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.

NO NCT classes around here and I went NHS to birthing centre on DS1. Never was intervention discussed or failure to breast feed. All they banged on about was how 'nature' was and intended to do.

Sadly, never discussed, I had to endure sweeps and inductions, once in the throws of labour in an NHS hospital you can forget decision making because its done for you and after not sleeping for days, being on gas n air you have not control at all - the class tutorial goes out the window. Nor was once CS what a nightmare getting a VBAC. DS2 induction again ending up in crash section (proper crash section this time - head slammed to the table!!!).

My point is - its worthless, once you cross the NHS threshold (unless lucky to have these posh birthing rooms or not be continually monitored) the process of these classes has been a waste of time. Leaving us mums who 'failed' nature to be overcome with grief over what we were meant to have.

Perhaps more emotional and PND would be beneficial as no-one was there for me at all I suffered terrible after failure to give birth twice and having to endure a proper crash section with DS2. No one ever talked about how low you can feel.

About to do NCT classes, and due to other issues am planning an ELCS... so we'll see how they handle it.

We did get the 90% reduction... I just emailed the course co-ordinator, and she sorted it out. Otherwise, I wouldn't be able to afford to go. All our Antenatal classes at hospital in the middle of the day, and DH wouldn't have been able to go with me.

I did the NCT classes and thought they were fantastic, but perhaps I was on the fortunate side, judging by some other comments. Our teacher(?) spent an entire session on C-sections, on the basis of the 1 in 4 statistic. She was very much pro giving people all the information and letting them make their own decision, including about breastfeeding. She didn't promote ff (obviously can't) but was clear that bf can be hard, can be painful and doesn't always work.

For what its worth, I was quite relaxed about whether I bf or ff, but ended up going through six weeks of hell to get it to work. This was more to do with the amazing support of the community midwives than anything else though :-)

Classes was too expensive, NHS offered ante-natal classes in the evening at local surgery for free, partners included, presented by community midwife. I don't think I would have paid for classes even if I had the money too, tbh.

The NCT usually comes over as strongly pushing an agenda, they should rather be women's advocates in all things childbirth rather than prescriptive, issue around CS, FF and PAIN RELIEF INCLUDED. I was very lucky to have had 2 normal deliveries and no problems with breastfeeding, but I have been very lucky, and there are many with no one to speak up for them.

The group leader hated me. I misunderstood the brief and when I said I'd be bottle feeding and having an epidural she looked like she wanted my head on a pike. She was also unbelievably scathing toward midwives, which was categorically unhelpful and in my case wholly inaccurate.

I've just remembered a bit more about my NCT leader. She told us she was also a marriage councillor for the local Catholic diocese and I think that was linked to why she told us it was our duty to lie-back-and-think-of-England for our OHs at six weeks...

I can also clearly remember researching whether not having pain relief was linked to the Catholic concept of original sin i.e. that women are meant to suffer childbirth because of Eve's sin in the Garden of Eden. I cannot remember whether I used that information but I must have been pretty riled by her to have even considered doing so (and I'm a non-Catholic church goer so it's wasn't her religion per se that I had issues with).

On the upside, I'm still in touch with most of the ladies I met on the course, even though I have since moved 200 miles away from there.

I knew of the NCT whilst pregnant nine years ago with DD but was never tempted to sign up as I just didn't feel the need. In my experience, the birth classes provided by the NHS at the time were perfectly adequate and told me all I needed to know, and I made some good friends there too. The Midwives were non-judgemental about pain relief and breast/bottle feeding.

Do the NHS still provide classes of any sort?

Thanks for this. I posted in reply to Kirstie's original tweet as it struck a chord with me (although I also tried to be balanced - honest!).

Our NCT teacher was great and so was the group co-ordinator who stayed in touch after birth. However, I had so many complications (of which the least was a C section) that I honestly felt I didn't fit the NCT mould. There was an emphasis on "natural births" and breast-feeding (although other options were covered) which did make you feel a bit like a failure if you didn't, or couldn't.

However, looking at the other posts, it looks like there is a big range of experiences. Like another post said, having a healthy baby is the desired outcome, how you get there is pretty secondary (well, it was for me).

