Fewer Drugs for Happier Mothers

"Instead of being tired, I was exhilarated," said one mother. "In the recovery room," bubbled another, "I wanted to sing and shout about my Pavlov baby." The 300 young women wearing diaper-shaped name tags who flocked around the huge, white-icinged cake in a suburban St. Louis garden last week all showed the same enthusiasm. All of them had given birth without general anesthetics in St. Mary's Hospital, where more (1,182) babies have been delivered by natural child birth than in any other hospital in the U.S. The fifth-birthday celebration of St. Mary's natural-childbirth program last week reflected the growing acceptance of a method that was first tried (and denounced) in the U.S. less than 20 years ago, and is now at least a part-time practice in maternity wards from Long Island to Los Angeles.

Fear & Pain. Modern concepts of natural childbirth were first suggested more than 40 years ago by British Obstetrician Grantly Dick Read, who taught that bearing children is not necessarily painful, that pain comes only because of fear, which may interfere with contractions of uterine muscles that open the womb and push the child out through the birth canal. Pavlovian psychologists in Soviet Russia took Dick Read's idea one step farther. Both fear and pain, they reasoned, could be overcome by conditioning. During the 1940s, Soviet doctors began educating mothers to be unafraid of childbirth, and by 1951 hospitals in Moscow, Kharkov and Leningrad all used the natural-childbirth method.

Visiting Russia in 1951, French Obstetrician Fernand Lamaze brought psycho-prophylaxis, a new form of childbirth preparation, back to France with him, began insisting that maternity patients get ready for birth with a routine of exercise. He taught his patients chest breathing to prepare them for the time when their abdominal muscles would help expel the baby from the uterus. He schooled his patients in effleurage, a simple massage of the lower abdomen that serves to lessen muscular tension during contractions. Most important, Lamaze taught women to relax while participating actively in labor.

Slow & Shallow. The Lamaze method is now taught in a dozen major U.S. cities, and even hospitals where doctors are not Lamaze disciples admit to weaving some of his and Dr. Dick Read's teachings into their obstetrics. Just about all big-city hospitals allow the husbands to be with their wives during labor (a Lamaze precept; it helps to relax the mother), and the most diehard anti-naturalists among obstetricians now recognize the value of prenatal education and exercise.

St. Mary's in St. Louis begins teaching Lamaze breathing exercises (slow, deep breathing when contractions begin; shallow panting when they increase) to women in their seventh month of pregnancy. "The babies are born happier when they're delivered the Lamaze way," insists Sister Mary Charitas, a small, peppery nun who also teaches nursing at St. Louis University School of Nursing and Health Services. "They're easier to take care of, they're more alert--probably because the mother has not had medication that would make them sleepy."

Sister Charitas' observations are based on sound medical theory. Obstetricians are increasingly aware that an overdependence on anesthetics can lead to fetal damage. On the other hand, nobody expects mothers going through natural childbirth to be martyrs. St. Mary's Dr. Carl Dreyer tells all natural-childbirth mothers in the delivery room: "Any time this ceases to be fun, we can give you gas." But a surprising number never ask for it, prefer instead to reap the psychological benefits of wide-awake participation in their baby's birth. "It is common for a natural-childbirth mother right after birth to talk about having another baby," says Sister Charitas, "but I have never known a mother who had a general anesthetic to mention having another baby that soon."

Nonetheless, among U.S. medical men, nonbelievers still outnumber believers in natural-childbirth methods, and many obstetricians tend to deride the evangelical fervor of the naturalists for drugless childbirth. But even doctors who are not advocates of natural childbirth are willing to acknowledge that there is good in what the naturalists preach. Nowadays, fewer mothers are anesthetized in delivery--a practice long scorned by naturalists. There is also a growing trend toward the type of prenatal preparation and exercise that naturalists have been strongly recommending as standard obstetrics for more than three decades.

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