for thinking NCT Classes are far too labour focused...

[AliGrylls]

During the NCT classes I attended 4 out of the 6 sessions (12 hours in total) were spent on labour. We spent 3 hours talking about post natal care and 2 hours on breast feeding.

At the time I thought it was good to be prepared for labour and I had planned to have a water birth and assumed it would all go according to my plan. The thought of it made me really excited.

However, things did not go according to plan. I needed to be induced and ended up having a general anaesthetic c-section. After the c-section his father had skin-to-skin contact immediately and when I woke up I fed my baby.

The outcome was ultimately what I wanted. A lovely healthy boy. All those hours that I spent obsessing about the labour made me forget the most important thing - the fact that method of delivery is the least important thing in the process and it is the part of childbirth most of us have the least control over.

In reality the problems and minor worries we have had have been about practical things such as putting on baby grows, nappy changes and how often, how deeply our baby should be asleep. Breast feeding is generally going very well but it is a hard slog and I have so many questions and minor problems that I feel I would have benefitted from more focus on this.

In conclusion, a short period of time spent on the basic facts concerning child birth and the decisions I may need to take during labour and a far longer time on baby care would have been much more useful.

Alygrylls - I've just looked at your OP again and wanted to ask, why did you 'assume' your labour would go ahead exactly as you'd planned it? I knew when I had my first that a fairly sizeable proportion of births are by c-section and forceps/ventouse. Did your teacher not give you any information about induction either - about what it involves and the higher likelyhood of having other interventions when you're induced?

also just another small point...around where we live there are few choices, it is the NCT course or a single session at the hospital that lasts for 4-5 hours. I don't think the single long session is the best model of education at all and it gives very little scope for building up rapport with other expectant parents, so that is pretty much why we have gone with the NCT. If the hospital/community midwifery team held classes over several sessions I would probably have just gone to those instead.

I am an NCT Antenatal teacher. I teach short intensive courses and longer 8 or 9 session courses. This is what I try to cover; pregnancy problems, pelvic floors, optimal foetal position, breech babies, twin babies, perinneal massage, the stages of labour in depth, hormones, breathing, positions, what to do for a fast labour, self help pain relief, medical pain relief, forceps and ventouse, Induction, caesarean, Hospital bags, birth plans, the journey to hospital, home v hospital, homebirth, waterbirth, role of a birth partner, dealing with caregivers, how to make decisions about your or your partners care, newborn tests, newborn appearances, vitamin K, nappy changing, types of nappy pro's and cons, types of poo & what they mean, newborn health, newborn danger signs, infant jaundice, baby equipment (safety standards & what is essential to have, how & where your baby should sleep, blankets, baby sleeping bags, co-sleeping, baby temperature, baby bathing, topping & tailing, why babies cry& what you can (try to) do about it, 24 hours with a baby, baby routines, immunisations, postnatal recovery, postnatal bleeding, when the midwife stops calling, health visitors - who are they?, Postnatal depression (for Mums and Dads). Oh yes, and breastfeeding (how, why, it's hard, it can hurt, where to get help, signs of a problem, how to tackle said problem, where to find out how to mix a formula bottle, demand feeding, what will you wear? where will you do it? who will be around you, will other people's attitudes affect you? how/when to express, nipple cream, breast pads, and nipple shells & nipple shields.

I love my job, I never forget that it's a privilege to be with couples at this most special time in their lives, but our job is to get all the above information across. It's not to teach you about all the many situations you may encounter in the first 3 months. It's an 'antenatal course', labour, birth and the early days with a baby. That's as much as we can do. you don't expect the midwife to guide you through the first 3 months, so why expect it of your antenatal teacher?

There are NCT postnatal classes in some area's, they do the job you're talking about, but please, us antenatal teachers, we're doing our best for you, cut us a little slack here . . .

And there is no such thing as an NCT type either, anyone who's interested to meet people doing the same things they are and learn a little about the above list of subjects on the way is welcome.

