Dick-Read Grantley childbirth without fear. Read online "birth without fear"

Introduction

It’s high time to talk about the invaluable help that his dear wife Jessica provided to Grantley Dick-Read. After all, it was she who saved the manuscript from the fire when he, having encountered resistance in medical circles, decided to destroy everything he had written. It was she who accompanied her husband on a trip to South Africa when, unable to withstand the pressure of British doctors, he left England in despair. It was she who introduced Grantly Dick-Reed to the Marymount Maternity Hospital, where his success in painless childbirth became a role model throughout the world.
None other than Jessica started antenatal classes where expectant mothers could prepare for natural childbirth in small groups. She developed manuals, trained staff, and supervised classes. Until that time, Dr. Dick-Reed had taught his patients individually, but at the Marymount Maternity Hospital his practice had become so extensive that individual instruction was not possible. Currently, every maternity hospital in the United States, and in other countries, is engaged in prenatal preparation, but few people know that we owe the fact of its existence to the creative search of Jessica Dick-Reed.
Jessica had enough courage to decide to have a natural birth after a cesarean section, completely trusting Dr. Dick-Read's technique in the early years of his practice. Only quite recently has medicine questioned the postulate: “After Caesarean, only Caesarean” and, in some cases, began to practice natural childbirth after Caesarean section.
It is for these reasons that this edition of the book “Childbirth without Fear” is dedicated to the widow of Dr. Dick-Read.
Almost seventy years have passed since Dr. Grantley Dick-Reed (1890–1959) published his first carefully prepared monograph on the philosophy of childbirth. In those days, the very idea that childbirth could take place without suffering seemed seditious and revolutionary, unacceptable to many, so almost all women gave birth under deep anesthesia.
However, Dr. Dick-Read did not give up on his discovery, and time has proven the correctness of his teachings. In the twenties, he broke with tradition not only by teaching women the practice of natural childbirth, but also by organizing classes for husbands. Nowadays, training for wives and husbands is no longer challenged - in fact, it is widely promoted and practiced.
Grantley Dick-Read was far ahead of his time in his approach to the process of childbirth, and in many other areas of medicine. He paved the way for future generations. Unfortunately, it was only after his death that significant social changes that occurred in the world drew public attention to the ideas that he preached.
One of his “heretical” ideas was a protest against environmental pollution, as well as against the “pollution” of human minds with false fears and bodies with drugs. His approach to obstetrics was rigorously scientific, but at the same time he worked at the intersection of sciences, drawing on psychology, sociology and anthropology in research in the fields of physiology and natural sciences. He repeatedly emphasized that a woman must be perceived as a whole person, and not concentrate only on certain processes occurring in her body.
Concentrating his efforts on obstetrics, Dick-Reed moved to group teaching at a time when there was enormous opposition to the concept. He shocked public opinion by declaring that already at school, teenagers should learn such important things as sexual hygiene, the process of childbirth, and the basics of family life.
He was an anti-establishment man - not an outsider, but an active observer with a creative, truthful approach to reality. Based on his knowledge of human relations, he opposed the unproductivity and cold detachment from the life of academic science, against the categorical nature of materialism, and against the pursuit of social prestige.
Dick-Read loudly declared the equality of all residents of the country and in his articles repeatedly said that he admired the wisdom of blacks and recommended everyone to get acquainted with their life and their history.
None of these articles added to his popularity among his contemporaries!
At the pinnacle of success in the practical application of his teachings, in 1930, at the age of forty, Grantley Dick-Read wrote a book that radically changed the course of development of obstetrics. Based on his own medical experience, he proved that childbirth is a natural physiological process that should not be painful at all. Because his research was based on the “laws of nature,” he titled his book “Natural Childbirth.” But he did not imagine that the title of the book would give a “name” to a whole movement in the practice of obstetrics, that this term, although sometimes misunderstood, would in fact become a common expression throughout the world. It also played a significant role in the fact that by 1933, when the book was finally published, Grantley Dick-Read had risen from the relative obscurity of a practicing provincial doctor to the top, at which he represented a convenient target for the wrath of some and the slander of others. Like many great pioneers of medicine - Simpson, Semmelweis, Lister, Pasteur - he was not recognized by his contemporaries, but later his teaching became one of the cornerstones of medicine.
Grantley Dick-Read considered his teaching not as final, putting an end to the development of science, not as the ultimate truth, but rather as a foundation on which future discoveries would be based. He was never afraid to shake established traditions, boldly asking the uncomfortable question: “Why?” If he were alive today, he would undoubtedly encourage young people to ask uncomfortable questions, tirelessly testing in practice the correctness of medical methods, including his own developments. We believe that all those who share his belief in the consistency and orderliness of the laws of nature, which we so often neglect to our own misfortune, will continue the search for truth.
The fifth edition of the book "Childbirth Without Fear" contains descriptions of some of the latest discoveries that confirm the truth of the principles of the teachings of Grantley Dick-Read. New material is included in the first part, the second part sets out the philosophy and physiological foundations of natural childbirth; in the third - the autobiography of Grantley Dick-Read. This edition includes the best, timeless provisions of the author’s works.

