This document provides information about psychoprophylactic methods for labor and childbirth, specifically the Grantly Dick-Read method and the Lamaze method. It describes the history and development of each method, the underlying theories, and techniques taught to help alleviate pain and fear during childbirth. The Grantly Dick-Read method focuses on eliminating fear through education and the use of breathing exercises at different stages of labor. The Lamaze method originated in Russia and France and teaches breathing and relaxation techniques, as well as the importance of movement, positions, and partner support during labor and delivery.

1. PSYCHOPROPHYLACTIC METHODS
PRESENTED BY:
NELMA JOSEPH

2. PSYCHOPROPHYLACTIC METHODS IN LABOUR

3. INTRODUCTION
Bringing a baby into this world is one of the most
natural and instinctive acts that a woman's body is
programmed to do. Though childbirth is the most fantastic
adventure a mother can have, with all the pressures of the
modern world, it's a challenge for women to develop
confidence, trust their intuition and allow their maternal
instincts to take over.

4. GRANTLY DICK-READ CHILDBIRTH METHOD
It was the first "natural childbirth" program, a term coined by Dr.Read in the
1930s. Basically Read held that childbirth is a normal, physiological procedure and
that the pain of labor and delivery is of psychological origin-the fear-tension-pain
syndrome. He countered women's fears with education about the physiological
process, encouraged a positive welcoming attitude, corrected false information, and
led tours of the hospital. To decrease tension he developed a series of breathing
exercises for use during the various stages of labor. To foster relaxation and optimal
physical function in labor and recovery after delivery, he incorporated a series of
physical exercises to be performed regularly in classes and in practice at home during
pregnancy.

5. DEFINITION
Grantly Dick-read Method is a psychophysiological preparation for
childbirth. This technique alleviates pain during childbirth by blocking feelings
of fear and tension.

6. HISTORY
Dr.Grantly Dick-Read is an English obstetrician who was practicing
medicine in 1900’s. To alleviate pain during childbirth Dr.Dick-Read was
administering chloroform (generally given routine in those times during
the last stage of labour) to women. One woman whom Dr.Dick-Read
handled refused chloroform for pain relief. After this woman gave birth, the
gynaecologist’s curiosity led him to ask why she had not accepted the drug.
The woman responded that it did not hurt since delivery was not meant to
injure and hurt women.

7. The woman’s experience of a painless delivery without taking
chloroform led Dr.Grantly Dick-Read to study and observe about childbirth
in natural process. He wrote these observations and data in a manuscript
entitled, “Natural childbirth.” His work brought personal and professional
ridicule, but that did not stop him from sharing his thoughts and beliefs.
On 1933 his book, “Childbirth without Fear,” was published. He
explained in this publication that no physiological function in a person’s
body can give rise to pain under the condition that it is of normal course of
health. Unless a disease process is taking place, pain or agony would
associate delivery.

8. THEORY
Women who had been prepared for childbirth still experience pain because
of fears associated with the event. Dr.Dick-Read postulated that this fear felt by
women during delivery causes the blood to be carried away from the uterus to be
used by the muscles needing it due to perceived pain. This results to an
unoxygenated uterus which would be unable to perform its function well leading
to pain, a phenomenon called “the fear-tension-pain syndrome.” Dick-Read
believed that presence of fear and tension result to labor pains. Thus, eliminating
fear would increase blood supply to the uterus and alleviating labor pains. He also
identified that labouring women needed constant emotional support to help them
cope.

9. TECHNIQUE
To prevent the fear-tension-pain cycle Dick-Read developed a method of
slow abdominal breathing in the early stage of labor and rapid chest breathing in
the latter stage. A woman should break the chain of events occurring (between fear
and tension or tension and pain) to reduce the pain during contractions.
Relaxation, comfort and minimal pain are achieved only if the woman focuses on
abdominal breathing during contractions.

