Kirstie Allsopp and the NCT - what do you think?

[KateMumsnet]

Last week, journalist and MN blogger Linda Geddes accidentally ignited a heated debate when she appeared on the Today programme discussing NCT classes with a representative from the organisation. Fellow MN blogger Kirstie Allsopp - who's been critical of the NCT before - was listening in, and fired off this tweet:

"Turn to BBC Radio 4 for talk of a book about all the absurd myths surrounding pregnancy & birth. More NCT b** as usual though. Lots of people have good NCT experiences, but many don't. This is a very politicised, dogmatic and in my experience, scary organisation."

As she's done previously, Kirstie argues that the NCT is so focused on natural birth that they are letting down women who don't want, or aren't able, to have one by failing to prepare them - with the result that mothers who have Caesareans (for e.g) can feel stigmatized. Here's her blog post - fellow MN bloggers In a Different Voice and When The Baby Sleeps have also posted on the subject.

What do you think - do you agree with Kirstie, and if not, why? Tell us if you blog about this - and if you don't have a blog (why not? ) let us know what you think here on the thread.

What an odd comment MerlinScott - why would it be absurd to advise about having a vaginal birth over 40? It is perfectly possible to plan for, and therefore seek advise about, a vaginal birth at that age.

Last summer I attended an excellent antenatal class with my husband through NCT. We covered all options and interventions including induction, c sections epidural etc. We also covered bottle feeding including sterilisation etc. There was a seperate half day to cover breast feeding. I was particularly impressed with the emphasis our trainer placed on our partners taking a role in our children's births - being our advocates and support.

I went on to have an elective section c-section and have despite my intention to breast feed ended up bottle feeding my child. My course leader met with all of us post birth to hear our birth stories and was the opposite of judgemental. Nor have any of the mums I met ever been less than supportive.

I also attended a free postnatal 10 week drop in session funded by NCT which has been invaluable.

My antenatal trainer I think gave me one of the best pieces of advice about child birth. So much emphasis is placed on child birth, how and where it happens but it's actually such a tiny part part of parenting - the whole thing is rarely lasts more than 48 hrs.

All anyone wants is a healthy child and if you have a cascade of interventions to ensure that so be it.

Our NCT classes were brilliant, all aspects were covered from c sections to home births. Interestingly and similar to other comments the women that came in to do the bf lesson and the how will u feel afterwards lesson both left us all feeling terrible. We originally attended our local NHS class, but that was 2 x 1 hour long lectures and that was it, so NCT was the only option if we actually wanted any information that would be of use.
I'm now due with my second after ending up with an emcs with my first and the NHS are the ones pushing me to a natural birth far more than NCT did first time round.

My NCT leader was Caroline Flint, who if you google her is an especially prominent midwife very much in the natural birth movement (so you'd have thought 'typical' nct) and I thought she was really honest and good, covering difficult subjects like stillbirth sensitively and also covering c-section in a sensible, informative way - I would never post her name if I thought otherwise.

It is a difficult balance to strike to be fair to the NCT, because stats do suggest that some unnecessary c-sections are performed and the NCT does have a campaigning remit for less medicalised birth. I say this as someone who landed up with an EMCS but was OK with it - I think we should all try to have the defiance to look at our birth outcomes producing a baby and only temporarily battered mummy and think sod what anyone thinks!

The only thing I felt sad about with the NCT was the fact that at the end of the day, it is the well-to-do Mums with access to support who get so much info, whereas so many poorer Mums who need support more get so much less. I do think it is unfortunate that the NCT hasn't reached a wider range of parents.

what is there to not believe about other people experience of nct?may not be your experience but still it's a lived account

perhaps instead of the disbelief,have a think why nct threads habitually generate same themes.

why ka has swathe of people agreeing with her here and online

nct does great work has campaigned and influenced attitude and policy to birth.that's really fantastic. unfortunately though, something has also systemically gone wrong,so many also report a poor experience of nct. that's what nct need to think about and address, it's image, and ensuring good consistent information is disseminated

scottishmummy, when people say 'I can't believe...' they may mean "what I am reading is very far away from my own experience". It does not have to mean "people are not telling the truth".

