Midwifery and birth, NHS

Breathing , visualisation and psychoprophylaxis for labour and birth

Breathing through labour why is it beneficial ? Here’s how I explain it to women I meet
The Cervix
The cervix is an extension and integral part of the uterus – I recall learning about the cervix parrot fashion ‘finger like projection from the uterus’ . I uses the analogy of a ‘balloons tie’ for the cervix – a ‘balloons tie’ is holding in the air – the cervix is maintaining the integrity of the membranes – except it’s tightly closed not tied . The cervix is very vascular and has a mesh of nerves supplying it – hence it is very sensitive rich in blood supply .
A tightening / surge or contraction begins in the pacemaker(top) of the uterus situated close to the fundus and sends the signal down to push the baby’s presenting part onto the cervix which hopefully will cause it to efface and then dilate. This process is faster in subsequent pregnancies and may take hours in the first labour – no one really knows how long anyone’s labour will last-how fast-how slow – but breathing correctly can make a difference to the way it is approached and managed by you (by YOU I mean the woman) A lot of women I meet think they should feel pain high up in their abdomen and when I explain they are quite surprised but delighted.


The pressure of the presenting part on the cervix leads to discomfort and this is due in part to an ischaemic (lack of oxygen) effect on the cervix – for example press hard on the palm of your hand with one finger then watch the skin go white then quickly return to a normal colour – this is capillary refill time – the time when the area is white is when the oxygen and blood supply is diminished . Now imagine that in context to the cervix which is a lot more vascular and nerve enriched than the hand . If a woman learns how to relax through pain and breathe deeply staying calm absolving stress the pain will be reduced . I’m not waffling, I talk and teach women this technique daily. I’ve had comments such as ” how did you do that ?” “Thank you I feel better ” – but in fact I’ve done nothing they have done it all themselves . A major part of breathing is the ‘art of visualisation’ the ability to close your eyes and see in your mind what is happening – this gives focus and assists the woman in the process . I say “if you are saying ‘I’m allowing myself to efface and dilate’ then you are believing more in the process – calmness mindfulness and self-belief will all assist and make the journey less arduous .
Effacement and Dilatation
How to describe dilatation and effacement? You cannot see this body mechanism so I thought of a polo-neck jumper – before it is pulled onto the presenting part(pp) the polo-neck (cervix) is un-effaced , as it is pulled onto the pp the polo-neck(cervix) is starting to efface . As the top of the polo-neck (cervix) reaches the pp dilatation begins

So here is an example of a surge/contraction/tightening

“Your cervical pressure is starting – stay calm focus on your calmness, the beauty of your unborn child and visualise your cervix being pressed and the oxygen you are breathing in rushing to replace the oxygen that is being pressed out – you are fantastic – believe in your body – breathe deep , allow yourself to dilate and relax “think of this like climbing a hill the happiness in your heart you feel as you reach the top (height of surge) then run down (surge reducing) this breaks the discomfort into manageable parts . All the time this is happening it is crucial that there is minimal disturbance 1.no-one entering or leaving room 2. Calm ‘generic’ music with no beat 3. Supporters who believe in the woman 3. Low lights – in other words tranquility – other mammals go to seek out quiet places where they cannot be disturbed and so we as midwives must make this happen for women. Interruptions stop the flow of oxytocin and can lead to an increase in intervention

This technique can be used throughout labour and also with the use of gas and air and is also helpful in a pool or even during a vaginal examination – but I feel that woman should be offered gas and air during examinations must be given the choice to do so.

A happy positive approach to labour and birth as well as intricate and detailed communication will give women strength . Knowledge of her body will give her the ability to entrust in her own body

My son has just asked to read this and said he’s found it interesting and can see that it would work. My inspiration for this blog comes from the women I meet every day that believe in themselves plus their supportive birth partners who take my words on board and continue to support their partners through labour- from the latent phase, right through to the birth of their wondrous children . Also thank you to the student midwives I work with who have encouraged me to write about the way I teach ‘breathing’

Breathe,Relax,Calm,Believe,Visualise and interrupt NOT!

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