Tug of War Between Two Natural Childbirth Methods : Dr. Robert Bradley Defends His Technique and Criticizes the Widely Used Lamaze Training as Unnatural
Imagine Dr. Robert Bradley of Denver, Colo., and the French physician Fernand Lamaze standing on either side of a pregnant woman, each trying to persuade her to have a baby his way.
Lamaze and Bradley are founders of the two principal natural childbirth methods used in the United States today. In the contest over the soon-to-be-mother, Lamaze has the edge in name recognition; Bradley has to make do with what one doctor called his evangelical fervor.
Country-Doctor Style
Bradley might place a large, friendly hand on the woman’s shoulder and tell her in his country-doctor style all about his days on the farm and how effortlessly the animals there gave birth. The more scholarly Lamaze might counsel that with his method the woman could be conditioned to block out the pain of childbirth.
Pretty soon the discussion might deteriorate into a shouting match, with Lamaze taunting his rival with the nickname “Barnyard Bradley.” (A Lamaze instructor once dubbed him this because Bradley has studied animals in labor.) Bradley might assert that Lamaze’s psychoprophlyaxis method (it means “mind prevention”) is nothing more than hypnosis.
In reality, this theoretical tug of war will never happen since Lamaze died in 1957. But it’s true that the Bradley and Lamaze methods are in a kind of competition for every woman contemplating natural childbirth--or prepared childbirth, as many now call it.
Lamaze-Coached Mothers
Although there are a handful of lesser-known natural birth methods in use today, the name Lamaze has become nearly synonymous with natural childbirth. According to Robert Moran, executive director of the ASPO/Lamaze organization in Arlington, Va. (ASPO stands for American Society for Psychoprophylaxis in Obstetrics), more than 1 million Lamaze-coached mothers give birth each year in this country.
Bradley is the runner-up. The American Academy of Husband-Coached Childbirth in Sherman Oaks, Bradley’s national headquarters, reports about 20,000 Bradley births a year. The majority of those births are in the West, with California accounting for about one-fourth of all Bradley births.
“My method is coming into its own now because it’s right; Lamaze was wrong,” said Dr. Robert Bradley, 69, in an interview at his Colorado home.
The retired obstetrician has spent countless hours during his career explaining how his method differs from Lamaze’s. Bradley so vigorously defends his own childbirth style that he has been called bombastic by more than one close friend. And though they are milder in their criticisms, members of the Lamaze organization are not above taking potshots at Bradley.
Bradley claims that his is the only truly natural childbirth method. Of the Lamaze organization, he said: “They have the audacity to call their method natural. It is not natural.”
Both Lamaze and Bradley have their roots in the work of Grantly Dick-Read, a British physician who published his original work on natural childbirth in 1933. But Bradley contends that his predecessor was not a true advocate of natural childbirth because he allowed women to whiff at an anesthetic if their labor pains were severe.
The Lamaze technique is also unnatural in Bradley’s estimation because in the past the French physician advocated artificial breathing patterns intended to distract women from the pain of labor. (In recent years, the Lamaze organization has downplayed the importance of the breathing pattern Bradley objects to, according to Lamaze spokesperson Katherine Winter.)
Bradley, who crusades against the use of any pain medication in delivery, is also critical of the Lamaze stance on drugs.
“We (Lamaze advocates) are not proponents of everyone having an unmedicated birth,” said Winter. “We encourage people not to use medications, but sometimes labor brings untenable situations.”
Lamaze director Moran said that Bradley may be doing a disservice in telling women to expect a drug-free birth. Depending on hospital policy, or the degree of pain they may experience, some mothers may receive medication despite their plans to the contrary, he said.
Dr. Charles Brinkman, chief of the division of obstetrics at UCLA Medical Center, agrees that Bradley mothers sometimes harbor unreasonably high expectations for a totally natural birth.
“In general, our attitude here at UCLA is very enthusiastic about any of the prepared childbirth methods,” he said. “But some Bradley patients end up with a sense of failure if they don’t go all the way through labor without medication.”
It would not surprise Bradley that UCLA routinely refers patients to Lamaze coaches. He contends that most doctors prefer that method because it turns out compliant patients who are unlikely to dispute a doctor’s decision to use drugs, induce labor, or in other ways interfere with a natural birth.
(Lamaze director Moran refutes this charge. They do coach their clients to ask questions, he said.)