t also comes across bitty patrionising and don't diss the beloved nct
I appreciate we've all had differing experiences
nct is a fine organization in need of over haul,and significant quality assurance and delivery

Yes Caroline Flint was a laugh! My main problem with the NCT was the fetishization of the process, the pursuit of the perfect birth as implicit guarantee of the perfect baby/child/family life/domestic future forever more. Very implicit guarantee, of course, never explicit, but there nonetheless, in all that honing in on labour at the expense of the weeks, months, years thereafter. I know I'm not the first poster to mention this, but first-time parenthood is such a life-apocalypse that to focus excessively on those few hours seems in retrospect like a wilfully-cynical evasion.
That said, what else can antenatal classes do, since everyone starts and ends their transformation into parent at a different place - if the transformation does ever end (I'm still waiting)? Their main value is probably social, as C. Flint, to her credit, admitted at the time.
Which brings me to my other common gripe about the NCT. Suffice it to say that our group's 9 mums were not the 9 most-local due to give birth that month, but the 9 poshest over a fairly large, very densely populated area, which was, consciously or not, for many of us the whole point (how else can I find the other new-mums "just like me"?)
An area, incidentally, quite well-supplied with outstanding-rated though, erm, challengingly populated state primary schools. Several years later, of the 9 babies born, 6 are being privately-educated, and one has moved to a "better" area (this mum at least charmingly frank about "too many black kids." Managing to avoid glancing at mine in the process.)
That leaves two of us at state primaries; too bad the other mum is based the other side of the borough. I stopped attending meetings when the which-school? discussions started. They made me feel physically sick.

My group did discuss schools but to my knowledge we are the only family not using the state system (doesn't make me posh, just didn't want the failing state school we were allocated when didn't get our catchment one...). But at less that one year old I do admit it's a bit early!

I'm an NCT teacher and I want to make a couple of observations.

Every parent who does a course with the NCT is asked to fill out an evaluation form which is anonymous. The teacher sees these evaluation forms as does the NCT. I also ask parents to feed back directly to me immediately after the classes. I have a link to survey monkey and they can feed back without leaving names. What I've found is that parents regularly comment that they came along to their NCT classes thinking they were going to be all 'whale sounds and touchy feely, natural birth propaganda' (or words to that effect - you'd be amazed how often references to whale noises crops up!) and were pleasantly surprised to find that my classes are nothing of the sort. I'd say 8 out of 10 forms that come back to me specifically comment about how 'balanced' the information was.

The point I'd want to make is that it's clear to me that some parents have very rigid preconceptions about what the NCT is about BEFORE they attend the sessions, and come to the courses already feeling defensive, and sometimes positively antagonistic to the whole idea of 'natural birth'. I do sometimes wonder how this, along with the very intense anxiety some of them are feeling, and then the difficult birth and breastfeeding experiences they sometimes have, contributes to their perception and memories of what actually happened and what was actually said and meant in the sessions.

I think this every time I go to a reunion. I always ask parents to tell me, on the basis of their experience of birth and early parenting, what they think I should pass on to new parents. I can't tell you how many times someone will say 'You really need to talk about perineal tears/colic/infections after c-section, etc,' and I think 'I DID! We talked about it for half an hour. We did an exercise on it. I gave you a hand-out and then emailed you a link to a discussion of the topic on mumsnet, and a number for a helpline if you need to discuss it with someone!'. And it's just gone - they have NO memory of it at all. They look at me a bit reproachfully, but I never say 'actually we did talk about it, but maybe you didn't want to hear what I was saying'. In other words, when I hear stories about teachers not covering X, Y and Z, or implying that pain relief is 'bad', or that all interventions are unnecessary I don't immediately assume that these are an accurate report of what happened or what was said in class. I know this from the comments I hear at reunions from people who've attended my classes which cover EVERYTHING (to the point that I regularly get feedback from people saying that the classes have made them feel more anxious because they touched on issues that they'd never given much thought to before - like the possibility of significant postnatal ill health, stillbirth, emergency c/s under general anaesthetic, severe perineal damage etc).

