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The Russians experimented with hypnosis in the early 1900s but with limited 
success. They then began to explore the application of Pavlovian principles 
of behavior modification to the childbirth experience. Negative and painful 
responses to childbirth stimuli were deconditioned and replaced with other 
responses, such as breathing techniques and attention focusing. Introduced 
as the psychoprophylactic method of childbirth by the Russian Velvovsky, it 
was observed by Dr. Fernand Lamaze, a French obstetrician visiting the 
Soviet Union for a professional conference in 1951. Lamaze returned to 
France and adapted the psychoprophylactic method for use in his clinic, the 
Maternité.T de Metallurgiste. In his book, *Painless Childbirth*, Lamaze 
introduced a method that included teaching female anatomy, physiology of 
pregnancy, labor and birth, breathing techniques, and other exercises.6 
Psychoprophylaxis as a method for childbirth spread rapidly throughout 
Europe and China and was introduced to the United States through the 
efforts of Karmel7 and Bing8 and referred to as the *Lamaze Method*. At a 
time when women were heavily sedated and husbands excluded from the birth 
process, Karmel and Bing promoted medication-free, prepared childbirth with 
active support from the husband. A few years later, the American Society 
for Psychoprophylaxis was founded. This organization set up official 
teacher training programs for the psychoprophylactic method. Classes 
include reproductive anatomy and physiology, nutrition, the process of 
labor and birth, anesthesia and analgesia, and cesarean birth. Now named 
Lamaze International, the method no longer teaches complicated breathing 
techniques for coping with the various phases of labor. The philosophy 
includes

Other methods of childbirth education are increasing in popularity in the 
past decade, using various approaches. Hypnosis has been used since the 
19th century to prevent or reduce pain, usually as an adjunct to other 
preparatory classes. The Mongan Method of *Hypnobirthing* uses relaxed, 
natural methods of education with self-hypnosis. Emphasis is placed on 
pregnancy and childbirth as well as the pre-birth parenting issues and 
unborn baby.11 A holistic or psychophysiologic approach is described by 
Peterson in her book, *Birthing Normally*.12 This method focuses on 
self-growth and an integration of mind and body to call upon one's own 
resources to cope with birth. The *Gamper Method*, originated by Margaret 
Gamper in 1946, is the foundation of the Dick-Read teachings and has been 
adapted over time to embrace the family-centered approach. Preparation for 
birth is accomplished through instillation of self-determination and 
confidence in the woman's ability to work with the natural forces of 
labor.13 It is less available as a method of childbirth, as instructors of 
this method are few. A psychosexual approach promoted by the *Kitzinger 
Method* also is based on the early work of Dick-Read. This method uses the 
body's tactile and auditory sensory memory of past experiences to elucidate 
relaxation. Pregnancy and birth are viewed as only a part of the entire 
psychosexual life cycle; thus, the woman's relationships with her husband, 
parents, and children also are explored.14 Other classes, best referred to 
as *nonmethod*, teach pertinent information, relaxation, and breathing 
techniques but do not conform to any one childbirth pain theory.

Given that stress can interfere with the process of parturition, it is 
reasonable to expect that stress reduction might bring about a facilitation 
of the birth process. This is the foundation philosophy of most childbirth 
education methods. Despite many variations in treatment application, most 
contemporary labor preparation programs include four relatively discrete 
components, the primary purpose of which is to reduce stress. First, 
virtually all include a series of lectures designed to provide information 
about pregnancy, labor, and delivery. Second, most teach a series of 
respiratory behaviors to be used during various phases of the labor 
process. Third, brief training is provided in muscle relaxation. Finally, 
many programs encourage participation by the husband (or significant other) 
in the birth process by timing contractions, giving massage, and providing 
verbal encouragement and support.

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