Labor Breathing Made Easy With The Winner Flow Device
2024 Research Update
When I first saw the Winner Flow device it reminded me of a whistle and then I found myself humming the Disney song ‘whistle while you work’ and of course being a midwife and positive birth strategist that turned into ‘whistle while you birth’. I’m so excited to share this very simple but effective device to add to your labor toolkit.
What IS the Winner Flow?
It’s a small breathing device originally designed by a French physiotherapist for preventing Diastasis Recti and to improve pelvic floor fitness. It helps you to control your breathing during labor and birth. It can be set to different levels of resistance as you exhale so you have to work a little harder to empty your lungs.
That resistance engages your pelvic floor and core abdominal muscles. It’s also a great tool for pregnancy to reduce constipation and may prevent Diastis Recti (separation of the ‘6 pack’ muscles of the abdomen).
How Does It Help During Labor?
It makes you to focus on slow deep breathing (in through your nose and then exhaling a little longer through the device). By slowing your breathing you are activating the parasympathic, relaxation response - rest and digest.
Do not inhale through the device.
Slow focused breathing sends a message of safety to your brain so it turns off the stress response and turns on oxytocin. By making the exhale just a little longer you’re optimising that response. More oxytocin = more comfort = more efficient surges = a potentially shorter labor. French midwives report shorter labors, moms feeling more in control and less perineal injury.
It’s helpful for inductions too.
My pregnancy yoga instructor recommended it. I had never heard of it before. I feel very lucky I had it and feel all woman giving birth should be offered the use of one. It really helped me focus on my breathing, slowed down my out breath and helped me stay calm.. I had the gas and air beside me but kept thinking I will wait until it gets bad before I use it... it never did get bad and I labored with the use of a TENS machine, winner flow and had also been practicing hypnobirthing. It works! I’m a first time mom and I had been induced!
Hospital & Homebirths
I was 39 weeks when the baby decided it was time to come. I started to have very slight surges in the morning but I went on with my day as normal. At 5.30pm my water broke. I sent a text to Gail to let her know. At 6pm my surges were 5 minutes apart so I called Gail again and she decided she would come. Waiting for her while my partner was setting the pool, I sat on my ball breathing through my Winner flow device. Gail arrived at 7pm. She started to fill the pool and I quickly got in when it was ready. About 2hours later, at 10pm, Marco was born.
I felt so much in control the whole way through. Every time a surge would come, I would breathe through the winner flow and my partner would use pressure points on my back. It was a short labour but I can also say I enjoyed giving birth. The experience was so different from my first. It felt so easy and almost unreal.
This device was introduced to me when I was trying to find an alternative to the Entonox (gas & air), which had made me very dizzy and sick during my first labour. It made so much difference that I recommend mums to go for it!" - Myriam
Can it Help During Pushing?
Yes. Yes. Yes.
This is one of the most important uses of the winner flow. You’re not holding your breath continuously while you push which is still so common today in hospital births (closed glottis pushing / valsalva). Holding your breath for long periods, lying on your back, pushing until you’re purple in the face reduces oxygen to your baby, your organs and the perineum. It can also impact your cardiac functioning and blood pressure -even your brain is getting less oxygen.
You can learn more about the benefits of spontaneous mother led pushing here (with or without an epidural).
Tips for Using the Winner Flow in Pregnancy***
Begin in the 2nd trimester.
Experiment by setting the resistance to 2 (the higher the number the LESS resistance) just for the first couple of uses when you first take it out of the packaging. It’s important not to put any additional strain on the pelvic floor so as you begin your pregnancy practice.
For pregnancy practice don’t take a huge breath and blow into the device - that will only stress your pelvic floor. Take it gently as you get familiar with the device. As you breathe out imagine baby moving back towards your spine and up towards your heart. After a few gentle practice breaths you can turn the resistance to 1.5
As you exhale try to slowly lift your pelvic floor and engage your abdominal muscles (Practice with the Pelvic Floor Fitness Imagery in the GentleBirth App).
Practice every day with bowel movements too!
Place the narrow end into your mouth, hold it with your lips not your teeth. It will be in a horizontal position. It feels a bit odd to begin with but you’ll get the hang of it after a few breaths. Turn the device so the hole in the wider part of the device is pointing down or you’ll experience some not so enjoyable post dinner breath wafting up towards your face as you practice. (Not fun in labor either).
Use this level to practice your breathing techniques or pelvic floor exercises listening to the GentleBirth hypnobirthing App. Sit/stand with the chest open (if you’ve worn a strapless top recently we automatically push the ribs forward a little so it doesn’t fall down). It’s important to pay attention to your posture to maximize your lung capacity. Just try it for 10 minutes every day - especially if you’re feeling anxious.
When you are having a bowel movement you can turn the resistance to 1 or close the device completely so you can practice pushing on the toilet.
Slow belly breathing is not something most of us are used to doing so if you begin to feel dizzy discontinue and work at your own pace. It’s so important to practice with the device during pregnancy so you’re really familiar with it for labor. Try different positions too.
You’ll notice condensation in the tube as you practice - you can simply wash it in warm soapy water after each use and air dry. Personally I think it’s worth having two - one that’s safely tucked away in your labor bag and one to practice with during your pregnancy and to use during early labor.
You may find your abs feel like they’ve had a bit of a workout (and your cheeks too ).
***If your WF came in a plastic package instead of a box the recommendations are slightly different.
The setting would be 2.5 for labor and 1.5 for the 2nd stage (this WF doesn’t close completely).