I feel like the NCT can't do right for doing wrong, and a lot of the time is being scapegoated for the failings of the NHS. How do you help people prepare for giving birth in a system where a good proportion of them will have substandard care which is going to result in them having unnecessarily complicated births and difficult recoveries, without sounding like you're scare-mongering or attacking health professionals?

And it's going to get worse - I'm hearing so many negative stories at the moment about really poor postnatal care that's resulting in horrendous breastfeeding problems and early cessation of breastfeeding. It's a very weird experience to listen to woman tell you about a catalogue of failings in their care, and then have them turn around and tell you that the main thing they've taken away from it all isn't that they ought to have been listened to, given more help, been treated more kindly, but that we should make it clear to NCT clients that it doesn't matter if they 'fail' with breastfeeding. And I'm thinking (and not saying) 'But it DOES matter if someone's buggered up your experience of breastfeeding by not doing their job properly!' So I just nod and tell them they're doing an amazing job (they are!) and say sorry things were so difficult for them (because I am sorry, really sorry). And go home and feel cross.

But I suspect for some mums the memories they take away from NCT are not those of me urging them to get help early on if things aren't working well, or telling them about the importance of enjoying their baby and only doing what they feel they can happily cope with, or me talking about the importance of bottle feeding being a lovely experience for them and their baby (and giving them ideas about how to make it as satisfying as possible), but the general enthusiasm for breastfeeding, the discussion of how babies may try to latch on after birth, the discussion of oxytocin and biological nurturing positions, all of which talk which might make them feel sad, angry and guilty when recalled months later, after a horrible experience of breastfeeding.

"in all that honing in on labour at the expense of the weeks, months, years thereafter"

I mainly teach 12 hour courses. I say to parents before they do their agenda setting out what we need to cover that ideally we should spend 11 hours talking about postnatal life, and just an hour to cover birth. At the reunion they always say they wished they'd done more postnatal stuff. But then their agendas are predominantly about the birth. What should I do? Ignore what they've asked for and just do it my way? As it is I split the course 50/50 between birth and postnatal and I'm very conscious that it's not a great balance. But it's what they ASK FOR.

"The only thing I felt sad about with the NCT was the fact that at the end of the day, it is the well-to-do Mums with access to support who get so much info, whereas so many poorer Mums who need support more get so much less"

This is very true. The people who traditionally attend antenatal classes are the people who don't need to be there! It's true of NHS classes too. I think the government needs to think of a way of getting good antenatal education (education which is focused on what to expect in postnatal life, how babies develop and where to get support) to those people who would benefit most from it.

"An antenatal course price of about £50, or about £10 per session I can justify - but the £300 I was quoted is just ridiculous."

A 14 hour NCT course (including breastfeeding class) for 2 people works out at £216. That's £108 per person. Which makes it quite a lot cheaper than many of the courses on offer at the Mumsnet Academy!

And all the 'profits' from the classes go towards supporting other NCT activities which benefit all new parents - training breastfeeding counsellors and peer supporters, running the help lines, the campaigns for better maternity care, research into pregnancy, birth and early parenting etc.

The Relax, Stretch and Breathe NCT classes are about £10 per session I believe. I think you can pay it on a drop-in basis.

fabsmum I think your post is absolutely bang on. People do remember things based on their expectations more than their actual experience sometimes. I for one didn't even know that NCT was considered lentil weavy and as such didn't notice any in the classes. It wasn't till I got on MN months later that I was confronted with the concept....

Don;t think there is a position by NCT against c-sections I have had two - one emergency, second one planned - and have felt supported in both.

