Does breathing help with labour pain?

Reviews of relaxation techniques including breathing find some evidence for reduced pain intensity and better satisfaction, with mixed trial quality. It lowers arousal and bracing and gives you something to do — a coping tool rather than analgesia.

Should I hold my breath while pushing?

Current guidance generally favours pushing with your own urge rather than prolonged directed breath-holding, which has been linked with a longer second stage and pelvic floor strain. Follow your midwife's guidance in the room.

When should I start practising?

Now, a few minutes a day. Under high arousal you use what is automatic, and a pattern rehearsed for weeks is automatic in a way that one read on the day never is.

Breathing in labour: what the evidence supports, and what to practise now

You have been told to breathe and given very little detail. You would like to know what to actually do, whether it does anything, and what to practise in the weeks before rather than improvising on the day.

Do this now

The contraction pattern

3 minutes

At the start of a contraction: one slow breath in through the nose, then a long slow breath out through the mouth, with the jaw loose.
Keep the exhale longer than the inhale and let it be audible — a low sound, not a held breath.
Between contractions: breathe normally and let the shoulders drop. The gaps are where recovery happens.
If it becomes intense, shorten the pattern but keep the exhale longer than the inhale. Never hold the breath.
Practise it now, three minutes a day, so it is automatic rather than something to remember.

Run it with a timer

What it does, realistically

Slow breathing through contractions lowers arousal, reduces the muscular bracing that increases pain, gives attention a task with a rhythm, and keeps you from breath-holding. Cochrane reviews of relaxation techniques including breathing in labour find some evidence for reduced pain intensity and improved satisfaction, with the caveat that trial quality is mixed. It is one component of coping rather than an analgesic.

Why holding the breath is the thing to avoid

Breath-holding during contractions raises intra-thoracic pressure and tension, and prolonged holding during pushing — directed Valsalva pushing — has been associated with a longer second stage in some trials and with pelvic floor strain, which is why spontaneous pushing guided by your own urge is now generally preferred. The practical rule for the whole of labour is that air should be moving.

Why practising in advance matters

Under high arousal you do what is automatic, not what you read. A pattern rehearsed for a few minutes a day over several weeks is available in labour; one learned from a leaflet on the day is not. That is the single most useful thing on this page, and it costs three minutes.

What changes it, over a week

Daily, three minutes
The contraction pattern — slow nasal in, long audible mouth out, jaw loose. Rehearsal is the point.
With your birth partner
Practise together so they can breathe with you. A partner setting the rhythm out loud is more effective than remembering it yourself.
Add something physical
Practise it while leaning forward, on hands and knees, and on a birth ball. The position you use it in matters.
In your notes
Write down what you want to try and what you are open to. Breathing is one tool among several and it is fine to use others.

When this is not a breathing pattern

See a clinician — promptly, and before assuming any of this applies to you — if any of these describe you:

Reduced fetal movements, bleeding, fluid loss, or severe abdominal pain — contact your maternity unit immediately
Headache with visual changes, upper abdominal pain, or swelling of hands and face — same-day assessment for pre-eclampsia
Breathlessness at rest, chest pain, or fainting
Fever, or waters broken with any concern about colour
Nothing on this page replaces your midwife or obstetric team, and breathing is not a pain-relief plan on its own

This page is education, not medical advice, and no part of it is a diagnosis. Full disclaimer.

Questions people ask

Does breathing help with labour pain?: Reviews of relaxation techniques including breathing find some evidence for reduced pain intensity and better satisfaction, with mixed trial quality. It lowers arousal and bracing and gives you something to do — a coping tool rather than analgesia.
Should I hold my breath while pushing?: Current guidance generally favours pushing with your own urge rather than prolonged directed breath-holding, which has been linked with a longer second stage and pelvic floor strain. Follow your midwife's guidance in the room.
When should I start practising?: Now, a few minutes a day. Under high arousal you use what is automatic, and a pattern rehearsed for weeks is automatic in a way that one read on the day never is.

What this page is built on

— Smith et al., 2018, Cochrane Database — relaxation techniques for pain management in labour
— Lemos et al., 2017, Cochrane Database — pushing/bearing down methods in the second stage of labour
— Traditional: antenatal breathing practice from the Lamaze and psychoprophylaxis traditions onward

Named by author and year. The DOIs live in the journal.

Put a number on it

Most of what is on this page tracks one measurement: the Control Pause. It takes sixty seconds, needs no account, and it is the thing that tells you whether any of this is working.