The Lamaze Method
Obstetrician Fernand
Lamaze developed his birthing philosophy after observing techniques
for "painless childbirth" on a 1951 trip to Russia. These
techniques were based on the work of Ivan Pavlov, the Russian psychologist
who argued that the brain plays a major part in the perception of pain.
The Lamaze method
assumes that birth is a natural and healthy process that can run its
course with very little need for medical intervention. It teaches women
to make informed choices in their health care and then to trust their
inner wisdom to guide them through birth. In the typical course, which
begins in the seventh month of pregnancy and runs two hours a week for
six weeks, expectant couples learn different strategies for helping
the pregnant woman cope with the stress of childbirth. At the heart
of the course are three techniques: relaxation methods, breathing exercises,
and pushing during contractions. For instance, the woman and her partner
in the birthing process are taught that by massaging and stroking the
mother-to-be and learning to tense single muscle groups while relaxing
the rest of the body, the woman can diffuse stress. Parents are also
coached in how to relax the body using meditation and other mental imagery.
For example, a woman might imagine a blossoming flower, symbolic
of her cervix opening. She might envision her baby moving down the birth
canal, or she might focus on a certain color or mental picture to help
her relax. Walking during labor or changing positionsÑ from the
woman lying down on her side to squatting or kneeling on all fours,
for instanceÑcan also help relaxation. Many of the Lamaze positions
take advantage of gravity and keep the pelvis tilted so that the baby
can pass more easily through the birth canal.
The Lamaze system
also stresses breathing techniques for each of the three stages
of labor. During the first phase, in which contractions begin and the
cervix becomes fully dilated, Lamaze emphasizes slow breathing, in which
the mother exhales slowly and keeps her stomach muscles tight as she
inhales. In the second stage, also known as transition, when the contractions
come fast and furious, the woman takes a breath and holds it for 6 to
10 seconds, exerting downward pressure on her stomach muscles as she
does so. After no more than ten seconds, she exhales and repeats the
pattern until the contractions stop and the third phase begins. During
the third phase, the baby's head makes contact with the pelvic floor,
stimulating an expulsive reflex which brings the baby through the birth
canal. Lamaze teaches the mother to push until the baby is born.
The Bradley method
An alternative to
Lamaze is the Bradley method, which is used by 30,000 to 40,000 women
each year. Developed by Denver obstetrician Robert Bradley in the late
1940s, the method differs from Lamaze in that it doesn't teach breathing
techniques; it relies solely on relaxation exercises to control pain
during labor. "The whole philosophy is that you can give birth
without drugs," says Marjie Hathaway, a leading spokeswoman for
the Bradley method. Hathaway became a convert herself after she and
her husband first heard Bradley explain his approach in a speech while
she was pregnant in California in the mid-1960s. When her own doctor
refused to allow her to deliver her baby without using drugs, she arranged
to fly to Colorado once she entered labor so that she could have her
baby delivered by Bradley.
In the typical Bradley
class, which begins when the woman is five-and-a-half months pregnant,
expectant couples learn 12 different relaxation techniques to help the
woman cope with pain during labor. Classes meet in weekly two-hour sessions.
Many of the relaxation
techniques involve the husband either touching or stroking the mother-to-be
or offering reassurance to boost her confidence. In another technique,
called "warmth," the woman imagines standing in a warm shower.
The Bradley method
also teaches women that changing positions during childbirth helps manage
pain. "During labor women are encouraged to walk, to take a shower,
to change positions, to do anything but lie on her back," says
Hathaway. "Lying on your back casues a tremendous amount of pain."