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Maternal Newborn Nursing

14.4 Alexander Technique

Maternal Newborn Nursing14.4 Alexander Technique

Learning Objectives

By the end of this section, you will be able to:

  • Discuss the history of the Alexander Technique for childbirth, including how to find an instructor
  • Summarize the benefits to the birthing person during labor and birth when using the Alexander Technique
  • Evaluate the education provided to the birthing person regarding self-awareness and releasing muscle tension
  • Discuss how the Alexander Technique is taught to the birthing person
  • Summarize the positions the birthing person is taught to utilize for comfort using the Alexander Technique

The Alexander Technique is a form of muscle relaxation and positioning to use during pregnancy, labor, and birth. The technique teaches common causes of pain in pregnancy and body mechanics that can help prevent pain and injury to the body during pregnancy. The goal for use in pregnancy is progressive muscle relaxation for the improvement of mindful movement to optimize the body position and health for childbirth.

History of Alexander Technique

F. Matthias Alexander, born in 1869, was an actor who experienced complications from overuse of his voice that impacted his performance. He stumbled upon the solution to his voice problems by learning to release excess tension in his neck and body, which greatly improved his ability to speak, act, and move his body. Over time, he further developed the technique and began training other people to be teachers of the Alexander Technique (Who was F. Matthias Alexander?, n.d.).

Research Supporting Alexander Technique

Evidence of the efficacy of the Alexander Technique is readily available for all types of chronic pain, health conditions, and discomforts. This method is taught to athletes, dancers, and musicians to improve speed, breathing, and vocal production. There is less evidence specific to pregnancy, but some research can be generalized to overall health and well-being that is relevant to pregnancy as well. Some studies support the Alexander Technique’s use in pregnancy and the postpartum period for improved satisfaction during these formative times of a person’s life (Banoofatemeh et al., 2017; Hanefeld et al., 2021). The technique uses freedom of movement, flexibility, balance, and coordination to allow the pregnant body to birth as it was designed to do.

Benefits of Alexander Technique

Benefits of the Alexander Technique include greater comfort during pregnancy, labor, and birth, as well as improved general well-being leading directly to psychologic well-being due to mind-body integration (Kinsey et al., 2021). These benefits continue for the lifespan as long as the person continues to practice the learned techniques. This technique is especially useful in the early postpartum period, the breast-feeding period, and the first year postpartum when people are most at risk for postpartum mood disorders. The technique teaches that if a person supports their body with these techniques, they can “get out of their own way” and allow the body to birth (Likar & Clare-Newman, n.d., p.1). The technique also discusses breast-feeding and caring for the newborn using proper body technique to avoid strain or injury. Other benefits include improved posture, improved balance and mobility, better stress management, better breathing, and pain relief (Likar & Clare-Newman, n.d.).

Shortcomings of Alexander Technique

The Alexander Technique works best when started early and practiced often with the support of a well-trained instructor. To find an instructor, the birthing person can visit the Alexander Technique website and select their location to find the nearest local practitioner. The drawback to this method is that it can be hard to find an instructor. Some articles and videos are available online for the pregnant person to begin working through techniques to see if this method is helpful for them.

Alexander Technique: Self Awareness and Releasing Muscle Tension

The Alexander Technique for pregnancy includes the concepts of inhibiting and directing. The conscious act of preventing oneself from rushing into an action without thoughtful consideration of the body is inhibiting. Consciously organizing one’s body prior to and during an action so that the head leads the body’s movement is directing. People who practice the Alexander method make measured adjustments to the balance of the head in relation to the rest of the body to reduce tension and resistance within the body to maintain healthy postures (Hanefeld et al., 2021).

Awareness of Posture

Students of this modality learn to undo the tension in their muscles so that their body movements are freer and more relaxed, as in Figure 14.6. Avoidance of compressing the head down to the chest is one of the postural recommendations. Encouraging body awareness and adjusting alignment help practitioners to feel loose, open, and free for movement (Hanefeld et al., 2021).