Birth Experience shared by Private Midwives
I tried to go to bed for a while and listen to some hypnobirthing tracks but was far too excited and wanted to start prepping a few things. I pottered about and started getting a few surges around 12:30 and started on the ball.
I then started using The Winner Flow to relax me and control my breaths. The Winner Flow was introduced to me by Angela. I had been practicing with it but had no idea how effective it would be. I had ordered entonox for the birth as I had used it on my last birth. My surges started coming regularly at 1.30am but they were very manageable with The Winner Flow. My husband started to fill the pool and get everything prepped. I called Angela sometime after 3am and asked her to come whenever it suited (thankfully I did call her when I did!!!). The surges started ramping up at that stage and especially when I was leaning against the kitchen island, so I got back on the ball in an attempt to slow things down a bit until Angela arrived. I had the Tens on also, so between that and the Winner Flow I still felt I was managing well. Angela arrived around 4.30am and she got all set up. She set up a nice little area over near the couch and I instinctively went over to it, knelt down, and then I suddenly realised our baby was about to arrive (no time for the pool!). A few surges and our boy Beauden, arrived into the world as cool as a cucumber, so calm, weighing 7lb 12.5oz. I couldn’t believe it, a few hours before I was watching The Bake Off! I couldn’t believe I hadn’t used the entonox either. The Winner Flow literally helped me breathe my baby down and assisted me to keep control the whole way through - Genny
Using the Winner Flow in Labor
As your surges begin to demand more of your attention set your winner flow to about 1.5. In early labor sleep and rest as much as you can listening to your labor playlist in the GentleBirth App. Start at 1.5 and see how that feels. In contrast to your pregnancy practice you can take long deep inhales in labor, breathing in through your nose and a long slow exhalation (only to your comfort level). If you’ve been practicing you’ll find it very comfortable to just keep a long exhale going with that deep belly breathing.
Visualize your baby being lifted back towards your spine and up towards your heart.
There’s no need to turn up the resistance again until you’re close to the end and you really need your focus. The extra resistance supports your body to nudge your baby along as you engage your abdominal muscles. If you’ve been practicing throughout your pregnancy this will be second nature to you. You’ll find it easier to to stay calm and focused as that irresistible pressure builds. Welcome that pressure - it means baby is on the way!
Partners remember to close the device completely when mom starts pushing.
More testimonials from parents.
I have been practicing breathing through winner flow few weeks before my due date. When labour started I knew exactly what to do, winner flow, birthing ball and salsa music and then call the midwife Angela (by the way she is amazing). By the time she came, I was bouncing away breathing through winner flow and listening nicely, no pains at all. I was doing that through all my labour until I was 6cm and for no reason dilation stop at 6cm so Angela arranged hospital transfer as high blood pressure went slightly high as well and temperature little bit. But I still kept using my winner flow I wouldn’t let go of it even in the ambulance and in the hospital I was using it for the rest of my labour. I found that it makes you breathe and shift the mind of everything else around but focus on breathing. I still use it for postpartum recovery and I swear my belly was flat few days after delivery as it ever was before. I had a great experience and love the birth even though I had planned homebirth and ended up in the hospital, it was great - Lucy
Can I Use it With an Epidural?
Yes - and ask your careprovider for lots of time for your body to do most of the work for you - it’s known as ‘passive descent’ or ‘laboring down’. When you start to feel that pressure build you can use the winner flow to support your pushing efforts especially if you are in a supported upright position with your epidural (yes you can request an upright position on the bed if you are well supported and have sensation in your legs). Learn more about position options with an epidural here. Personally I think there is huge benefit to using the Winner Flow with an epidural so you won’t end up doing that Hollywood style ‘purple pushing’ that reduces oxygen. Using the Winner Flow will ensure you and your baby have lots of oxygenated blood circulating.
Gentle Cesarean
In some French hospitals the Winner Flow is being used by mothers as part of their Gentle Cesarean. Slow deep breathing that actively engages the diaphragm and core muscles help your baby to be born slowly through the incision - you get to play a very active role in your baby’s birth. It’s a much more gentle birth for baby too.
What a difference that can make!
Postpartum Recovery
See a women’s pelvic health physio about 6 to 8 weeks after your baby arrives (whether you had a cesarean or vaginal birth). Take the Winner Flow along to your appointment so your therapist can see which resistance level will be best for your unique needs and create a pelvic floor fitness program for you. An individual assessment is so important so you don’t cause yourself any injury as your body recovers.
What’s the Evidence for Winner Flow?
2023 saw the arrival of the first RCT on the use of the WinnerFlow. 120 women were randomly assigned to using the Winner Flow or the standard of care. There was a non-significant decrease in cesarean rates with the tool (18.3% cesareans with WinnerFlow Vs 26.7% without). It also significantly reduced the second stage of labour time (29.980 ± 18.758 min in WF group vs. 41.955 ± 29.789 min in WF group.
According to midwives, it had a significantly positive impact on the mother’s breathing (P < 0.0001) and pushing efforts intensity. It facilitated communication with mom. Moreover, using the WF had a significant positive impact on mom’s in feelings of empowerment for pain management.
Dimassi, K., Halouani, A., Zina, F.B., Khemessi, N. and Triki, A., 2023. Regulated Expiratory Methods During Childbirth Process: A Randomized Controlled Trial. Journal of Obstetrics and Gynaecology Canada, p.102265.
US WinnerFlow - back in stock on June 1 2024
If you live in Europe contact GentleBirth Instructor and holistic therapist Myriam Liaigre .
Did you use the Winner Flow? Was it helpful for you?
Tracy