10. The woman is helped to manage labor and delivery by using the Read method in
the following way:
• During the early and middle first stage of labor:
Before cervical dilation has reached 7 cm, contractions are 2 to 5 minutes
apart and last for 30 to 40 seconds. The mother lies on her back with her knees
bent. Abdominal breathing is used during contractions. Her hands are placed over
her lower abdomen, fingers touching. She breathes deeply and slowly-in through
her nose and out through her mouth. The abdominal wall rises with each
inhalation, which she can feel with her hands. The rate of breathing is not more
than six breaths in 30 seconds, or 12 to 18 in one contraction.

12. • During the late part of the first stage of labor:
After 7 cm of cervical dilation, the contractions are 1½ to 2 minutes
apart and last for 40 to 60 seconds, costal or diaphragmatic breathing is used
during contractions. The mother's hands are placed on her sides, over the
ribs. She breathes in more shallowly, feeling her ribs move sideways against
her hands. Each breath is drawn in through her nose and exhaled through her
mouth. The abdominal wall does not rise and fall with this kind of breathing.
The rate of breathing is no more than six breaths in 30 seconds, or 12 to 18 in
one contraction.

13. • At the end of the first stage of labor:
Near full dilation, contractions may be very strong, occurring every 1½
to 2 minutes and lasting 60 to 90 seconds. The mother lies on her back with
her knees bent. Panting respirations are used during the contractions. The
mother holds one of her hands on her sternum, which rises and falls as she
pants lightly and rapidly through her mouth. Panting continues through the
end of the first stage to full dilation as the urge to push grows. Panting helps
the woman avoid pushing.

14. • During the second, or expulsive, stage of labor:
After full dilation of the cervix, the contractions occur every 1½ to 2
minutes, last 60 to 90 seconds, and are accompanied by an urge to bear down
and push. The woman lies back, head and shoulders supported in a semi-sitting
position. She is helped to draw her legs up and hold them, with her hands behind
the lower thighs and thighs on her abdomen, spread apart. As each contraction
begins, she raises her head, takes a deep breath, tucks her chin on her chest,
blocks the escape of air from her lungs, and bears down. During each contraction
she may need to blow the air out, refill her lungs, and push again two or three
times.

15. Throughout labor she is helped to understand what is occurring and to
participate and accept the experience in anticipation of the birth of the baby.
Currently many authorities who advocate use of other aspects of the Read
method strongly recommend that a woman in labor not lie on her back. Supine
hypotension is frequently the result of this position, because the uterus can fall
back, occluding the vena cava and decreasing the volume of blood returned to the
heart, thus reducing the volume of the cardiac output. Maternal hypotension
follows, resulting in decreased placental perfusion and an inadequate supply of
oxygen to the fetus. Today the woman using the Read method spends most of labor
lying on her side or in a semi-sitting position with her knees, back, and head well
supported.

16. THE LAMAZE METHOD
Lamaze originated in Russia and then became popular in France before it was
introduced in the United States in the 1960s. Designed to educate and prepare
expectant mothers to help them conquer fear and tension, its popularity grew in
tandem with the women’s liberation movement in the 1970s. Teaching specific
breathing techniques to prepare for and control pain, Lamaze appealed to a
generation of women who had been challenged to take control of their bodies. As
women changed over the last four decades, so has Lamaze. “We don’t call it
‘natural’ or ‘prepared’ anymore,” says Barbara Hotelling, president of Lamaze
International, “but rather ‘normal’ childbirth.”

17. The term “normal” implies, for example, that labor starts on its own and
interventions, such as the artificial rupture of the membrane, are not routinely
administered. Today’s Lamaze classes, Hotelling says, are more interactive than
they used to be and instructors use a greater variety of teaching strategies.
Breathing techniques, like the much-disparaged “dog panting,” are de-emphasized
and replaced with labor-support techniques, such as massage and aromatherapy.
Above all, Lamaze today is focused on helping women become fully informed and
confident about childbirth.

18. 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 Psychoprophylaxis in Obstetrics (ASPO
Lamaze). Currently Lamaze International, founded by Karmel
and Elisabeth Bing,[2] is the premier childbirth education
certifying organization in the world.

19. 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.

