Breathing in labour: what helps, stage by stage

Breathing will not take the pain of labour away. It gives each contraction a shape you know, and that turns out to matter more than it sounds.

4 min read · Updated 2026-11-08

What the evidence actually says

The best summary of the research is a Cochrane review of relaxation techniques for pain in labour, a category that includes breathing, relaxation, yoga, music and mindfulness [1]. It found that relaxation and yoga may reduce pain intensity and improve satisfaction with pain relief, and the authors rate the quality of that evidence as low: the trials are small, varied and hard to blind.

That is a modest claim, and it is the honest one. Nobody should expect a breathing pattern to replace other pain relief, and choosing an epidural or gas and air is not a failure of technique. What breathing reliably offers is something to do: a rhythm that keeps you from holding your breath and tensing at the peak of each contraction, which is the instinct almost everyone has and the one that makes things harder.

The UK's national guideline on care in labour recommends that women be supported to use breathing and relaxation techniques if they want to, alongside the other options for pain relief [2]. It is one tool among several, not an alternative to the others.

Early labour: rest between, ride the wave

Early, or latent, labour can last many hours, often at home, with contractions that are irregular and not yet very strong. The main job in this phase is not coping with each contraction; it is staying rested so that you have energy for what comes after.

Two patterns cover it. During each contraction, a slow breath in through the nose and a longer, loose-jawed breath out through the mouth - the surge breath here - gives the contraction a beginning and an end. Between contractions, a single long sigh as the contraction fades, then an easy rhythm a little slower than normal, lets the shoulders, jaw and hands drop. That second habit is the one people forget, and it is where the energy for later goes.

Active labour: one breath shape, every time

As contractions become longer, stronger and closer together, the same surge breath carries on, but it often becomes slower and lower, sometimes with a sound on the exhale. A low moan or hum on the out-breath is common and useful: it lengthens the exhale and keeps the throat open. High-pitched sounds tend to come with a tight jaw and shoulders, which is the opposite of what you want.

Birth partners can help here more than in any other phase. Counting the out-breath slowly aloud, and dropping your voice as you count, gives the person in labour something to follow when their own rhythm starts to break up. Timing contractions is also a partner's job: how long each lasts and how far apart they are is what your midwife or maternity unit will ask on the phone.

Transition: when the urge to push comes too early

Transition, at the end of the first stage, is often the most intense part of labour. Some people feel a strong urge to push before the cervix is fully open, and a midwife may ask them to hold off. You cannot do that while holding your breath, because bearing down needs a closed throat.

The traditional answer is pant-pant-blow: two tiny, light pants, then one longer, gentle blow out, as if cooling a spoonful of soup. The pants must stay small; panting hard blows off carbon dioxide and quickly causes tingling and dizziness. This is a practice that comes from midwifery experience rather than trials, and on the day it should only be used when your midwife asks for it.

Pushing: breathe down, rather than hold and strain

There are two broad approaches to the second stage. Directed pushing asks you to take a big breath, hold it and push for a count of ten, often called purple pushing. Spontaneous pushing lets you follow your own urge, usually with shorter pushes and the breath moving out.

A Cochrane review comparing the two found no clear difference in most outcomes for mother or baby, though the evidence is limited [3]. Given no clear advantage to holding the breath, many midwives now encourage following the body's urge. The J-breath here is one version of that: a quick breath in, then a long, steady breath out while the pressure moves down and forward. Rehearse it gently in late pregnancy without bearing down at all, and on the day follow your midwife's lead.

How to rehearse

The point of practising beforehand is that, on the day, you will not have the attention to learn anything new. A few minutes a day from about 36 weeks is plenty: a round of the surge breath, the sigh that ends it, and a gentle run through pant-pant-blow and the J-breath, so the shapes are familiar.

Practise with your birth partner at least once. They will be the one counting, timing and reminding you to drop your shoulders, and they need to know the patterns as well as you do.

Call your midwife or maternity unit straight away, without waiting for a pattern of contractions, if your waters break, you are bleeding, the baby is moving less than usual, or you have severe pain, a headache or changes in your vision. This page is general information, not medical advice.

References

Smith CA, Levett KM, Collins CT, Armour M, Dahlen HG, Suganuma M. Relaxation techniques for pain management in labour. Cochrane Database of Systematic Reviews, 2018. Link
National Institute for Health and Care Excellence. Intrapartum care (NG235), 2023. Link
Lemos A, Amorim MMR, Dornelas de Andrade A, et al. Pushing/bearing down methods for the second stage of labour. Cochrane Database of Systematic Reviews, 2017. Link

Techniques mentioned

General information about breathing practices, not medical advice. How this is written and sourced.