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which organisations are supporting women's right to Choice during childbirth?

(13 Posts)
UpsideDownMama Wed 15-Jul-15 17:56:23

I really want to help improve maternity services in the UK but most of the campaigns I find are about promoting natural birth and non-intervention. Is their one that supports women's right to choose without any ideologolical bias? I want to support a campaign about including women in decision making about their care and supporting women whatever their choice (hospital birth, homebirth, vaginal, ELCS, epidural, no epidural etc). I've seen that mumsnet is feeding into the National Maternity Review so I have commented on that thread which is a great start. Does anyone know of any other campaigns or charities? Or ways I can get involved? Thanks in advance for your ideas!

NCT and AIMS

cakedcrusader Wed 15-Jul-15 19:02:08

Birthrights

UpsideDownMama Thu 16-Jul-15 12:57:15

Unfortunately I didn't fine NCT wholly unbiased. For example our nct teacher wasn't allowed to show us how to make up a baby bottle and there were some things said about hospital births that I felt was trying to scare people out of going there rather than support them if hospital was their choice (it was all 'there'll do interventions to you there!' rather than 'your more likely to have interventions there so it's worth asking the following questions before consenting...' . I think the NCT is brill in other ways tho.

AIMS and BIRTHRIGHTS seem to be just what I was looking for! Thanks so much! Let's hope they can make a difference!!

CommanderShepard Thu 16-Jul-15 13:29:50

Positive Birth Movement

RedToothBrush Tue 21-Jul-15 16:56:04

Bit late to the party but Birthrights. I had personal contact with one of the current board members, who I believe joined them fairly recently. They were completely of this mindset. Despite being passionate about promoting natural birth, they supported me whole heartedly and without question in getting an ELCS. They saw it about treating women as individuals with varying needs and experiences who should be given appropriate care for their circumstances and based on their wishes. I don't think that my experience would have been anywhere as nearly as positive as it was without their influence. I hope that they will extend this to other people. I genuinely don't think there are many people who would be better in the role.

pinguina16 Tue 21-Jul-15 18:46:07

Wellbeing of women might be of interest to you?
www.wellbeingofwomen.com/about-us/

Couple of docs you might also find interesting?
About the origins of the "natural childbirth" in Britain
pmj.bmj.com/content/79/929/168.full.pdf
An ethnographic study of postnatal care and recovery
www.rcn.org.uk/__data/assets/pdf_file/0008/459035/Wray_Julie_complete_thesis_2011.pdf
smile

Saltedcaramel2014 Tue 21-Jul-15 18:55:02

Marking place as I'm also interested. I definitely would not include nct in this - they are definitely biased towards 'natural' birth. C-section addressed in class but only discussed as an emergency procedure usually brought about by having accepted the dreaded epidural in the first place. Sorry unhelpful rant...

Fabsmum Tue 21-Jul-15 21:43:31

NCT teachers don't all do the same thing.

I talk to my groups about how they might go about gaining consent for a c/s if they are low risk.

I encourage them to consider what their priorities are (ie, effective pain relief? a straightforward birth? A predictable birth?) and then think about birth choices in relation to this.

TBH I tend to find that lots of NCT clients struggle with the concept of choice in relation to birth. They're so scared and risk averse that some of them have almost entered a state of paralysis by their third trimester. They want to be told what to do by health professionals because it takes the responsibility for choice off their shoulders. It can be a bit frustrating, maybe it's something to do with the way the NHS works and our attitude to it. A sort of reverence that makes us unwilling to question the care offered. I suspect where parents have a wider choice of maternity care provider and there's more of a market, women are encouraged more to think about what they want and how to seek it out.

The best teaching experience I've had recently has been with some Americsn clients who didn't know the meaning of the word 'compliant'. They were pragmatic and realistic but also knew what they wanted, did their research, and then bulldozed their way through shed loads of NHS opposition to get it. It was awe inspiring. grin

Fabsmum Tue 21-Jul-15 21:55:17

"For example our nct teacher wasn't allowed to show us how to make up a baby bottle"

Want to just address this. there is research which shows that group demonstrations of how to make up a bottle of formula are unsafe when done antenatally as parents often don't retain the information accurately enough to guarantee making up a feed safely after their baby is born (but think they know because they've seen it being done so may not seek out additional information). Hence no reputable organisation offering evidence based antenatal classes (including NHS) do bottle making demonstrations to expectant parents.
It's the NCT teacher's fault for not explaining that and signposting you clearly to written instructions showing how to make up a bottle that you could read after your baby arrived.

pinguina16 Wed 22-Jul-15 08:06:31

"TBH I tend to find that lots of NCT clients struggle with the concept of choice in relation to birth."

My personal reaction: then the teaching is poor.

First time parents are starting from scratch and that's why they go to antenatal classes. The onus is on antenatal teachers to explain "the concept of choice".
Parents might think (anecdotal evidence suggests this is widespread) that choice means choosing an experience and an outcome when in reality choice simply means preferences according to one's own personal situation and beliefs.
Choice also means understanding the possible consequences of certain interventions. In my experience the agenda of lowering fear and not scaring people from the NCT is so strong that quite a lot of information is not passed onto parents (I have kept my NCT teacher's notes and nowhere can I find the words "anal incontinence" and prolapse is described as "something that could happen later on in life").

I'm certain many posters will disagree with me but this is my view.

Fabsmum Wed 22-Jul-15 11:12:11

"First time parents are starting from scratch and that's why they go to antenatal classes. The onus is on antenatal teachers to explain "the concept of choice".