21. SIX PRACTICES
The Lamaze method encompasses six practices for women to have a healthy birth:
•You should allow labor to begin on its own. Your baby will come when he is
ready!
•Avoid interventions that are not medically necessary.
•Having the support of a partner, friend, or doula is essential. People who can offer
love, reassurance, and encouragement will make the birth experience a positive
one.
•It is helpful to walk, move, and change positions throughout labor. Freedom of
movement makes it easier to cope with contractions.

22. • Squatting, sitting, or lying or your side can make it easier to follow your
body's urge to push. If possible, you should avoid giving birth on your back.
• After birth, mother and baby should be left together to facilitate bonding.
Skin-to-skin contact on the mother's chest or abdomen is especially helpful for
breastfeeding.

23. LAMAZE TECHNIQUES:
• Beyond the Breathing
Controlled breathing is an important technique in Lamaze. Focusing on breathing
helps women manage the pain of contractions. Changing the rhythm of your
breaths with the strength and length of the contractions is another method to cope
with pain. Although breathing exercises are an important part of the Lamaze
method, they are accompanied by several other exercises that can help ease pain
and discomfort of labor and birth.

24. • Imagery and Visualization
One important technique is the use of imagery and visualization. Focus on
something pleasant to engage yourself and distract your mind from the pain.
Imagining the process using positive thoughts and feelings while visualizing the
birth in a constructive light can be very helpful.

25. • Relaxation Techniques
Relation techniques involve learning ways to relax the entire body; this also helps
the woman deal with contractions. The progressive technique is a common
strategy and begins with relaxing one body part at a time, like the toes, and
continues until the entire body is relaxed. Some women practice this strategy
throughout pregnancy.

26. • Partner Massage
Having a Lamaze coach/partner learn massage techniques can ease the pain and
discomfort of the laboring woman. One of these techniques include pressure
massage and another is lightly massaging the abdomen with the fingertips. The use
of heat and cold can also be soothing.

27. • Focal Point Imagery
This technique involves focusing on a particular place or moment in time and
taking in all of the sights, sounds, and smells to ease discomfort. This may also
include focusing on a particular person or point in the room; some women bring in
an object from home to use. Concentrating on one object keeps the mind occupied
to distract from the pain.

28. • Movement
Movement throughout labor can assist in the birth. Moving into a comfortable
position, such as upright or walking, throughout the labor process is encouraged
and allows gravity to help move the baby downward. Movement may also distract
you from pain as well.

29. • Another Technique: Pushing
As Judith A. Lothian explains in the article Really Teaching Lamaze: What About
Pushing?, pushing in Lamaze is not a directed activity. It is a natural response to
contractions and the descending baby. Women should be encouraged to respond
naturally by using techniques like the following:
• Moving, tightening, and releasing vaginal and perineal muscles
• Moaning
• Occasional breath holding
• Not using a prescribed "right" position for birth

30. Taking classes through Lamaze International can help expectant parents learn
more about Lamaze techniques. Although hospitals may offer classes, instructors
may be restricted on what is and is not taught by hospital guidelines.
LAMAZE CLASSES
Most doctors recommend first time mothers attend a childbirth or Lamaze class,
where you can learn the following information and techniques:
• What to expect during your pregnancy and after the baby is born
• How to eat healthy while pregnant and breastfeeding

31. •How to curb morning sickness
•Vaginal and caesarean childbirth and alternative methods of birth, such as home
birth and water birth
•Stages of labor and the signs of going into labor
•Breathing techniques
•Relaxation techniques
•Communication techniques with doctors and nurses
•How to be a good coach

32. • Coping techniques for labor
• Pregnancy and birth complications
• Pre-admittance to the hospital and possibly a tour of the hospital
• How to take care of a newborn
• Breastfeeding verses bottle-feeding
Women typically begin taking Lamaze classes in the seventh month of
pregnancy. However, many communities find that classes fill up quickly. It is best
to plan to enroll in Lamaze six to eight weeks before classes begin.

