15/06/2026
It isn’t all ‘Push!’ and ‘Breathe’ during labour.
What we want you to know, is that during the pushing stage our pelvic floor needs to lengthen and release, not contract or brace. The baby passes through our levator hiatus (the U-shaped opening in the pelvic floor muscle), and this needs to be as relaxed as possible for this to happen.
Exhalation-based breathing during pushing (inhaling, then exhaling while bearing down) has been shown to reduce perineal trauma, help manage pain and can shorten the pushing stage significantly; while breath-holding while pushing - known as the Valsalva manoeuvre - increases downward pressure but doesn’t support pelvic floor release.*
Research has linked the Valsalva with greater perineal trauma and can affect how your baby copes with labour.*
At PhysioSista, our team can show you how to coordinate the release of your pelvic floor before birth, using real-time cues and a model to help you feel the difference. This is one of the things we can discuss and add to your plan during your initial assessment.
*Research published in the Journal of Perinatal Education (Heim & Makuch (2023), Breathing Techniques During Labor: A Multinational Narrative Review of Efficacy)