Stigaloid - if NCT classes covered (in any useful detail) all the possible difficulties connected with birth, including sick babies, c-sections, strep-b, induction, breastfeeding difficulties, postnatal infections, postnatal depression, and stillbirth, plus covered birth skills, normal labour, pain relief, baby care etc etc, you'd need a 9 month long course!

Our teacher was quite frank about how painful labour can be, but I blocked the thought out of my head and was very shocked by the pain when it happened.

I honestly think that if antenatal classes focused on all the things that can go wrong, and how bloody appalling labour is you'd end up with a bunch of traumatised women utterly terrified about going into labour.

I'm glad I never realised how bloody awful labour could be until it was too late to do anything about it!

By the way - don't think it's fair to blame the NCT for not telling you about Strep B - that was your midwife's job. It was also her job to make sure you got appropriate pain relief in labour.

I think this is probably why the NCT gets such a bad press. In the "olden" days people made a conscious decision to go tot ehir NHS classes of to go for the NCT course which was much more focusd on achieving a "natural birth". The couples who went HAD signed up to the ethos.
Now people go because there is no other choice, but many of their teachers chose to work for the NCT because they agreed with its agenda. They teach what they have always taught but the clientele has chnaged a great deal.
I teach my first set of classes next week. I hope to be balanced but will talk to my clients about how it is advisable, if medically possible, to avoide caesareans, induction and epidurals. I also do plenty of stuff on the early postnatal period as I myself found this a massive shock. I hope to get empower people to be able to make the decisions that they face in labour with all the information to hand.
But my point stands, the NCT does have an agenda (even as a charity) and is not a charity that provides what the NHS should be providing. My analogy would be that people don't sign up for hypnobirthing courses unless they have researched it first; why do they assume that the NCT will cover all aspects of hospital intervention?

Apologies for the many typos!

I don't blame the NCT about the strep information as i agree the mid-wife should have let me know about what Strep was and what could happen if you have a strep baby. I do however feel that i was under-prepared in birth and felt that i was not told the truth about it. As a result my first birth has left me a "traumatised women utterly terrified about going into labour." I am pregnant now and i lie awake at night utterly terrified about going through labour again.

I remember clearly thinking during birth last time "i'm really angry at someone - i have no idea who, but someone hasn't been honest with me here and whoever they are - i am angry with them" When i mentioned this to my mother she just said "but dear if women knew the turth about birth they wouldn't do it". Fair point i guess.

I have to say that i paid a not inconsiderable sum to the NCT for my classes, I feel they could have been more thorough, but I also agree that there is a lot to cover in a class and more than one family attending so a lot of questions and subjects. You can't expect miracles or please everyone.

I do think however that they should be happy to underline the pros of epidurals as much as they do about home births.

Just my experience and opinion.

"But my point stands, the NCT does have an agenda"

I'm an NCT teacher. My understanding of the NCT 'agenda' is that it's about supporting parents to make informed choices about labour and birth, and about helping to increase women's chances of having a normal birth. There is no other agenda as far as I know.

Our aims are no different from the aims of the Royal College of Midwives. The charity supports the view that with better maternity care more women would be able to have normal, healthy births.

And our clients haven't changed. What has changed is the rate of normal birth, which has plummeted over the past two decades. That's not the NCT's fault.

And most NCT courses do cover hospital interventions, as this is what women ask us to include on the course.

Clemette - are you a midwife?

No, a trainee NCT teacher!
As you know though, there are teachers in the NCT who don't teach what you do (and I hope to). The research shows that the clientele has changed over the decades and that people who attended classes in the 1980s for example, did so understanding that the NCT would talk about "normal birth". The recent press reports and complaints on MN suggest that some women interpret this as judging those who don't achieve one. I hope that my clients don't feel like this at the end of my classes, but as there are such variations amongst NCT teachers the clients are going to have such different experiences.

Before I had my first child, what I wanted to know about was pain relief and how I would know I was in labour. And the pros and cons of feeding methods.

By the time DD1 was a few days old I was wondering:
Why the didn't anyone tell me anything about how babies sleep? (or in her case, don't sleep). Or how much noise they make? Or wind? Everyone in the hospital kept banging on about wind - which according to my NCT teacher, breast-fed babies don't suffer from. Ha bloomin' ha.