Shortly after birth, my son was also diagnosed with a serious medical condition and I didn't feel that NCT prepared me for that. OK, they can't cover everything, but I did feel that I was very much the odd one one (especially as we weren't well enough to attend the meet-ups) and it was a bit like we dropped out of the picture.

If the feedback can make NCT more inclusive and open to mothers who don't fit the stereotype, then that's a good thing. Looks like the debate is getting that ball rolling.

I didn't even consider this lovely organisation, as I had no desire to be made to feel inferior because of my choice of CSection as the modus operandi of the birth itself.
I had my DTs with a marvellous consultant and his professional team and it was a glorious birth experience. For some reason I don't think NCT would have shared my opinion.
Why is it so? Why the animosity against CSections. pray tell.

Hmm, not overly impressed with the NCT. We were allowed to underestimate how painful giving birth was and not really given a lot of information about painkillers. The breast feeding counsellor who came to see me when DS wouldn't feed, was absolutely useless. Just tried to get him to latch and then said it was because I had funny shaped breasts and left after about 20 minutes. First baby, not helpful.

NHS class held at my local GP surgery was run by a lovely HV who was pragmatic about things and non-judgemental.

I phoned my local NCT teacher 16 years ago when pregnant with DD. I knew the score but thought it would be good for me in a new area. The woman was very friendly until she asked me what I did. I told her I was a doctor, at that time working in Obstetrics. She suddenly went cold and said she was sorry but she could not have me in her class. To be fair, she offered to phone around to see if any other group leaders would be willing to have me but I was gutted. Absolutely speechless. I might have been quite comfortable doing ventouse deliveries and assisting at sections but I didn't know anything about being a mum and was hoping to make friends. Truthfully, I may have been tempted to pipe up if I felt people were being misled or if she plainly did not know medical facts or if she put people down for not towing the party line .
I went to NHS classes in the end and they were fine and I did go to NCT post-natal meetups for a bit too. Kirsty A. and Dara O'Brian are spot on .

I went to two sets of NCT classes about two miles apart, with different course leaders. One was fab and covered c-sections as a good thing as well as natural birth. The other was was crappy, pushed hypnobirthing as the only thing to do, stigmatised c-sections and was a waste of money. I think it's more to do with the individual leader than the NCT in general.

I have to say that I wasn't a great fan of my NCT experience 4 years ago. My GP surgery actually paid for an NCT instructor to lead a class for its expectant mums - consequently there were usually at least 15 couples at every meeting, so we never really got much past going around the circle to introduce ourselves. Or so it seemed to me at the time.

I had originally paid £185 to go to a private class led by the very same teacher (which I cancelled when I realised I could get her wisdom for free). I'm glad I didn't have to pay. She kept asking us to tell her what topics we'd like covered, and then never got round to discussing any of them.

I remember her telling us to call her if our waters broke early and she would give us advice about how to get labour moving. Mine broke before labour had started. I rang her. Her phone was switched off and she never called back.

At the breastfeeding session we were told by the bf specialist that powdered formula was full of bacteria and that formula in tetrapaks is carcinogenic. You would wonder why any ff babies survived the way she was talking. We were all planning to bf but had asked about formula as a back up plan. And at that point we were all petrified about what we do if we had to succumb to the dreaded formula for any reason. I remember one of the other mum's really struggled with bf and went to see her for advice. The only pearl of wisdom that she took from the session was being told that ffing your baby is like give them McDonalds. It made a very guilty mum feel even worse about her inability to bf her baby.

Yeah, so to be honest, the NCT way wasn't of great appeal to me. Whenever I've been asked my opinion by pregnant friends I've always said that the only good thing about NCT is the friends that you meet. I'm still in touch with most of the mums I met and we're beyond all the competitiveness thank god. We had a 4th birthday party for all the kids last year. It was lovely. So I can't complain too much I guess.

I went to NCT classes, not for the childbirth information but because we don't have any friends or family near us who I could talk to.

It was lucky this was what I went for, because the focus on 'natural' or 'normal' birth and breastfeeding was overwhelming. We didn't talk at all about C sections, pethidine, or epidurals, except as things you want to avoid at all costs.