I think there is evidence that Ms K A is adept at self-publicity and setting up positions to have a pop at is one classic method of that as she has done so on a number of topics across different media. But then she is a media professional so should we be surprised. Suggest judge topic on its merits rather than on such hype.

ok,you keep fingers in ears go lalala.dd bad kirsty say something unpleasant
take ka out picture if you wish,what about other accounts?are they media hungry too?
every time there's a nct thread same themes,stop ignoring abs denying. nct needs to change. with good leadership and vision it can, first step IMO is acknowledge perceived failings and move on

marytuda and scottishmummy both made good points that I agree with. When my best friend couldn't understand why I didn't want to join the class she had been attending, it was for the reasons you made. If I hadn't heard all the stuff that her NCT teacher had said e.g. 'well she did have pethidine and a c-sec could have been avoided if she had persevered' , I may have gone. What I would have wanted is informative, balanced classes with properly covered aspects of alltypes of birth (not a flipping leaflet) and breastfeeding and natural birth not being (no pun intended) pushed at you, but just discussed in a sensible way. Also, a more mixed bunch of mothers would be preferable. marytuda those mums sounded annoying and are exactly the type that were in my friend's class. She is still friends with them, but it all sounds so bloody competitive!

meant to say all* types of birth

scottishmummy - the picture painted by these stories of the NCT as an organisation which condemns c/s and those women who have one, is fascistic about breastfeeding, and unresponsive to the needs of modern parents is simply not reflected by anything you will find on their website, in their organisation at a national level, or in the information they disseminate through head office. Therefore it is unfair to keep insisting that it is the NCT as a whole which is at fault.

Of course there are individual teachers who are poor. But if those teachers are regularly not meeting the information and support needs of the parents attending their courses then they would not be defended by the NCT (actually formal complaints are dealt with very seriously). The NCT provides an opportunity for all parents to feed back their opinions of their course and the bottom line is that the VAST majority of people (9 out of 10) who do classes love them and find them useful and don't have an issue with what's taught! What more do you want the NCT to do?

And as a teacher I know for a fact that people DON'T take away an accurate memory of what was said and done in class, which is why I take some accounts of NCT classes which I read on mumsnet with a massive pinch of salt.

I also think the NCT is being partially scape goated for the failings of the NHS. They are taking a beating for being the most visible advocate of normal birth in a system of maternity care where women are experiencing a rising tide of avoidable interventions, the growth of which EVERYONE involved in the care of mothers and babies acknowledges as a problem that needs to be addressed.

Fabsmum your post about people not remembering what was covered in classes is interesting.

Let's assume that out of a hundred critical accounts of NCT teachers' products, a fair percentage of those complaints are down to customer bias against the teacher after having had a difficult time at birth - call it wilful blindness ("I did not listen to comprehensive advice about positioning and was unable to persuade the midwife that I wanted to be upright, ergo I was not advised enough in the class I paid for and did not get value for money").

Can you not see that this is still a problem which needs to be addressed? It is NOT going to go away just because you are a conscientious passer-on of information. The problem does not solely lie with the customer here. There is something fundamentally wrong with the approach to teaching if this is happening as often as is clearly is. Teaching isn't just telling people stuff and hoping they remember it!

This is why the whole NCT teaching system (and choice of teachers) needs an overhaul, or else just bloody admit that it's a fundraising introduction service for MC people to meet other MC people so they can network. (NCT representatives, you do realise this is how you are seen by the chattering classes themselves? Someone said to me the other day 'God, yeah, it was a bit of a waste of time, but we met this architect who's going to do our extension...'!!!)

Stephanie - if you look in journals dedicated to antenatal education (which are produced by people not involved with the NCT but intended for all antenatal educators, the majority of whom are midwives), you'll see that this issue (what parents take from antenatal classes and how they use it in birth and afterwards) is seen as a central issue.

But fwiw, why should the entire system need an overhaul if 9 out of 10 people who do the classes think they're good?

I didn't think what Kirtie said would even be controversial TBH. Ours did discuss C-sections- but only becasue we had twin pregnancies where the parents had already been told they were likely to end up with a section- but the instructor didn't come accross as keen to talk about this. Intervention was bad- pain relief was discussed but the downsides emphasized- as much time was spent on homeotherapy as the other methods. But the worst aspect was the breastfeeding sessions which were dogmatic and useless- there is no such thing as inability to breast feed - anyone who says they can't is wrong- any problems with b/feeding are caused by the mother doing it wrong. No discussion at all of why people stop, no discussion of alternatives. And the counsellor was actually apalling in actually helping when i was having problems b/feeding ( advice - try a different position -goodbye)
That said - I didn't go into NCT expecting unbiased views so I wasn't disappointed and i got a lot out of it in other ways

I didn't do NCT classes as I didn't know that most people sign up at the moment of conception! I rang up after my anomaly scan so about 22 weeks and was told all the classes were full.

