Tools for Labor
Childbirth training prepares you for birth on three levels—mentally, emotionally, and physically. You prepare mentally by learning all that you can about the natural process of labor and birth, and about the complications that sometimes arise. You also become aware of various comfort measures that can reduce pain perception and provide relief. Emotionally, you are encouraged to think positively about your birth experience and to openly face your anxieties and fears. Physically, you practice exercises that promote comfort during pregnancy and birth, as well as techniques that encourage relaxation, offer distraction, and help focus attention during labor.
Fernand Lamaze, a French obstetrician, first realized the importance of preparing for childbirth while observing the labors and deliveries of Russian women using the techniques of psychoprophylaxis. The word psychoprophylaxis means “mind prevention”, and the techniques involve using the mind to reduce the awareness of pain sensations. Upon returning to France, Dr. Lamaze modified the techniques and began practicing them in his clinic. The techniques have since become synonymous with his name. Marjorie Karmel introduced the Lamaze method into the United States in the 1950s after having a baby under Dr. Lamaze’s guidance in France.
The Lamaze method is based primarily on the principles of conditioned response training discovered by the Russian physiologist Ivan Pavlov during experiments with dogs. Each time Dr. Pavlov fed the dogs, he would ring a bell. When the dogs saw the food, they would naturally salivate. After a period of time, whenever the dogs heard the bell, they would salivate. In other words, they become conditioned.
Using Pavlov’s theory for childbirth preparation, you will learn new, positive response to the contractions of labor. When you feel a contraction begin, you will consciously relax and breathe in patterned, controlled way, rather than holding your breath and tensing your muscles the way an unprepared woman does.
Your preparation will also break the fear-tension-pain cycle, first identified by Dr. Grantly Dick-Read as a major contributor to the pain of childbirth. This cycle accurately describes the labor experience of an unprepared woman, who enters labor full of fear—fear of the unknown; fear of what she was taught to expect by television, books, friends, family and other sources; and fear of being alone. Her natural response to this fear is to tense her muscles. (Consider how you react to narrowly missing a traffic accident or watching a terrifying movie). This muscular tension creates painful contractions, which make her more fearful of the next contraction, which is then more painful because of the increased tension. The cycle continues, increasing in intensity throughout the labor.
Adequate preparation, however, breaks the cycle. The fear is eliminated by gaining information about labor and birth, which promotes a positive attitude. The tension is relieved by using relaxation techniques, and the painful sensations of labor are reduced by using breathing techniques and other comfort measures. The fear-tension-pain cycle is therefore eliminated before it can even begin during labor. Other methods of prepared childbirth are based on the same principles, but offer variation in techniques.
In France, during the early days of Lamaze, the laboring woman was accompanied and aided by her monitrice, the woman who taught her the techniques. In the United States, the labor companion is usually someone emotionally close to the woman, such as her husband, boyfriend, mother, sister, or close friend, who is also trained in the techniques. In addition, some women choose to hire a professional labor support person, or doula.The love and support of the labor companions are other important factors in creating a confident, positive attitude toward the childbirth experience.
Chapter  presented physical exercises to enhance comfort during pregnancy and to prepare the body for giving birth. Chapter  will discuss the physical process of labor and birth, as well as normal hospital and birthing center procedures. This chapter focuses on the relaxation techniques and breathing patterns that will become your response to the contractions of your uterus during labor. A variety of other comfort measures that can be used by you or your partner during labor are also provided.
By practicing the exercises in Chapter  and this chapter together, you and your labor partner will develop teamwork, as well as learn specific skills. The ability to work together as a team—to communicate clearly and to trust each other—is as important to the labor experience as are the skills you are learning. Teamwork takes time to develop, however, so give each other encouragement and positive feedback at first. As you become comfortable working with each other, slowly begin discussing where you need improvement.
Take time each day to practice together. The quality of your labor experience will depend greatly upon the amount of time you prepare together and the quality of those sessions.