33. LAMAZE FOR SINGLE MOMS
One of the goals of Lamaze is to make the baby's father feel involved in the birth process
through his role as the birth coach. But you can still use these techniques even if you are
going to be a single mom; your birth coach may be someone else who can still benefit
from the education. Some of the topics Lamaze classes cover for the birth coach include
the following:
• Massage techniques
• Comfort measures, such as hydrotherapy
• Relaxation skills
• How to offer labor support and advice

34. EMPOWERING WOMEN DURING CHILDBIRTH
Learning about Lamaze techniques can empower women to make informed
decisions regarding their childbirth experiences. Whether or not you use the
techniques during actual childbirth, it is good to know the options available to help
work through the pain and discomfort that comes naturally with labor.

35. PREPARING FOR BIRTH WITH THE LAMAZE METHOD
The Lamaze method was developed by French obstetrician Ferdinand Lamaze in
the early 1950s and is one of the most common birthing programs today. You can
learn this method by taking a series of classes. The goals of these classes are to
help you get ready for labor and to replace any negative preconceptions about
pregnancy and the birth process with positive feelings.
These classes will also help you learn coping and pain management skills for the
birth. Participants and their Lamaze partners are taught relaxation techniques and
breathing patterns to help ease the discomfort of labor and birth.

36. These skills are taught in classes over the course of six to eight weeks. Pregnant
women can attend with their chosen Lamaze partner. Keep reading to learn about a
typical series of Lamaze classes and what you’ll learn each week.
1. FIRST CLASS
First class: Third trimester
Your first Lamaze class will give an overview of the anatomical, physiological,
and emotional changes that are part of pregnancy. It will focus on changes in the
third trimester.

37. Common topics and activities in the first class include:
• Your expectations
You and your partner are encouraged to share your thoughts, fears, and feelings.
You’re taught to trust each other and to work together.
• Normal discomforts of pregnancy
You and your partner are taught to provide counter pressure for low backaches and
pains by steadily pushing on your lower back. You’re both encouraged to discuss
any discomfort you’re experiencing. Your instructor will teach you about different
remedies.

38. • The benefits of breast-feeding
Breast-feeding helps your uterus contract after childbirth. These contractions also
reduce blood loss after delivery. The mother's milk immunizes the baby from
childhood illnesses. The breast-feeding experience strengthens the mother-baby
bond.
• Nutritional needs
You continue to need additional nutrient-dense calories for a healthy baby. Brain
cell development occurs throughout the last trimester and up until 18 months after
birth, during which time proper nutrition is very important.

39. • Changes in the third trimester
The first Lamaze class will also cover changes in the third trimester. As your body grows
to accommodate the growing baby, you may begin to experience the following changes:
You may feel a lack of energy or tiredness.
You may laugh or cry easily.
You’ll have an increase in blood volume.
You may notice generalized swelling.
You may need to urinate frequently.

40. • Activities
The activity session for the first class may include progressive relaxation, positive
affirmations, and positive imagery.
You and your partner can practice progressive relaxation. During progressive relaxation,
you first contract and then relax each body part, starting with your feet. This process helps
you recognize how your body feels when it’s relaxed and not tense. During labor, your
cervix opens more easily if you’re relaxed.
You’ll also practice positive affirmations, replacing negative thoughts with positive
images. One example is welcoming the contraction as you feel the pain begin.
You can also visualize the work of the contraction by using positive imagery.

41. 2. SECOND CLASS
Second class: Special place imagery
During the second class, you’ll discuss:
•fetal growth
•fetal development
•fetal movement counting
•waking and sleeping cycles of babies
You’ll build upon the discussion of feelings about labor and birth that you explored in the first
class. You’ll also review anatomical and physiological changes during labor and birth. Some
instructors choose the second class as the time to show birthing movies to participants.

42. • Special place imagery
A second relaxation sequence is taught during the activity portion of the class.
Using special place imagery involves picturing yourself in a pleasant place and
focusing on the sights, sounds, and smells of the special place. This technique
helps you distract yourself from the pain and focus on positive feelings.

43. 3. THIRD CLASS
Third class: The Lamaze theory
You’ll probably learn more about Lamaze's theory as well as fetal development
and some breathing techniques during the third class.
• The Lamaze theory
Your instructor will present and discuss the perception of pain. You may be
encouraged to share what you’ve been told or believe regarding labor. A detailed
discussion about what happens during birth can help demystify the delivery
process.