The cost would have been a big stretch for us and only possible because of the old HiP grant. I'm really glad we didnt bother and spent it on a nice pushchair instead!

I agree that NCT is very very middle class and exclusive. The cost is prohibitive and in my city the classes are only in very mc suburbs right on the outskirts. Not much use for inner city dwellers with no car...there weren't any NHS antenatal classes, only a tour of delivery suite, didn't go as planned a hb.

Oh and I know loads of people (myself included) who have had emergency cs but the two I know who had big guilt issues both did NCT...one friend freely admits until her birth she believed I just hadn't really tried hard enough because of what she was told by her NCT teacher

a lot of the time is being scapegoated for the failings of the NHS

AHA! NOW we come to the nub! And in this we come up against the socialist state religion, the cult of the glorious untouchable NHS.

Because let's face it kids: in a socialist centrally provided healthcare system where the client doesn't pay (and so like the comprehensive education system has no say), WHAT IS THE CHEAPEST BIRTH OPTION?

It is convenient for the NHS to politicise midwives and give them too much say over obstetricians relative to training. It is convenient to have a propaganda wing the NCT pushing for that cheapest option. Who cares about the needs of the client?

[this does not mean that the NHS has bad intentions, not at all - but this is the known failing of socialist systems, the disconnect between the centralised service provider and the end user. People respond to who pays them. It is human nature]

I certainly agree that it is ridiculous to point the finger at the NCT when they are essentially filling a role that the NHS should have covered in the first place. NCT should be an option on top of decent antenatal coverage by the NHS.

Where I am I could have 1 hour class on the NHS plus a tour of the maternity ward.

The issue of 'how do we teach so people remember?' is a massive one, for educators at every level from school upwards. By the time you get to a type of adult education which includes experiences, feelings, relationships (and not just facts) it's even more of a challenge.

In NCT's case you are also reaching people at a hugely important stage of their lives and one which has a fair amount of baggage. This makes the chance you can teach something and find out later that some of the people there really, really don't recall it, even higher.

I have had the experience myself (as a bfc) where I hear I did not tell people that breastfeeding can sometimes be really difficult, or that babies feed often, or that it can hurt. I now try to emphasise - by having the same information come out in various ways throughout the 2 or 2.5 hrs I have with them - info I know will be important. Many (most? actually prob all) bfcs do the same thing. I still get calls from women who are surprised when things are difficult for them, so I clearly haven't got it right.

Several years ago, NCT made it compulsory for people who want to train other NCT teachers, breastfeeding counsellors and postnatal leaders (in NCT parlance these trainers are known as tutors) to have a BEd - an additional BEd if they already had one - in antenatal education. Over the years, this has led to better training, and continued reflection on what we offer parents. Our parents satisfaction levels are high (93 per cent say 'excellent' or 'good' throughout all services, a/n, bf, p/n; 6 per cent is 'fair', 1 per cent is 'poor') . NCT is positively obsessive (in a good way) about getting feedback, and very thorough when it comes to complaints.

It's significant that some of the bad experiences listed here come from some time ago. The recent ones may well be from the 1 per cent who feedback they had a negative experience - probably a lot more than 1 per cent have a bad experience as no organisation could ever manage a 99 per cent satisfaction rate, and some people will walk out of a course and never give feedback, or have such a bad time they can't bring themselves to make a complaint.

None of this signifies a need for a systemic overhaul - if we did that, we'd risk alienating the 93 per cent who do like us :) It does indicate a need for continued listening, responding and changing where needed - and a continued searching for the answer to the question of how we ensure people remember 'stuff', 'cos I don't know that :(