Lamaze Method

Soviet psychoprophylaxis and Fernand Lamaze

A history of the method in Czechoslovakia says Soviet scientists developed a non-drug approach to labor pain in the late 1940s, resting on Pavlov's theory of conditioned reflexes, in which pain was treated as a learned reflex that training could reprogram. The same article reports that on 13 February 1951 the Soviet Ministry of Public Health ordered childbirth facilities to adopt the method, and that Soviet interest faded after Stalin's death, with criticism peaking at a conference in Kiev in 1956.

The article describes Fernand Lamaze as a left-leaning French obstetrician who was never a Communist Party member and who visited the Soviet Union in 1951 to learn about the method. It says he modified it, popularized it in France with support from women's leftist grassroots organizations, and added women's testimony about the method's benefits to training sessions. The author adds that in the West the method was refined mainly outside the biomedical framework.

Karmel, Bing and the American society

A 1999 interview in the Journal of Perinatal Education describes Madame Blanche Cohen, a French physiotherapist who was a colleague of Fernand Lamaze and Pierre Vellay and a primary teacher of the method, also called accouchement sans douleur or painless childbirth. The interview says she gave Marjorie Karmel private classes in her Paris apartment in 1955 and served as her monitrice at the birth of her first daughter, and it calls Karmel's book Thank You, Dr. Lamaze a landmark. The abstract opened for this page does not give the book's publication year.

The Schlesinger Library's collection description says the organization was founded in 1960 by Marjorie Karmel and Elizabeth Bing, both inspired by their own experiences with natural childbirth. It was first called the American Society for Psychoprophylaxis in Obstetrics (ASPO), taught the method of the French obstetrician it names Ferdinand Lamaze, and later became ASPO/Lamaze and then Lamaze International to reflect the central role of Lamaze's teachings. The Library spells Bing's first name both Elisabeth and Elizabeth.

Later emphasis

The Czechoslovak history reports that in the 1980s, as use of the method declined there, advocates in the United States turned to the Lamaze method as a philosophy favoring more natural, less interventionist birth. A 2014 editorial in the organization's own journal says Lamaze International conducts a comprehensive job analysis of what childbirth educators teach and consider important, with the stated aim of promoting natural, safe and healthy birth. The sources opened do not date when the organization's emphasis moved from early psychoprophylactic training to its present practices, and this page does not assert a date.

Names for the method

The Czechoslovak history calls the original approach the psychoprophylactic method of painless childbirth and says it became known as the Lamaze method in Western English-speaking countries. The 1999 interview gives accouchement sans douleur, or painless childbirth, as another name for the Lamaze method in France.

Lamaze International, the organization that teaches it, was formerly the American Society for Psychoprophylaxis in Obstetrics (ASPO) and for a period ASPO/Lamaze. The credential for its instructors is the Lamaze Certified Childbirth Educator (LCCE), a term defined on the organization's certification page.

How research uses the label

Studies apply the word Lamaze in different ways. One randomized trial of antepartum breathing exercises lists Lamaze breathing among its keywords, while a Swedish trial of a mindfulness-based childbirth program used a Lamaze childbirth class as its active control condition. The abstracts opened for this page do not describe the curriculum behind either label, so findings from such studies should not be assumed to describe the organization's current classes.

The Six Healthy Birth Practices

Lamaze International publishes six Healthy Birth Practices. As worded on its practices page, they are to let labor begin on its own; to walk, move around and change positions throughout labor; to bring a loved one, friend or doula for continuous support; to avoid interventions that are not medically necessary; to avoid giving birth on the back and follow the body's urges to push; and to keep mother and baby together. The page says the practices are adapted from the book Giving Birth with Confidence, third edition.

Classes and educators

A 2016 article in the Journal of Perinatal Education says Lamaze International classes use positive group dynamics and interactive learning techniques. The organization states that LCCE credential holders teach families about birth, help them communicate with health care providers and prepare them for labor. It names doulas, lactation consultants, perinatal health professionals and parents as common backgrounds among its educators.

