The method of preparing for labor involves the use of specific breathing and relaxation techniques.

Lamaze is the oldest and most popular technique of childbirth preparation in the United States. It originated in the 1950s by Dr. Fernand Lamaze, who was inspired by the natural relaxation and emotional support strategies he observed during childbirth in Russia. Nowadays one in four deliveries—or about one million births each year—are to parents educated in the Lamaze method. Keep reading to learn more and decide whether it's right for you.

The Lamaze method prepares women for a safe, healthy birth by providing current and evidence-based information. It builds confidence, teaches childbirth coping mechanisms, and essentially serves as an alternative to medical intervention.

Lamaze is popularly known for its rhythmic breathing exercises that reduce heart rate, anxiety, and pain perception during labor. They work because when breathing becomes a focus, other sensations (such as labor pain) move to the edge of your awareness. Conscious breathing is an especially useful labor tool because it keeps you and your baby well oxygenated, and it's also easy to learn and use. And best of all, breathing is the one coping strategy that can't be taken away from you—even if you're stuck in bed attached to an electronic fetal monitor and intravenous fluids.

Teachers of the lamaze technique also stress consumer awareness, and they introduce medication as an additional tool by explaining its pros and cons. Former Lamaze International president Deb Woolley says, "Like the rest of life, childbirth isn't as good when it's experienced through a haze of drugs or fear." Lamaze teachers also encourage students to discuss all medical interventions with their caregivers so they can make well-informed decisions during labor.

According to Lamaze International, the foundations of the method are based on six research-based principles, called "The Lamaze Healthy Birth Practices."

1. Let labor begin naturally, which signals that all components (including your body, your hormones, the placenta, etc.) are ready for birth.

2. Stay active during labor by changing positions, moving around, and walking. Movement helps women cope with contractions, and it also encourages your baby to move into the correct place for delivery.

3. Receive continuous support during labor from a doula, a loved one, etc. The idea is that a trusting, loving environment makes childbirth easier.

4. Avoid non-vital medical interventions. Lamaze International says that unnecessary interference harms the "natural process of labor and birth."

5. When delivering your baby, avoid lying on your back. Instead, you should assume whatever position feels most comfortable, and push whenever it feels right.

6. The mother and baby should stay together after birth. Skin-to-skin contact promotes bonding and breastfeeding success, among other things.

Management of pain without drug intervention gives the Lamaze method widespread appeal among parents who seek a natural childbirth experience. When allowed and encouraged, a woman will naturally move, moan, sway, change her breathing pattern, and rock to cope with contractions, eventually finding the right rhythm for her unique needs. Such active comfort-seeking helps the baby rotate and descend, and it also prevents labor from stalling. As a woman's contractions get stronger, her body releases endorphins—nature's narcotic—to ease her pain.

After taking Lamaze classes, women also feel more confident about labor and delivery. They better understand how to navigate the maze of modern obstetrics, which helps them have a healthy birth in their desired way.

Usually you'll take Lamaze classes for five or six weeks toward the end of pregnancy, for a total of about 12 hours. In some areas you can take a full Lamaze series in a single weekend. Though most ASPO-certified childbirth educators (ACCEs) are nurses, Lamaze teachers can have a background in teaching, social work, counseling, clinical psychology, or physical therapy. Call Lamaze International at (202)-367-1128 or visit www.lamaze.org for a referral to a Lamaze Certified Childbirth Educator in your area.

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Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute to the popularity of complementary methods of pain management. This review examined currently available evidence on the use of relaxation therapies for pain management in labour. This is an update of a review first published in 2011.

To examine the effects of mind‐body relaxation techniques for pain management in labour on maternal and neonatal well‐being during and after labour.

We searched Cochrane Pregnancy and Childbirth's Trials Register (9 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 5 2017), MEDLINE (1966 to 24 May 2017), CINAHL (1980 to 24 May 2017), the Australian New Zealand Clinical Trials Registry (18 May 2017), ClinicalTrials.gov (18 May 2017), the ISRCTN Register (18 May 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (18 May 2017), and reference lists of retrieved studies.

Randomised controlled trials (including quasi randomised and cluster trials) comparing relaxation methods with standard care, no treatment, other non‐pharmacological forms of pain management in labour or placebo.

Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We attempted to contact study authors for additional information. We assessed evidence quality with GRADE methodology.