Preface to the first edition

The compilers included in this edition the author’s preface, published by him in the first edition of the book “Natural Childbirth” - albeit in a somewhat abbreviated form. The accuracy and modernity of the views expressed 50 years ago cannot but amaze and seem especially remarkable.
In recent times, no subject has attracted as much attention as obstetrics. Scientific societies everywhere invite lecturers and hold discussions on theory and practice, government commissions are established to study the causes of infant and maternal mortality during childbirth. Medical journals publish many articles on abnormalities and complications during childbirth, and the “secular” press, in turn, does not miss the opportunity to present to the public any information that can be obtained on this issue from scientific societies and associations. And although it cannot be denied that noticeable progress has been made in terms of awareness and technology of childbirth, unfortunately, this has not been reflected in the statistics, at least over the last 10–15 years.
On the following pages an attempt will be made to consider the process of childbirth from a slightly different angle than the usual one. Many dangers and complications can be avoided through careful prenatal preparation and careful monitoring of the expectant mother. Accurate knowledge of the size of the pelvis, the position of the fetus and the degree of its development allows you to act correctly and in a timely manner during childbirth, which prevents the occurrence of various complications.
As a rule, no one disputes the fact that one of the reasons for complications during childbirth and, as a consequence, maternal and child mortality, is the inability of obstetricians to calmly observe the progress of labor and not interfere with the natural course of events. The reason for this may be excessive zeal or groundless anxiety based on ignorance, but be that as it may, the fact remains that it is precisely this kind of intervention that poses the greatest danger to the mother and child.
However, there is also a contradiction in this issue: on the one hand, women often suffer due to misdirected human sympathy; on the other hand, it is obvious: if there is suffering, it needs to be alleviated. The problem arises: how to relieve prolonged suffering without harming the mother or child? What is more immoral: allowing the painful labor to continue or putting mother and child at risk?
Obviously, when solving this problem, it is impossible to avoid studying and revising many medical concepts - for example, such as the assessment and threshold of pain.
A new approach to the birth process has been developed, in which conclusions about the means used are based only on practical experience. The results, by the way, are very, very encouraging.
It is a mistake to believe that the ability to perceive the principles of natural childbirth depends on the degree of awareness in the field of obstetrics and the level of medical education. Rather, on the contrary, in this case, more tolerance will be required from a medical scientist or simply an academically minded doctor than from those whose perception is not clouded by the fear of deviation from the norm.
If it were not for the enthusiasm of those who accepted the teaching, the pages of this book would hardly ever have seen the light of day. We are far from declaring a 100% guarantee of success and always emphasize that when identifying pathological changes, it is necessary to resort to surgical methods of modern obstetric science. But, on the other hand, no one will object that the mother’s excited state leads to increased sensitivity and receptivity.
The first and most obvious advantages of taking care of not only the physical but also the psychological state of the mother are that childbirth begins to seem like a more natural process to her and that in such cases there are almost no complications in the subsequent ones, which we designated the second and third, periods of childbirth.
But the most important result is the achievement of the happiness of motherhood, when mother and child literally blossom after childbirth.
If, despite everything, pain still appears, it must be overcome immediately. Painless childbirth is the most valuable gift that people in our profession can give to humanity. However, if painlessness can only be achieved by disrupting the natural course of events, then you need to carefully choose the lesser of two evils.
Giving birth to a child is the highest purpose of a woman. Awareness and feeling of the beauty and uniqueness of this event is the highest reward not only for the mother herself, but also for the whole family, for society, for the nation. Yes, I know that in our time thousands of women would prefer to give birth to children in conditions that are called “modern and humane.” These women will be the first to indignantly condemn any talk about the beauty of natural childbirth, saying that, of course, it is easy for a man to initiate such a method. But those who understand will even sympathize with men who are not given the opportunity to know the enormous joy that is the reward for the natural birth of a child.
Grantley Dick-Reed, MD, 1933