44. As you understand more about the nature of birth, you may begin to see it more
and more as a normal event. Childbirth preparation can help you and your partner
trust more in your body’s ability to experience the birth of your baby positively. It
can also help you and your partner to participate in the experience more fully.

45. • Fetal development
Another focus of the third class is the developing fetus and its transition to a newborn
baby. You’ll learn:
how your developing baby is practicing breathing
how your baby is strengthening and exercising their muscles
when your baby begins to hear sound
when your baby starts to develop sight
You’ll also discuss how alert and reactive a newborn baby will be in their first 30 minutes
of life and that it’s often best to start breast-feeding while the baby is active.

46. • Breathing techniques
Lamaze breathing techniques teach you to pattern your breathing to decrease the pain you
feel. As each contraction begins, you take a deep, or cleansing, breath. This deep breath is
followed by slow, deep breathing in through the nose and out through pursed lips. The
focus on careful breathing distracts you and decreases how much discomfort you
perceive.
Another breathing regimen is to pant slowly while repeating the sounds “hee, hee, hee.”
Your partner will assist you, breathing with you and encouraging you. If you feel the urge
to push before your cervix is fully dilated, you may need to blow out more rapid, short
breaths. You’re encouraged to learn and practice these breathing techniques ahead of time,
finding the ones you find most useful during labor.

47. 4. FOURTH CLASS
Fourth class: Active labor
The focus of the fourth class is active labor, which begins when the cervix is
dilated about 4 centimetres (cm). Your partner will learn techniques to help
support you in active labor. You’ll also learn about touch relaxation, which is a
strategy to help loosen your muscles during labor.

48. • Active labor
As the uterus repeatedly contracts, the cervix progressively dilates. During early labor, the
contractions are short and occur every 20 to 30 minutes. Early labor usually progresses
slowly. When the cervix is about 6 cm dilated, active labor begins. Contractions will
occur closer together and with more intensity. Labor usually progresses more rapidly. You
may need help with focusing and dealing with the pain at this time.
As the cervix dilates to 6 to 8 cm, labor is intense. This level of dilation is sometimes
called the stage of transition. During this time, you and your partner will work very hard
to deal with labor. A jetted tub, rocking chair, or birthing ball may help you get more
comfortable.

49. When your cervix is fully dilated, the first stage of labor is complete. In the second
stage of labor, you’ll usually feel an urge to push as the baby descends into the
birth canal. With each contraction you’re encouraged to take in a breath and push
the baby down and under your pubic bone. As the baby's head stretches the
vaginal opening and becomes visible, you can reach down and touch the baby's
head to help you focus.

50. Your partner is encouraged to:
breathe with you
remind you that you’re doing a great job
massage your back, thighs, or lower abdomen
give you liquids to drink
give you a cool cloth for your forehead
be present with you

51. • Touch relaxation
Touch relaxation is a technique to you’ll be taught to help you cope with labor
pains. You learn to condition yourself to relax each muscle group as your partner
touches it. Your partner learns to identify how you look when you’re tense and to
touch the tense area to help you loosen the muscles.

52. 5. FIFTH CLASS
Fifth class: Pushing techniques
During the fifth class, you’ll learn pushing techniques and strategies to ease back pain during labor.
You’ll also discuss how to prepare for the first few weeks after you give birth.
• Pushing techniques
You may find yourself involuntarily pushing as your baby moves down the birth canal. There are
various techniques to assist this natural urge. You can take in a breath at the beginning of the
contraction and slowly release the air as you push. This is known as the open glottis method. You
can also take in a deep breath, hold the breath, and bear down with all the force you can muster.

53. • Back labor
Some women feel most of the pain of labor in their back. Pelvic rocking on your hands
and knees or squatting can ease this discomfort. A hot pack or an ice pack on the lower
back may also be helpful. Firm counter-pressure applied to your lower back by your
partner can also provide some comfort.
• Postpartum coping
You and your partner are encouraged to prepare yourselves and your home for the arrival
of a new baby. A supply of easy-to-fix, nutritious foods are helpful during this time. You
should learn to accept help from friends and family. You’re encouraged to nurture your
sense of humour as you learn the skills of parenting a new baby.

