Taking Great Pains
Written By Tina Cassidy
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circa 1960-1975: enter natural childbirth
British obstetrician Grantly Dick-Read had grown up on a farm, and he did not believe women should have it any harder than domesticated animals. He was sure a natural labor could be joyous and not very painful. Fear and tension were to blame for suffering during labor, Dick-Read insisted, and if he could reduce anxiety through education and support, birth could become a positive natural experience. His 1933 book Childbirth Without Fear (published in the States in 1946) helped seed a revolution: Dick-Read is credited with coining the phrase "natural childbirth." But a hostile medical establishment marginalized him before his death in 1959.
There was one doctor, however, who was keen to build on what Dick-Read had started. Fernand Lamaze, a French obstetrician, knew Dick-Read's work. He also believed that women could give birth drug-free and in control. Lamaze, however, had a more hands-on approach. His technique was based on psychoprophylaxis, or mind over matter, taking a cue from the Soviet physiologist Ivan Pavlov (as in Pavlovian — think dogs salivating at the ring of a bell).
Like Dick-Read, Lamaze might have been dismissed — had it not been for Marjorie Karmel, an American in Paris who had sought out Lamaze to deliver her first child. Karmel took classes with Lamaze's assistant, Madame Cohen, who taught her that she could train her mind to suppress pain. "That is why we don't call our system 'natural' childbirth," said Cohen (imperiously, one imagines). "The final result should be better than nature."
Lamaze's trick was to breathe more often (some called it the small-dog panting technique). He theorized that much of the pain of labor was caused by the extraordinary activity of the uterus, which exhausts the supply of oxygen in the blood. Karmel's experience provided the basis for her 1959 book, Thank You, Dr. Lamaze. In 1960, Karmel and one of the book's admirers — Elisabeth Bing, a clinical assistant professor at New York Medical College — formed the American Society for Psychoprophylaxis in Obstetrics, to teach childbirthing classes. In 1967 a New York Times article on natural childbirth quoted a nurse from the Maternity Center in Manhattan saying that, when it came to the Lamaze Movement, "the fad element has been weeded out. Now it's in the middle of the road."
Bing, now 92, is philosophical about this sea change: "It wasn't really a movement by Lamaze or Read or me. It was a consumer movement. The time was ripe. The public doubted everything their parents had done."