This review update includes 19 studies (2519 women), 15 of which (1731 women) contribute data. Interventions examined included relaxation, yoga, music and mindfulness. Approximately half of the studies had a low risk of bias for random sequence generation and attrition bias. The majority of studies had a high risk of bias for performance and detection bias, and unclear risk of bias for, allocation concealment, reporting bias and other bias. We assessed the evidence from these studies as ranging from low to very low quality, and therefore the effects below should be interpreted with caution.

Relaxation

We found that relaxation compared to usual care provided lowered the intensity of pain (measured on a scale of 0 to 10 with low scores indicating less pain) during the latent phase of labour (mean difference (MD) ‐1.25, 95% confidence interval (CI) ‐1.97 to ‐0.53, one trial, 40 women). Four trials reported pain intensity in the active phase; there was high heterogeneity between trials and very low‐quality evidence suggested that there was no strong evidence that the effects were any different between groups for this outcome (MD ‐1.08, 95% CI ‐2.57 to 0.41, four trials, 271 women, random‐effects analysis). Very low‐quality evidence showed that women receiving relaxation reported greater satisfaction with pain relief during labour (risk ratio (RR) 8.00, 95% CI 1.10 to 58.19, one trial, 40 women), and showed no clear benefit for satisfaction with childbirth experience (assessed using different scales) (standard mean difference (SMD) ‐0.03, 95% CI ‐0.37 to 0.31, three trials, 1176 women). For safety outcomes there was very low‐quality evidence of no clear reduction in assisted vaginal birth (average RR 0.61, 95% CI 0.20 to 1.84, four trials, 1122 women) or in caesarean section rates (average RR 0.73, 95% CI 0.26 to 2.01, four trials, 1122 women). Sense of control in labour, and breastfeeding were not reported under this comparison.

Yoga

When comparing yoga to control interventions there was low‐quality evidence that yoga lowered pain intensity (measured on a scale of 0 to 10) with low scores indicating less pain) (MD ‐6.12, 95% CI ‐11.77 to ‐0.47, one trial, 66 women), greater satisfaction with pain relief (MD 7.88, 95% CI 1.51 to 14.25, one trial, 66 women) and greater satisfaction with childbirth experience (MD 6.34, 95% CI 0.26 to 12.42 one trial, 66 women (assessed using the Maternal Comfort Scale with higher score indicating greater comfort). Sense of control in labour, breastfeeding, assisted vaginal birth, and caesarean section were not reported under this comparison.

Music

When comparing music to control interventions there was evidence of lower pain intensity in the latent phase for women receiving music (measured on a scale of 0 to 10 with low scores indicating less pain) (MD ‐0.73, 95% CI ‐1.01 to ‐0.45, random‐effects analysis, two trials, 192 women) and very low‐quality evidence of no clear benefit in the active phase (MD ‐0.51, 95% CI ‐1.10 to 0.07, three trials, 217 women). Very low‐quality evidence suggested no clear benefit in terms of reducing assisted vaginal birth (RR 0.41, 95% CI 0.08 to 2.05, one trial, 156 women) or caesarean section rate (RR 0.78, 95% CI 0.36 to 1.70, two trials, 216 women). Satisfaction with pain relief, sense of control in labour, satisfaction with childbirth experience, and breastfeeding were not reported under this comparison.

Audio analgesia

One trial evaluating audio analgesia versus control only reported one outcome and showed no evidence of benefit in satisfaction with pain relief.

Mindfulness

One trial evaluating mindfulness versus usual care found an increase in sense of control for the mindfulness group (using the Childbirth Self‐Efficacy Inventory) (MD 31.30, 95% CI 1.61 to 60.99, 26 women). There is no strong evidence that the effects were any different between groups for satisfaction in childbirth, or for caesarean section rate, need for assisted vaginal delivery or need for pharmacological pain relief. No other outcomes were reported in this trial.

Relaxation, yoga and music may have a role with reducing pain, and increasing satisfaction with pain relief, although the quality of evidence varies between very low to low. There was insufficient evidence for the role of mindfulness and audio‐analgesia. The majority of trials did not report on the safety of the interventions. Further randomised controlled trials of relaxation modalities for pain management in labour are needed. Trials should be adequately powered and include clinically relevant outcomes such as those described in this review.

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Relaxation compared to usual care for pain management in labour