To correct NCT teacher

[Skeetle]

Lurking through pregnancy but thought I'd try my first AIBU

I recently went to an NCT class and spent quite a bit of the evening sitting on my hands due to the dubious nature of some of the information on pain relief. Having researched myself quite a bit, including a detailed conversation with obstetric anaesthetists and reading up on NICE guidelines I was surprised to hear the following:

They won't let you have an epidural past 8th dilated.

Epidurals are now allowed to wear off for the second stage as this reduces birth trauma.

And most strange of all, she managed in a roundabout way to link entonox with postnatal depression

There were some other inaccuracies too. As I say, I sat on my hands and didn't say much apart from a quiet comment to her when no one else appeared to be listening that I'd been told I could have an epidural past 8cm dilated.

Without wishing to start a fight on pros and cons of pain relief in labour, I do think accurate information should be given so a woman can choose accurately. I don't like to think of my fellow NCT classmates making decisions based on this but equally don't want to undermine the teacher.
So WIBU to send her an email pointing some of this out or have I missed the chance to say something without making a big issue of it. Should I have simply made a comment there and then?

And will look for Dara O'Brien too

Well - just going to the labour ward seems to make many women's labours go shit-shaped.

You don't see a lot of normal, physiological birth outside of home births and birth centres. The whole environment of hospital militates against it, whatever the intentions of the doctors and midwives who work there.

Paper is by Shatken, Greenough and McPherson - Epidural fever and its implications for mothers and neonates: taking the heat

And I bet a c section was never even mentioned. And if I was it was mentioned in a hush voice as if it's something to be ashamed of!

I'd rather have the NCT approach than that of the NHS MW running the classes who laughed in my face when I said I'd prefer not to have drugs for pain relief, waved the epidural needle and said "You'll be begging for this," which was nice.

Appalling hospital.

Yes, some NCT teachers have their own agenda, but since it's an agenda that is mainly about getting better births with better outcomes for women and babies, I pretty much support it. Of course there are some loons, as there are everywhere.

Fine, if you want an epidural and are making an informed choice, go for it. Too many people are not making informed choices though. I had a pethidine type drug administered without permission, it was horrible and I hated it. Drugs don't suit everyone, not everyone needs them, they are counter-productive for some women. I had none at all (no, not even gas and air) with the other two births, and they were infinitely preferable to the first, unnecessarily over-medicalised travesty. (Usual disclaimer about not wanting a medal, just a statement of fact, for me, drugs make birthing a more difficult, more unpleasant experience)

It would be nice if there was a way to get a balanced view, but all too often hospital MW are very protocol bound, and NCT teachers are a little rose-tinted (I believe a lot of what they teach is great for homebirthers, but hospital changes birth for a lot of women.)

If I were ever to have another (god forbid) it would be either drug free home birth or ELCS. There is no way on this earth I would be persuaded to have a vaginal delivery in a hospital setting.

Regarding the wearing off of the epidural for 2nd stage at a practical level is it not easier to push if you can respond to your body's signals and move off your back? Presuming there are no issues with awkward position of course.

I've never been able to get my head around the logic of paralysing the part of the body that you need to use most.

my friends had a mad NCT teacher who told them natural birth was better by using the following analogy:

'imagine you were a gold miner. you could spend weeks mining for a lump of gold, or someone just hands you a lump of gold. which makes you feel like you've earned it more? it's the one you've worked for, isn't it? if someone just handed you a lump of gold, it wouldn't be an achievement!'

sadly for her, an economist in the class pointed out that you actually end up wealthier if handed a lump of gold, as you don't have to pay for hours of work put into mining it.

our NCT teacher was brilliant, very sensible, discussed all pain relief options and possible interventions. can't fault her.

anyway, I don't think YABU but I would challenge it at the time if I were you.

gruffalosbitch I have a close friend who is an NCT teacher. One of the classes includes a C-section role play, so that the parents have a good idea of who would be present in the room and why.

Maybe she's unusual and the only one in the country that does so, but I wouldn't have thought so.

crunchy I haven't done NCT but a friend who did told me about that role play, so unless my friend had your friend maybe it isn't that unusual.

Dara obrian was talking about the fact the nct teacher said a tear heals better than a cut which is shite. A tear can be better for other reasons but that point was bollocks. I went to one nct class and the demanded a refund

My NCT teacher was fantastic - lessons were really good fun and informative and she was completely non-judgemental.

If you're unhappy about the information in the classes, then write to the NCT nationally. They like having feedback on teachers, and are very keen that they're teachers aren't giving out misleading information.

Having said that, I agree with Shagmund that a) it's quite common to be refused an epidural after 8cm and b) it's quite common for epidurals to be allowed to wear off for second stage.

I find the NCT ranting on MN weird. My course was great, the people were great, the teacher backed up every thing she said with the statistics for us to look through and make our own mind up. She also talked through the differences between what should be and what might actually turn up. We were all very supportive of each other after the deal was done and the teacher came around and talked through my horrible birth with me which was extremely valuable to me at the time.....