Dr. Gary Richwald, medical director of the Los Angeles Childbirth Center in Santa Monica, said most doctors do prefer compliant patients--and thus, Lamaze patients--simply because they have limited time to devote to argument during an office visit. But he is one doctor who is on Bradley’s side.
“I think both methods (Lamaze and Bradley) work,” Richwald said. “But the Bradley method encourages people to question commonly assumed beliefs and to take more responsibility for their own care.”
At the Los Angeles Childbirth Center, where there are about 150 births a year, most patients use an “eclectic” approach, combining elements of the Bradley method and others, said Richwald, who is also a professor in the UCLA School of Public Health.
Natural childbirth advocate Suzanne Arms has suggested that the real measure of a method is the number of unmedicated births it produces. In her 1975 analysis of childbirth in America, “Immaculate Deception,” Arms wrote: “For all the talk, the popularity, the trendiness and occasional faddishness surrounding natural childbirth, the process itself is seldom achieved.”
By Arms’ standards, then, Bradley may be ahead in the race. The Bradley organization in Sherman Oaks claims as many as 96% unmedicated births. And Richwald said that at his center, only about 1% of the Bradley-trained mothers require pain medication. (The Lamaze organization said it doesn’t keep records on the number of unmedicated births to Lamaze-trained mothers.)
Observations on Farm
A grandfather of 15, Bradley got his training in the birth business on his family’s dairy farm near Atchison, Kan. For wild and domesticated animals, Bradley observed, birth was a joyful business, reflected in the “shiny-eyed wonderment” of the laboring animal mothers.
Quite a different look was on the faces of mothers he would later see in hospital delivery rooms. These medicated mothers appeared to Bradley to be “screaming, cursing, foul-mouthed maniacs.”
Putting the two observations together, it occurred to Bradley that human mothers had forgotten what animal mothers knew instinctively--how to give birth with a minimum of distress. In 1947, he set about to restore that loss by teaching women at the Mayo Foundation for Medical Education and Research in Rochester, Minn., to give birth like the animals.
Bradley started by providing women a quiet, dark place to rest during the early stages of labor. In between resting, human and animal mothers alike become restless, Bradley said, and should be allowed to pace.
Later on in labor, the human mother retreats to her bed, usually lying on her side. (Hospitals often have a woman flat on her back at this point.) This is in preparation for the next stage of labor, which in animals appears to be a deep relaxation, almost like sleep.
Time of Birth Nearer
As the moment of birth draws closer, Bradley mothers breathe deeply and from the abdomen. They attempt to work with the process of labor, not to distract themselves from it as in the Lamaze technique.
The introduction of a husband or other support person as a birthing coach was not derived from Bradley’s barnyard study, but from the practical concern that doctors didn’t have the time to stay with a woman throughout labor and coach her in the relaxation and breathing techniques she’d learned during the last months of pregnancy. (Here, too, is a dispute with the Lamaze advocates who claim their founder was the first to bring dads into the delivery room.)
The husband-wife Bradley team begins its preparation in the weeks before delivery with a series of exercises designed to strengthen the birth-giving muscles, and to teach the woman the proper positions and breathing patterns for labor.
Individual teachers set their own fees for instruction. Marjie and Jay Hathaway, directors of the Bradley center in Sherman Oaks, charge $125 per couple for a series of 12 classes. (More information on the classes is available from The Bradley Method, P.O. Box 5224, Sherman Oaks, Calif., 91413.)
In the early ‘60s Marjie Hathaway, 45, endured three painful medicated births. Hathaway and her husband, a 46-year-old film and video producer, began searching for a doctor that would deliver their next child without drugs, and allow the father to be present at the birth.
“I really felt I needed the support of my husband to do it,” Marjie said.
Plane Ride to Denver
When her doctor told Hathaway she was four centimeters dilated and could expect to give birth any day, the Hathaways boarded a plane for Denver where they gave birth the Bradley way.
“We haven’t been able to stop talking about it since,” Marjie said. The couple have had two more children by the Bradley method since then and have personally trained 3,000 couples in the technique. They also travel around the country teaching Bradley childbirth educators the method.
Marjie Hathaway said their purpose is not so much to convert people away from Lamaze as to convince them that the correct stance toward childbirth is “absolutely anti-medication.”
“I think we take a harder line on drugs than Lamaze and that gets us friends and enemies,” she said.
Jay Hathaway speculated that, although interest in the Bradley method is growing, it may always be No. 2 because its point of view has been interpreted as rigid and unrealistic.
