Lamaze: An International History by Paula A. Michaels (review)

Michaels has managed the enviable feat of producing a comprehensive scholarly review that is both accessible and engaging. She draws on the disciplines of sociology, psychology, and political science to situate the startling history of Lamaze within the political imperatives of the postwar Soviet Union, France, and the United States.

Mention “Lamaze” and most people think of unmedicated childbirth and patterned breathing, but that is just one of the many incarnations of Lamaze, far removed from both its origins and its contemporary philosophy. Though Lamaze now has countercultural associations, at its inception, it was largely a product of the ruling elite—mandated from above and dismissed from below.

In the postwar period, while Britain, France, and, most importantly, the United States were increasingly providing access to pharmacological pain relief to its female citizens, the Soviet Union could not afford the medications, and could not access or create the delivery systems to administer them. Making a virtue of necessity, Soviet obstetricians created a psychological method of pain control that drew heavily on the work of the Soviet psychologist Ivan Pavlov, known for his work in classical behaviorism and the conditioned response.

According to the original theory of what became known as psycho-prophylaxis (preventing labor pain through psychological conditioning), the pain of labor was psychologically conditioned by culture and maintained through fear. Therefore, psychological conditioning involving education in the mechanics of birth, reassurance that birth is not painful, and rigid adherence to a physician’s instructions could produce “painless” labor and compliant patients.

Psychoprophylaxis was imported to France as part of a Franco-Soviet scientific cooperation meant to curtail American cultural imperialism. Although Fernand Lamaze was not a Communist, he worked in a hospital system maintained by the French Communist Party. French Communists were eager to promote a method developed by Soviet scientists and mandated by Soviet decree for the benefit of proletarian women, in contrast to pharmacological pain relief that could be accessed only by those who could afford to pay.

Although Lamaze (the technique, not necessarily the obstetrician) enjoyed a heyday in 1950s France, it fell out of favor as disillusionment with the Soviet Union grew. Lamaze achieved its greatest success in the United States where its origins had been forgotten, and where it was changed to become a powerful battering ram against medical paternalism. It subsequently changed again to be viewed as a means of achieving an authentic, ecstatic personal experience. More recently, Lamaze has become a corporate enterprise, run from above and profiting through the certification of Lamaze instructors and the licensing of Lamaze merchandise.

Lamaze: An International History is an excellent example of interdisciplinary history, situating historical facts within the sociological and political framework of each time and culture in which it became established. It will be of great value and interest to medical professionals, midwives, doulas, and childbirth educators, as well as professional historians.