Childbirth Preparation

Dick-Read and the natural childbirth movement

A 1979 historical analysis of psychoprophylaxis concludes that contemporary preparation methods have diverse and complex origins. It credits the English obstetrician Grantly Dick-Read, author of Natural Childbirth (London, 1933) and Childbirth Without Fear (New York, 1944), with the most substantive contributions to the area. The same analysis notes that none of the early authors it examined presented data that allow conclusions about cause and effect.

A history of film describes Dick-Read as a controversial British physician whose bestselling books argued that relaxation and education, not drugs, were the keys to freeing women from pain in childbirth. Around 1950 he made an educational film in South Africa that was used to teach his method to doctors and to the first generation of Western women dissatisfied with highly drugged, hospitalised maternity care. The article's account also associates his teaching with a cycle of fear, tension and pain, a description that a reviewer should confirm against the full text.

Psychoprophylaxis and the Lamaze method

A historian of Czechoslovak maternity care states that the psychoprophylactic method of painless childbirth originated in the USSR and became known as the Lamaze method in Western English-speaking countries. In that account the method ceased to be pursued as a scientific method in the USSR in the 1950s, was imported to Czechoslovakia in the early 1950s and promoted politically, became widespread in the 1960s, declined in the 1970s and was revived by enthusiasts in the 1980s.

The 1979 analysis compares Fernand Lamaze's 1958 text with the Soviet source published in English in 1960 and reports that he deleted and modified substantial portions of the regimen. It adds that many training manuals presented as outlines of the Lamaze method have origins that differ from the label.

Bradley Method and HypnoBirthing

A 2015 comparison of two class-based methods reports that the American obstetrician Robert Bradley developed the Bradley Method in 1947, in objection to artificial conditions in hospitals, and that it emphasises education and a supportive coach, usually the partner. It reports that Marie Mongan developed HypnoBirthing, first described in her 1989 book, and that she was inspired by Dick-Read's Childbirth Without Fear, which the source dates to 1942 whereas the 1979 analysis cites a 1944 New York edition. The founders' own accounts are relayed through the organisations that teach the methods.

An umbrella for several kinds of education

Health-service documents use the terms antenatal classes and antenatal education. The National Institute for Health and Care Excellence (NICE) in England recommends antenatal classes for nulliparous women and their partners, and separately recommends antenatal education about the signs and early stages of labour. A Cochrane review defined its subject as structured antenatal education programmes for childbirth or parenthood, or both, usually offered to groups but sometimes to individuals.

A 2015 systematic review of small-class education observes that both the form and the content of antenatal education have changed over time without evidence of effects on relevant outcomes. Studies it examined varied greatly in what the intervention and the comparison contained, so a result for one programme cannot be assumed for another.

Natural childbirth and named methods

Natural childbirth was the title of Dick-Read's 1933 book, and a historian uses the phrase, in quotation marks, for the philosophies and methods of a post-war movement that favoured relaxation and education over drugs. A 2015 comparison describes the Bradley Method and HypnoBirthing as two forms of natural childbirth education that nonetheless give participants very different experiences. The sources reviewed give no single definition of the phrase, and it is not treated here as another name for childbirth preparation in general.

The name Lamaze method refers, in English-speaking countries, to the psychoprophylactic method that originated in the USSR. Bradley Method and HypnoBirthing are the names of specific curricula, and the second is also called the Mongan Method. Naming one of these methods says little about what a general antenatal class contains.

Classes in health services

NICE antenatal care guidance recommends offering nulliparous women and their partners antenatal classes that include preparing for labour and birth, supporting each other, common events in labour and birth, caring for the baby, bonding and planning how to feed the baby. It also recommends that classes be welcoming, accessible and adapted to local communities, and that the timing allow a partner to attend if the woman wishes.

NICE intrapartum guidance recommends that all women are given information before labour about what to expect in the latent first stage, how to work with pain, how to contact the midwifery team and what to do in an emergency. It recommends education about the signs of labour, including how to tell Braxton Hicks contractions from active labour contractions, and a discussion of the woman's preferences and choices for care.

Format and content of two named methods

A comparison of curricula reports that the Bradley Method runs to about twelve classes covering relaxation, the partner's coaching role, nutrition, exercise, anatomy, complications, medication and informed consent. HypnoBirthing, in the same comparison, is a shorter course of about five classes that spends most of its time on relaxation and self-hypnosis, natural birth and releasing fear.

The same author reports that the HypnoBirthing curriculum she reviewed does not include discussion of dangers in pregnancy, medication, complications or caesarean surgery, on the stated philosophy that discussing certain dangers causes fear. She reports that the Bradley Method includes such topics. Content therefore differs between programmes, and readers cannot assume that a class covers every option.

