Lamaze method /ləmäz″/ [Fernand Lamaze, French obstetrician, 1890–1957] , a method of psychophysical preparation for childbirth developed in the 1950s. It requires classes, practice at home, and coaching during labor and delivery. The classes, given during pregnancy, teach the physiology of pregnancy and childbirth, exercises to develop strength in the abdominal muscles and control of isolated muscles of the vagina and perineum, and techniques of breathing and relaxation to promote control and relaxation during labor. The woman is conditioned by repetition and practice to dissociate herself from the source of a stimulus by concentration on a focal point, by consciously relaxing all muscles, and by breathing in a special way at a particular rate—thereby training herself not to pay attention to the stimuli associated with labor. The kind and rate of breathing change with the advancing stages of labor. During the early part of the first stage of labor, when the uterine cervix is dilated less than 5 cm and the contractions occur every 2 to 4 minutes, last 40 to 60 seconds, and are of mild to moderate strength, the mother does slow chest breathing during contractions. Her fingers may rest lightly on her lower ribs to feel them rise and fall. The abdominal wall does not move with respiration. She may perform an effleurage, or rhythmic fingertip massage, of her lower abdomen during the contractions. The rate of respiration is 10 or fewer breaths a minute, increasing to 12 per minute as labor intensifies. During the active part of the first stage of labor up to the transition to the second stage, the cervix is from 5 cm to nearly fully dilated, the interval between contractions is from 1½ to 4 minutes, and the duration of contractions is from 45 to 90 seconds. (The interval decreases, and the intensity and duration increase as labor progresses.) During contractions the mother breathes quietly and shallowly in her chest. The rate of her breathing varies with the strength of the contractions, increasing during a contraction to as fast as once a second at the peak and slowing to every 6 seconds as the uterus relaxes. She is coached to concentrate on the focal point she has selected, to perform the effleurage of her abdomen, to relax her perineal and vaginal muscles, and to take a cleansing breath at the beginning and end of each contraction. At the end of the first stage of labor, when the cervix is almost completely dilated and the contractions are strong, occurring every 1½ to 2 minutes and lasting 60 to 90 seconds, the mother begins to feel the urge to bear down and push during contractions. She avoids pushing before full dilation by combining several light, shallow breaths in the chest with short puffing exhalations as the urge increases during the contractions. During the second stage of labor the cervix is fully dilated and contractions are strong, frequent, and expulsive. The mother’s head and shoulders are supported on pillows. During contractions she is helped to draw her legs back, flexing the thighs against the abdomen, holding them behind the lower thigh with her hands. Her chin is tucked on her chest, the air is blocked from escaping from her lungs, her perineum is relaxed, and she bears down forcibly. Depending on the length of the contraction, several pushes of 10 to 15 or more seconds may be possible during the contraction. As the baby’s head crowns, she is asked to pant lightly so that the head may be delivered slowly. The advantages of the method include the need for little or no analgesia for relief of pain and participation in the labor by the mother, giving her a great sense of self-satisfaction at delivery. The father of the baby also benefits by participating in the birth of his child. Compare Bradley method, Read method.
