'Lamaze is basicaly keeping the pain of childbirth to a minimum
through developing breathing and relaxation techniques'

Pregnancy,
the essential guide from NEW BABYmagazine, February/March 2002

Tools of the trade: how you'll know what is what

If there was ever a healthcare practitioner you'd want by your side through the stresses and strains of labour, Jane Howard is that person. Warm, funny, and a mother of four, here is a lady who knows her stuff – and manages to impart it in actually looking upon your labour as an enjoyable experience. Well, almost.

Lamaze (pronounced la-marrs) was developed by French obstetrician Fernand Lamaze, who hypothesised that the pain associated with labour could be reduced by "welcoming" each contraction and learning to work with it instead of against it. He also advocated thoroughly education the women about her impending labour, thus reducing the fear attached to the birthing process that contributes to increased levels of tension and therefore pain.

The philosophy behind Lamaze classes is very much about making the labour as positive an experience as possible, and focuses on giving women a choice in the type of labour and pain control they want. It is designed to prepare the couple for every eventuality, giving them coping tools for that painful bit between starting labour and holding your beautiful baby in your arms.

Despite the fact that she is obviously hugely knowledgeable in her field, one of the most endearing things about Jane is she's a little bit scatty – a million miles away from draconian midwives or antenatal teachers of years gone by. A practising obstetric physiotherapist, Jane has been teaching Lamaze classes for 26 years – since she was expecting her first child when she lived in Los Angeles.

'I already had a medical degree as I had trained as a physio previously, and although a medical background isn't necessary, you must have a degree if you want to train as a Lamaze teacher,' says Jane. 'Often, it's sort of career you can combine with bringing up your own children – it is a subject very close to childbirth educators' hearts. There is not enough childbirth education out there, but there are plans afoot to introduce Lamaze training courses to the UK. It's early days but the ball is rolling!'

Jane fully admits that one of the reasons Lamaze is rarely practised in the UK may be because its image is a little 'hip' for us pragmatic Brits. 'When I trained, even in the States, no-one in the medical profession approved of a non-medicated delivery – it was thought of as very hippy,' she says. 'It's true that it's quite hard to define Lamaze – basically it's keeping the pain of childbirth to a minimum through breathing and relaxation techniques. Visualisation is an important factor, as is massage. If women are educated about what they'll go through, this reduces the fear factor greatly.'

A common perception to this sort of natural approach, however, is that women are wrapped up in cotton wool throughout their pregnancy, only to find the harsh reality of the big day sends them waddling for an epidural as fast as their swollen feet can carry them.

'I imagine it all to be a bit airy and vague,' says mum-to-be Vicky Watson, who is seven months pregnant with her first child. 'I'm sure it's because of my lack of knowledge, but with my first child, at leas, I'd like to go with something more familiar. I'd be worried if I committed to a drug-free labour that I wouldn't be able to have anything if things got bad and I couldn't cope.'

'This is a common misconception, but in fact Lamaze is not about enforcing a drug-free labour,' says Jane. 'Of course there is a time and a place for medication. My thing is allowing the women to have a choice. 'Being empowered' is the key word these days. Think about it: for nine months we have looked after ourselves probably better than we ever have, as we nurture the baby inside us. We've given up booze, cigarettes, even soft cheese – then, right at the last minute, we allow ourselves to be pumped full of drugs.'

'I am absolutely not against pain medication – it's about allowing our bodies to give birth rather than have the medical profession take over. We can no longer assume that our bodies will be allowed to get on with what they are made to do quite naturally,' adds Jane.

Feedback from midwives is positive. 'Many say that it makes their lives a lot easier, that couples understand exactly what's happening and they know what's what,' says Jane. 'My Lamaze classes are structured as four tow-and- a-half hour sessions, with only five or six couples maximum – it's so much more manageable that way. I'm finding that I am getting busier – word is filtering through – but of course, there's a limit to how many classes I can teach.'

'We start by going over the physical problems of pregnancy, such as caring for your back and pelvic floor, then look at the anatomy and physiology of labour, using tools of the trade. We'll go over massage techniques the partners can use to help alleviate the pain, and discuss medication, the position of the baby, labouring positions, Caesareans tec. The group leaves the session fully informed. They have to – if a woman wants to go through labour without pain relief, she's better be prepared. It's the biggest thing she'll ever do.

'The thing about Lamaze classes is they are very practical, focusing on the couple working together, but all the things learnt can be used with an epidural or TENS machine, for instance – they are not mutually exclusive. But the hormones released naturally during labour – endorphis and oxytocin – will help if you know how to use them.'

Jane continues: 'Giving birth is something that all women have the innate wisdom to do. In many cases, an epidural is the right thing, but my concern is for the woman who'd like to go through labour without medication and don't get the chance or feel able to voice their opinions. There is no such thing as 'failure' in terms of labour – my job is simply to ensure as positive a birth experience as possible, as naturally as women feel comfortable with.'

Tools of the trade: how you'll know what is what

When you are attending a Lamaze class a number of apparatus will be used to provide you with a good idea of what will happen during labour:

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