As you think about where you'd like to deliver your baby, you can also choose the type of labor experience you would like to have. Although the baby will push his way down the birth canal and into the world whether you're ready or not, it's better to be prepared. When you look for a childbirth class, you'll find that there are many different kinds. There are classes offered by hospitals, YWCAs, health maintenance organizations (HMOs), physician medical practices, and so on. Each offers a unique approach to pregnancy and childbirth, so look around to find one that reflects your beliefs and philosophies. The most popular include classes that teach the birth methods of the International Childbirth Education Association, Lamaze, The Bradley Method, Grantly Dick-Read, and Leboyer gentle birth.
Classes sponsored by the ICEA do not emphasize any particular approach to childbirth. They offer general information about the process of labor and birth. They discuss natural childbirth, teach various methods of dealing with the pain of labor and birth, and present the options available for pain relief. All instructors are certified by the ICEA.
Lamaze is probably the most widely used method of birth in the United States. It was first introduced in France in 1951 by the French obstetrician Fernand Lamaze.
It emphasizes natural birth and offers a variety of relaxation methods to deal with pain (although an overview of anesthesia and pain relief is included for women who prefer this). Visualization, guided imagery, massage, and coaching from a partner are all part of this program. Lamaze is best known for its patterned breathing routine that teaches a woman to focus on certain breathing patterns and a concentration point (such as a mark on a nearby wall). This technique makes it possible to block pain messages to the brain. If practiced throughout the pregnancy, a woman's conditioned response to contractions becomes a relaxed method of breathing rather than muscle tension and fear. Official Lamaze classes are taught by teachers who are certified by the American Society for Psychoprophylaxis in Obstetrics (ASPO/Lamaze) and use the initials ACCE (ASPO-certified childbirth educator) after their names.
The Bradley Method emphasizes natural childbirth with the parents working as a team. Diet and exercise are practiced throughout the pregnancy to prepare the body for the rigors of birth. Bradley students are taught deep abdominal breathing and an understanding of the labor and delivery process. Rather than try to block out pain, the Bradley method encourages concentrated awareness that works through the pain. There is much emphasis on the education and training of the woman's labor and birth coach.
It was the Bradley Method that first introduced the idea of husband coaches in the delivery room. Before this method became popular, expectant dads stayed out of the way, paced the floor in the waiting room, and worried. Some men say they like it better that way, but many appreciate the fact that they can now participate in the birth of their child, support their partner, and be present the moment their baby greets the world.
Grantly Dick-Read was an English obstetrician in the 1920s when the management of birth pain was handled by knocking the women unconscious with chloroform. After watching a woman refuse chloroform and deliver her baby without trauma or pain, Dick-Read came to believe that fear and tension were the cause of labor pains. He noticed that no other animal species experienced suffering, pain, or agony during the birth process and hypothesized that a woman's fear of labor pains caused blood to be filtered away from the uterus, so it could be used by the muscles that would flee if the fear were caused by a dangerous situation (sometimes called the flight-or-flight response). As a result, the uterus did not have the oxygen supply it needed to perform efficiently or without pain. He believed that by eliminating the fear, women could return the uterus to its normal function—without pain. In 1933, Dick-Read put his ideas into a book called Natural Childbirth that was not well received by the British medical community.
Dick-Read died in 1959, but his theory remains the basis of many of today's childbirth classes. His ideas are still quoted in books and papers by many of the world's most notable childbirth educators. He believed that education about the birth process and relaxation exercises during labor were the keys to reducing labor pains. Today, few disagree with this insight. Although it is out of print, Dr. Dick-Read's book Childbirth Without Fear is still available through various online booksellers such as amazon.com. You might also enjoy reading Post-War Mothers: Childbirth Letters to Grantly Dick-Read by Mary Thomas (University of Rochester Press, 1998).
After the birth of your baby, don't hold your breath waiting for the sound of a slap on the bottom and a sudden loud cry. This method of greeting a newborn is no longer common practice. Today, the baby is stimulated by a gentle rubbing on the back, if stimulation is needed at all.
A hospital delivery room is not the most inviting place for a newborn. The lights are bright, the noise level can be high, and until a few years ago the newcomer was welcomed by being hoisted aloft by his ankles and slapped on the buttocks. A French obstetrician named Frederick Leboyer wrote a book in 1974, Birth Without Violence, calling for a more sensitive and gentle approach to birth. His recommendations have evolved into the Leboyer method, which advocates low lights and soothing music in the delivery room. The newborn is immediately placed on her mother's abdomen, postponing umbilical cord cutting and suctioning. The baby is then placed in a warm bath to enjoy a return to the weightlessness of the womb. This method of childbirth is gaining in popularity. The birthing rooms are now often well-designed with adjustable lighting and with medical equipment available nearby, but out of sight.
Excerpted from The Complete Idiot's Guide to Pregnancy and Childbirth © 2004 by Michele Isaac Gliksman, M.D. and Theresa Foy DiGeronimo. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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