Lamaze Childbirth Method
Lamaze Childbirth Method
Lamaze method is a prepared labor and delivery technique. It is often called psychoprophylactic method as it uses the mind (psyche) to prevent labor pains (prophylaxis).
Lamaze childbirth method is an alternative to the use of medical intervention during childbirth. The method was originally developed in Russia (based on Pavlov’s conditioning studies) but was popularized by a French obstetrician Dr. Ferdinand Lamaze. After watching a woman gave birth in Russia Dr. Lamaze developed his own system of painless childbirth.
The Lamaze method of prepared childbirth is based on the gating control theory of pain relief. It involves concentration and conditioning to help the woman respond to contractions with relaxation from techniques thereby alleviating pain. This is based on the theory that through stimulus-response conditioning, women can learn to use controlled breathing to reduce the pain in the labor. Lamaze method is the most popular approach used to today.
Techniques and Methods
Gating Control Theory of Pain
The gating theory of pain refers to gate control mechanisms in the substantia gelatinosa that has the ability to stop an impulse at the level of the spinal cord so the never would not reach the brain as pain. This process is similar to that of closing a gate.
The following techniques are used to assist gating mechanism:
- Cutaneous stimulation
This technique involves:
- Effleurage – slow massage of the abdomen during contractions. The massage is done with just enough pressure to avoid tickling. The woman can perform effleurage using her fingertips and tracing a pattern on her abdomen. Massage and pressure on the palms and fingertips stimulate the large diameter nerves to decrease the ability of the small nerve fibers at the site of pain to transmit impulses.
- Sacral Pressure – firm pressure against the sacral area may help relieve strain on the sacroiliac joint. The partner (husband) can increase the pressure on the sacrum as soon as the contraction begins.
- Thermal stimulation – application of heat and cold stimulates the thermoreceptors thereby decreasing pain felt by the woman. This is done by wiping the woman’s face with cool cloths and ice chips offered to the woman for eating. In early labor a warm shower directed against the back may be soothing.
- Positioning – position changes during labor also provides cutaneous stimulation. Ambulation and fowler’s position makes contractions less painful. Changing position can be done every 30-60 minutes to increase comfort.
An impulse cannot register in the brain if it is distracted. Techniques of distraction are as follows:
- Breathing techniques
- Focal point – a focal point is an object in which the woman focuses during contractions to help her direct her thoughts away from the contractions.
- Reduction of anxiety
- Giving the woman idea of what to expect during labor
- Presence of a support person (husband)
Concepts stressed in Lamaze method
- Labor should not be induced
- Women should move freely during labor
- A continuous support should be available for the woman
- No routine interventions should be done (IV fluids)
- Woman should change position during labor
- The newborn and mother should stay in the same room after birth and breastfeeding opportunity should be unlimited