54. 6. SIXTH CLASS
Sixth class: Rehearsal
The sixth and final class will consist of a review of the materials covered throughout the
program. You’ll also participate in a labor rehearsal. An important goal of the final class is
to help you understand that the birth process is a normal process.
7. TAKEAWAY
The Lamaze method is just one program that can help you get ready for birth. Many
people find the strategies and techniques it teaches helpful for the big day and beyond. A
little preparation can help you go into labor feeling positive and confident about what’s
going to happen.

55. LEBOYER METHOD
(Birth without violence method)
The LeBoyer method stresses a relaxed delivery in a quiet, dim room. It
attempts to avoid over-stimulation of the baby and to foster mother-child bonding
by placing the baby on the mother's abdomen and having the mother massage him
or her immediately after the birth. Then the father washes the baby in a warm bath.
This method is also known as “birth without violence‟

56. HISTORY OF LEBOYER METHOD:
LeBoyer childbirth method was introduced by Frederick Leboyer. He is a French
obstetrician who believed that the traditional hospital births of the time (1975) were traumatic for
the infant. In 1975, he published a book entitled “Birth without Violence,” where depth of a new-
born’s sensitivity and the importance of how the baby is handled by the people around him were
emphasized LeBoyer postulated that moving from a warm, fluid-filled intrauterine environment to
a noisy, air-filled, brightly lit extra-uterine environment creates a major distress to the new-born.
He believed that holding a new-born upside down at birth and cutting his/her cord immediately
from the mother is not beneficial to the baby. In his view, the new-borns‟ senses are intact at birth
and intense sensations at birth such as by slapping the baby’s buttocks are vividly perceived. He
emphasized that a sensitive, unobtrusive technique of care, respecting the natural process and
promoting a peaceful atmosphere at birth will help the baby to be born with a minimum stress.

57. LEBOYER TECHNIQUES
Leboyer childhood method or “birth without violence,” creates an environment of
peacefulness. To decrease the trauma at birth this technique is an advocate of the
following:
• The birthing room is darkened or dimmed. Doing so prevents sudden contrast of
light that might distress the new-born. Leboyer thought that this is less shocking for the
neonate’s eyes that have been in semi-darkness for several months.
• A soft music is played or at least harsh noises are kept to a minimum. All the
talking inside the delivery room is done by whispering.

58. • The room is kept pleasantly warm, not chilled, to help the new-born be
comfortable with the new environment and adapt to extra uterine life more easily.
• New-borns are handled gently and carefully. Leboyer recommends not
pulling the baby’s head to completely allow a natural childbirth.
• The umbilical cord is cut late (It is cut after it has stopped pulsating).
According to Leboyer, this allows the new-born to continue receiving the maternal
hormones and oxygen carrying red blood cells. This is also done to allow the baby
to breathe when he is ready and not have to be rushed.
• The infant receives a warm bath immediately after birth for relaxation.

59. • Before maternal and new-born bonding is done, the infant is massage to
ease crying. Nowadays, mothers do this massaging to encourage immediate
bonding.
• Placing the infant in the mother’s abdomen is done for maternal-neonate
bonding. Since fewer drugs are given to the mother during delivery with this
method babies are typically more alert and need less invasive measures to help
them breathe.

60. OPPONENTS TO LEBOYER METHOD
• Some neonatologists are questioning the principle of warm bath because
doing so can reduce spontaneous respiration and allows a high level of acidosis
can occur.
• Cutting of the cord until it stops pulsating can lead to excess RBC in the
neonate’s circulatory system that could lead to extra blood viscosity and increased
risk of jaundice

61. BRADLEY METHOD
(Husband-coached child birth method)
The Bradley Method of natural childbirth (also known as "husband-coached
childbirth") is a method of natural child-birth developed in 1947 by Robert A.
Bradley, and popularized by his book “Husband-Coached Childbirth”.
The Bradley Method emphasizes that birth is a natural process: mothers are
encouraged to trust their body and focus on diet and exercise throughout
pregnancy; and it teaches couples to manage labor through deep breathing and the
support of a partner or labor coach.