Image of pregnant person sitting cross legged on the ground.
Figure 14.6 Sitting Posture Sitting posture stretches the pelvic floor, allowing it to relax. (attribution: Copyright Rice University, OpenStax, under CC BY 4.0 license)

Deep Breathing

Deep breath work is one component recommended to prepare for pregnancy and birth due to changes in the chest wall and lung function during pregnancy. The Alexander Technique teaches practiced breathing called “whispered ah” (Duffee, 2021). This technique states there is a connection between jaw tension and the cervix; therefore, a low breath sound allows the person to relax the mouth and throat muscles, thereby allowing the cervix to relax (Duffee, 2021).

Alexander Technique: Learning the Technique

A few books and online resources exist, but most Alexander Technique educators recommend private classes to customize the teaching to the specific person. The private lessons usually last between 30 and 60 minutes, with the instructor introducing practices that will open awareness of how the nervous, muscular, and skeletal systems function (American Society for the Alexander Technique, n.d.-b). The instructor uses verbal and manual guidance to assist the person in moving with more ease and flexibility. As the student sits, stands, walks, and so forth, the instructor guides the movement to help maintain ease of movement (American Society for the Alexander Technique, n.d.-b).

Thorough History

The teacher assesses the student’s body by addressing any discomforts that may be linked to tension. These can include low back pain, hip pain, sciatic pain, symphysis pubis pain, gastrointestinal complaints, neck pain or tension headaches, and stress. Obtaining a thorough history allows the instructor to personalize the techniques taught.

“Hands-On” Examination

Alexander Technique instructors provide hands-on assessments to help identify muscle tension and enhance postural adjustments for the most benefit during body movements. The instructor will assess all muscles and posture, as shown in Figure 14.7. In-person courses are most effective because of this hands-on evaluation. Teachers of the Alexander Technique are required to be certified in the method. They complete an approved teacher training course and must have 1,600 hours of training over a 3-year period (American Society for the Alexander Technique, n.d.-a). They must also maintain continuing education.

Photo of person feeling back of another person.
Figure 14.7 Examination of Muscles The Alexander Technique instructor performs hands-on assessments to identify areas of tension. (credit: “The Back Pain SOS” by Sebel Babu/flickr, Public Domain)

Online Courses

Online courses can successfully teach the Alexander Technique because much of the work is done through self-awareness of one’s own body movements. The person can practice the movements while watching the courses. This also allows students to replay techniques while practicing.

Alexander Technique: Positions for Pregnancy

Typical posture in pregnancy includes an arched back, which causes low back pain. This should be adjusted to a relaxed head and neck in neutral positions with the head leading the spine. This posture is employed in body movements such as sitting in a chair or standing up from a seated position. Suggested movements in pregnancy include squatting, breath work with the whispered “ah,” and release of tension when sitting, standing, and walking (The Alexander Technique, 2023).

Using Alexander Technique in the First Stage of Labor

During the first stage of labor, progress can be assisted by maintaining a relaxed body with continued release of tension before, during, and after contractions. Restful positions like side lying can be alternated with vertical movements and squats to encourage regular progression. The whispered “ah” or a reminder to the self to smile can release the jaw and throat, which may also release the chest and abdomen (The Alexander Technique, 2023).

Using Alexander Technique in the Second Stage of Labor

Similar to the first stage, squats and the whispered “ah” can help create a relaxed pelvic floor that the fetus is able to move through with ease. Pushing with expulsive efforts while directing the movement down without tension in the head and neck can be helpful. Pushing in different positions can also be helpful (The Alexander Technique, 2023).

Breast-Feeding and Alexander Technique

Breast-feeding can be associated with significant neck, shoulder, and back pain. Back pain is one of the most documented conditions that improve with use of the Alexander Technique. Movements to consider would be neutral head position with supported sitting for upright or forward-leaning spine. The breast-feeding person will release tension and support the newborn in a way that prevents hunched shoulders (The Alexander Technique, 2023).

Postpartum Year and Alexander Technique

Reminders to the birthing person to continue to utilize this resource throughout postpartum recovery can encourage wellness and relieve many aches and pains. Positions to consider are the release of upper body strain with a neutral head. Proper sit-to-stand and stand-to-sit techniques with alignment will help prevent pain and injury. As the child grows, they will notice and mimic parental movements of a relaxed posture with free movement (The Alexander Technique, 2023).


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