Grantly Dick-Read
In his book Childbirth Without Fear, first published in the 1940’s, Dr Grantly Dick-Read brought the principles of natural childbirth to public attention. His philosophy was to try to lessen and hopefully eliminate fear and tension, and the pain that resulted from these options, through proper education and emotional support.
The Grantly Dick-Read method taught women how to cope with tension but lay strong emphasis on the fact that knowledge allays fear and prevents tension, which in turn controls pain.
To help do this, he developed courses of instruction that included breathing control exercises and relaxation of muscles, information on what to expect in a normal situation and what women can do to help themselves.
His method also taught mother show to look for support in the form of guidance, reassurance and sympathy. Grantly Dick-Read laid great emphasis on preparation for parenthood and childbirth itself.
Psychoprophylaxis
This involves training in breathing methods as a preparation for labour. The techniques were pioneered in Russia and introduced to the West by Dr Fernand Lamaze. The Lamaze method is by far the most popular in the United States and is the basis for the teaching of the national Childbirth Trust in Britain.
It encourages the woman to take responsibility for herself, to enter into partnership with her companions, friends and counsellors. It greatly values teamwork. The woman must prepare her body throughout pregnancy with special exercises and she has to train her mind to respond automatically to each type of contraction she will feel in labour.
Her partner acts as a coach and as emotional support. He is expected to attend the course with the expectant mother and to co-operate with her at home on the conditioning exercises, and he coaches, coaxes and comforts her throughout labour and delivery.
The Leboyer Philosophy
This relies on several basic precepts and relates more to the baby than her mother and her progress throughout the labour. Dr. Frederick Leboyer in his book Birth Without Violence states that the newborn baby feels everything, reflecting all the emotions surrounding it – anger, anxiety, impatience and so on – and that the baby is extremely sensitive through its skin, its ears, its eyes.
For that reason, he believes that all stimulation to the baby should be minimalised with low lights, few sounds, little handling, and with immersion in water at body heat so that the baby’s entry into the world is as little different from its life in the womb as possible.
This teaching is in fact not entirely in line with the physiology of what occurs at the moment of birth for the baby. It is contact with air at a temperature different to body temperature that makes the baby take its first gulp of air to start the initial crucial function of the lungs and causes the baby’s blood circulation to change from a foetal one to a mature one.
It is also simply not true to say that a baby’s hearing is so sensitive that it is disturbed by noises around it. The sound of the uterine vessels within the womb are akin to a loud vacuum cleaner. Leboyer also believes that the mother is an “enemy and a monster” to the child, driving it and crushing it within the birth passage. He likens her to a torturer. Many women object to this view as it minimises, even diminishes the role of the mother.
Dr Leboyer believes that the baby should not be touched by foreign material but by human skin. The ideal place for the bay is to be laid face down on the mother’s abdomen and covered by her arms. It has been proven by experiment, not Leboyer’s, that this is far more efficient in preventing the baby form losing heat than overhead heaters. Research has shown that a baby is able to clear mucus from its respiratory passages more efficiently when lying down on its mother’s stomach than with a suction tube.
Leboyer suggests that the curtains and blinds in the delivery room are drawn and that the lights are dimmed. Some medical authorities object to this because they say it is not possible to assess the baby’s condition in a dim light.
Few centres practice the pure Leboyer method but many hospitals and community midwives practice Leboyer-based birth. Hospitals were slow to adopt Leboyer because research has shown that Leboyer babies appear to receive no extra benefit compared to others, though many ‘Leboyer mothers’ may feel they do.
Dr Michel Odent
A French doctor named Michel Odent has advocated placing the mother in an environment which is cosy and home-like, giving her complete freedom to act as she wishes and encouraging her to reach a new level of animal consciousness where she forgets her inhibitions and returns to a rather primitive biological state.
Dr Odent believes that the high levels of endorphins, the body’s natural narcotics, should be allowed to have full reign in the mother’s body. He logically argues that if a woman is given painkillers and analgesics, her endorphins are cut off, thus depriving her of the benefit on natural pain relief.
Dr. Odent’s clinic in Pithiviers in France, where he pioneered his natural childbirth techniques, became a centre for those who wished to change opinion and practices in childbirth.
Dr Odent believes that during labour there should be music, soft furnishings, and a relaxed atmosphere. A woman who goes into labour should be allowed to sit, walk, stand, eat and drink, ad do whatever she likes. Women should not be interfered with in any way and can take up whatever position is most comfortable at any stage of labour. Left to their own devices, many women take up a position on all fours, which seems to help the pain. Later on in birth, many stand up or semi-squat so that the force of gravity can help them, a natural thing to do, which most primitive tribes practice.
Odent encourages the supported squatting position where he, or the woman’s partner, stands behind her, takes her weight underneath her armpits and upper arms and allows her to bend her knees and place her weight on her partners arm.
Dr. Odent believes that birthing pools, which he now uses for many home water births, should be primarily viewed as a means of pain relief. The birth itself does not need to be underwater, though Dr. Odent is quite happy to deliver the baby into the water of the bath, if that is what happens. There seems to be no proof that an underwater birth is dangerous to the baby so long as the heads is lifted out of the water immediately.
Dr. Odent’s methods have always had low rates of episiotomy, forceps and caesarean section. The supported squat position is the one that prevents severe perineal tears during delivery. Because the mother has been in an upright position when the baby emerges, she remains sitting upright with the cord still intact and the baby in her lap.
The baby immediately smells the mother’s skin and it is thought that this is important to the baby in establishing breastfeeding. Within a few seconds, most mothers instinctively lift he baby up and place it on the breast. No partner needs to be told to encircle the mother and the baby with his own body and arms. Each will do what comes naturally in these very personal moments.
Yoga-Based Methods
This is not just for those who already practice yoga. During birth a woman should concentrate her awareness on being totally at one with what is happening to her. Through yogic methods she is able to control her awareness according to her capacity and tolerance, so sometimes she is able to distract herself form the contractions and at others, be totally involved in them. She may use meditation and chanting with the support of yoga groups’ spiritual participation.
Practitioners in yogic methods believe that a woman can handle childbirth in a mature and serene way. Yogic childbirth education helps in the belief that a woman has the ability to create or destroy her own pain and joy during birth.
