Following Kirstie Allsopp's post, a guest blog by Belinda Phipps, CEO of the NCT

[KateMumsnet]

A couple of weeks ago, Mumsnet Blogger Kirstie Allsopp wrote a blog post in which she argued that the National Childbirth Trust is over-focused on natural birth, and that women who don't have one can feel underprepared, and even stigmatized. Her post sparked a lot of debate - have a look at the Talk thread for more background.

This week, NCT Chair Belinda Phipps has written us a guest blog in which she tackles some of Kirstie's points, and sets out how the organisation is changing to respond to the needs of all mothers. 

What do you think? Let us know if you post on this subject - or let us have your thoughts here on the thread.

[oldebaglady]

"Whatever your income"........ so long as you have a car! round here anyway! The nearest NCT antenatal classes are in a posh village miles out in the sticks that you can't get to by public transport at that time in the evening! So they may offer me a discount on class fees, but they still make damn sure it's not accessible to the likes of me!

[BartletForTeamGB]

I think that polkadot might be reading too much (or in one sense, not enough) into 'normal' births.

There is a very specific definition used in obstetric statistics:

<a class="break-all" href="http://www.birthchoiceuk.com/BirthChoiceUKFrame.htm?www.birthchoiceuk.com/NormalExplain.htm" rel="nofollow noindex" target="_blank">A "normal birth" has been defined as one which starts naturally and does not involve any medical or technological intervention. This definition would therefore exclude births which involve induction, acceleration, medical pain relief (including epidurals), forceps, ventouse, a Caesarean or an episiotomy.

This means that my otherwise entirely uncomplicated home birth was NOT 'normal' by this definition because I had an episiotomy. I have also been induced following an intra-uterine death - definitely not normal. Next week, I expect to be induced due to complications with this baby. That will not be normal.

My experiences don't mean that we shouldn't try to improve labour care for women all round and it doesn't mean that there isn't a very appropriate place for medical interventions for some mothers. The issue is ensuring that these are done no more and no less than what is appropriate.

"Hmmm in all my years of wearing contacts I 've never actually heard the word "normal" used,there are far too many variables."

Incidentally, normal vision is 20/20 vision (although we actually do in metric measurements now, so it is 6/6 vision).

[tiktok]

It's a briefing document to inform a discussion at a conference.

It's not a leaflet written for mothers.

It uses technical language, of the sort common in the obstetric literature.

It does not 'infer' anything (I guess you mean imply)....it points to evidence about different effects and outcomes for mothers and babies in general related to birth; these do not not necessarily apply to every individual.

Hope you are not still feeling insulted or offended.

[PolkadotCircus]

There are some good bits in there though,shame as I suspect some of the wording of the bits I have mentioned would switch many mothers off.

However maybe they wouldn't be "normal" NCT mothers so who cares.

[PolkadotCircus]

" negative effect of interventions on transition to parenthood" puts unnecessary pressure on something you have little choice about.I've yet to meet anybody where this is actually the case,this infers it's widespread and scaremongering.Most mums I know after interventions are just grateful their babies/themselves are still alive and out.

You can look at all the knitted wombs you like but if you need intervention,you need intervention,this infers otherwise.

[PolkadotCircus]

Oh and birth with medical intervention is still giving birth- just sayin'.

I think done of the wording and structure in that doc is offensive,sorry.

[PolkadotCircus]

Hmmm in all my years of wearing contacts I 've never actually heard the word "normal" used,there are far too many variables. My dc all have perfect eyesight but none have the same prescription.

[tiktok]

Polka, the word 'normal' is clearly used as technical term - as it is throughout the literature - to mean 'physiologically normal'.

The word 'normal' is used three times in the document, which is a formal briefing paper, making no comment on individual women's experiences:

"Birth is a normal physiological process and most pregnant women are fit and healthy"

"Improving the opportunities for women to have a normal birth has positive benefits, both physical and psychological."

"Over the past 20 years birth centres have become increasingly recognised as highly appropriate options for healthy women with normal pregnancies"

In other publications, NCT uses the word 'straightforward' as a synonym, and many of us prefer this word when speaking to (or writing for) women directly, as it is more readily understood and accepted.

No need for you or anyone to feel 'insulted' by the use of a technical term like 'normal' to refer to the physiological process of vaginal birth...any more than you would feel 'insulted' if the optician told your friend she had 'normal' eyesight because you wear specs.

[PolkadotCircus]

The mode of birth section in that piece I found rather insulting to be frank."normal" birth- wtaf!We're all born with different bodies,pregnancies and babies,there is no "normal"but a huge amount of luck.

Many women would also actually give anything not to have had a "normal" birth,having to subsequently live with the injuries it can cause and which are often swept under the carpet.

Seems to me buying into that piece is akin to buying into a fantasy rather like those extortionate Stagecoach lessons parents shell out for and which in most cases are very unlikely to make your child a star.

[natbod]

I had a great experience at my antenatal classes and found the teacher very informative. She gave us all the options and it definitely helped to build my confidence for the birth, which I was absolutely terrified about! It wasn't all middle-class people that attended our classes, but generally the people that go to classes have moved away from their families to new areas for work, like myself, who don't have the support network around. I don't know what I'd do without the people that I met.

[BartletForTeamGB]

'wi' - Women's Institute?

www.nct.org.uk/sites/default/files/related_documents/Briefing%20for%20NFWI%20on%20resolution%20for%20AGM%20May%202012.pdf

[PolkadotCircus]

Hmmm you know what I think MN should do their own version of NCT- cheaper so all could go,encompassing all mothers,better planned out and more realistic courses which cover the subjects mothers actually want in a depth they actually want.