Or maybe they did try and tell me and I wasn't listening. But I really, honestly didn't have any clue about the whole feeding/burping/sleeping/nappy changing thing.

They did tell me how to bath her, though.

Stigaloid although I agree we need to discuss the pros and cons of different forms of pain relief, it is not likely that a charity dedicated to normalising birth would promote epidurals.

In our class we each picked an approach to pain relief to research and report back on - so it certainly wasn't the teacher pushing her own point of view. At least one member of the group was disappointed after the birth that there wasn't time for the epidural she had planned; I think we were left with a realistic idea of what to expect and able to make choices accordingly.

I found all the 'here are all the tubes stuff' really useful, especially the caesarean enactment; I can imagine that if I had needed a caesarean and hadn't expected there to be so many people present I would have found it incredibly daunting. So I guess it depends on the classes you attend and the particular teacher's approach as much as the NCT itself. We did do some sessions on babycare, but I didn't really take a huge amount of that in and agree that a doll and a baby are so different there's only so much you can learn that way.

Hmmm - i don't think there is such a thing as a 'normal' birth. As long as the baby is born healthy and the mother survives, then that should be as normal as you want to get, no matter how the baby gets here. I think as it is a paid service it should cover all aspects of birth from pain relief (without making epidurals sound frightening) to hypnobirthing, water births etc etc. Also - what to do with a baby once it first gets here (i.e. how to put a babygro on).

I think they're very focussed on as little intervention as possible and (in my case) the teacher seemed to have a deep hatred of doctors (she said something along the lines of 'they're always poking their heads into the room to see if they can intervene and wheel you down for a c-section'

The classes were very good, and did teach how to avoid unnecessary intervention, but the message came across loud and clear that intervention = bad, which isn't always the case.

YANBU

We specifically requested babycare and 'life with baby' info, but what we actually did in the course was useless afterwards. This was our main objective in attending the courses and we were very clear about that! We both felt v let down.

We were totally subscribed to a natural birth philosophy and the classes lulled us into a false sense of security that this was actually achievable in our local hospital. None of us got it , at least not first time round. Second time round several of us took alternative classes and without the NCT we managed 3 home waterbirths and one natural drug-free hospital birth . The things we practised for labour didn't prepare us for the reality of a dad trying to advocate for a scared labouring woman and in a position to have no clue as to whether what he is being told is accurate and evidence-based or not, especially when he's never been to a birth before and is v worried about his partner. Arguing with medical professionals under those circumstances is almost impossible. Kneeling and leaning backwards for 60 seconds is not like having a contraction, yet this is what we were told! In the water birth video we were shown, retrospectively it's obvious the woman was using hypnosis techniques. We all wanted her birth, but we weren't being taught those techniques.

The breastfeeding class was not in depth enough and left us with the impression that babies feed 8 times per 24hrs, i.e. every 3hrs. No-one covered signs that a baby was feeding well, so when ours did not, we didn't recognise it. In other classes the teacher also mentioned her personal experiences of bf and mixed feeding, which did influence some of the class, even though she wasn't (to my knowledge) trained in bf.

If I had my time over, the only reason for paying for them was to get a group of friends due around the same time, which was great .

Stigaloid although I understand what you mean about a healthy mum and baby being the objective, it still stands that that is not ALL the NCT is about.

One thing that strikes me in how little input people are getting about feeding for example, is that there are real shortages in the provision of community midwives and health vistors. After my first birth it was these women we went to for help with baby health care/feeding.

NCT does stand for National childBIRTH trust, you know!

Clemette - agree. My experience has left me a little dour but i am also very appreciative of it's existence and the friends i made through it. I wish you all the best with your training and being a teacher and understand you have an ethos that you believe in with teaching through them, but i hope if you find inexperienced women like me coming to the class unware of the ethos that you let them know that accepting pain relief isn't wrong/bad and that sometimes intervention whilst not always desirable, isn't always wrong either.