Preface to the fifth edition

I want every medical student, every doctor and every obstetrician who is unfamiliar with the principles of natural childbirth to become familiar with the basic teachings of Dr. Grantly Dick-Reed. The mere fact that they have stood the test of almost fifty years of experience and have not been refuted speaks volumes. Of course, we should not take each of his statements as a postulate, but at the same time, his widespread criticism of fellow specialists should not turn us away from a comprehensive study of the physiological processes that are the most important during pregnancy and childbirth.
If anyone believes that the birth of a child must inherently be accompanied by pain and suffering, then we dare to remind him of the following:
1) in no species of animals does childbirth involve suffering and pain, with the exception of pathological cases or childbirth in unnatural conditions, for example, in captivity;
2) there are cultures and nations, dubiously called less civilized, where a woman awaits the birth of a child with joy, with anticipation of a significant event; it is difficult to detect any signs of suffering there during childbirth, except, again, in pathological cases;
3) not a single physiological process in our body is accompanied by pain, with the exception of complications caused by illness, fear and stress;
4) experience shows that when a woman is prepared in such a way that there is no fear and stress during childbirth, she does not experience suffering and pain, except to a small extent;
5) in the absence of pathological changes, the strength of pain is directly dependent on the strength of fear and tension;
6) currently in America, prenatal preparation of women is practiced almost everywhere and words about the natural process of childbirth are heard more and more often, stories about positive results are passed on from mouth to mouth; More and more women are realizing that natural childbirth is the most delightful and rewarding way to give birth to a child.
In the mid-fifties, I had just finished my studies and began giving my first professional lectures at medical congresses. Oh, it was a wonderful time when you knew everything! Personally, I had no doubt that I knew the answers to all the questions. The subject of the slides I showed at one of the congresses was pain relief during childbirth and the practice of applying forceps. I was very proud of the slides and the results of my practical work. Over the course of a year, 87 of my patients received complete pain relief during childbirth. In 82 cases, forceps were used.
Looking back, I realize what an idiot I was. How little I knew about childbirth and “delivery,” how scientifically we spoke then. The principles of natural childbirth and their importance have already been outlined in the literature, but I did not even bother to study the articles that were quite accessible to me.
Between the fifties and the eighties, I attended approximately seven thousand births and witnessed an evolution in obstetrics. I believe that obstetricians who have not experienced evolution are unlikely to be able to fully experience progress.
If we look back at the fifties, we can safely say that since then we have advanced from the process of “delivery” to childbirth. In the fifties we were constantly led by women; nowadays they do a lot of things themselves. In the fifties we talked about rooms for “delivery” - a woman was gradually transferred from room to room, and all this was done at the most critical moments of labor! These days there is only one delivery room and the woman stays in the same bed before and after the baby is born.
In the fifties, we tried to give complete anesthesia to every woman, with the exception of those fortunate cases when rapid labor occurred and we simply did not have time to do it. Nowadays, complete anesthesia is used extremely rarely. In the fifties we tried to use forceps at every birth and then proudly reported on their use; nowadays we rarely see any reason to use such instruments. In the fifties, we completely unphysiologically compensated for the loss of moisture with the help of intravenous infusions, these days they simply give you more to drink. In the fifties, women had their perineal area shaved and given an enema. I remember with a shudder how women were literally stretched out by their arms and legs and their faces were covered. This practice stopped only in the early sixties, when we began implementing our program.
In the fifties, in the first days after birth, mother and child were separated, and no one disputed this. Nowadays we talk about the inalienable, inseparable bonds of a child not only with his father and mother, but also with his siblings, considering this not even desirable, but a necessary condition. In those days, it seemed completely unimportant whether a woman breastfed her child. Even if she strived for this, she was allowed the first feeding no earlier than a day later. During childbirth, she only had time to cast a fleeting glance at the child, and this was the only contact in the first twenty-four hours of his life. Now we encourage every woman to breastfeed in the very first moments after the birth of a child, even before the umbilical cord is cut.
In the fifties, women breastfed for two or three months at best, and this was already considered an outstanding achievement. Nowadays, we advise a woman to feed her child only breast milk for nine months, without water and complementary foods, of course, if there are no pathological changes or processes.
In the fifties, the only appropriate place for a father to be during a caesarean section was in the waiting room, since it was a surgical procedure. In maternity hospitals of our time, the father is assigned a responsible, extremely important role. If a vaginal birth occurs, then the husband must support his wife directly, but if a cesarean section is performed, then while doctors are caring for his wife, he must be inextricably linked with the child.
In the fifties we began to practice hypnosis. In those days it became something of a mass insanity. Without a doubt, hypnosis expands the scope of non-medical intervention, which is extremely useful, but it should be noted that such intervention is labor-intensive. The doctor must contact every woman, be present during childbirth, and if there are many patients, this becomes simply impossible. Therefore, tape recordings began to be used for most patients, where they talked about how to overcome pain with the help of relaxation. Indeed, to some extent the tape recording was hypnotic, and once I even performed a caesarean section on a patient under hypnosis. But think about it: after all, the woman on the birthing table is supported only by a soulless electronic device! In such cases, everything goes well only for the time being. Then there is always someone who accidentally pulls the cord out of the socket, and everything goes down the drain. And at this time, the husband of the woman in labor is sitting calmly in the corner and reading the newspaper!
In the late fifties, I began teaching hypnosis to husbands so that they could help their wives during childbirth, and this was a remarkable achievement for both me and them. During this period I also taught at the University of California, Irvine and Los Angeles Hospital. I delivered babies to the wives of undergraduates, graduate students, and faculty members, allowing their husbands to be present at the birth (this was not usually allowed in those days). To my surprise, I discovered that the further my students progressed in their education, the less they supported their wives during childbirth. Future doctors were overly interested in the clinical aspects of childbirth, while all they were required to do was help their wives. But they didn’t know how! And so it went on until I started telling everyone, “Listen, buddy, you should go to antenatal classes,” and the picture immediately changed.
In the mid-fifties, Dr. Charles Mount III introduced me to the works of Grantley Dick-Reed (by the way, it was from Dr. Mount that I first heard the saying: “Doctor’s tension = woman’s tension = uterine tension = pain”). Later, Dr. Robert Bradley encouraged me to involve fathers in childbirth. In 1959, we began conducting training courses for expectant mothers, mainly for husbands. Much has changed since then: while in those days husbands came only to watch, today they come to work; Then they were allowed to be present at birth; today their presence is considered necessary. In the fifties, we thought that a woman during childbirth should act in harmony only with her obstetrician; today we know that at such a moment her harmony with her husband is even more important.
In California, it is still the practice to keep all newborns in one large room. Babies lie swaddled in sheets, and this is believed to provide warmth and security. In our maternity hospitals there are not even separate children's wards. The baby should receive warmth and protection from physical contact with the mother, and not from rags! Our mother and child go home without ever being separated.
At first we kept the mother and child simply in the same room, but this was not enough. They must be in the same bed! The baby should fall asleep next to the mother. During the first 24 hours of life, the child needs continuous physical contact with the mother. We believe that the experience of the first day of life is especially important in laying the foundation for future relationships between mother and child.
The study and application of the philosophy of natural childbirth has been very satisfying and beneficial. At the moment, we have a large obstetric practice, and for every three obstetricians in our clinic there are about twenty-six teachers. They receive every married couple who contacts us and conduct a 45-minute conversation, finding out the spouses’ attitude towards pregnancy, childbirth, the unborn child, etc. - in short, they try to find out as much as possible about the patients. Such a survey helps to establish mutual understanding from the very beginning and determine what to pay special attention to in the future.
Natural childbirth, of course, cannot solve all the problems of obstetrics; many problems still remain. They simply increase the percentage of normal vaginal births, births without medical intervention. The essence of what we do was laid out by Grantley Dick-Read almost fifty years ago. But since then something important has happened - life itself has proven the correctness of the principles of Grantley Dick-Read, their importance for mother, father, child, family and, ultimately, for society as a whole. And we are all indebted to him for the invaluable contribution that the concept of natural childbirth has made to the cause of the happy birth of a new person.
Harlap Ellis, MD.
This book is not an instruction for women in matters that fall solely within the competence of physicians. Correct diagnosis and treatment of all symptoms associated with pregnancy and the postpartum period can only be established by qualified specialists.

