History of CAPEA
Knowing the rich and fascinating history of our organisation can provide a depth of understanding about how CAPEA began and how we arrived at where we are now, so that CAPEA can better map a path forward.
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Everything old is new again – an early history of childbirth education in Victoria
by Bronny Handfield, Nov 2013
Currently women attending Childbirth Education Classes are offered 4 sessions at a nominated birthplace. These classes can be supplemented with additional classes: Hypno-birthing, Calm Birth, Active Birth, Positive Parenting, Pilates Exercise, Yoga, Breastfeeding, Homebirth classes, Private personal classes, Water-birthing, Workshops for Busy Parents or the alternatives: Reike, Kinesiology, Music Therapy, Crystal Therapy etc.
The alternative choices listed are openly discouraged by maternity health care professionals. This reaction is not new, similar choices for childbirth inflamed political arguments between those offering services for childbirth preparation between the 1930-50s. A quote by Leon Chertok about Preparation for Childbirth in 1956 expresses this amusing confusion:
Passionate doctrinal arguments reign in lieu of [a solid theoretical framework] which explains the diversity of names given to non-pharmacological methods of obstetric pain relief: psychoprophylatic, psycho-physical, neuro-physical, childbirth without anxiety, without fear, without suffering, without agony, without apprehension, eased pain etc. LC
Pain medication offered during the1930s for women in childbirth were an amnesiac cocktail of scopolamine & morphine (known as twilight sleep) in both the USA and Australia, while British women mostly used nitrous oxide.
Dr. I.Z. Vel’vovskii from Kharkov (1930-40s) developed the ‘Psychoprophylatic Method of Childbirth’ (PPM) based on Ivan Pavlov’s theory of the ‘conditioned response’. This particular Russian version of pain relief was promoted by the British Obstetrician; Grantly Dick-Read as ‘Natural Childbirth’ (1933). It was almost indistinguishable from the later ‘Lamaze Method’ (1950s) that was far more popular.
Politically Dick-Read’s method failed to win adherents because he was not didactic about the scientific grounding, although many International approaches for promotion were made by his supporters, Dick-Read’s book was only popular in Britain and Australia. His famous phrase: the ‘fear – tension – pain cycle’ was based on the belief that pain during a normal labour was entirely due to lack of relaxation.
From the moment that fear is introduced into the mind of the parturient woman normal physiological activity becomes impaired… Fear is the fundamental cause of painful labour… fear is the parasite which plays havoc with the mechanism of parturition… fear has brought more agony to the females of the human race than ever war or pestilence will bring. GDR
In 1951 Professor Nikolaev from Leningrad presented the Psychoprophylatic Method of Childbirth (PPM) to the International Congress of Obstetrics and Gynaecology. The belief that the pain experienced in normal labour was psychogenic in origin and the method was:
- Patterned breathing practiced for six weeks.
- Distraction focused on contractions; deep & slow, quick & shallow breaths.
- Education about the body and the physical process.
- Comfort methods such as strong and light massage (effleurage).
Ferdinand Lamaze an Obstetrician from Paris was impressed and childbirth preparation came to be represented in France and the United States by his name, ‘The Lamaze Method’. The emphasis was promoted as mind-body medicine, which also encompassed Sigmund Freud’s understanding of the psyche.
At the same time hypnosis had gained popularity in the USSR but this method was not practical on a mass scale. The arguments between Lamaze and Dick-Read were basically political, those pro Pavlov’s psychophysiology were anti- Freudian.
Male Obstetric dominance of the process was maintained. Fathers were banished from Maternity hospitals in USSR and generally fathers in USA, Australia, France and Britain were always outside the delivery suite, pacing the corridors or using the waiting room.
Women who conducted themselves with ‘dignity and calm’ were celebrated in the literature about both Natural Childbirth and the Lamaze Method. However, it was not the method questioned, but the woman who was considered a ‘failure’ when all did not go to plan.
In Victoria ‘The Association for the Advancement of Painless Childbirth’ (1961) was started by (physiotherapists) Marcelle Frame and Jean Webber. Later the name was changed to Childbirth Education Association. This was instigated by their visit to France and films of Ferdinand Lamaze (d.1957) and his collaborator Pierre Vellay. The classes were strictly based on Pavlov’s theory of conditioned reflexes. It was called the Psychoprophylaxis method.
(Rhea Dempsey and Bronny Handfield CAPEA attended a special class conducted by the spry elderly Jean Webber in 1981 for the Childbirth Education Association)
The fundamental basis of Childbirth and Parent Education groups began with the Childbirth Education Association (CEA). It was a consumer-based organisation with classes held by physiotherapists, midwives and trained ‘Lay Educators’. It was an 8-week course with methods very similar to those described above.
