What Is Cooperative Childbirth?

By Susanrachel Condon LMT, CCCE, CNM

Cooperative Childbirth Education (CCE) classes given by certified Childbirth Education Association teachers may be one of New York's best kept secrets in the realm of family-centered maternity care. For decades, when it's come to childbirth education classes, the term "Lamaze" has been used as generically as "Kleenex" is for tissues. While many hospital-based class series are based on the work of Dr. Ferdinand Lamaze, the French obstetrician who pioneered "natural childbirth", many are more eclectic and many may be based on the policies of the facility in which they are given.

While some expecting families today opt for classes in the Bradley Method, developed by Dr. Robert Bradley, these are rarely given in the hospital setting. Fewer families know about Cooperative Childbirth Education, or CCE. CCE classes are offered in a variety of venues, including hospitals. Many people taking CCE classes don't even realize that they aren't Lamaze. But, in contrast to Lamaze and Bradley classes which were designed by male obstetricians, CCE classes were developed entirely by women who experienced pregnancy, childbirth and breastfeeding. Because of this crucial difference, CCE emphasize the uniqueness of each woman's life experience and how it impacts her labor and birthing process. No single "method" is taught, but rather, women and their partners are encouraged to draw upon their own innate strengths and intuition in order to allow birth to reach its transforming potential.

Dr. Lamaze applied the Pavlovian model to labor and birth. In the classical Lamaze tradition, emphasis has usually been placed on carefully designed, learned and practiced breathing techniques, abdominal massage (effleurage), choosing a "focal point" to look at during uterine contractions, counting during contractions and understanding standard hospital procedures. Dr. Lamaze believed in the premise that distractions from pain reduces the perception of pain. Therefore, most women could labor and give birth awake, aware and under their own power if they mastered his techniques in order to avoid being overwhelmed by the intensity of labor.

The Bradley Method is less well known than Lamaze. It involves the partner or father to a considerable degree, emphasizes nutrition, exercise and aspiring for unmedicated births with minimal medical intervention. Dr. Bradley felt labor is too big to be distracted from, so by being educated, using visualization and focusing inward, the laboring woman could work with her body for an easier birth. This method is popular among people for whom achieving "natural childbirth" is of considerable importance.

So how is CCE different? Cooperative Childbirth Education classes are taught by teachers trained through the Childbirth Education Association of Metropolitan New York. CEA/MNY teachers are passionate consumer advocates trained through an extensive two year program. CEA/MNY maintains that childbirth is a normal physiological, spiritually and socially profound experience for a woman and her partner. Birth is part of family life and should be prepared for and anticipated with confidence and with information. Classes are designed to encourage women to recognize their innate abilities to cope successfully with the challenges of labor and birth in any setting.

The approach to "techniques" for labor is an eclectic one. Primarily, CEA/MNY offers the latest, most up-to-date information on issues surrounding childbirth so that women and their partners can make informed choices that are best for them. Classes tend to be discussion and participation oriented.

A typical series would cover: anatomy & physiology of pregnancy, nutrition, exercise, perineal massage, relaxation massage, relaxation techniques, developing a birth plan and discussing it with the care provider, a detailed explanation of the process of labor/birth and of course coping strategies for labor such as positions, massage counterpressure, hydrotherapy and vocalization. The physiology of pain and ways to avoid exacerbating the perception of pain are covered. Labor is put into a realistic perspective and ways to apply coping skills used by the individual in day to day life are explored.

The uses of common medical interventions, their potential benefits and their risks are discussed in detail. This includes the true indications for cesarean section and what cesarean entails. Procedures performed on the newborn in the hospital setting and normal variations in newborn appearances are taught. Breastfeeding and infant care are taught and demonstrated. Most teachers show a variety of labor and birth films and breastfeeding films. Many also use numerous models and visual aids and distribute written material.

CEA/MNY teachers work in various settings, including hospitals, birth centers, women's shelters and private homes throughout the tri-state area.