Of the eight of us, here is a one-line summary of our birth stories:

1. Emergency C-section after baby got distressed
2. Forceps after an epidural. Mother lost 5 pints of blood and had to have a transfusion.
3. Gas and air delivery.
4. Three day labour, gas and air and pethidine.
5. Mother got gestational diabetes, baby had to be induced and then delivered by forceps after baby got stuck. One push away from an emergency C-section.
6. Planned home birth. Got induction followed by emergency C-section.
7. Two hour labour - mother barely made it to the midwife unit!
8. Induction, constant vomiting during labour. Gas and air.

None of these are unusual or particularly bad stories, but barely any of us were prepared by the NCT for what happened! We also had almost no information on what to do to care for the baby in the first few days.

BUT it's not about feeling smug about having lots of other middle-class yummy mummies to bond with. It's about having people who get you out of the house when you really need it, people who find activities for you to do with your baby, people who don't mind you boring them for hours with details of your birth/labour/baby, people to babysit for you and to babysit for when the children get a little older and you don't have anyone else you trust nearby, etc etc. Considering we live away from family and close friends, that was crucial for us.

I felt intimidated by all the middle class mummies in their big houses and I am a middle class mummy a big house lol. One woman there was quietly (!)bragging about how her hubby had just been offered a salary package of circa 100k. The babies were at weaning stage, it was chit chat about all home made organic etc etc! Like that happens in reality (well, maybe with your first!)

I kept quiet, I care not about how much people earn or what they do but who they are.

I didn't go back.....

Our NCT class was great... we did a role play of an emergancy.... every one in the room had a role to play (to show how many people appear, when that buttons pressed, it certainly opened my eyes!)

We discussed ALL types of pain relief

out of the 8 of us
1 planned C section (for medical reasons)
1 emergancy C section
2 easy straight forward home births (mine was very fast)
1 breech vaginal birth
3 normal births in the hospital

7/8 tried hard to BF
6/8 were still BFing at 6m (5 of these had never tasted formula)
5/8 still BFing at 1st birthday

3/8 are in cloth nappies almost all the time (1/8 is always in cloth, even in holiday!)

I loved my NCT classes and met a lovely bunch of friends.... we are all still in touch 16m later, and 1st second child is due in 2 weeks,!

I attended NCT classes due to poor provision of nhs ante natal classes in my area. I would also like to know why the sessions are so expensive!
I did find them useful and the teacher did not seem to be obsessed with natural birth. She gave a balanced view of all types of birth.
I was determined to breast feed but did find the breast feeding person patronising. Dismissing bottle feeding all together.
I was successfully able to breast feed for 6 months but wonder how the other ladies got on.
I didn't keep in contact with them because I did feel the undercurrent of checking each other houses and careers out.
It was interesting to note that out of the 5 of us 3 people had complicated births. Thankfully all the babies were fine.

I agree it can be hit and miss with the classes depends so much on the teacher and other parents-to-be.

Of the 6 in my class with DS1, 3 of us still meet up every 2 weeks 10 YEARS on! (we have just gone through the secondary school application angst together!)

But I have friends in the same area who just didnt get on with anyone in their classes.

All my children have been mainly clothed from their Nearly New Sales.

Yes the NCT, is at a local level, is very middle class and what is wrong with that?

Degree level educated middle class mum's can feel very isolated indeed.

Very many of them have since they were 18 lived in away from their families and many may have moved several times.

If, as I did you commute to work in the nearest large city, you have absolutely no local friends.

When I had DD1, I knew a few local mum's with older DCs because I ran the local Brownies, when I had DD2 we had moved and I knew absolutely no one.

In both cases the local NCT was an absolute life line.

The house I lived in when DD1 was born no way big and posh enough to host coffee group, (it was a scruffy ex-council house, small and as DD was a baby unchildproofed).

No one worried, I went to bumps and babies and coffee at other peoples places and did my bit by type setting the local magazine. Something that having just finished writing up my university research I was set up to do.

Both here and back there most of the NCT people I've met and certainly my second antenatal class are well educated, but very variably well off.

