Pain Relief and Anaesthesia in Childbirth BREATHING
From the earliest days of childbirth education, attention has been placed on learning breathing techniques for use during labour. Breathing patterns were (and in some centres, still are) taught primarily as a distraction during uterine contractions. As labour progressed and the contractions became longer, more painful and closer together, women were taught to alter their pattern of breathing. It is now recognised, however, that a rigi adherence to breathing patterns is often associated with over-breathing (hyperventilation), fatigue and inability to maintain the pattern - resulting in feelings of failure. Since the early 1980s, much less emphasis has been placed on rigid, pre-learned breathing patterns and women are encouraged more to 'do what comes naturally'.

Breathing awareness
In order to avoid the harmful effects of overbreathing, breath-holding or forced breathing out in labour, it is necessary to have some awareness of normal breathing. 'Breathing- awareness' simply means to be aware of one's own normal breathing pattern. This inwardly directed form of attention encourages breathing to become slower, deeper and more rhythmical.

To become more familiar with your normal breathing pattern requires some practice. You will need to find a quiet place, choose a comfortable position (but not lying flat on your back) and focus on some aspect of your breathing that will hold your attention for 3-5 minutes. Some people find it easier to concentrate on the rise and fall of the chest or abdomen; others prefer o listen to the sound of their own breathing. Allow your breathing to occur naturally. Some people find that they can concentrate easier by mumbling a sound as they breathe out (e.g. 'calm', 'ah', 'ohm').

Breath release
Once you feel that you are able to tune into your breathing, then you can go on and develop a technique called 'breath release'. This relies on the fact that when we breathe out, our respiratory muscles relax. By concentrating on breathing out, and experiencing the feeling of 'release', the whole body begins to feel more relaxed. Developing the outward breath has been shown to be helpful for many women in labour who are having to deal with high levels of pain and stress. A variety of sounds can be added to the outward breath in order to channel and release your feelings. Breath release is naturally associated with sounds such as sighing, moaning, groaning, swearing, laughing and crying.

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