I actually think the fault mainly lies with GP's and midwives, who are the 'gatekeepers' when it comes to maternity services. By the time we see them in their third trimester for what may be perhaps a 12 hour course (of which in my case 6 hours are usually spent on postnatal issues, leaving just 6 hours - minus 2 hours for breaks and chit chat - to cover pain relief, onset of labour, the physiology of labour, induction, c-section and assisted delivery, birth skills, birth support) honestly there's not a huge amount of time for complex and developed discussion around the subject of individual needs and preferences. Not to say I don't try to give some space to this. They've also already made a lot of choices regarding care provider at that point, which understandably they may not want to change.

The journey should have started with the GP at the first visit. That's the point where parents should be asked their thoughts on how they want to be cared for, and what their priorities might be for birth. Even deciding which hospital to go to - that's the GP's job to explain and discuss the issues surrounding setting for birth. That's the point for parents to be signposted to further information and given some time to think it over. But it's not always happening.

"Choice also means understanding the possible consequences of certain interventions. In my experience the agenda of lowering fear and not scaring people from the NCT is so strong that quite a lot of information is not passed onto parents (I have kept my NCT teacher's notes and nowhere can I find the words "anal incontinence" and prolapse is described as "something that could happen later on in life").

No - possibly not a lot of in depth discussion about the following either: birth defects, stillbirth, severe postnatal depression, relationship breakdown, hysterectomy, severe PPH, shoulder dystocia, needing a general anaesthetic for labour, DVTs....... I could fill my entire 12 hour course delivering information to a bunch of scared parents which would totally destroy their peace of mind and ruin the end of their pregnancy. I'm not saying that these things shouldn't be acknowledged and touched on, but in the end the teacher has to deliver a course which is a pretty general exploration of birth and early parenthood - not 'Introduction to obstetric disasters and neonatal emergencies"..

I think the bottom line with antenatal education is to ask the question: what are these classes for? Primarily mothers come to find a peer group, and they (usually, not always) get that in spades with NCT. Of course they need skills and information to make the birth (however it happens) and their first few months with a baby a more manageable experience. But there are limits to what these classes can and should cover.

It's also the case that even if you signpost people clearly to further information and support, the majority won't follow it up. While parents do absolutely colossal amounts of research into what cot or buggy they'll buy, they seem very reluctant to follow up recommendations for further information about birth choices. Doesn't excuse the teacher/midwife from not providing this information for parents though, or making themselves available for further discussion if necessary.

Anyway was going to mention, some hospitals are now running a specialist clinic for women whose preference for how their birth is managed falls outside of the normal NHS protocols. One that I'm aware of is run by a consultant midwife who will see parents whose choices for birth are 'unconventional'. The purpose of this clinic is to give time for indepth discussion of the issues, and to try to find a way forward to meeting the needs of these parents. Really hope more hospitals decide to make this sort of provision for parents - it's a really good thing.

pinguina16 Wed 22-Jul-15 11:44:06

"The journey should have started with the GP at the first visit. That's the point where parents should be asked their thoughts on how they want to be cared for, and what their priorities might be for birth. Even deciding which hospital to go to - that's the GP's job to explain and discuss the issues surrounding setting for birth. That's the point for parents to be signposted to further information and given some time to think it over. But it's not always happening."

Yes, I think you're right. Parents are expected to "know" before options are even presented to them.
From the classes point of view, couldn't the classes be much earlier on in pregnancy? Second trimester start with a couple of sessions in third trimester?

"No - possibly not a lot of in depth discussion about the following either: birth defects, stillbirth, severe postnatal depression, relationship breakdown, hysterectomy, severe PPH, shoulder dystocia, needing a general anaesthetic for labour, DVTs....... I could fill my entire 12 hour course delivering information to a bunch of scared parents which would totally destroy their peace of mind and ruin the end of their pregnancy. I'm not saying that these things shouldn't be acknowledged and touched on, but in the end the teacher has to deliver a course which is a pretty general exploration of birth and early parenthood - not 'Introduction to obstetric disasters and neonatal emergencies".."
Could there be a "Obstetric disasters and neonatal emergencies" section in the course?
I was given pregnancy and postpartum health red flags. This was no more than a list with basic symptoms to look out for. It wasn't covered in depth at all but it was there. Not-so-great scenarios could simply be listed and given in the printed hand-outs?

"I think the bottom line with antenatal education is to ask the question: what are these classes for? Primarily mothers come to find a peer group, and they (usually, not always) get that in spades with NCT. Of course they need skills and information to make the birth (however it happens) and their first few months with a baby a more manageable experience. But there are limits to what these classes can and should cover."

Again I agree. Personally I wish I had understood that before birth. I was working on the assumption that my classes would "prepare" me for birth. They did in some way but fell very short in quite a few areas.

"Anyway was going to mention, some hospitals are now running a specialist clinic for women whose preference for how their birth is managed falls outside of the normal NHS protocols. One that I'm aware of is run by a consultant midwife who will see parents whose choices for birth are 'unconventional'. The purpose of this clinic is to give time for indepth discussion of the issues, and to try to find a way forward to meeting the needs of these parents. Really hope more hospitals decide to make this sort of provision for parents - it's a really good thing."

Wouah! That sounds like a really good initiative! I hope this takes off and can be "rolled out" for any birth.

Anyway, I'm not going to reform antenatal classes/information on one MN's thread.grin
Nice chat though. I wish you'd been my antenatal teacher...

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