Aaargh. I can't believe I wrote "they're teachers".

You should challege the teacher (nicely) if you think she is incorrect. Ask which research her assertions are based on.

It is true that NICE guidelines state that you should be able to have an epidural at any stage of labour...but in NICE guidelines do not mean it will actually happen. There are lots of elements of the guidelines which do not seem to happen in reality.

Most women/couples come to NCT classes with the idea that that they would like a normal straightforward birth in an ideal world. The teacher can teach all about how to maximise the chances of this (and sometimes be accused of raising unrealistic hopes and inducing guilt when intervention happens or being all 'woo') or they can teach about all the interventions (and he accused of making clients worry and feel negative). It is a really hard balancing act.

In reality out of a class of 8 couples often only 2 have a completely straightforward birth. Most often because of things like induction leading to cascade of intervention and epidural leading to not being mobile and/or upright in labour.

When I see this over and over, being accused of being 'woo' is not really an insult!

I agree with everyone above. If you think she is wrong about something ask for clarification. They are classes not political rallies, you as the student are allowed to ask questions and to disagree. My uni students disagree with me all the time but then I am quite often wrong! A good teacher won't be undermined by this and if she does feel undermined maybe she shouldn't be teaching.

FWIW my NCT classes seemed mostly accurate and sensible. They didn't remotely prepare me for birth or parenthood but I think only being beaten over the head at unpredictable hours of the day or night with a sledgehammer would have come close and I wouldn't pay £140 for that.

I had a great NCT teacher too and we did the c-section role play.

And agree epidurals are given post 8cms but surely its harder to sit still when contractions are so close together and if the delivery suites is busy well its cutting it fine.

"nct teacher said a tear heals better than a cut which is shite" "A tear can be better for other reasons but that point was bollocks"

It's not bollocks. Women are less likely to report pain, especially during intercourse, following a tear than following an episiotomy of the same magnitude.

And if it is 'bollocks' then NHS midwives are getting it wrong too, because they give the same information.

I'd say that Dara O'Brien's wife was more likely to be wrong than the massed ranks of the NCT and the RCM.

But then she's primarily a surgeon and cutting holes is women to get babies out is her bread and butter, so you can understand her prejudice.

By the way, I don't know if an episiotomy or tear is worse, but this is what babycenter.com says:

"Research has shown that women with a spontaneous tear generally recover in the same or less time and often with fewer complications than those who had an episiotomy.
Women who have an episiotomy tend to lose more blood at the time of delivery, have more pain during recovery, and have to wait longer before they have sex without discomfort. An episiotomy also increases the risk of infection, and a recent study showed that getting an episiotomy for a first vaginal birth is linked to an increased risk of tearing in the next birth.
What's more, women who get an episiotomy are more likely to end up with a serious tear through the anal sphincter or even all the way through the rectum (known as a third- or fourth-degree laceration, respectively) than those who deliver without being cut.
These serious tears result in more perineal pain after the birth, require a significantly longer recovery period, and are more likely to interfere with the strength of the pelvic floor muscles. Tears that disrupt the anal sphincter make it more likely that the mom will have anal incontinence ? trouble controlling bowel movements or gas."

So, whether true or not, it's not just something the NCT made up.

"I find the NCT ranting on MN weird"

There are some NCT teachers whose approach to birth is very ideologically driven.

The problem is that on mumsnet the views of the loopy few are taken to be representative of the whole organisation and all its practice.

This also happens with midwives.

It's used as a way in to slagging off the whole normal birth agenda.

Childbirth classes make me think of a French and Saunders sketch, knitted wombs and undressed dollies

My NCT class was great - there was in the main good evidence based stuff, but also with a decent nod to actually questioning the medics and thinking outside of the box (see what I did there ) and "informed consent" etc etc.

In terms of the friendship thing - that is primarily why I did the class - and I'm so glad I did, we are still very close, our children are very close, we have a dinner party circle and go on holiday together etc etc. That may sound like middle-class hell to some but really its just what I needed to make the transition from professional person who commuted home to house to sleep there and person who was home indefinitely who knew sod all people locally and knew nothing about babies

Long live the NCT, without them women may still be giving birth with the legs in stirups and pushing their babies uphill...

I have a knitted uterus. Who doesn't? It's very useful.

Obstetricians do seem to have a funny view of the NCT. I had an epidural and my baby was delivered by an obstetrician who knew I'd been to NCT classes. When she said it was time to push, I said, "But how can I push? I've had an epidural" and she replied, "Oh, that's the NCT again. They will go round telling mothers that they can't push if they've had an epidural." But that wasn't what I meant. What I meant was, "How on earth can I push when I can't feel a thing from my waist downwards?"

TittyWhistles we didn't have knitted wombs but we had dollies and knitted breasts

I was going to nick one for my collection of weird stuff but thought it was rather not in the spirit of things so didn't.