Part I

Prospects for natural childbirth

In his works, Grantly Dick-Read wrote not about the method of childbirth, but about a certain philosophy of life, an essential part of which is natural childbirth. He believed that the experience gained during childbirth affects (in a good or bad sense) not only the child, but also the entire family into which this child was born. He believed that the distinctive characteristics of clans and the attitude towards them characteristic of a particular nation directly reflect its views on the value of each individual life, which, in turn, influences (good or bad) the entire nation and, ultimately, on humanity as a whole.
Grantley Dick-Read believed that not only the method of birth and the period following it influence the child, he believed that the fetus already in the womb is subject to the influence of life circumstances and the mother’s moods. He wrote:
We have come to understand that the baby in the womb is nourished through the mother's blood and that changes in the mother's emotional state can affect the nutrition and metabolism of the unborn child. I do not believe in biochemical constants; moreover, I do not consider genes to be constants. I believe there is something in a mother's blood that changes depending on her mood. When the psychological and emotional state of the mother changes, the endocrine glands produce substances that enter the blood, which nourishes not only the mother, but also the child. Thus, the child's condition cannot remain the same. Today we know that when the mother’s emotional state changes, we can register an increase or decrease in the fetal heartbeat, i.e. we can definitely say that the child’s development also depends on the mother’s mood during pregnancy.
The research that was carried out after Dick-Read's death led to the emergence of a new scientific discipline - prenatal and postnatal psychology, and his assumptions and assumptions were confirmed in the most remarkable way. In subsequent chapters, the birth of a child will be considered as one of the links in a continuous process: from conception to several months after birth - from a psychological and physiological point of view for both mother and child.

Chapter 1. Child in the womb

The birth of a child is a short but important episode of a single whole - a person’s life from conception to death. At this moment, more than ever, the connection between generations is clearly manifested. None of us can avoid the consequences of the prenatal period of our lives, the consequences of the way we were born and spent the first months of life. The conditions in which we spend our first eighteen months - from the moment of conception to the nine months of independent existence - have a huge impact on our entire subsequent life. In this chapter we will look at how environmental conditions affect the emotional, mental and psychological development of the fetus.

Grantly Dick-Read; Beccles, UK; 01/26/1890 – 07/11/1959

Grantley Dick-Read is a world-renowned British obstetrician who advocated natural childbirth throughout his life. Having visited many countries of the world, he spent a long time studying the process of bearing and giving birth to a child. Grently Dick-Read's books “Natural Childbirth” and “Childbirth Without Fear”, which were on the world bestseller list for a long time, brought him worldwide fame.

Biography of Grantly Dick-Read

Grantley Dick-Read was born in the small market town of Beccles in the winter of 1890 into the family of a miller. In addition to him, the family had six more children. Since childhood, Grantley was fond of sports and learned horse riding. In addition, he has been actively studying art since childhood. Grentley Dick-Reed was partial to poetry and studied piano and cello at a music school. He studied first at Storford, and a little later at Cambridge College. After this, Grently Dick-Read decides to connect his life with medicine. He enters a special teaching hospital in London, where after several years he receives the qualification of a doctor. Thus, in 1914, the young man began to work as a doctor.

When the First World War began, Grentley Dick-Read's biography took an unexpected turn - he was forced to join the Royal Army Medical Corps. After several months of service, the doctor is seriously injured during the Dardanelles operation. At the end of hostilities, Grantley Dick-Reed returns back to London and continues to work in the hospital, while preparing to defend his dissertation. In 1920 he received his master's degree and began practicing at Woking Hospital. In 1921, Grantley married his sweetheart Dorothy. Their marriage produced four children, but the union itself subsequently fell apart.

For a long time, Grentley Dick-Read observed the process of childbirth in women. At that time, the use of general anesthesia in such a process was common in Great Britain. It was believed that childbirth was so painful that not every woman could endure it. However, the obstetrician categorically did not like this theory. He began to think about the psychological nature of pain and the influence of fear on the birth process.

Some time later, in 1933, the doctor’s first work, entitled “Natural Childbirth,” was published. If Grently Dick-Read buys the book, we will see that the author’s entire theory, as in, was based on his many years of work experience. On the pages of the publication, he described various cases during childbirth and presented several practices that helped readers get rid of fear. Unfortunately, the work was not accepted by the obstetricians, and the doctor was fired from the clinic. Grantley Dick-Reed was upset by this public reaction. He even wanted to get rid of the book and stop writing. However, his second wife Jessica convinced him.

