The groups bicker a bit among themselves about which way is best, and they bicker with the doctors about whether any way is best. And even at best, the doctors tend to be a mite patronizing. But when you come right down to it, the natural-childbirth movement has lent an air of unselfconsciousness to the process of giving birth (outdone only by those old tales of peasant women giving birth in the fields -- then continuing with their scything, infants at their breast).
Example: A young woman journalist, very pregnant, visits a friend at a maternity hospital. She is herself under the care of the clinic at that hospital so she decides to have a quick check-up. She is a Bradley trainee and knows what's what, so when her OB tells her she is two-fingers open, she smiles sweelty and goes on back to work, knowing she's got a day or so, maybe even two.
This is not to say, however, that she is not excited. She turns to her editor. "Guess what, I'm two fingers open," she offers brightly. Well, her husband is a Bradley trainee, but her editor is not. He turns green, then red, then green again. "Do me a favor," he pleads, "please go home."
The Bradley method is not quite the same as the Lamaze method which is different from Grantly Dick-Read's. But between them, and with the increased emphasis on medical self-help, they and countless spinoff movements and courses, have played a genuine role in the evolution of the practice of obstetrics in the Western world. What we've got is one big anatomy lesson for the pregnant set.
A veteran Silver Spring obstetrician, who once refused cases in which the father wanted to be present at the delivery, now says these account for as many as 35 percent of his patients. "And they really do remarkably well," he concedes. But even more striking, 95 percent of his patients are now remaining awake through the delivery process, an almost complete turnaround from 15-20 years ago.
Twenty-five years ago, courses for new expectant parents consisted principally of learing how to diaper a doll.
That doll is still being stuck by pins in fumbling fingers, but now, as in the Bradley method, for example, the parents learn about the importance of controlling the pubococcygeus muscle, relaxation techniques, fitness, the side effects to common drugs, complications, and, perhaps most important, the importance of good nutrition to both mother and infant.
They learn about pair-bonding and familial bonding , an old process getting new scrutiny from psychologists who feel its importance may have been overlooked by older colleagues.
The Bradley method is relatively new to this area among so-called "Natural-childbirth" proponents, although it has enjoyed considerable popularity and success in the West. (The American Academy of Husband-Coached Childbirth is in Sherman Oaks, Calif.)
Probably its principal difference from Lamaze -- the method that is better known in this area -- is in breathing techniques.
A hallmark of the Lamaze training has been a panting technique which appears to have the effect of distracting a patient's attention from contractions. Obstetricians, however -- and Bradley proponents -- feel that this could cause a potentially unhealthy hyperventilation and lowered respiration. Bradley breathing is abdominal, of the sort used in meditative relaxation.
A breadth of physiological and psychological training is offered under the Bradley unbrella, possibly more inclusive than its rivals.
A quartet of Bradley group leaders of Maryland recently discussed their philosophy, their goals and their budding classes in the area. There is a certain missionary zeal to their approach, and a tendency to belittle the good faith, if not the competence, of the medical establishment. But there is still a solid program of consumer-oriented health and nutrition practices to bring its participants up to date in modern obstetric practices, and in some areas, even put them out front.
A case in point may be the change over the past few years in the way weight gain is regarded during pregancy. Traditionally, a visit to the obsetrician meant a perhaps humiliating confrontation with a balance scale. It often meant at least a gentle suggestion that weight should be watched. Now medical intelligence, supported by all the prestigious professinal medical societies, holds that both babies and mothers are healthier with a combined gain of up to 35 pounds over a pregnancy. Moreover, weight loss by use of stringent diet or use of diuretics to reduce swelling or even, in some cases, salt restrictions, can cause toxemia in pregnant women.
Even within the past year, several dramtic and tragic cases of dieting-induced toxemia among well-educated, middle-class women have been made public.
Although most doctors are aware of these changes and their underlying scientific bases, the facts have not caught up with some popular women's magazines, which continue to publish outdated guidelines and contribute to the sort of public confusion the consumer-oriented Bradley trainers have vowed to dispel.
In fact, groups like Bradley and their lower-cost hospital versions, serve as useful adjuncts to traditional medicine.