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Lamaze technique

Abstract

The Lamaze technique, also known as the psychoprophylactic method or simply Lamaze, started as a prepared childbirth technique popularized in the 1950s by French obstetrician Dr. Fernand Lamaze based on his observations in the Soviet Union as an alternative to the use of medical intervention during childbirth. Today, Lamaze has become a popular way to get information about pregnancy, birth, and parenting through Lamaze International.

The stated goal of Lamaze is to increase a mother's confidence in her ability to give birth; classes help pregnant women understand how to cope with pain in ways that both facilitate labor and promote comfort, including relaxation techniques, movement and massage.

History

Dr. Lamaze was influenced by childbirth practices in the Soviet Union, which involved breathing and relaxation techniques under the supervision of a ""monitrice"", or midwife. The Lamaze method gained popularity in the United States after Marjorie Karmel wrote about her experiences in her 1959 book "Thank You, Dr. Lamaze", and with the formation of the American Society for Psycho prophylaxis in Obstetrics (ASPO Lamaze). Currently Lamaze International, founded by Karmel and Elisabeth Bing, is the premier childbirth education certifying organization in the world.

Modern Lamaze childbirth classes teach expectant mothers many ways to work with the labor process to reduce the pain associated with childbirth and promote normal (physiological) birth including the first moments after birth. Techniques include allowing labour to begin on its own, movement and positions, massage, aromatherapy, hot and cold packs, breathing techniques, the use of a "birth ball" (yoga or exercise ball), spontaneous pushing, upright positions for labour and birth, breastfeeding techniques, and keeping mother and baby together after childbirth. Each class has a specific curriculum that includes learning about common medical interventions and pain relief such as an epidural in an evidence based, non-biased manner.

The "Six Healthy Birth Practices"

The core beliefs of Lamaze International can be summarized with their Six Healthy Birth Practices. Each is heavily sourced from medical literature to provide sound evidence for the safest possible birth for baby and mother. These six practices are as follows:

1. Healthy Birth Practice 1: Let labor begin on its own

2. Healthy Birth Practice 2: Walk, move around and change positions throughout labor

3. Healthy Birth Practice 3: Bring a loved one, friend or doula for continuous support

4. Healthy Birth Practice 4: Avoid interventions that are not medically necessary

5. Healthy Birth Practice 5: Avoid giving birth on your back and follow your body's urges to push

6. Healthy Birth Practice 6: Keep mother and baby together - It's best for mother, baby and breastfeeding

Each of the above practices include a video, a patient handout, and professional references for medical personnel. The Lamaze Healthy Birth Practices are also available in eleven languages: English, Mandarin, Russian, Spanish, Portuguese, Czech, Polish, Romanian, Greek, Arabic, and Hebrew.

Lamaze Certified Childbirth Educators (LCCE)

The Lamaze Certified Childbirth Educator (LCCE) designation is awarded to those who, after a period of learning and teaching, sit for and pass a certification exam. This exam is accredited by the National Commission for Certifying Agencies (NCCA), the only childbirth education organization to hold this designation.

Criticism

Lamaze himself has been criticized for being over-disciplinary and anti-feminist; "[t]he disciplinary nature" of Lamaze’s approach to childbirth is evident from Sheila Kitzinger’s description of the methods he deployed while working in a Paris clinic during the 1950s. According to Kitzinger, Lamaze consistently ranked the women’s performance in childbirth from "excellent" to "complete failure" on the basis of their "restlessness and screams". Those who "failed" were, he thought, "themselves responsible because they harbored doubts or had not practiced sufficiently", and "intellectual" women who "asked too many questions" were considered by Lamaze to be the most "certain to fail". The Lamaze technique has also been criticized for being ineffective.