62. Teachers of The Bradley Method believe that - with adequate preparation,
education and help from a loving, supportive coach - most women can give birth
naturally, without drugs or surgery. The classes teach nutrition, relaxation and
natural breathing as pain management techniques along with active participation
of the husband as coach The "Method" itself is first of all an application of what
Dr. Bradley termed "the six needs of the laboring woman," most notably deep and
complete relaxation and abdominal breathing, but also including quiet, darkness
and solitude, physical comfort, and closed eyes and the appearance of sleep. The
Bradley Method relies heavily on training fathers to be labor "coaches," or
partners.

63. The Bradley Method teachers usually supplement these primary techniques
with training in different labor positions and comfort measures. In order to master
the ability to relax completely as a pain relief tool, couples are taught several
different relaxation techniques and encouraged to practice relaxation daily, so that
the mother can rely on a conditioned relaxation response to her partner's voice and
touch.

64. HOW BRADLEY METHOD IS APPLIED:
• Bradley method classes are offered to the couples for a 12 week period.
• Classes are given by trained instructors who have undergone an extensive
training program with the “American Academy of Husband-Coached Childbirth‟
and are required to complete continuing education requirements and re-affiliate
every year.
• Classes are always kept small in size (6-8 couples) so that they may get
individual attention.

65. THE COURSE WILLADDRESS:
• Nutrition and how it affects a growing foetus.
• The importance of exercise (when appropriate) during pregnancy
• Common pregnancy symptoms and complaints, and how to cope with them.
• Techniques for relaxation during labor and birth, with an emphasis on breathing
methods to help you "tune-in" and manage your pain rather than distract you from it.
• Methods to help your partner be an active participant and a skilled coach on labor
Day.

66. • The stages of labor and how to cope with the changes your body
experiences during each one.
• Medical interventions and how to avoid unnecessary ones.
• How to reduce your risk of having a C-section and what to do if it becomes
medically necessary.
• Making a birth plan and how to communicate effectively with your medical
team.
• Breastfeeding.

67. KITZINGER METHOD
(Psychosexual method)
“Our bodies know how to give birth, just as we know how to swallow food,
breathe and make love... An exultant experience of birth comes from self-
confidence and a good relationship with those supporting us."
-Sheila Kitzinger
In Kitzinger method the client focuses on internal sensory experiences so that she
can respond to her body signals. Body awareness enhances the sensuality of child
birth.

68. TECHNIQUES
• Techniques including touch relaxation, during which the birthing woman
learns to respond to her partner's massaging touch.
• Communication skills for working with birth attendants.
• Visual imagery
• Birth dance - movement during labor to reduce pain and help contractions.
• Information and techniques for labor support givers.

69. • Relaxation based on imagery and an inward focus to promote comfort
during the labor.
• Breathing as a relaxed response to contraction.
• No predetermined breathing pattern.
• No forces pushing until the client feels the urge to push.

70. NOBLE METHOD
(Gentle push method)
This method was put forward by Elizabeth Noble. According to her labour is a
normal physiological process. The client should maintain awareness of body
feelings and rely on her ability to cope with labour.
• Physical and self-awareness exercise.
• Spontaneous pushing during exhalation, typically with a grunt or groan and
partial closure of the glottis.

71. • No forceful pushing or structured breathing.
• Take a position that encourages the baby to move down through the birth
canal without needing to push very hard for the second stage of labor, such as
standing, squatting or kneeling.

72. ODENT METHOD
(Instinctive birth method)
Women can be self-reliant during child birth because they have an instinct for and an
innate knowledge of the process. Child birth is a sexual experience that should be
experienced with spontaneity and freedom.
• Use of pool of warm water, music and dim light for relaxation.
• Use of any comfortable position during labor and birth.
• Immediate contact with the mother, father and neonate, possibly including a warm
bath for the neonate.