Mother in control, naturally: Esther Oxford reports on an obstetrician's new school to teach the secret of drug-free births

Photographs of ecstatic, alert mothers suckling their newborn babes adorn the walls of Dr Gowri Motha's surgery in east London. But these are just a handful of the 500 mothers who have given birth without drugs under Dr Motha's supervision during the past 10 years.

Demand for a 'drug-free birth has escalated, said Dr Motha, who trained as an obstetrician in Bangalore, India. 'Women are better educated. They are used to being in control at work, and want to continue being in charge while they give birth, she said.

To cope with the increase in the workload, Dr Motha is setting a course up to teach mothers who have experienced a 'drug-free childbirth how to pass their learning on.

The women will pay pounds 600 to learn about reflexology, self-hypnosis, and water births by practising on mothers-to-be. At the end of the year-long course the trainees should be able to talk the labouring mothers through the birth process and teach natural birth preparation classes.

'Alternative' methods of giving birth have attracted criticism from mainsteam medical practitioners who question their efficacy and in some cases, their safety. In reply, Dr Motha cites what she says is the increasing popularity of her methods. She says women should be allowed to chose for themselves.

'Women are worried about the high caesarean rate. They realise that much of it is due to stress. My ante-natal care de-stresses naturally. It helps women have a pleasant experience when they give birth.

Demand is such that Dr Motha is turning down requests for 'birth supervison: 'I have two or three calls a day from couples all over London asking about self-hypnosis and reflexology. I end up referring them to other people, she said.

Creative visualisation (self-hypnosis) trains patients to 'explore the space inside them, Dr Motha explained. Mothers are taught how the birth canal works so they are able visualise it expanding as the baby works its way downwards. The effect of 'self-hypnosis is to distance the mind from the body. The distance means the pain can be kept in control.

Reflexology complements the creative visualisation by allowing the

mother to relax. Dr Motha said it also helped circulation, stabilised blood pressure and eased the back pain and swollen ankles associated with pregnancy. Mothers-to-be are also encouraged to exercise regularly, avoid sugar and to eat organic wholefood. By the end of the pregancy the pelvis needs to be 'soft and jelly-like to make the birth easier, Dr Motha said.

'Women now recognise that a stress-free pregnancy is more likely to result in a stress free-birth. The more fit a woman is mentally and physically, the more enjoyable the labour.

Pain-free, drug-free births do not come to all. But Dr Motha says those who 'fail and turn to conventional pain-killers 'have compromised somewhere along the way. They have to accept the consequences. Those who do what I say get results.

Some specialists have voiced reservations about the methods used by Dr Motha - particularly the water births. Humans do not have mechanisms to stop their newborn from breathing until their heads are above water. There is a danger that the baby may inhale water and either drown or suffer some form of brain damage.

Dr Michel Odent, the pioneer of the waterbirth technique, has been particularly vocal. Water is a way of facilitating the birth process, he has declared. 'Intentional underwater birth could be dangerous.

Dr Motha is unmoved. She says she has delivered more than 300 babies underwater, keeping them there for 'up to three minutes. Her success rate among water-born babies is excellent: just two out of 300 have had difficulty breathing once out of the water.

She said babies instinctively resisted inhaling water: 'They are used to being surrounded by liquid. They breath via the placenta. Mothers sometimes liked to keep their babies underwater for longer than was necessary to lessen the shock. 'It re-creates the warmth of the womb, she said.

Some hospitals do not permit midwives to deliver babies underwater, but Dr Motha said: 'As a private doctor I can do whatever I like. How the child is born is a decision made by the couple and myself. The midwives just followed suit, she said.

She predicted that trainee doctors would soon be open-minded enough to embrace her ante-natal philosophy. 'The changes I have seen in the last 10 years have been wonderful. The average midwife is very happy to help a woman give birth in whatever way she wants.

Certainly the Royal College of Obstetricians and Gynaecologists was keen to be open-minded. 'We endeavour to make all kinds of pain relievers available, said Frances Smyth, spokeswoman for the college, when asked about reflexology.

And creative visualisation? 'Individual practitioners can do as they wish as long as it is not life-threatening.

Waterbaths were encouraged, Ms Smyth said, but only during contractions. The college advised women to leave the bath for the delivery: 'It can be difficult to help the birth if things are not going as they should. Electronic foetal monitering could not be performed underwater either, which could be a problem if the baby was at high risk of oxygen lack.

CONFIDENCE THE BIGGEST GIFT

Ruth Winterson, 42, headmistress of a south London school has had two natural childbirths. Her children are age 3 and 8 months. Both births were supervised by Dr Motha.

Both my babies were born in a water-tank - the first in hospital and the second at home. I felt calm and unruffled throughout.

The secret is to concentrate on what is going on. If you imagine the baby pushing down with each contraction - if you can actually visualise it - your mind is taken off the pain. You go with the process.

Often the pain can be made worse by the tensing of muscles. You can spend the whole time wishing it was over. But after five or six sessions of reflexology and self-hypnosis I didn't feel so tense. My mind was relaxed so my body responded. I felt consciously in control.

You have to practise before the birth. I was taught about the process, how the body works. After a bit you start to understand what it must look like. You can imagine looking inside the birth canal. You can see what is happening like a picture. Visualising the birth canal helped me to stay calm and focused during and between contractions.

My first birth wasn't as successful as the second. I hadn't practised. I couldn't concentrate. Instead of starting the creative visualisation at the beginning, I spent the first few hours filling up time with pizza deliveries and Who Framed Roger Rabbit videos.

The second time I knew what to do. I had a better idea how long the labour would last. I concentrated on my breathing and how to relax my muscles. It seemed to me the pain was much reduced.

The waterbath worked well - though for the second birth I only got in at the end. The sensation is so powerful when the baby comes down the birth canal. The water kept my weight balanced - relieving me of the most exhausting part of giving birth - staying upright]

It also made a difference having the baby at home. It was familiar, I had my favourite music on, the fire was lit, nobody interfered. It was marvellous. Just my husband and Gowri were there.

The biggest gift Dr Motha gave me was the confidence to do it myself. The experience gave me faith in myself as a birth-giver and a mother.

(Photograph omitted)