Imagine Dr. Robert Bradley of Denver, Colo., and the French physician Fernand Lamaze standing on either side of a pregnant woman, each trying to persuade her to have a baby his way.
Lamaze and Bradley are founders of the two principal natural childbirth methods used in the United States today. In the contest over the soon-to-be-mother, Lamaze has the edge in name recognition; Bradley has to make do with what one doctor called his evangelical fervor.
Bradley might place a large, friendly hand on the woman's shoulder and tell her in his country-doctor style all about his days on the farm and how effortlessly the animals there gave birth. The more scholarly Lamaze might counsel that with his method the woman could be conditioned to block out the pain of childbirth.
Pretty soon the discussion might deteriorate into a shouting match, with Lamaze taunting his rival with the nickname "Barnyard Bradley." (A Lamaze instructor once dubbed him this because Bradley has studied animals in labor.) Bradley might assert that Lamaze's psychoprophlyaxis method (it means "mind prevention") is nothing more than hypnosis.
In reality, this theoretical tug of war will never happen since Lamaze died in 1957. But it's true that the Bradley and Lamaze methods are in a kind of competition for every woman contemplating natural childbirth--or prepared childbirth, as many now call it.
Although there are a handful of lesser-known natural birth methods in use today, the name Lamaze has become nearly synonymous with natural childbirth. According to Robert Moran, executive director of the ASPO/Lamaze organization in Arlington, Va. (ASPO stands for American Society for Psychoprophylaxis in Obstetrics), more than 1 million Lamaze-coached mothers give birth each year in this country.
Bradley is the runner-up. The American Academy of Husband-Coached Childbirth in Sherman Oaks, Bradley's national headquarters, reports about 20,000 Bradley births a year. The majority of those births are in the West, with California accounting for about one-fourth of all Bradley births.
"My method is coming into its own now because it's right; Lamaze was wrong," said Dr. Robert Bradley, 69, in an interview at his Colorado home.
The retired obstetrician has spent countless hours during his career explaining how his method differs from Lamaze's. Bradley so vigorously defends his own childbirth style that he has been called bombastic by more than one close friend. And though they are milder in their criticisms, members of the Lamaze organization are not above taking potshots at Bradley.
Bradley claims that his is the only truly natural childbirth method. Of the Lamaze organization, he said: "They have the audacity to call their method natural. It is not natural."
Both Lamaze and Bradley have their roots in the work of Grantly Dick-Read, a British physician who published his original work on natural childbirth in 1933. But Bradley contends that his predecessor was not a true advocate of natural childbirth because he allowed women to whiff at an anesthetic if their labor pains were severe.
The Lamaze technique is also unnatural in Bradley's estimation because in the past the French physician advocated artificial breathing patterns intended to distract women from the pain of labor. (In recent years, the Lamaze organization has downplayed the importance of the breathing pattern Bradley objects to, according to Lamaze spokesperson Katherine Winter.)
Bradley, who crusades against the use of any pain medication in delivery, is also critical of the Lamaze stance on drugs.
"We (Lamaze advocates) are not proponents of everyone having an unmedicated birth," said Winter. "We encourage people not to use medications, but sometimes labor brings untenable situations."
Lamaze director Moran said that Bradley may be doing a disservice in telling women to expect a drug-free birth. Depending on hospital policy, or the degree of pain they may experience, some mothers may receive medication despite their plans to the contrary, he said.
Dr. Charles Brinkman, chief of the division of obstetrics at UCLA Medical Center, agrees that Bradley mothers sometimes harbor unreasonably high expectations for a totally natural birth.
"In general, our attitude here at UCLA is very enthusiastic about any of the prepared childbirth methods," he said. "But some Bradley patients end up with a sense of failure if they don't go all the way through labor without medication."
It would not surprise Bradley that UCLA routinely refers patients to Lamaze coaches. He contends that most doctors prefer that method because it turns out compliant patients who are unlikely to dispute a doctor's decision to use drugs, induce labor, or in other ways interfere with a natural birth.
(Lamaze director Moran refutes this charge. They do coach their clients to ask questions, he said.)