I completely agree that NCT classes are far too labour-focused. I too was hoping for a water birth and for it to be as natural as possible following the classes, but I ended up having an emergency Caesarean after 24 hours of labour. Following the classes I felt almost guilty asking for an epidural during my labour. I had horrendous problems with breastfeeding from start to finish, and looking back there was only one class on this where the lady showed us a 2 minute video. I don't regret going to the classes because I've made some good friends through it but I do think the topics need to be far more varied.

Thanks Stigaloid. Although I am trained not to talk about my own experiences in class, it would be hypocritical for me to condemn pain relief even if I was of that ilk because I very much enjoyed my pethidine first time around

In our class we had one woman who knew from the outset she would have a caesarean for medical reasons, but she still gained from the class. We covered general topics of relaxation/warning signs etc re late stages of pregnacy as well as the obvious labour and birth. As someone said earlier, the usual practice is for teachers to ask in the first session what topics people want to cover, and she will tailor the class accordingly. The NCT promotes childbirth as a natural experience, but accepts that everyone's perception of pain is different, and all the options are discussd, together with the relative pros and cons. We also had some baby-dressing practice with dolls (including a nasty marmite surprise in the nappy for the dads who were practising!), a session led by a breastfeeding counsellor, and a visit from a new mum who told us what life was like for them with a newborn.

Stigaloid, I'm sorry that you felt "duped" by the experience, certainly in the 2 areas I have lived in I have gone to NCT classes (twice as I had an emergency section first time and needed a refresher) and to NCT coffee groups, and have come across a broad range of people who have had no pain relief, epidurals, c-sections, water-births & home births, also those who have breast fed and bottle fed.

After my first baby, I'm really happy with my NCT classes. Partly the teacher was great, but it really helped that all 6 women in the class wanted roughly the same thing - all planning a hospital birth, bit scared of interventions, worried about pain, planning to try bf but no role models, natural good but modern science damn useful.

I know other people who've been in a class with a couple die-hard hippies totally anti medical intervention, and a couple others who plan to demand an epidural at the first contraction and hope for a C-section - there's no way any teacher could tailor a class perfectly for that as both extremes would complain the teacher 'kept going on' about breathing/pain relief.

In our 12 hours we had about 2 on bf, 2 on pain relief, 1 on c-sections and 2 on post-birth, inclduing the marmite nappy demo and a 20-min crying tape, and making a plan for the first 12 weeks (apparently the men always cite money as a worry; women never do)

Given that there were no NHS classes at all available, I found it invaluable.

I didn't do NCT exactly because of the reasons above. I did ante natal at hospital through Early Start. The person giving the course was a fully qualified midwife. We covered a lot of health related issues post birth - such as what to do if your child vomits, or has a fever. There was a bit of first aid, some info about what clothes to buy for them, we even had a Speech Therapist who came over to tell us how important it was to talk to newborn, sing, communicate, etc. We had training on how to buy and fit a car seat. It was great.

Well our NCT classes were brilliant. We had 4 evening sessions, 2 half day sessions and 2 evening sessions on breastfeeding, which were separate and run by a bf counsellor.

First we went round and our teacher split us up into men and women, to get us chatting to people we didn't know - she sent the men off with a big sheet of paper to see what they wanted to learn about and the same for us, and we covered the mechanics of childbirth, most interventions/pain relief (pros AND cons) including caesarean, and 2 of our group ended up with a caesarean and said that it had really helped. We also covered the postnatal period and didn't have much on babycare, but she did say that that was because most of it was common sense, we wouldn't remember much of it anyway and reminded us we could call the midwives at the hospital for the first few days for advice at any time. We did cover crying (using the "5 Ss" - swaddle, sway, side, ...something, suckle) and practised nappy changing and swaddling on a doll, she also went through the cot death recommendations (ie feet to foot and tucking in blankets tightly)

I haven't had time to read all the posts so apologies if I am repeating...

I completely agree - the NCT classes, and indeed pregnancy, is so focussed on labour and giving birth that no one really prepares you for actually having a little person to feed and care for. I was completely unprepared for being a mum and I wish our NCT classes had more content about being a parent and its challenges rather than the birth which is such a small part of it all.