Then the doctor decides to gather his strength and open his own clinic in London. He continued to analyze all the cases that he encountered during his hospital practice, and in 1942 he published his second work, “Childbirth without Fear.” Unlike the first work, the second edition began to gain rapid popularity in the first months after publication. Soon Grently Dick-Read's book could be purchased in many countries around the world. It has been on the world bestseller list for a long time. Gradually, readers began to become interested in the author’s previous work. The once risky approach to childbirth now looked innovative and daring. The writer began to be invited on world tours, where he gave his lectures.

In 1948, Grently Dick-Read moved to South Africa, where he continued to practice obstetrics. Five years later he returns to London and writes lectures and books. In 1956, an organization specializing in natural childbirth was founded in the UK. Its founder, Prunella Brians, invites Grently Dick-Read to become president of the company. However, the doctor could not hold this position for long. In 1959, Grantley Dick-Reed died. Today, half a century after the death of the British doctor and writer, his works are used by obstetricians around the world.

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" GrentLee Dick-Read - founderconceptsnatural birth"

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In recent times, no subject has attracted as much attention as obstetrics. Scientific societies everywhere invite lecturers and hold discussions on theory and practice. Medical journals publish many articles on abnormalities and complications during childbirth, and the “secular” press, in turn, does not miss the opportunity to present to the public any information that can be obtained on this issue from scientific societies and associations.

Eighty years have passed since Dr. Grantley Dick-Reed (1890-1959) published his first carefully prepared monograph on the philosophy of childbirth, entitled Childbirth Without Pain. At that time, the very idea that childbirth could take place without suffering seemed seditious and revolutionary, unacceptable to many. However, Dr. Dick-Read did not give up on his discovery, and time has proven the correctness of his teachings. In the twenties, he broke with tradition not only by teaching women the practice of natural childbirth, but also by organizing classes for husbands. Grantley Dick-Read was far ahead of his time in his approach to the process of childbirth, and in many other areas of medicine. He paved the way for future generations. Only after his death did significant social changes that occurred in the world attract public attention to the ideas that he preached.

Dick-Read's approach to obstetrics was rigorously scientific, but at the same time he worked at the intersection of sciences, drawing on psychology, sociology and anthropology for research in the fields of physiology and natural sciences.

The relevance of this topic is significant, since in the modern world the issue of painless and comfortable childbirth for a woman is especially acute and is discussed by many specialists.

1. BIography of Grantley Dick-Read

Grantley Dick-Read was born in 1890 in the north of England. He was the sixth child. In total there were 10 children in the family. The future doctor spent his childhood on a family farm in Norfolk, where his acquaintance with nature began. He preferred communicating with animals to communicating with older brothers and sisters, more than once watching dogs whelp and cats give birth. Dick-Read spent most of his time on the Grantley farm alone, completely immersed in contemplation of the mysteries of nature.

In 1908, Dick-Read entered Cambridge to study and began his medical career. Having a stock of already ingrained ideas in his mind, he began to encounter misunderstanding and inflexibility from his senior mentors. His long-standing passion for natural history resulted in a love for zoology, biology and physiology. Observing the birth of young animals of any type, class or order aroused his curiosity. It was not even his innate insight that pushed him into such research, but rather his resentment that the laws of nature had so unfairly circumvented women. During all four student years at Cambridge, only once did Dick-Read muster all his courage and ask a question about the pain of childbirth. He observed one of the professor's experiments on the study of the sympathetic nervous system. In an experiment, the nerves of a cat's uterus were stimulated by nicotine, and he asked, "Is it possible that the sympathetic nervous system has anything to do with pain in the uterus during a woman's labor?" The professor looked at him sternly, and after a five-minute pause said very quietly and very slowly: “Yes. Yes, it is indeed possible.” That is all that has ever been said on this subject.

In 1912, his internship began at the London Hospital. He worked in a hospital whose outpatient department handled between one and a half to two thousand patients a day. However, he was exclusively interested in gynecology and obstetrics. Among the women he visited in 1913, there was one whose random words had far-reaching consequences for Dick-Read. It was a normal birth. But at the moment when the head appeared and the vaginal opening noticeably widened, the doctor tried to convince the patient to allow him to put a mask of chloroform on her face for pain relief. Without offense, she politely but firmly refused to accept such help. After the end of labor, he asked why the woman refused pain relief, to which she replied: “It didn’t hurt. It shouldn’t hurt, right, doctor?”

Shortly after passing his final exam at London's Grantley Hospital, Dick-Read was called up for military service as the First World War began. He was assigned as a doctor to the ambulance unit and sent to Gallipoli. Where in 1915 he was wounded by a shell and sent to Malta. Blind in one eye, with an enveloping haze in the other, almost paralyzed from the waist down, weakened by dysentery, with a pulse barely reaching 30 beats per minute and wracked with fever, he spent several months in a military hospital.

When the war finally ended in 1918, filled with the joy of returning to what he loved, Dick-Read returned to work at a London hospital as the hospital's senior obstetrician.

