Images of Lambze breathing patterns.

An educational video explaining five patterns of breathing exercises was shown and their benefits were taught to women enrolled in the intervention group during the first appointment. These breathing patterns were demonstrated by the investigator to the women on a one-to-one basis. Women were asked to repeat these breathing patterns immediately after teaching and were advised to practice them twice daily for 15 minutes. Instructions were given to continue during the active phase of the first stage of labour under the supervision of labour room nurses.
Women in the intervention group continued practising breathing exercises and compliance was monitored with help of a daily log along with the daily fetal movement count (Sadovsky method, as advised by obstetrician). This daily log was followed-up by the investigator during weekly antenatal visits. Occasionally the investigator checked for compliance through phone calls and enquired if they had any difficulties.
Monitoring during labour was done at the active phase of labour by the observers (nurses in the labour room), who were oriented on breathing exercises.
Likewise, the women randomized to the standard care group received health talk on antepartum care and services according to local health care provision. They were also monitored during the active phase of labour by the observers in the labour room.