"Painless Childbirth: The Lamaze Method" (Lamaze); A book review

If Dr. Grantley Dick-Read is the father of natural childbirth, then Fernand Lamaze is probably the uncle. He is arguably our society's most recognized expert and forerunner on the subject, and it all started with the book, Painless Childbirth. I recently picked this book up for the first time and I was surprised at the depth of knowledge that it contained, both from a physiological and philosophical perspective. Being trained as a HypnoBirthing instructor, I was always taught that painless childbirth was inherently natural and normal, although the promise of such an experience was beyond the scope of an instructor such as myself. That said, Lamaze was presented as a hopeless optimist, one who indeed brought useful ideas, techniques and outcomes to many women and families, but who varied slightly in his approach--as one would who started a movement, but did not see it through to complete fruition. This book has given me a new and different perspective on Lamaze, one that presents his philosophy and life's work as nothing less than extraordinary.

This book talks about several pertinent topics in great detail and frequency--hypnosis, the nervous system's role in pain and the physiology of childbirth. First, hypnosis is mentioned by Lamaze several times throughout the book (particularly at the beginning in Chapter 1, where hypnosis is presented in the traditional sense as an analgesic technique for relieving pain. Hypnotic concepts, similar to those taught in Hypnobirthing classes, are also mentioned, although not given names. This content was most fascinating! He describes how the brain works with the nervous system to create conditioned reflexes (such as that discovered by Pavlov's salivating dogs) and a concept called reciprocal induction (also by Pavolv). Conditioned reflexes can be likened to the practice that Hypnobirthing moms use for relaxation, so that by the time labor comes, she knows exactly how to breathe and to move her body, and her body responds in-kind. Reciprocal induction is similar to what I understand to be pacing (focusing on a present-moment visual, auditory or kinesthetic reality). According to Lamaze, this activity in the body/mind "distracts" the mind from focusing on one sensation (e.g., surges) or one mind-set (or thought process) such as an assigned meaning that is given to that sensation (e.g., surges will hurt). He also describes the neurology behind the focus on typical Lamaze "distractions"--the purpose of focusing on other sensations and thoughts is not to take the mind away from it, per say, but to initiate the function that allows all other thoughts and functions to fade into the background.

This function is the physiological mirror to "The mind can only hold one thought at a time." According to Lamaze, when a mom in labor chooses to focus on the physical sensations of her breathing, and the thoughts that accompany that action, the brain automatically puts more energy into that one function, while all other functions, though still happening, are allowed to proceed without undue attention. In the case of labor, those "other" functions would be the surging uterus, resulting in the brain's lack of ability to register pain.

That is a great start, but that isn't all. There's more to it. Lamaze also talks about the effect of words and emotion in the presence of pain, and spends a chapter discussing the contributions of Grantley Dick-Read to the philosophy of painless childbirth experiences. According to Lamaze, Dick-Read's work (presupposing that pain in labor and birthing is a cause of a macrosomic devergence from more primitive, animal-like birthing practices, caused by fear and creating fear-tension-pain) was important, but lack's the attention to the modern day woman who lives in a civilized world where pain in birth is real. I think it's an important distinction, because Lamaze goes further to say that there are other reasons why moms in labor are uncomfortable, and that all of these reasons need to be addressed. In my mind, HypnoBirthing is a perfect blend of these two approaches, in that it does address all of the contributing factors to discomfort.

Lamaze's book goes on to describe the actual labor and birthing process, with very detailed physiology. Please keep in mind that this book was written in the 1950's, which makes it a bit dated as far as birthing techniques go. It reminds me of Bradley's work in some instances, because it teaches techniques such as valsava's maneuver (a.k.a., purple pushing, forced pushing, closed-glottis pushing), which have found to be unnecessary and even harmful (to the pelvic floor) in modern studies. Without the help of the most modern science, these early natural birth advocates can be seen only as early pioneers or contributors--although, they are great ones, at that. Our modern practices are riding on the coattails of these amazing early philosophies.