After returning to the London hospital, Grantley worked for some time as a house physician under the direction of Sir Henry Head. He was one of the greatest pioneers of neuroscience, whose work helped develop an entire branch of science known as psychosomatic medicine. He proved that somatic and physical changes in the human body can be a direct result of a psychological state. Knowing that Dick-Read was interested in obstetrics and gynecology, he drew his attention to the changes that occur in a woman’s mind after pregnancy and how they affect the subsequent course of childbirth. Thanks to this, Grentley Dick-Read began to take an interest in the emotions of his patients, hoping, by observing their state of mind, to get as many answers to his questions as possible. For long hours he sat near the beds, trying to establish the strength of the relationship between fear and tension, which entails pain. Every free minute he rummaged through books that could help. And he didn’t calm down until he found the answer. Long before this, it became obvious to the doctor that the first thing that must be dealt with in order to avoid pain is tension. Later the aphorism matured: “A tense woman is a tense womb.” All obstetricians are well aware of the consequences of a tense uterus: pain, resistance, countless complications of protracted labor and, possibly, an operative outcome. Grantley Dick-Read was sure that the cause of tension was fear. The return of a sense of confidence allowed women to relieve enough tension to give birth to a healthy child in a fairly short period of time.

At the pinnacle of success in the practical application of his teachings, in 1930, at the age of forty, Grantley Dick-Read wrote a book that radically changed the course of development of obstetrics. Based on his own medical experience, he proved that childbirth is a natural physiological process that should not be painful at all. Because his research was based on the “laws of nature,” he titled his book “Natural Childbirth.” But he did not imagine that the title of the book would give a “name” to a whole movement in the practice of obstetrics, that this term, although sometimes misunderstood, would in fact become a common expression throughout the world. It also played a significant role in the fact that by 1933, when the book was finally published, Grantley Dick-Read had risen from the relative obscurity of a practicing provincial doctor to the top, at which he represented a convenient target for the wrath of some and the slander of others. Like many great pioneers of medicine - Simpson, Semmelweis, Lister, Pasteur - he was not recognized by his contemporaries, but later his teaching became one of the cornerstones of medicine.

2. TOconcept of natural childbirth

Giving birth to a child is the highest purpose of a woman. Awareness and feeling of the beauty and uniqueness of this event is the highest reward not only for the mother herself, but also for the whole family, for society, for the nation.

Every medical student, every doctor and every midwife unfamiliar with the principles of natural childbirth should certainly become familiar with the basic principles of the teachings of Dr. Grantly Dick-Reed. The mere fact that they have stood the test of almost a century of experience and have not been refuted speaks volumes. Of course, we should not take each of his statements as a postulate, but at the same time, his widespread criticism of fellow specialists should not turn us away from a comprehensive study of the physiological processes that are the most important during pregnancy and childbirth.

If someone believes that the birth of a child must inherently be accompanied by pain and suffering, then it is worth reminding him of the following:

1) in no species of animals does childbirth involve suffering and pain, with the exception of pathological cases or childbirth in unnatural conditions, for example, in captivity;

2) there are cultures and nations, dubiously called less civilized, where a woman awaits the birth of a child with joy, with anticipation of a significant event; it is difficult to detect any signs of suffering there during childbirth, except, again, in pathological cases;

3) not a single physiological process in our body is accompanied by pain, with the exception of complications caused by illness, fear and stress;

4) experience shows that when a woman is prepared in such a way that there is no fear and stress during childbirth, she does not experience suffering and pain, except to a small extent;

5) in the absence of pathological changes, the strength of pain is directly dependent on the strength of fear and tension;

6) currently in America, prenatal preparation of women is practiced almost everywhere and words about the natural process of childbirth are heard more and more often, stories about positive results are passed on from mouth to mouth; More and more women are realizing that natural childbirth is the most delightful and rewarding way to give birth to a child.

In his works, Grentley Dick-Read wrote not about the method of childbirth, but about a certain philosophy of life, an essential part of which is natural childbirth. He believed that the experience gained during childbirth affects (in a good or bad sense) not only the child, but also the entire family into which this child was born. He believed that the distinctive characteristics of clans and the attitude towards them characteristic of a particular nation directly reflect its views on the value of each individual life, which, in turn, influences (good or bad) the entire nation and, ultimately, on humanity as a whole.

Grentley Dick-Read believed that not only the method of birth and the period following it influence the child, he believed that the fetus already in the womb is subject to the influence of life circumstances and the mother’s moods. He wrote:

“We have come to understand that the baby in the womb is nourished through the mother’s blood and that changes in the mother’s emotional state can affect the nutrition and metabolism of the unborn child. I do not believe in biochemical constants; moreover, I do not consider genes to be constants. I believe there is something in a mother's blood that changes depending on her mood. When the psychological and emotional state of the mother changes, the endocrine glands produce substances that enter the blood, which nourishes not only the mother, but also the child. Thus, the child's condition cannot remain the same. Today we know that when the mother’s emotional state changes, we can register an increase or decrease in the fetal heartbeat, i.e. we can definitely say that the child’s development also depends on the mother’s mood during pregnancy.”

Giving birth in a dignified environment means that the newborn finds himself in an atmosphere where he and the mother are treated humanely and with care. All necessary medical care is provided unobtrusively, and the mother’s wishes are respected. The presence of a father is considered an undeniable advantage. Medical staff communicate politely and kindly not only with parents, but also with each other. The child comes into a world where respect and dignity reign, and immediately receives affection and support. The main goal for everyone is the birth of the healthiest, most beautiful baby in the world and facilitating the birth of the mother. All of the above clearly coincides with the concept of safe obstetrics. In fact, giving birth in this environment is the safest way to have a baby, it is natural birth at its best.

What is natural childbirth?

Natural childbirth is one of the links in a chain of continuous physiological processes that represent and illustrate the basic laws of nature, the law of reproduction and the law of maintaining the species. Natural childbirth is a normal physiological birth. When childbirth is associated with fear, and therefore with tension, it, to one degree or another, immediately becomes non-physiological, pathological.

