing should be switched up continously to match the needs of the body. The above repetitions may not be as effective during advanced labour so at this point, the needs will change again. The intensity of the contractions guides the breathing technique. When the contractions are greater, the breathing should be more gentle. This is ideal in order to preserve the strength for pushing and to focus the exhalation towards contractions. The breathes inhaled should be short and shallow while those exhaled should longer. Breathes should be paced at one second intervals unlike the longer breathes practiced before (Rickard et al., 2015).
Silent Breath in and Loud out Breathing Technique
At this stage of labour, it is important to change the breathing technique to match the body's requirements. The new technique that can be applied is the Silent breath in and the Loud out breathing. According to Rickard et al. (2015), the technique is used during intense labour when the woman feels that she is overwhelmed. It can also be used during initial stages when a mother experiences fear or panic attacks. It is an excellent exercise go apply during the last stages of labour. It removes focus on the exhaustion that characterises the final child bearing process. This activity helps the body to focus the energy reserves constructively. The technique is also called variable breathing or pant pant blow hee-hee-who breathing.
Each breath should match the contractions as they come in. The contractions should be accompanied by a deep breathe as it begins. The exhalation breathe should then release the tension. The woman should use this opportunity to tense and relaxing her muscles. The inhalation breathe should be slow and silent to allow more oxygen into her system while the exhalation breathe should be loud while the muscle contract. This repetitions should continue as the patient experiences each contraction. The aim is to power each contraction with an influx of oxygen then to let out the tension through the loud exhalation process.
This exercises may be harder to do during this stage because of the intensity of the contractions. There are a few practices that can help the woman get her concentration back. First ,the woman may look at something else in the room to distract her from the pain. A good focal point may be the person supporting her in the delivery room such as the spouse or relative. A painting or any other wall hanging may also present a good distraction. While looking at this focal point, the woman may then take quick shallow breathes to begin the exercise. The breathes should be numbered between 5-20 during a 10 second interval. This should be programmed to start at the same time as the contractions. As the intensity of the contractions increases, it may be tempting to breathe erratically. However, the breathing should remain programmed and controlled so as to aid the child bearing process (Rickard et al., 2015).
Out of the 20 breathes per interval, the breathing should be punctuated by a longer exhaled at the 5th breath. This longer exhale should be followed by a woo sound or a puh sound. This verbalisation is important as it prolongs the exhalation and releases the tension. Additional breathing repetitions should continue as the patient goes through the entire course of labour. The periods in between labour 11be marked by taking in one or two deep breathes to enhance relaxation and rest.
The next breathing exercises should focus on the baby. Each of the following breathing exercises should now be guided by the expulsive nature of the final contractions. This can be characterised by breathing techniques that help the baby to descend. Each breathe should be like a loud sigh. It should accompany the contractions that are now much closer together. The breathing exercises at this stage are called open mouth breathing or expulsion breathing. There is no particular structure to this exercises as the body will ultimately guide itself on this path. The breathing should be lightened or accelerated according to the body's needs. Between pushing exertions, the breathing can be exhaled. It is important to hold the breath in and release air slowly by panting or groaning as the baby is slowly expelled from the body. Releasing the breath every 5 or 10 seconds can help provide more oxygen to the lungs and make it easier to continue pushing.
Open Mouth Breathing
This technique is applied during the last stage of delivery. By now the baby has crowned and is probably partially on the way out. It will be harder to control breathing techniques here. Using a focal point or concentrating on the birth partner who is assisting will help through this stage. It will take personal discipline to refrain from taking in depth breaths as the urge to push will still be present. However, since the baby only requires gentle nudging at this stage, the breathing should be gentle as well. The breathing should be controlled into short gasps and releases. It can be compared to the panting of a dog at rest or while trying to cool down. The process should be repeated so that the baby is able to ease out of the mother's body gently. Once the baby is out, shallow gentle breathes will assist the mother to return her heart rate to normal.
The following signature sheet will be used to track the training of patients and their supporting members during pre natal clinical visits.
| DATE | NAME OF PATIENT | BREATHING TECHNIQUE 1 | BREATHING TECHNIQUE 2 | BREATHING TECHNIQUE 3 | BREATHING TECHNIQUE 4 |
References
Rickard, K. B., Dunn, D. J., & Brouch, V. M. (2015). Breathing Techniques Associated With Improved Health Outcomes.
