Natural childbirth has moved from the status of controversial cult to ecumenical movement. During the last decade, it has shed its mystical fervor, liberalized its strict tenets, won new adherents, and forced hospital administrators to revise their rules.
“The fad element has been weeded out,” said Barbara Williams, a nurse who conducts a free course in preparation for childbirth at the maternity center here. “Now it’s in the middle of the road, accommodating a wide variety of needs.” Mrs Williams is expecting her first child in August, and her husband, an intern, has no intention of being present in the delivery room.
The apostle of the movement was Dr Grantly Dick Read, a British obstetrician who reasoned that fear provoked a state of tension that inhibited the natural process of childbirth. If women were educated to overcome fear and tension, he contended, they could give birth without pain. Education consisted of exercises and controlled breathing.
Endorsed By Pope
Read’s book, “Childbirth Without Fear,” published in 1942, was translated into 10 languages. In 1956, Pope Pius XII endorsed his concepts. Nevertheless, natural childbirth encountered the hostility of obstetricians, a hostility that survived Read’s death in 1959.
In 1951, a French obstetrician named Ferdinand Lamaze introduced a method, called the psycho-prophylactic technique, based on Pavlovian conditioned-reflex theories that he had observed heing applied in the Soviet Union.
Although the goal was the same — childbirth with minimal discomfort and without medication, enabling the mother to see her child coming into the world — the Lamaze method differed from the Read method chiefly in advocating that the mother be very active during a contraction instead of concentrating on relaxing.
Introduced in US in ’59
The Lamaze method was introduced to the United States in 1959 with the publication of “Thank you, Dr Lamaze,” a book written by Marjorie Karmel, an American whose first child had been delivered by the French physician in Paris.
The following year, Mrs Karmel and Elisabeth Bing, a Berlin-born physical therapist, founded the American society for psychoprophylaxis in obstetrics, a nonprofit teaching organization of doctors, teachers and parents. Since the founding of the society, the Lamaze method has spread steadily. It has acquired six chapters and five affiliates throughout the county.
Natural childbirth is a family-centered movement. It advocates a working team consisting of the wife, her husband, the physician and, in some cases, a monitor or instructor. The husband helps his wife during pregnancy by drilling her in her exercises. During labor, he acts as a coach, seeing to it that she responds to her contractions with proper breathing and assisting her with back massage. He is present when the child is delivered.
The husband’s presence in the delivery room is the constant crusade of all factions of the natural childbirth movement. It is also one of the most hotly disputed — not only among physicians but also among cocktail conversationalists.
Dr Martin L Stone, chairman of the department of obstetrics and gynecology of the New York Medical College, under whose auspices the Lamaze method is taught at Flower-Fifth Avenue Hospital, has this to say:
“I personally don’t believe fathers belong in the delivery room any more than they belong in the operating room, but I’m allowing it on a trial basis because of some patients’ and some doctors’ needs. Some husbands are very gung-ho on all this, and other husbands are tickled silly to be relieved of the obligation.”
A relaxation of other natural childbirth doctrines has won a wider following for the movement, although its critics seem unaware of the changes. Many doctors say that the woman who commits herself to natural childbirth and then fails to go the whole way without an analgesic (painkiller) or anesthetic I feels guilty, and thereby acquires a psychological burden.
“There is no absolute goal, no threshold that all or any of us must reach. You certainly must not feel any guilt or sense of failure if you require some medication, or if you experience discomfort.”
In the preparation for childbirth courses, participants discuss their fears, are disabused of their old wives’ tale notions, and are supplied with factual information about what is in store for them — from officious hospital clerks to nausea and hiccups. The courses are a kind of group therapy in which some members arrive as fanatics and depart with a tolerant, wait-and-see attitude.
Women who have seen their children born, through whatever method of natural childbirth, tend to wax enthusiastic about their accomplishment.
Stone pronounced the preparation-for-childbirth courses “whether Read or Lamaze” to be of definite value, “in being able to having an educated, prepared, understanding patient who can go through labor with less need for analgesic or anesthesia.” Anesthesia is still one of the biggest problems in obstetrics, he said, because of shortages of learned personnel in hospitals.