For comparison, the American College of Obstetricians and Gynecologists (ACOG) describes childbirth classes in general as places to learn about pregnancy, giving birth, breastfeeding and being a parent. This page does not reproduce breathing patterns, positions or other instructions, and the sources reviewed do not set out a standard class schedule.

Historical purpose

The Soviet method was developed as a non-drug approach to labor pain, based on the idea that pain was a learned reflex that training could change. The Schlesinger Library describes the method taught by the early American society as using psychological and physical techniques to manage pain and assist delivery without drugs.

Stated aims today

Lamaze International states that its educators prepare families for labor and help them communicate with health care providers. Its six practices are framed around supporting a physiological birth process, and the organization's editorial describes its aim as promoting natural, safe and healthy birth. These are the organization's own statements of purpose, not findings from independent studies.

Reviews of antenatal education

A 2007 Cochrane review of individual or group antenatal education for childbirth or parenthood included nine trials with 2,284 women. It reported no consistent results, small to moderate sample sizes, and no data on anxiety or breastfeeding success, and concluded that the effects of general antenatal education remain largely unknown.

A 2018 Cochrane review of non-clinical interventions to reduce unnecessary cesarean section found moderate-certainty evidence of little or no difference in cesarean rates between usual care and antenatal education on natural childbirth preparation with breathing and relaxation training. Separately, one study of 60 participants suggested childbirth training workshops might reduce cesarean section, which the reviewers rated low certainty.

Breathing and relaxation

A 2022 systematic review of antenatal classes that included skilled breathing and relaxation techniques covered ten studies, nine of them randomized trials. The authors report that these techniques may positively influence self-efficacy, epidural use and the memory of labor pain, found no effects on predefined newborn outcomes, and describe the evidence as inconsistent because the classes differed.

The 2018 Cochrane review of relaxation techniques for pain in labor included 19 studies of 2,519 women, rated low to very low quality. Relaxation lowered pain in the latent phase in one trial of 40 women, but evidence for the active phase showed no strong difference, and most trials did not report safety. A single-center randomized trial from India reports that women taught antepartum breathing exercises had more spontaneous onset of labor and fewer cesarean births, but only its abstract was reviewed here.

Studies naming a Lamaze class

In a randomized trial of 197 first-time pregnant women at risk of perinatal depression, a mindfulness-based childbirth program was compared with a Lamaze childbirth class. The mindfulness program reduced perceived stress and depressive symptoms more than the Lamaze class, and the authors note that the groups also differed in number of sessions. The trial tests the mindfulness program, not the effectiveness of the Lamaze class.

Gaps and criticism

Searches of PubMed for Lamaze childbirth education, antenatal education reviews and relaxation in labor did not identify a controlled trial that evaluated Lamaze International's current curriculum as a defined intervention. A 2013 column in the organization's journal argues that the content and teaching techniques used in Lamaze-style classes may sometimes elicit a nocebo response and lower women's confidence; it is an opinion piece, not a trial.

Medical care boundaries

Childbirth classes are education and do not replace prenatal, labor or postpartum medical care. ACOG states that its public information is not a substitute for a physician's advice, and decisions about pain relief, induction, positions and interventions are made with the treating clinician. The Lamaze practice of avoiding interventions that are not medically necessary concerns necessity as judged by the care team.

The reviews opened report little about harms. The Cochrane review of relaxation noted that most trials did not report on the safety of the interventions, and the editorial on the nocebo effect raises the possibility that class messages could reduce confidence. No harms specific to Lamaze classes were identified in these sources.

Educator certification

Lamaze International states that LCCE certification must be renewed every three years, with a recertification application, 25 continuing education contact hours and a fee. A 2025 article in the Journal of Perinatal Education says Lamaze Certified Childbirth Educators are guided by the organization's standards of practice and code of ethics. These are the organization's own standards. No statutory regulation of childbirth educators was found in the sources reviewed, and the title is not a license to deliver medical care.