Among most expectant parents today, the name Lamaze has become synonymous with natural childbirth techniques. The Lamaze organization estimates that 2.2 million deliveries each year employ relaxation and breathing methods popularized in Lamaze classes. A second childbirth program, the Bradley method, resembles Lamaze in its premise that much of the pain of childbirth can be alleviated by easing fear and tension. Here is a guide to the two leading approaches:

The Lamaze Method

Obstetrician Fernand Lamaze developed his birthing philosophy after observing techniques for "painless childbirth" on a 1951 trip to Russia. These techniques were based on the work of Ivan Pavlov, the Russian psychologist who argued that the brain plays a major part in the perception of pain.

The Lamaze method assumes that birth is a natural and healthy process that can run its course with very little need for medical intervention. It teaches women to make informed choices in their health care and then to trust their inner wisdom to guide them through birth. In the typical course, which begins in the seventh month of pregnancy and runs two hours a week for six weeks, expectant couples learn different strategies for helping the pregnant woman cope with the stress of childbirth. At the heart of the course are three techniques: relaxation methods, breathing exercises, and pushing during contractions. For instance, the woman and her partner in the birthing process are taught that by massaging and stroking the mother-to-be and learning to tense single muscle groups while relaxing the rest of the body, the woman can diffuse stress. Parents are also coached in how to relax the body using meditation and other mental imagery. For example, a woman might imagine a blossoming flower, symbolic of her cervix opening. She might envision her baby moving down the birth canal, or she might focus on a certain color or mental picture to help her relax. Walking during labor or changing positionsÑ from the woman lying down on her side to squatting or kneeling on all fours, for instanceÑcan also help relaxation. Many of the Lamaze positions take advantage of gravity and keep the pelvis tilted so that the baby can pass more easily through the birth canal.

The Lamaze system also stresses breathing techniques for each of the three stages of labor. During the first phase, in which contractions begin and the cervix becomes fully dilated, Lamaze emphasizes slow breathing, in which the mother exhales slowly and keeps her stomach muscles tight as she inhales. In the second stage, also known as transition, when the contractions come fast and furious, the woman takes a breath and holds it for 6 to 10 seconds, exerting downward pressure on her stomach muscles as she does so. After no more than ten seconds, she exhales and repeats the pattern until the contractions stop and the third phase begins. During the third phase, the baby's head makes contact with the pelvic floor, stimulating an expulsive reflex which brings the baby through the birth canal. Lamaze teaches the mother to push until the baby is born.

For more information on the Lamaze method, contact the American Society for Psychoprophylaxis in Obstetrics /Lamaze, % 800-368-4404.

The Bradley method

An alternative to Lamaze is the Bradley method, which is used by 30,000 to 40,000 women each year. Developed by Denver obstetrician Robert Bradley in the late 1940s, the method differs from Lamaze in that it doesn't teach breathing techniques; it relies solely on relaxation exercises to control pain during labor. "The whole philosophy is that you can give birth without drugs," says Marjie Hathaway, a leading spokeswoman for the Bradley method. Hathaway became a convert herself after she and her husband first heard Bradley explain his approach in a speech while she was pregnant in California in the mid-1960s. When her own doctor refused to allow her to deliver her baby without using drugs, she arranged to fly to Colorado once she entered labor so that she could have her baby delivered by Bradley.

In the typical Bradley class, which begins when the woman is five-and-a-half months pregnant, expectant couples learn 12 different relaxation techniques to help the woman cope with pain during labor. Classes meet in weekly two-hour sessions.

Many of the relaxation techniques involve the husband either touching or stroking the mother-to-be or offering reassurance to boost her confidence. In another technique, called "warmth," the woman imagines standing in a warm shower.

The Bradley method also teaches women that changing positions during childbirth helps manage pain. "During labor women are encouraged to walk, to take a shower, to change positions, to do anything but lie on her back," says Hathaway. "Lying on your back casues a tremendous amount of pain."

For more information on the Bradley method, contact the Bradley Method Pregnancy Hotline, % 800-422-4784.

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