Lamaze Video Gives Birth to Controversy

In a darkened room on the maternity ward of St. Joseph Hospital in Orange, Tanya Ucher closes her eyes, takes deep breaths and thinks of waves beating against a seashore as tension slips from her arms, legs, neck and back.

“Notice how calm and relaxed you are,” a soothing voice coos from a videocassette player. “This is the way you’ll feel in labor.”

For Ucher, who was hospitalized with pregnancy complications before she could begin Lamaze classes at the hospital, a video is the only practical way to receive instruction in prepared childbirth. So she practices relaxation techniques from the hospital bed to which she has been confined with her “coach”--her husband, Joe--at her side.

She is among a growing number of expecting mothers using “Having Your Baby: Lamaze Prepared Childbirth,” a two-hour videocassette on breathing and concentration techniques that experts say minimize some of the pain of giving birth.

On Shoestring Budget

The brainchild of two Orange County nurses, the videocassette was made last year on a shoestring budget. But it attracted widespread attention only recently after its creators were able to save enough money to purchase ads in two publications geared to expectant parents.

Featuring 10 expecting couples from Orange County, the video takes a viewer through a single Lamaze class and includes footage of vaginal and Caesarean births attended by the “coach” husbands.

Though expectant mothers who have used “Having Your Baby” speak highly of it, experts do not always agree. In fact, nearly a year and a half after its release, the video still stands at the center of a controversy.

In the lead are some members of the American Society for Psychoprophylaxis and Obstetrics, an Arlington, Va., organization that certifies Lamaze instructors and sets professional standards for them. Partially in response to “Having Your Baby,” ASPO last October released a position statement against videotapes that purport to replace childbirth education classes.

“Our problem with the video is that its makers are marketing it as an alternative to classes in their promotional material,” said Cathryn Winters, national director of education for ASPO. “In my mind, it’s false advertising. Telling someone that watching a video is the equivalent of participating in a fuller educational experience is just not true.”

Creator Feels Need Filled

But the videocassette’s creator, Stacy McCullough, 35, of Newport Beach, a labor and delivery nurse since 1974 and a Lamaze teacher since 1978, believes that the videocassette fills an important need that had been staring her in the face for years.

Bedridden mothers constituted only a portion of the population that she believed could benefit from a portable Lamaze class. Physically isolated couples and couples with scheduling conflicts would be served by an alternative to the classes that usually are given in hospitals or instructors’ living rooms, she reasoned. But women who had already given birth according to prepared-childbirth techniques sold her on the idea.

“On the average, I teach 200 couples a year,” said McCullough. But she saw very few repeat couples, even though she knew that some were now having a second or third child.

Those “repeat parents” who failed to brush up on Lamaze techniques had problems in the delivery room, she noticed: “When they get in labor, they realize they don’t remember as much as they thought they did, and they wished they’d practiced.”

Then Ronnie Hammond, 34, of Irvine, a labor and delivery nurse since 1976, began to study under McCullough, who also is certified to teach the series of breathing and concentration techniques. Because the women worked so well together, they decided to produce a videocassette.

Though McCullough had a friend film the natural births of her three sons and used to show some of the footage in her classes, neither women knew anything about technical aspects of video production. But a marketing study persuaded them to go ahead. Ten months and $35,000 of combined life savings later, they had developed what they believe to be a unique commodity. While there are at least three videos available on birth-related topics, “Having Your Baby” is the only one to depict an entire Lamaze class, according to its makers.

Designed as Supplement

“Jane Fonda’s Pregnancy, Birth and Recovery Workout” includes a brief segment entitled “Skills for Birth.” Dr. Art Ulene’s three-part series on pregnancy exercises, produced in conjunction with the American College of Obstetricians and Gynecologists, includes a two-hour video entitled “Childbirth Preparation Program” for “practicing labor techniques at home.” “The Lamaze Method,” a full-length video narrated by Patty Duke and produced by ASPO, comes the closest to containing a complete Lamaze course but was designed only as a supplement to regular classes.

With 300 videos sold to date (not nearly enough for the project to break even), McCullough and Hammond appear to be reaching many women who praise the video.

Toni Mathis of Irvington, N.J., said that although her high-risk pregnancy was one consideration to buy the tape, the fact that her husband, Aaron, works six days a week as a dispatcher for a trucking firm was a bigger concern.

“My husband won’t be able to attend the Lamaze class that I’m taking at the hospital where I will deliver,” she explained. “His only day off was not the day when classes are being offered.”

So the 34-year-old woman, who is due to deliver twins in November, plans to attend classes, then review lessons with her husband using the video. That she will be able to continue watching “Having Your Baby” when she is bedridden in the last weeks of her pregnancy--an inevitability, her doctor has said--is so much icing on the cake.

Then there’s Holly McCoy of Irvine, for whom the birth sequences provided an important supplement to the conventional Lamaze classes she took at Hoag Memorial Hospital in Newport Beach. The 19-year-old new mother said they helped her muster courage for an experience that she was dreading.

“You knew more of what to expect” from childbirth after watching them, she explained. “You hear a lot of stories from people about how the pain is so excruciating that women scream. It definitely helped to see women in control.”

Unexpected Use

Terri Freedman of Irvine, meanwhile, found an unexpected use for the video while brushing up at home on Lamaze techniques for her third son in June.

