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We encourage you to be flexible in adapting the breathing patterns to your own needs. Try the patterns offered here and then decide how to adapt them to your own needs and comfort level.

Pushing Pattern

• To begin a contraction, take one or two cleansing breaths to allow the contraction to begin to intensify.
• Inhale a third breath, hold, and push. (See the two pushing methods in the “Pushing Methods” list.)
• When you need air, take a quick “catch breath” (exhale quickly, inhale a new breath), hold, and push.
• Repeat this pattern until the contraction subsides.
• To end a contraction, take two cleansing breaths, then totally relax.

Pushing Methods
Strong pushing is done by holding your breath while simultaneously bearing down with your abdominal muscles.

Your glottis is closed using this method, so there is no release of air, and therefore no sounds are made.

Gentle pushing is done by slowly exhaling your breath under pressure while simultaneously bearing down with your abdominal muscles.

Your glottis is opened or partially opened using this method, so air is released and sounds such as grunting, moaning, or groaning are often made.

Exhalation of your breath also can be done through pursed lips.

Pelvic Floor Muscles (Perineum)
It is important that your perineum remain relaxed while you are pushing.
Practice the Kegel exercises during pregnancy so that you will be able to feel the difference between a tense and relaxed perineum.