I still have the scruffiest house, and neither the largest or the smallest income and 11 years later many of my last antenatal group are still friends.

We paid for NCT classes just over five years ago. At 28 I was the youngest in the class so didn't bond that well with the group. C-section and formula feeding were not covered, I went on to have failed forceps/ventouse and then an emergency c-section which I knew nothing about at all. I couldn't breastfeed, no milk came through and generally had no idea what to do. I then discovered my son had a tongue tie. So much for the perfect birth and straight forward breast feeding hey NCT! For two years I felt like I failed at breast feeding and having the perfect birth. My daughter came along two years later, I had a better time and was able to put the sadness I felt first time round behind me. I would never ever pay for classes again and knowing what I know now I wish I had never bothered paying for them in the first place...they need to get real!

"The only think that I really struggled with with NCT classes is that they can't talk about bottle feeding at all. Not a peep about it."

We can. And I do! (antenatal teacher).

"I phoned my local NCT teacher 16 years ago when pregnant with DD. I knew the score but thought it would be good for me in a new area. The woman was very friendly until she asked me what I did."

Why were you talking to the teacher directly? Even 16 years ago all bookings were done through a booking clerk. Teachers' details aren't available to the public as far as I know.

"and even if the instructor got paid (and my understanding is that they volunteer)"

Teachers are paid for their services - roughly what you'd expect a teacher to get paid, whatever sector they work in.

As someone who works for the organisation, I think we just need to accept the reality of modern UK maternity services, and modern birth - which is that for the client group we tend to attract to NCT we are going to see increasingly:

high rates of epidural use
high rates of interventions in birth
high rates of breastfeeding fall-out
high rates of disappointment with care in labour
high expectations about what degree of control women want to have during birth

And find a way of acknowledging that this is the reality for most mums, without either a) implying it's always inevitable and b) that these things imply a failure on their part.

Until then we'll continue to get a massive kicking from women and from the media.

Having read the comments (blog post) by Belinda now, I feel that the natural birth and parenting agenda still comes through quite strongly, even though they say they are there to support all. So, personally I have a feeling they are not being completely honest. As I say I think they should have stuck with their original name "Natural Childbirth Trust" and admit openly that that's where they're coming from.

I would have no problem with that as I'm quite lentil weavery/ attachment parenting etc. style myself. But I just feel it would be more honest, and if that wasn't for you you'd know and feel more free to look elsewhere
As I'm sure plenty of people do anyway eg. going for hospital antenatal classes etc.

We do talk about bottle feeding (I'm a breastfeeding counsellor). In the session, we do focus on breastfeeding - it is the breastfeeding session, after all, and clearly badged as such.

Group teaching of bottle/formula feeding weeks/months before the knowledge is needed - making up bottles, safety, hygiene, which are the most important bits people need to have - is not especially effective or even safe. Most people at an NCT breastfeeding class want to know about breastfeeding, and don't want to spend much time talking about using formula - though I do talk about it, as do my colleagues, in response to questions, or why early use of formula can affect the choice to breastfeed.

LadyHel, I don't understand why it would be wrong to point out that formula powder has bacteria in it - it does, routinely, which is why preparation has to be done in a particular way. Three or four years ago, there were many articles in the press about the potential harm of packaging including the packs of ready-to-feed formula. I have not heard of this scare recently, and maybe the packaging has changed. Perhaps that's why it came up in the class you did.

Just to set the record straight some bookings clerks were teachers. They haven't been for at least 5 years now since it became an employee role and teachers are not employees (self employed apparently).

I'm delighted everyone commenting has read the blog and had a recent experience of NCT. It would be dreadful if we all just spouting our impressions formed from a position of ignorance or the idea that the organisation and strategy has not changed at all in the last few years...

On a serious note I wish the organisation would hold it's hands up and admit sometimes they get it wrong. Anyone who feels a failure as a direct result if attending any NCT run activity or class has been failed and there needs to be a clear route to tackling this. Being honest does not detract from the thousands who have a positive experience but dismissing those who recently have not is folly. Organisational falibilty was not mentioned in the blog. It should have been.

Good post Fabsmum