A Randomized Clinical Trial of the Leboyer Approach to Childbirth

To examine the effects of the Leboyer method of delivery, we randomly assigned 56 women to either a Leboyer or a conventional delivery and used a variety of clinical and behavioral measures to assess the outcome in mother and child. No differences were noted in maternal or newborn morbidity, in infant behavior in the first hour of life, at 24 or 72 hours post partum, or at eight months of age; or in maternal perceptions of her infant and the experience of giving birth, except that eight months after delivery, mothers who had used the Leboyer method were more likely to say that the event had influenced their child's behavior (P = 0.05). Women who expected a Leboyer delivery had shorter active labors (P = 0.03), suggesting that psychologic factors (expectations) influence physical outcomes in perinatal medicine. Our results suggest that the Leboyer procedure has no advantage over a gentle, conventional delivery in influencing infant and maternal outcomes. (N Engl J Med. 1980; 302:655–60.) The nature of obstetrical care for women at low risk is a subject of controversy. The Leboyer method of delivery has added to the debate. In his book Birth without Violence , 1 Leboyer suggested specific maneuvers that he believed would minimize the neonate's first separation experience. He described the ideal birth as occurring in a dark and quiet room, without sensory overstimulation: "Birth is a tidal wave of sensation, surpassing anything we can imagine." He suggested placing the newly delivered baby on his mother's abdomen and delaying the clamping of the cord: "To sever the umbilicus when the child has . . .