June 17, 2010
PHOTO: National Humanities Center/Kent Mullikin
Lamaze lowdown: how a popular childbirth method crossed the Iron Curtain
Lamaze and its signature “hee-hee-hoo” breathing pattern is a staple in pop culture depictions of childbirth, from “Friends” to “The Simpsons.” Employed by countless laboring mothers in the 1960s and ’70s, the pain-management technique became a household name and still exists as an option for natural childbirth.
Despite its familiarity, few people know that it was developed in the Soviet Union during the Cold War under the unwieldy name “psychoprophylaxis.”
Paula Michaels, associate professor of history in the University of Iowa College of Liberal Arts and Sciences, is writing an international history of Lamaze. Her book is slated for publication by Oxford University Press in 2013.
Michaels received a UI Faculty Scholar Award to begin her project, and subsequently was awarded funding from the Guggenheim Foundation, the American Council of Learned Societies, the National Institutes of Health and the National Endowment for the Humanities.
The project began in 2000, when Michaels was pregnant and searching for childbirth methods. A brief history of Lamaze mentioned its roots, and Michaels -- who specializes in the history of medicine and 20th century Russian and Soviet history -- was intrigued. By 2006, she was learning a fourth language, French, to investigate the history of Lamaze.
She discovered that the Soviet Union promoted a baby boom after World War II, but couldn’t supply the pain medication authorities believed would encourage women to have more children. Seeking an affordable way to make childbirth less painful, a Ukrainian psychologist developed psychoprophylaxis in 1948.
“It was ideologically kosher because they could explain why it worked on the basis of Pavlov’s theory of conditional response,” Michaels said. “The idea is that women respond to labor contractions with relaxation because they’ve been trained to do so, and the patterned breathing occupies the cerebral cortex and interferes with pain signals.”
In 1951, psychoprophylaxis was declared the official childbirth method for Soviet moms. It was presented at an obstetric conference in Paris, and in the audience was French obstetrician Fernand Lamaze. After observing a psychoprophylactic birth in Leningrad, he was a believer.
The technique was a hit in his clinics. One clinic was funded by the Metallurgists Workers Union, which had communist ties, so administrators were eager to promote Soviet science. At Lamaze’s upscale private practice, women appreciated an alternative to strong drugs that deprived them of a participatory birth experience.
By 1956, psychoprophylaxis was fading in the Soviet Union. As de-Stalinization ramped up, pressure to use the technique decreased and doctors questioned its effectiveness.
Elsewhere, it took off. The Pope declared it an acceptable method, and Lamaze died during an argument with clinic administrators, but his protégés dispersed, spreading psychoprophylaxis.
In the United States, Lamaze’s former patient Marjorie Karmel became pregnant again and was disappointed that New York doctors were unfamiliar with the childbirth method she’d used in Paris. Her 1959 book “Thank You, Dr. Lamaze” caught the attention of childbirth educator Elizabeth Bing and obstetrician Benjamin Segal. The trio founded the organization today known as Lamaze International.
“Detractors called it Pavlov’s method to associate it with communism, and to link it in women’s imaginations to salivating dogs,” Michaels said. “Supporters downplayed its Soviet origins, and were quick to note that there was nothing ideological about it.”
Before Lamaze, childbirth pain was often handled with drugs that put women in an amnesic, drowsy state called twilight sleep. Some awoke confused or violent and had to be restrained.
“It wasn’t, by today’s standards, a pleasant birth experience,” Michaels said. “The popularity of Lamaze in the ‘60s and ‘70s was fueled by consumerism -- women asserting their power to choose -- and feminism, which urged them to take charge of their bodies.”
Some American women began to consider a drug-free delivery an accomplishment, but French feminists questioned why they should face childbirth pain without anesthesia. In both countries, Lamaze declined by the 1980s, when epidurals gained popularity.
“Whether or not it’s the truly empowering birth experience it was billed to be, Lamaze was the predominant method used by a generation of American moms,” Michaels said. “Psychoprophylaxis would never have made its way to the United States during the Cold War had it not made a stop in France and been repackaged as Lamaze.”
STORY SOURCE: University of Iowa News Services, 300 Plaza Centre One, Iowa City, Iowa 52242-2500
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