They'd be so successful. You could link them to the local forums on here,sales etc,books are already written and they've got the perfect platform to actually listen to mothers and keep up to date on what mothers actually want.

Hmmmm

[tiktok]

"an email survey in partnership with the wi asking about my birth experience with no mention of cs or options how to feedback on that experience. "

I don't know what 'wi' means - typo? But asking about your birth experience includes cs (that's why it's called 'caesarean birth') and 'asking about' means asking for feedback....maybe I'm misunderstanding you, sorry, but I don't get the problem you are raising here.

[Andcake]

I had a good experience of nct although I felt the bf advice was to idealistic and did not prepare anyone in my class for the realities and struggles. The bf class was done by a different lady whereas the rest was done by a v down to earth practical mother of 4. I also did the local one day nhs and both were similar.
I had a planned cs due to my ds being breach our nct teacher was nothing but supportive. However this morning the nct sent me an email survey in partnership with the wi asking about my birth experience with no mention of cs or options how to feedback on that experience. Sigh seems Belinda Phipps recent blog views isn't reflected throughout the organisations research!

[SnakesheadFritillary]

That's the sheet that my NCT teacher did choose to include in the pack.

[louschmoo]

Yes, having that included in the pack you get when you start the course would be great, perhaps accompanied by a brief 'don't use cooled boiled water to make up bottles please' instruction in the class. Because nobody actually tells you that, and LOADS of people tell you cooled water is fine as long as it has been boiled.

[CelineMcBean]

Do you mean some thing like this?

I found that Googling "NCT formula feeding fact sheet"

There was another one for breastfeeders who need to use bottles too

[louschmoo]

juggling yes I completely agree with you re: the simple guide to best practice for preparing bottles. It's all very well saying 'read the packet' or 'there are so many places you can got to get advice on FF', but in practice there are still SO many misconceptions about how to safely prepare formula. I BF to 6 months then switched to formula, and the number of friends who told me to just use cooled boiled water to make bottles was unbelievable. It's a really common belief that it's the water which needs to be sterile, not the powder.I would say it's akin to the 'BF every 4 hours' myth which is still prevalent amongst a lot of women who gave birth decades ago. And most people who BF will also give formula at some point, even if it's just the odd bottle when the baby is older. So I really do think it would be added value to most people to include a very short briefing on the dos and don'ts of preparing bottles.

Also, when you sign up to an NCT course you don't get a choice about signing up to the BF session, it's an integral part of the course. If you do NCT antenatal then that's what you get. So it's a bit disingenuous to say 'well you signed up to a BF session'. No, I signed up to an antenatal course.

I'm not saying this to be antagonistic, i think it's really important to encourage and support BF and the NCT does really valuable work in this area. And I certainly wouldn't want to disparage any of the work that volunteers do. But it would be really great if there were a little more acknowledgement of the issues raised here, specifically with regard to the (very expensive) courses.

[JugglingFromHereToThere]

Yeh, yeh, I know you add the powder later these days ... my friends gave me that tip in case we were out and about with baby ... but as I said I was BFing anyway.

But in any case that was more my point than yours ... that Mums-to-be should probably be given a simple guide to best current practice on preparing bottles as well as on BFing. Seems like many would appreciate it. Just as part of an inclusive "covering all bases" reassuring approach.

[Maebe]

And it looks like you haven't read the responses to your comment either.

[CelineMcBean]

Ah I knew some of you wouldn't read the disclaimer

RL beckons. Have fun

[Maebe]

Oh, yes, Celine, that's an appropriate analogy

There is more involved in making up healthy formula than just reading the instructions. I was one of the only mums on the ward to use formula and even though the hospital itself had been part of the decision for me to ff rather than bf, I got no support and was barely shown the room with the fridge, let alone talked through what temperatures might be appropriate to serve formula at, or how long to store a made-up bottle or an open carton, or the best way to sterilise a bottle. Things that can seem pretty daunting when you have a tiny little newborn to care for and you only gave birth 48 hours ago and are still an absolute mess.

I'd have appreciated being able to have a chat about it during the NCT courses (though it seems my tutor was sticking to the bf-only line more closely than others).

Not all mums start ff when their baby is a month or two old.

FFS, that's kind of like saying all there is to bf is sticking a nipple in a baby's mouth...

[tiktok]

Juggling, the antenatal session on breastfeeding does teach something of the skills of breastfeeding, but much of the preparation lies in 'making the baby real', emphasising the unpredictability of a newborn's needs, discussion of social factors eg night feeds (all of which are also applicable to formula feeding, anyway) together with a brief outline of how breastfeeding works, to enable mothers who want to bf to approach it with more confidence. There is not much risk that a faulty memory about the content of the session would put the baby's life/health at risk. And of course, the bf session takes place (usually) a very few weeks or even days before this is needed.

Contrast this with formula feeding. Actually, it is more complex than most people think. Unless you trained as a student nurse within the past 5-6 years, you will not have learnt how to make up formula powder and store bottles according to current safety guidance, either :) . As I said, the first few times of making up a bottle, parents really need to read the tin and not think they already know what to do, 'cos of a session months before or a student nurse experience years before.

[JugglingFromHereToThere]

Nonsense Celine - I hate following instructions on boxes, and much prefer to learn first-hand by seeing someone else do it -
Babies don't come with a manual - following written instructions is not an essential skill in raising a baby

[CelineMcBean]

If you really need face to face, hands on support to make up a bottle of formula with the instructions on the box you probably shouldn't be in charge of an infant.

Sometimes you have to take a bit of personal responsibility and just get on with it.