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(p. 533) Foreword to Childbirth with Confidence: By Prunella Briance 

(p. 533) Foreword to Childbirth with Confidence: By Prunella Briance
(p. 533) Foreword to Childbirth with Confidence: By Prunella Briance

Donald W. Winnicott

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Subscriber: null; date: 23 October 2018

Originally published by Dick-Read School for Natural Birth, London, 1982.
This Foreword was written some time after Dr Dick-Read’s death in June 1959 but was not published until 1982. Winnicott had corresponded with both Briance [CW 5:3:19] and Dr Dick-Read [CW 5:4:1].

I write this foreword with much pleasure. It is important to me to be able to pay this small tribute to the late Dr Grantly Dick-Read whose work in the obstetric field had something very much in common with what I consider to be important in the field of paediatrics. I always liked the way that he observed natural processes and then gave them emphasis in order to support a woman’s natural instincts.

Unfortunately, not being astute observers and supporters of the natural process, some doctors and midwives tend to take part in unnecessary interference during labour. Even the best doctors and nurses, those we must have around us if we are to feel confidence these days and on whom we rely if our bodies go wrong, tend to pursue the line of giving instruction and advise when they meet health; but health does not respond well to the techniques which work in illness.

It seems to me in this book and recording, Mrs Briance has found a way of explaining Grantly Dick-Read’s work that is understandable to anyone at first glance, and which will encourage them to further study and practice. Moreover I think that she has avoided both sentimentality and propaganda.

It might be thought that one could leave this instruction to the medical profession but this in fact is not practicable although a serious study of these ideas should be part of their study and certainly included in examination questions. Doctors and nurses have so much to learn in order to be able to deal with what goes wrong that they cannot be expected at the same time to (p. 534) be involved in the needs of the vast majority of women for whom childbirth will go according to the natural plan. In only about three per cent of births physical abnormality or illness in the mother makes a doctor’s intervention in childbirth necessary. Someone must cater for the needs of the other ninety-seven per cent; those women who want to enjoy their labours and who need no medicine or surgery but merely the encouragement, support and understanding of their medical attendants or husband in their efforts to produce their babies as nature intended.

In order to be of such assistance it is necessary that medical attendants should be taught to understand the simple instruction outlined in this book. It is so important that the spontaneity is not taken out of this important process and also out of breast-feeding which should be fundamentally pleasurable both to mother and child.

Quite often enthusiasts over-emphasize some form of the instruction, they notice for instance that a mother during contractions breathes hard and the edict goes out that mothers must learn how to breathe hard and must breathe even harder and faster in order to ‘distract’ herself from the ‘pain’ they have been taught to expect. In this way the natural process is disturbed and mother and child, through this fashion of ‘exaggerated breathing’ are robbed of oxygen and tranquility, both natural assets which are needed for a calm and efficient birth.

The only way that these matters of health can be preserved from well-meaning but often disastrous interference is for mothers themselves to be given instruction of the simplest possible kind while at the same time acknowledging that sometimes the skill of doctor and nurse may be needed and must be available.