Aims set out by proponents and services

Dick-Read's supporters presented relaxation and education as a way of reducing pain in labour without drugs. The Bradley Method is described by its association as based on the belief that most women with preparation and a loving, supportive coach can be taught to give birth naturally, and HypnoBirthing is described as built on the belief that a woman can call on a natural maternal instinct to birth in comfort. These are statements of the methods' own philosophies and are not trial results.

Health-service guidance frames classes more broadly, as preparation for labour, mutual support, baby care, bonding and feeding. Researchers have measured knowledge, anxiety, sense of control, pain, labour support, breastfeeding, infant-care ability and psychological adjustment.

Outcome claims that lack independent support

The Bradley Method's association states that more than 86 per cent of women who used it nationally had a spontaneous, unmedicated vaginal birth. The 2015 author could not obtain an explanation of how the figure was derived, and notes that available data are self-reported and that no well-designed studies of the method exist. The sources reviewed do not document why people choose classes in everyday life, so this section records claims and research targets only.

General antenatal education

A 2007 Cochrane review of structured antenatal education for childbirth or parenthood included nine trials in 2,284 women. It found no consistent results and concluded that the effects of general antenatal education remain largely unknown. A 2015 systematic review of antenatal education in small classes included 17 trials from Western countries and concluded that evidence was insufficient because of heterogeneity and high risk of bias.

A 2026 meta-analysis of online antenatal education pooled 12 studies in 4,982 participants and found no statistically significant effect on depression, anxiety or self-efficacy. The reduction in fear of childbirth was borderline (standardised mean difference -0.53, 95% confidence interval -1.06 to 0.003). Heterogeneity exceeded 85 per cent for most outcomes.

Breathing and relaxation techniques

A 2022 systematic review compared antenatal classes that included skilled breathing and relaxation techniques with classes that did not. Ten studies were included, nine of them randomised. The authors report that the techniques may positively influence self-efficacy, epidural use and memory of labour pain, with no effect on the neonatal outcomes examined, and that evidence quality was inconsistent.

A 2018 Cochrane review addressed relaxation, yoga, music and mindfulness used for pain in labour, a narrower question than preparation. It included 19 studies in 2,519 women and rated the evidence as low to very low quality. Relaxation lowered pain intensity in the latent phase in one trial of 40 women, but four trials of 271 women showed no clear difference in the active phase.

Hypnosis-based preparation

A 2016 Cochrane review of hypnosis for pain management in labour included nine trials in 2,954 women, eight of which assessed antenatal hypnotherapy that differed in timing and technique. Women in hypnosis groups were less likely to use pharmacological pain relief (risk ratio 0.73, 95% confidence interval 0.57 to 0.94, eight studies), but this was very low-quality evidence. There were no clear differences in sense of coping or spontaneous vaginal birth,.

A later English trial randomised 680 nulliparous women to usual care or usual care plus two 90-minute group self-hypnosis sessions and a daily audio recording. Epidural use did not differ significantly (27.9 per cent against 30.3 per cent; odds ratio 0.89, 95% confidence interval 0.64 to 1.24), nor did 27 of 29 pre-specified secondary outcomes. Fear and anxiety were lower than anticipated in the intervention group.

Evidence on named methods

The 2015 comparison found no published studies of the HypnoBirthing curriculum itself at that date and no well-designed studies of the Bradley Method. A 2025 Turkish randomised trial of 50 first-time mothers tested 12 hours of HypnoBirthing training combined with oxytocin back massage and reported lower self-rated fear and higher birth satisfaction one week after birth. The small size and combined intervention limit what it shows about HypnoBirthing alone.

What guidelines recommend about techniques in labour

NICE intrapartum guidance advises that breathing exercises, a shower or bath and massage may reduce pain during the latent first stage of labour. It advises against offering or advising aromatherapy, yoga or acupressure in the latent first stage, and against offering acupuncture, acupressure or hypnosis during labour, while saying that a woman who wants to use these techniques should be supported. It also says that a woman who chooses breathing and relaxation techniques should be supported. The guideline was published in 2023 and last updated in June 2026.

Reporting of harms and differences in content

The sources reviewed give no systematic account of harms from antenatal classes. The 2018 Cochrane review notes that most trials of relaxation techniques did not report safety, and absence of reporting is not evidence that harm does not occur. The 2015 comparison suggests that curricula differ in whether they teach about complications, medication and caesarean birth, which bears on how well a participant is informed before consenting to or declining care.

Care boundary and training

Classes provide general education and are not individual obstetric advice. NICE recommends that every woman is told how to contact her midwifery team and what to do in an emergency, and concerns about the pregnancy or labour need assessment by the person's own midwife or doctor rather than a class. No verified source reviewed describes a training standard, register or protected title for childbirth educators in any jurisdiction, so none is stated here.