The mother of happy birth days

Forty years ago next week a small ad announcing the formation of "a natural childbirth association ... for the promotion and better understanding of the Dick-Read System," was placed in the personal columns of the Times and the Daily Telegraph. Anyone who wanted to know more was invited to write to a box number.

The response to the ad stunned the woman who had placed it, Prunella Briance, a 30-year- old mother of one and a disciple of Dr Grantly Dick- Read, an advocate of painless childbirth. But the response confirmed what she instinctively felt: that there had to be a better way of giving birth than that experienced by thousands of women from all over the country whose letters were flooding into her home each day. The Natural Childbirth Association of Great Britain, later to become the National Childbirth Trust (NCT), held its inaugural meeting eight months later in January 1957, and a revolution in attitudes to pregnancy and birth was born.

Mrs Briance's difficult experiences of giving birth - the first by Caesarean section, the second to a stillborn daughter whose death she blamed on medical intervention - were her motivation.

"You cannot possibly imagine what it was like back then in the 1950s," says Mrs Briance, an energetic 70-year-old whose upright posture and expansive, graceful gestures are the legacy of ballet training. "We knew nothing about having a baby and there was no one to to tell us; no books or magazines that told you what to expect."

In fact, a popular book of the time, the Sunday Express Baby Book, devoted just one paragraph of its 240 pages to the delivery itself. The author, a Mrs Woodman, reassured young mothers-to-be that all would be well: "In the delivery room, white with bright lights, you will be taken from a hospital trolley to the delivery table. The nurses will be standing by with the doctor and with their gentle help and encouragement, aided by the science they have studied so long, your baby will be born," she wrote.

It hadn't been quite like that for Prunella Briance. Her first child was born in 1953 during a power cut in a hospital in Cyprus, where she was living with her diplomat husband, John. As a former Wren and one of the first British air hostesses on long-haul flights, she had led an action-packed life before meeting her husband at London University, where they were both studying Russian. Their first diplomatic posting had been to Iran for three years. But nothing in her previous life had prepared her for childbirth.

Early in labour it was discovered her placenta was in the wrong place, low down in the womb over the cervix. Her doctor had sat up all night in her room, surrounded by text books, trying to find out how he should deal with it. He decided he couldn't and a Caesarean was the only option, but the operation was stopped halfway through so an electrician could rig up temporary lighting.

"I wasn't 'out' or anything because they'd used a local anaesthetic on my stomach," Mrs Briance recalls. "There were all these Cypriot nurses around the table with their hands on me asking 'will she die?' and the doctor saying 'I don't know.' They didn't know I could understand them. I wasn't frightened, I was just praying hard. I even said thank you to the electrician when he finished."

She was eventually delivered of a healthy boy, called Richard. Back in England she became pregnant again and was determined that this time it would be different. A sculpture she saw in a Cypriot museum of a woman squatting to give birth fired her imagination. She wanted to know why women didn't have babies like that anymore. Someone gave her a copy of a controversial 1943 book, Childbirth Without Fear, by Dr Dick-Read, a GP-obstetrician who believed in relaxation techniques. She was an immediate convert, beginning a correspondence with him, and preparing herself for a natural birth using his methods.

Prunella Briance refuses to name the London hospital where her second child was born dead, but the tragedy of that loss is with her still. "I had a three-hour labour and it was perfect. I had controlled it all myself and it was going well, but then this callous midwife came along and would not wait. She gave me a leg-up on to the labour bed - it was flat and narrow just like an ironing board - but she dropped me and I fell hard on my bottom.

"Then I was made to have some castor oil because the 'Professor' always insisted on it to start labour, and I was violently sick. My stomach was in agony from the fall and I asked for a pillow but they said 'no'. She pauses. "The baby died. It got stuck, a lovely baby girl. I wanted it so much ... it nearly destroyed me. When it was all over the midwife just said: "Oh dear me, I'm all thumbs today."

Mrs Briance wrote to Dr Dick-Read to tell him what happened, and also that she would now devote herself to promoting his theories. The ads followed soon after and then the letters. They made heart-rending reading, she says. "... even though I objected they forced a mask over my face as I was in labour," one woman told her. Another asked, "Couldn't the Government do something to prevent cruelty in the maternity wards?"

The launch of the Natural Childbirth Association was a PR dream, with acres of newsprint - supportive and critical of this "new rebellion" by women - radio, and television coverage. Several aristocratic ladies of the time were happy to lend their support, and the actress Gina Lollobrigida gave an enormous boost to the fledgling movement when she spoke publicly about her plans for natural childbirth, and subsequently wrote of her "painless" delivery. A "good luck" telegram from the Queen, herself a mother of two, on the day of the launch, appeared to confirm rumours that the younger Royal women had more than a passing interest in natural childbirth.

The NCT network that thousands of women know today developed to meet the demands of pregnant women. It provided groups where women could talk and share information. Dr Dick-Read's wife, Jessica, was one of the first NCT teachers, soon to be joined by other committed women, including Sheila Kitzinger.

They faced an uphill task, regarded with suspicion and outright animosity by the medical establishment. Twice in the early years of the NCT, the leading members were summoned to appear before the British Medical Association to explain themselves. Acceptance grew as more doctors and midwives became involved in the NCT, and pregnant women were advised to involve their GPs in their antenatal education.

But the antagonism persisted into the 1970s, the "battlefield years" according to a new book, New Generations: 40 years of Birth in Britain. Birth had become more, instead of less, medicalised: induction of labour, episiotomies and forceps deliveries were reaching an all-time high, and the NCT became almost militant in its zeal, leading to ridicule from some who focused on the brown rice and sandals image of its leaders.

Prunella Briance was by this time no longer directly involved with the NCT, but watching closely "her baby's" coming of age. She credits the Trust with challenging the medical horrors of modern obstetrics, and eventually changing them and winning the support of doctors, midwives and eventually politicians along the way. The culmination of their efforts was Changing Childbirth, the 1993 report of the Government's Expert Maternity Committee, which aimed to place women back in control in the labour ward.

Today the issues are different from those of the 1950s but no less important to pregnant women: antenatal screening, water births, and rising Caesarean rates, for example. But there is room for improvement, says Mrs Briance. "Birth can still be nerve-wracking for women. I would like to see every doctor properly trained in natural childbirth techniques, and more midwives who have had experience of their own children." She intends to keep on spreading the word.

'New Generations: 40 Years of Birth in Britain' by Joanna Moorhead is available to 'Independent' readers at the special price of pounds 8.95, including p&p - a discount of pounds 1. Order by credit card on 01223 352790 or send a cheque or postal order to NCT Publishing Ltd, 25-27 High Street, Chesterton, Cambridge CB4 1ND.