Natural childbirth does not mean absolutely painless for every woman - although, as a rule, the discomfort encountered does not exceed the level that the woman herself wants to experience and which can be controlled by adhering to the basic principles of natural childbirth.

3. WITHfuck - tension - pain

childbirthphysiologicallyth law

Fear - tension - pain: this is exactly the sequence of events that can be traced in all similar situations. Fear of pain provokes resistance to the working muscles of the uterus, increasing tension and causing pain. Fear is a natural protective reaction of the body. The intensity of fear ranges from apprehension and doubt to overwhelming terror. Even slight anxiety can cause tension in a woman, which will lead to contraction of the orbicularis muscles and resistance to the work of the uterine muscles to expel the fetus. If a woman is in tension, then the outlet of the uterus is also in tension, which gave the basis to the formula: “A tense woman - a tense cervix.” And cervical tension in most cases means a long and painful labor: the mother herself closes the door to her newborn child. On the contrary, a calm, relaxed woman allows her neck to open easily. If she understands what is happening, if she is completely relaxed and confident, then at the moment when the longitudinal muscles begin their work of expelling the fetus, the muscles that kept the uterus locked during pregnancy relax and stretch easily. In this case, there is no resistance to the birth of the child, there is no pain, and the child is born much easier. For a woman expecting a child, rest is absolutely necessary, at least for half an hour during the day. In later stages of pregnancy, physical fatigue can be problematic if the habit of proper rest has not been developed earlier in pregnancy. Rest becomes more effective if you learn how to relax properly. Relaxation has huge benefits during pregnancy. Half an hour of relaxation gives the body much more than an hour of sleep. This relieves tension that has unconsciously accumulated in the body, which helps avoid discomfort and pain. A feeling of calm and confidence arises, which is completely impossible to achieve in a tense state. Tension is caused by anxiety, and relaxation helps overcome anxiety, thereby relieving tension in the mind and body.

Relaxation is a huge help during childbirth. If a woman in labor is able to completely relax during contractions in the first stage of labor and between contractions during expulsion, then during a normal birth she will find that she does not experience any discomfort.

Muscle relaxation makes changes not only physical, but also at the level of biorhythms of brain activity. In a normal human condition, the brain's beta rhythms range from approximately 13 to 25 cycles per second. If a person is relaxed, then they decrease to the level of alpha rhythms with a frequency of 8 to 13 cycles per second, becoming the same as in a state of distracted attention or drowsiness. If relaxation becomes deeper, then brain activity decreases to the level of theta rhythms with a frequency of 4 to 8 cycles per second. This level of biorhythms is observed during dreamy, “twilight” rest, which usually occurs before falling asleep. In such a state, it is simply impossible to worry about anything.

Muscle relaxation is a condition in which muscle tone throughout the body is reduced to a minimum. If there is no muscle tension, then all emotional reactions and even thoughts fade away. Thus, if the body is completely relaxed during childbirth, this eliminates the excess tone of the circular fibers of the lower segments of the uterus, cervix and birth canal. But that's not all. In a state of complete relaxation and calm, the activity of the uterus during childbirth is perceived as it should be - simply as muscle contraction and nothing more.

Zconclusion

The philosophy of natural childbirth is as relevant now, in the last half of the twentieth century, as it was in 1919, when Grantley Dick-Read first announced it. For he learned the philosophy of natural childbirth while observing women who gave birth, and gave birth joyfully, without any special difficulties or suffering. Women revealed the truth to him, and this truth remains valid to this day. For the first time, this question arose before Grently Dick-Read in 1913 thanks to his patient, a young woman. She surprised him by refusing the proposed pain relief. After the baby was born, the new mother said: “It didn’t hurt at all. It shouldn’t hurt, right, doctor?” Dr. Dick-Read nodded in agreement, but then the next inevitable question arose before him: “Why does this still happen and hurt?”

Much has changed in obstetric practice since the life of Dr. Dick-Read, which he himself contributed to, because it was his teaching that revolutionized obstetrics throughout the world. However, modern obstetric practice still often violates the laws of childbirth as a natural process. Everyone who is in any way connected with the birth of a child should familiarize himself with the works of Grantley Dick-Read, and only then apply his own methods if he proves that they are superior.

WITHlist of sources used

1. Grentley Dick-Reed, “Childbirth without fear”, Moscow, 2005, pp.: 113-116

2. Website “Wikipedia. Free encyclopedia", Pain relief in childbirth, https://ru.wikipedia.org/wiki/Pain relief in childbirth (date of access: 10/03/2016)

3. Website “Electronic Library”, http://modernlib.ru/books/dikrid_grentli/rodi_bez_straha/ (access date: 10/03/2016)

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Learning to relax

Bright light interferes with relaxation, so the best time for relaxation is twilight (you should close the curtains during the day, and turn on only one table lamp in the evening). It is important that nothing restricts your body: you need to unbutton your collar, take off tight shoes, watches, bracelets, glasses, contact lenses, dentures (if any). In addition, it is advisable to empty the bladder and rectum to effectively relax the pelvic muscles.

Stand up, stretch, taking a deep breath through your nose, exhale all the air from your lungs, lowering your shoulders and head. If you start training early in your pregnancy, you can achieve the best relaxation by lying on your back. Lie on a hard, flat surface, place a pillow under your head and shoulders, as well as under your knees (the joints of your legs and pelvis should be slightly bent). Spread your legs about 20 cm, at the same distance from your body, place your hands, palms down, slightly bending your elbows and knuckles.