The length of classes was based on the premise that language learnt in classes would act as a trigger to automatically cope with a contraction with the programmed breathing.
CEA was not appreciated by Maternity Hospital Professionals’, except a few rare places where the physiotherapists were connected to Obstetricians. In Victoria this was the Queen Victoria Hospital. (Monash Medical Centre). A consumer representative was invited to join the Patient Care Committee (B. Handfield).
In the 1970’s CEA championed the ‘right to choose’ and the role of ‘personal responsibility for birth’. A controversial tactic was for CEA to hold a doctors’ file, so that pregnant women could look up information about a doctor’s behaviour. The information was collected from women’s personal experiences.
‘Naissance’ was a film with French Pierre Vellay (Obstetrician) CEA brought this to Australia. The film ‘Birth with RD Laing’ focused on the baby’s needs and a woman’s right to choose. It made a big impact. CEA was a parent-run organisation, fitting into the consumer power ethos of the 1970’s. Women at the time complained of being anaesethetised for delivery and being separated from their baby.
CEA in Melbourne ran a very important conference, ‘Birth and Being’ in May 1979 where International experts in the field spoke on radio and television and publicised the concept of drug free birth. Speakers included: Sheila Kitzinger, Jean Leidloff, Suzanne Arms, Murray Enkin, John Kennell, Jean & Paul Ritter, Michael Adamson, Graham Farrant, and Judith Lumley.
CEA developed a one-year training course for new childbirth educators. It consisted of one day of lectures and workshops held fortnightly complemented by conducting supervised childbirth education classes. Guest lecturers for the course included: doctors, midwives and educationalists.
The over-arching organisation for CEA branches was the Australian Childbirth and Parenting Association (ACEPA). It operated on the principle that the state organisations wanted to meet the needs of new parents, but unfortunately educators worked without collegial support, funding, educational resources or opportunities.
The Victorian Association of Childbirth Educators was established in 1986. It was a time of transition as professionalism replaced the consumer advocacy approach of CEA. A conference called, ‘A Movement on the Move’ was held in Melbourne in August 1987. This was the first biennial conference for Childbirth Educators and it was pivotal in the establishment of the National Association of Childbirth Educators (NACE). Although at this time the organisation was still called the Australian Childbirth Education and Parenting Association (ACEPA).
Before the impetus of the Birthing Services Review (1990) was lost, a campaign to lobby for change was implemented by NACE and Maternity Coalition represented by Bronny Handfield and Gennie McGregor. 5000 postcards were sent to State Ministers involved in Health decisions. Meetings, radio and television appearances were held to rally more support.
Over the years the organisation name changes have reflected the changing emphasis and interests of educators and their response to clients’ needs. Everyone reading this account will know that NACE is now CAPEA (Childbirth and Parenting Educators of Australia) acknowledging the expanding role of childbirth education to include parenting education.
More information is available about the Russian and French: Paula. A. Michaels. Pain and Blame: Psychological Approaches to Obstetric Pain. A chapter in her new book. Also: The Journal of Perinatal Education, 19(2), 35-43,doi: 10.1624/10581210X495532
Breathing techniques for pain management
The Association for the Advancement of Painless Childbirth
In Victoria ‘The Association for the Advancement of Painless Childbirth’ (1961) was started by (physiotherapists) Marcelle Frame and Jean Webber. Later the name was changed to Childbirth Education Association (CEA). The classes were strictly based on Pavlov's theory of conditioned reflexes. It was called the Psychoprophylaxis method.
The right to choose
CEA champions the 'right to choose' and the role of 'personal responsibility for birth' and brings the film 'Naissance' to Australia.
The film ‘Birth with RD Laing’ which focuses on the baby’s needs and a woman’s right to choose makes a big impact.
'Birth and Being' conference
CEA runs conference in Melbourne where international experts publicise the concept of drug free birth.
Victorian Association of Childbirth Educators is established
The Victorian Association of Childbirth Educators was established as CEA moves to a professional set up in favour of a consumer advocacy approach.
ACEPA to NACE
The first biennial conference for Childbirth Educators, 'A Movement on the Move', was held, which ultimately led to establishment of National Association of Childbirth Educators (NACE). This was a moving away from the name Australian Childbirth Education and Parenting Association (ACEPA).
NACE is updated to CAPEA - Childbirth and Parenting Educators of Australia, acknowledging the expanding role of childbirth education to include parenting education.
CAPEA Hall of Fame
Induction into the CAPEA Hall of Fame and lifetime membership is a rare event. It is only awarded to a member who has contributed voluntarily and significantly over a period of time. These people have helped to raise the standards of knowledge and skills of Australian Childbirth and Parenting Educators and the professional profile of the organisation.
List of members of the CAPEA Hall of Fame
|Presented at National Conference
|Surfers Paradise, Qld
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