Childbirth without pain

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Abstract 

Psychoprophylactic childbirth, better known as “painless childbirth,” consists of psychological pain relief based on the theory of conditioned reflexes. Invented in the USSR and imported to France by Fernand Lamaze, it later spread throughout Europe despite political resistance prompted by its origins. It challenged the biblical injunction of giving birth in pain, and gave women more control over their bodies.

“Giving birth without pain,” cover of the magazine Regards 356 (1952).

“Giving birth without pain,” cover of the magazine Regards 356 (1952).
Source : Private collection, DR.

Until the 1950s, the suffering connected to giving birth was imagined as being ineluctable owing to the biblical injunction of painful childbirth as the price for original sin. However, the changing viewpoint of doctors with regard to the suffering of those wounded in the Great War (considered not only as a symptom, but also as an illness that had to be treated) had repercussions on the suffering associated with childbirth.

The initial research on psychoprophylactic childbirth, better known as painless childbirth, was conducted in the USSR under the influence of conditioned reflexes in psychology. The psychiatrist Velvoski, who was trained in hypnosis and was a disciple of the physiologist Pavlov, along with professor Nikolaev, the director of the Institute of Gynecology and Obstetrics of the Academy of Medical Sciences of the USSR in Leningrad, suggested preparing women for childbirth through mindfulness and breathing exercises. This method was considered a success and recommended for all deliveries in the Soviet Union in 1952, although it was abandoned in 1956 due to a lack of political will and indifference on the part of civil society. It nevertheless spread to France, and later to the rest of Europe. In fact, during the International Congress of Obstetrics and Gynecology in Paris in 1951, the doctor Fernand Lamaze (1891-1957) found Nikolaev’s presentation on painless birth convincing. He later took part in a trip to the USSR organized by the French Communist Party, whose faithful fellow traveller he had been since his years in the resistance. While he was there, he witnessed a painless delivery. Convinced that pain was not inherent to childbirth, but rather the result of a painful conditioned reflex inculcated by society, Lamaze decided to import the method to France, with support from the Confédération générale du travail and the Union des femmes françaises. Painless childbirth was founded on specially adapted training that enabled women in labour to control childbirth and its pain through a better understanding of how their body functioned, the role of uterine contractions, and the use of corporal procedures (relaxation, breathing, etc.). By virtue of the importance it gave to the essential education of women, it distinguished itself from the method recommended by the Briton Grantly Dick-Read. Upon completing his experience in India, Dick-Read recommended in his book Natural Childbirth (1933) that relaxation be used to decrease the suffering of childbirth, in his opinion due essentially to the parturient woman’s fear. Painless childbirth gave women a certain control over their bodies and provided the father with an accompanying role. The first painless childbirth took place on February 7, 1952 at the Bluets maternity in Paris, the healthcare establishment managed by the General Confederation of Labour’s (CGT) metallurgy federation. While a majority of its staff was communist, it also included progressive Christians, united since their struggle against Nazism.

The communists played a decisive role in the spread of painless childbirth. In December 1952, the magazine Regards devoted twenty-nine pages to the subject, and the communist group of the Paris city council succeeded in having it practiced in the capital’s public hospitals. Regional social security authorities accepted to reimburse the additional costs associated with this method, which recommended giving birth in individual rooms in the presence of midwives. Well-known figures also committed themselves to the promotion of painless childbirth. For example in 1954, Colette Jeanson, the wife of the philosopher Francis Jeanson who was close to Sartre, published the Principes et pratique de l’accouchement sans douleur, which was the result of her observations at Les Bluets, while in 1957 Jean-Paul Le Chanois produced, with support from the Bluets maternity, the fictional film The Case of Dr. Laurent, with Jean Gabin in the starring role.

Painless childbirth nevertheless sparked political and ideological resistance, which was heightened by the context of the Cold War. Lamaze and his disciple Pierre Vellay (1919-2007) were summoned by the Order of Doctors, but in vain, as the method proved convincing both inside and outside of France. The Bluets clinic became a training centre for doctors and midwives across Europe. Painless childbirth spread to Switzerland, the Netherlands, Belgium, Great Britain, and the Iberian Peninsula. In Italy, professor Malcovati from Milan, who was won over by the method, influenced the pope in his report sent to the Roman Curia. On January 8, 1956, before an assembly of seven hundred European gynecologists, Pius XII rejected the accusation of materialism hovering over painless childbirth, and declared that the Scripture was not opposed to eliminating the pain of delivery. This speech gave legitimacy to the method in the eyes of Catholics. In France, the association Maternité heureuse [Happy Motherhood], which was created in March 1956 by Marie-Andrée Lagroua Weill-Hallé and Evelyne Sullerot, defended painless childbirth. In June, the French national assembly voted for the reimbursement of six sessions for the preparation of childbirth (eight from 1980 onwards).

This success, which was essentially won in more privileged and educated circles, was nevertheless tarnished that same year when the team of the Bluets maternity split up, sparking violent conflicts against a backdrop of personal rivalry, economic difficulty, and especially political arguments following the Khrushchev report and the Soviet intervention in Hungary. The conflict had an effect on Fernand Lamaze, who passed away in 1957. Doctor Vellay continued his work, and in 1958 founded the International Society for Psychoprophylaxis in Obstetrics.

However, criticisms emerged, as the basis of painless childbirth was questioned by psychoanalysts, who believed that the suffering of childbirth was related to the individual’s unconscious rather than cultural impositions. In 1968, some feminists denounced the hypocrisy of painless childbirth, which obscured the alienating character of maternity. Advances in epidural anesthesia in the 1980s limited use of the Lamaze method, although it was still taught to midwives and pregnant women. Painless childbirth has enjoyed greater favour in the early twenty-first century owing to its “natural” character, the risks of anesthesia, and its conformity to certain religious convictions.