After 18-20 weeks of pregnancy, relaxation on the back is not suitable for many women; in this case, sessions can be carried out while leaning back in a comfortable chair. In the later stages of pregnancy, as well as during childbirth, the optimal position is lying on the left side (blood circulation is not hampered, the uterus does not put pressure on the diaphragm and does not interfere with breathing).

The left arm should be thrown behind the back and placed along the body, the right arm should be bent and placed near the pillow, which should support the right shoulder (without such support it becomes very tense). You should place your head on the pillow and turn it towards your right shoulder, raising your chin slightly - it’s easier to breathe in this position. Bend your left leg just a little, pull your right leg close to your stomach. To best relax the muscles of the abdomen, lower back, legs and pelvis, place a pillow under your right knee. Abdominal breathing is best suited for this pose (with each inhalation, the abdominal cavity is filled with air). Having taken the correct position and begun relaxation, a pregnant woman immediately feels confident and comfortable: there is no pressure from the uterus, the back and abs are relaxed, and breathing is free.

Relaxation technique

Inhale and exhale deeply several times, try to relax your muscles as best as possible. Imagine that your legs and arms become heavy and your shoulders fall back. You should feel like you are falling through the bed, drowning in it. It is important to completely relax the neck muscles, so the head and shoulders should be in a comfortable position. Feel how your eyelids get heavier, let them close under the influence of their own gravity.

Concentrate for a while on each arm, leg, and back muscles in turn, making sure they are not tense or moving. If you have managed to completely relax your back muscles, you should feel the pressure of your body on the surface below you. Concentrating on the muscles of the forehead, cheeks, and around the mouth, achieve their complete relaxation. Eyes and eyelids should be motionless. Feel how your head presses through the pillow, your facial muscles sag, your mouth opens slightly, your lower jaw drops.

Finally relax the abdominal and pelvic muscles: take several deep breaths in and out through your mouth, as you exhale, your chest and stomach should “fall” under their own weight, after exhaling, hold your breath for 2 seconds. With each exhalation you relax more and more, tension in the abdominal and pelvic muscles disappears (make sure that your jaws are open, tension in the mouth muscles causes tension in the pelvic muscles). You feel yourself “opening up” from below, your breathing slows down, becomes inaudible, deep and even, like in a dream. Such breathing sufficiently provides the body with oxygen during contractions if relaxation is achieved.

Continue to relax all parts of your body one by one until the feeling of heaviness is replaced by a feeling of lightness and flight. At this stage of relaxation, warmth spreads through the limbs, and a slight tingling sensation is felt in them.

A state of half-asleep occurs, the sense of time disappears, thoughts do not linger on anything specific. For effective rest, it is recommended to stay in this state for about 30 minutes.

You need to get out of the state of relaxation gradually. To avoid dizziness or fainting, rise slowly, after taking 2-3 deep breaths, bending your arms and legs several times. After you are in a sitting position, take another 2-3 deep breaths and stretch. This completes the procedure.

Women who have mastered the Dick-Read method usually do not experience fear, despair, or severe pain during childbirth, so they “do not miss” the moment of the birth of their baby and feel the most complete happiness that can only happen in this world.

Grantly Dick-Read (Grantly) (1890-1959) was born in Great Britain.

British obstetrician who is considered by many to be the father of natural childbirth. He graduated from Cambridge in 1890 and worked in a London hospital.

Since 1933, when the book Childbirth Without Fear was first published under the title Natural Childbirth, it has had and continues to have an undeniable influence on the whole world.

In those days, the very idea that childbirth could take place without suffering seemed seditious and revolutionary, unacceptable to many, so almost all women gave birth under deep anesthesia. He did not back down from his discovery, and time has proven the correctness of his teaching.

In the twenties, he broke with tradition not only by teaching women the practice of natural childbirth, but also by organizing classes for husbands. Nowadays, training for wives and husbands is no longer challenged - in fact, it is widely promoted and practiced.

In 1948 he moved to South Africa where he continued to practice and teach.

Grantley Dick-Read was far ahead of his time in his approach to the process of childbirth, and in many other areas of medicine. He paved the way for future generations. Unfortunately, it was only after his death that significant social changes that occurred in the world drew public attention to the ideas that he preached.

Books (1)

Childbirth without fear

Fear of the upcoming birth has always worried expectant mothers. Often this was facilitated by medicine itself, which claimed that childbirth without pain is impossible.

The outstanding English doctor Grantley Dick-Read proved that this is not so. His discovery was a real revolution in medicine.

For a painless birth, not only the physical preparation of the body is important, but also the correct psychological and emotional mood of expectant mothers.

This book has become a reference book for hundreds of thousands of women!

Reader comments

Alla/ 08/08/2018 This is an incredible book that helped me during childbirth. I've read it 6 times and recommend it to everyone.

Anastasia/ 02/13/2014 I am currently very interested in the topics of natural childbirth and preparation for motherhood. Perhaps, after many books I have read, this one deserves special attention. Interesting, comprehensive and inspiring.

Gisele/ 03/12/2012 I’m preparing for childbirth, the book is simply wonderful, I will follow all the advice.

Radmila/ 12/17/2011 The most worthwhile book about childbirth! She really helped me get rid of my fears, give birth to a healthy baby, and even enjoy the process!

Oksana/ 02/14/2008 This book helped me with my first and second births. And now I’m preparing for the third one with her! If you believe the author, childbirth will be a real miracle!!!

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