Have it Your Way

From traditional to alternative, there's a world of choices in childbirth education.


It’s inevitable: Sometime during pregnancy, you realize (with panic! with dread!) that the living, growing being inside you will have to come out. Not with a dainty parting of curtains or a gentle opening of doors, but with hard work, pushing and sweat: with labor. You realize you need assistance, not of the “let me fetch you some iced tea” variety, but serious, get-down-on-your-haunches help.

You’re in luck. In addition to standard hospital-based childbirth-education classes, a world of choices awaits you—whether you want a tried-and-true approach, the latest tools and techniques or a complete mind/body transformation. Here, a guide to finding a happy fit.

Lamaze Relax and breathe

Perhaps the best-known program belongs to Lamaze International. Popularized in the 1970s, the Lamaze method is nearly synonymous with childbirth education (witness the frequent lampooning of Lamaze-style breathing techniques in TV and movie depictions of childbirth). This may add up to great brand recognition but a sketchy overall picture of Lamaze and its teachings.

The elaborate breathing techniques that French physician Fernand Lamaze introduced in the 1950s to take a laboring woman’s mind off her pain are still part of Lamaze, but this method is about more than giving labor the old hee-hee-hoo. Lamaze has always been instrumental in promoting a woman’s innate ability to give birth without unnecessary medical intervention and her right to be an active participant in her baby’s birth. Though these ideas no longer seem revolutionary, they are still among the best reasons to take a childbirth-education class.

So what’s modern Lamaze like? Typical courses run 12 hours or more over six weeks and offer a mix of basic information and in-class exercises. “We spend time learning to communicate. We talk about the effects of [anesthesia and other medical interventions] in labor so that women can make informed decisions,” says Teri Shilling, M.S., L.C.C.E., a Lamaze instructor in Gunnison, Colo. Lamaze is not dogmatic about avoiding medications and procedures. But, says Shilling: “We believe all women can get through labor without drugs, and we teach them tools that can make this happen: positioning, conditioning, confidence-building and a variety of active-relaxation methods, [such as] sitting on a birthing ball or dancing slowly with their partner.”

Bradley Let nature take its course

If Lamaze encourages women to pursue natural childbirth, the Bradley method makes a mission of it. Working in the late 1940s, obstetrician Robert Bradley drew inspiration from the way animals deliver their young—capably, instinctively and in solitude. No, Bradley graduates don’t build nests out of palm fronds and feathers, but 87 percent of them who deliver vaginally do so without drugs, according to Marjie Hathaway, executive director of the American Academy of Husband-Coached Childbirth (the formal name for the Bradley program).

Bradley is not for the lightly committed. Typical courses run 30 hours over 12 weeks. Students learn the benefits of prenatal nutrition and fitness, as well as muscle awareness and relaxation techniques for labor. Husbands take an active role, coaching their partners through everything from preparatory pelvic tilts to final-stage pushing. Parents become vigorous advocates for having a drug-free, intervention-free delivery.

This approach can be empowering. With the help of her husband, Dino, Pennie Gioia, 37, of La Crescenta, Calif., delivered her now 8-year-old son, Antonio, after 16 hours of labor. “There was no point where I thought ‘I can’t make it,’” says Gioia. “Taking Bradley classes was like training for a marathon; I really felt prepared. I learned how to focus within myself, to work with my body instead of fighting it.” The Gioias were so pleased with their experience that they returned to Bradley classes to prepare for the birth of their second child, Giovanni, who is now 3 months old.

Birthing From Within and Birth Works The spiritual side of birth

Childbirth is an undeniably physical experience. But it’s no less an emotional and spiritual one. Two increasingly popular programs—Birthing From Within and Birth Works—approach pregnancy and birth as nothing less than a life transformation.

“Our classes aren’t about teaching women where the cervix is,” says Birthing From Within founder Pam England, C.N.M., M.A., a midwife for 22 years who had an epiphany following the birth of her now 18-year-old son. “I realized that attending a birth as a midwife was nothing like giving birth as a mom. I knew a lot about the external experience of childbirth — the technical and scientific aspects — but very little about the internal experience: what it feels like to give birth.”

In a typical eight-week Birthing From Within course (two of the classes are postpartum), couples explore their hopes and fears about labor. They learn the physical processes but also delve into murkier territory: How do they feel about the impending delivery? How will they respond to the stress? In one exercise called “Taming Your Birth Tigers,” students visualize themselves facing an unwished-for surprise, such as an unplanned Cesarean section. They plan ways of dealing with the outcome, then replay the “tape” with their resolution in place. “Once women can visualize themselves coping,” says England, “they experience not only greater physical relaxation [at the prospect of labor] but also emotional relaxation.”

This type of experiential learning looks and feels different from traditional coursework. In Birth Works classes, which typically run 10 weeks, students learn about the baby’s descent through the mother’s pelvis by feeling and identifying their own pelvic bones (clothing stays on). They explore their attitudes about childbirth through expression of feelings, multisensory visualization and art. They also learn about the risks and benefits of medical procedures and drugs in pregnancy and labor so they can make informed decisions.

“Our program is oriented toward personal growth,” says Birth Works creator Cathy Daub, R.P.T., C.D., C.C.E. “Women who make it through get more than a better birth experience; they also learn something about themselves.”

Birth Works graduate Lori Grande, 33, of Atlanta recalls a moment while laboring with her daughter Sophia, who is now 2: “I was in the shower and I suddenly told my mom, ‘I don’t know how to take care of a baby.’ I just needed to say it; I was still struggling.” This admission may not have shortened Grande’s labor, but it lessened her distress. “I felt safe and supported,” she says. “I knew that I could ask for whatever I needed.”

A world of alternatives

If all of this leaves you wanting more information, keep reading. Maybe you’ve heard rave reviews about hypnosis. Or you’re curious about water birth or prenatal yoga. Finding the help you need has never been easier.

If hypnosis piques your interest, two competing programs with the same buzzword in their names — hypnobirthing — are your likeliest bets. The Leclaire Hypnobirthing method, created by psychologist Michelle Leclaire O’Neill, Ph.D., R.N., offers intensive one-day pregnancy-preparation classes on using hypnotherapy to achieve relaxation and alter the woman’s perception of pain during labor. The HypnoBirthing program, created by hypnotherapist and counselor Marie Mongan, M.Ed., M.Hy., covers traditional childbirth-education topics as well as self-hypnosis techniques, usually in a multiweek format.

Ellie Shea, a childbirth educator in Torrance, Calif., who has taught Lamaze for 30 years and HypnoBirthing for nearly two, says students find the deep relaxation achieved during hypnosis invaluable — not just for coping with pain but for helping them to deal with labor itself. “Through hypnosis, women are able to relax at a deeper level than they might be able to using other techniques,” she says. “That gives them a wonderful kind of confidence.”

Water birth is another alternative that is becoming more popular in the United States. Many women find that the warm, gravity-free environment not only comforts and relaxes them but also seems to help labor along. In Gentle Birth Choices (Inner Traditions International, 1994), Waterbirth International founder Barbara Harper, R.N., says that women have referred to the pool as a “wet epidural” and that the reduction of anxiety helps them focus inward on the birth process.

Cultivating a wide and diverse base of knowledge will allow you to make the right choice about your own labor. Learn about water birthing on the Internet. Take a prenatal yoga or water-fitness class. Have your partner learn prenatal massage. Read books. Talk to new mothers. Spend time cradling your beautiful expanding belly — whatever it takes to get comfortable with the awe-inspiring, life-transforming big bang to come. That’s the best preparation you can get.