“I showed it to my kids, and they loved it,” said the 34-year-old woman, who had trouble persuading her first son to visit her at the hospital for the birth of her second son because he previously had been hospitalized with a broken arm.

“Hospitals have a negative connotation,” she explained. “When children see a tape like this, they know not to be afraid. The mother on the tape was so relaxed that they realized there is nothing scary about birth, so they didn’t worry. They couldn’t wait to come to the hospital to visit me.”

Expectant mothers are not alone in their praise of the video, which is available only by mail for $39.95 plus postage and handling from Pearent Productions, P.O. Box 8745, Newport Beach 92658-8745.

An article in a recent issue of Expecting magazine, for instance, lauded “Having Your Baby” as “a very clear and thorough presentation of Lamaze techniques and footage of vaginal and Caesarean births. . . . If a canned class is the only option you have, this is the one to pick, as it includes a full discussion of what Lamaze is meant to accomplish and how it works, signs of labor, fetal monitoring, nonconforming labors and other topics that would be included in a live class.”

Homes for unwed mothers, childbirth clinics in remote settings and libraries have purchased the videocassette.

Two local hospitals have incorporated it in their childbirth education programs. At Fountain Valley Regional Hospital, the videocassette’s labor and breathing sequences are shown in regular Lamaze classes. At St. Joseph Hospital, women bedridden with complicated pregnancies in the hospital’s high-risk antepartum unit watch the video in their rooms, learning exercises that would otherwise be off limits because of travel involved in attending a Lamaze class.

And obstetricians across the country have bought copies that they either sell or loan to patients.

“Some of my patients don’t have time to take classes,” explained Santa Monica obstetrician James Moran. “Others only decide at the last minute to take childbirth classes, but then can’t find an opening. For people who can’t attend classes, this is ideal.”

‘Talks a Lot of Fear Out’

“I’ve found it very useful for my patients who are pregnant for the first time,” said Fountain Valley obstetrician Donald Murphy. “It talks a lot of the fear out of childbirth, and that’s important because fear produces pain and inhibits normal labor.”

He even believes that the tape can serve as a substitute for regular Lamaze courses in first-time pregnancies.

“I don’t know how anything could be more complete,” he said. “It provides more than adequate information for the first-time pregnant woman to deliver naturally.”

But Orange Lamaze teacher Janis Ryan, who has been in the forefront of local opposition to the videotape, does not agree.

“No one would gripe if this were being marketed as a supplement, but as long as it’s being marketed even partially as a replacement, then they’re going to continue to run into opposition.”

She believes the videotape should carry a disclaimer, warning women that it be used only as a supplement and not as a substitute for regular Lamaze classes.

“The pregnant population is very naive . . . (and) they may think that they’re getting proper training from this,” she said. “In fact, the Lamaze in its purest form is nothing you can glean from reading a book or watching a video. You need someone who knows what they’re doing to help you.”

Even Moran, the Santa Monica obstetrician, cautions the first-time mothers he treats against watching the video without attending classes.

Indeed, a promotional brochure bills “Having Your Baby” as a “complete Lamaze prepared-childbirth program” and as an “alternative . . . (that) provides all the information and skills you need for a prepared childbirth program if you or your partner are unable to attend a regular class.”

While the cassette’s package carries a disclaimer, it only warns against being considered as a substitute for regular medical care--not for conventional Lamaze classes.

Primary Marketing Target

Hammond and McCullough contend that their intentions have been misconstrued by ASPO in an attempt to protect the economic interests of its members.

“We never intended for this to take the place of classes for first-time mothers,” McCullough said. “In fact, we believe that first-time mothers need classes in order to get that one-on-one training.

“Our primary marketing target was women who couldn’t or wouldn’t attend classes for scheduling or medical reasons. Our advertising was never intended to take away from attendance at classes in the community.”

As for marketing the video as a class supplement, McCullough does not think that would deflect criticism because ASPO members even objected when their organization produced its own class supplement in 1984--”The Lamaze Method.”

ASPO’s Winters agrees that economics are partially behind the organization’s stance against “Having Your Baby” and videos like it: “It’s a real issue for people who make a living teaching childbirth education because these women want to put them out of business by claiming that their tape can take the place of classes, which it cannot.”

But it was concern for the well-being of pregnant women that played the biggest role in ASPO’s actions, she said: “Whenever you take out the human element--teachers correcting students whenever they do something wrong--you increase the risk that there could be an injury.”

Ryan went so far as to say that substituting the video for class may lead to increased drug use on the part of delivering mothers: “If people don’t have good training (in Lamaze techniques), they’re drastically surprised by how painful birth is, and they may ask for more drugs than they otherwise would, and that can be dangerous.”

Targeting Special Needs

Also missing from the video, she maintains, is the sort of consumer advocacy that can only come from a Lamaze teacher who tailors advice on medical treatment to the particular needs of a specific couple.

Others, such as the Expecting article, note the lack of what many mothers come to view as the next-best benefit of Lamaze classes--”other couples with whom you can share. Some lifelong friendships have begun in prepared-childbirth classes.”

But to the Uchers, the debate is remote. The couple, both 21, appear happy to accept whatever it takes to prepare them to participate in the birth of their first child.

“I just want to be in the delivery room with her,” Joe Ucher said. “She needs me.”