to by annoyed at this NCT antenatal group

[birthstoryvisit]

Ok, I know I'm being unreasonable, that's why I've name changed, but I need to get this off my chest.

My DS is three months' old. Yesterday, I went back to my old NCT teacher's class to give my birth story (long, epidural, ventouse, lots of stiches). A friend with a wonderful birth (waterbirth, soft lights) went too.

They were horrid to me. Did not ask me one question about my labour (I thought that they'd want to know what some of the interventions were really like). Their basic attitude was "You failed to have a natural labour. I do not need to talk to you because my labour will not be like that. I am coming to classes and will have a lovely, natural birth with maybe a bit of gas and air. You are a failure." They spent their whole time asking my friend about her ante natal yoga and whether it was the raspberry leaf tea that ensured the quick labour.

This isn't just me. The first thing my friend said when we left was "goodness, they were a bit judgy weren't they?". I get it, they're first time mums and in denial, but am I being unreasonable to hope that at least one of them has a long labour and needs an epidural?(I know I am really ). I gave up part of my weekend to try and be helpful. Grrr, won't be doing that again.

alysonpeaches, you said, "I should have been suspicious about the NCT classes as they were just in one certain area of town, where all the judgemental people live!!!"

I suppose this is a joke, because of the !!!. I suppose you are laughing at yourself being judgmental about an area of town, assuming people who share the same postcode also share the same judgmental attitudes towards labour and birth.

I fail to see the relevance, though, as this is about an experience that took place over 20 years ago.

But whatever....NCT classes then and now are not usually 'neighbourhood' classes in that the attenders don't usually live in the same part of town as the classes are held in.

upsylazy - your 'exams' and your 'grades' are in your head, they really are. NCT does not promote 'natural' birth or expect everyone to have one. NCT supports normal birth - while understanding and accepting that this is neither appropriate nor desirable in all circumstances - because it gives quicker recovery, is generally safer for mother and baby, and because this is what most women want.

Appropriate use of technology and intervention in birth is fine. Inappropriate or forced or unnecessary is not fine - this does not mean the women who have technology or intervention (whether appropriate or not) are inferior or should feel judged.

I don't think that things were any better 20 years ago and certainly my sister read lots and had opinions on how she would like things to be (my nephews are about this age). Certainly Sheila Kitzinger (one of the doyens of natural childbirth) had started writing and having an influence back then, and the movement has it's roots in the '40s.
Actually I don't think that many mothers were that different even 40 years ago, listening to my mother's stories. Most mothers to be would rather have a positive birth experience than a horrible one (obviously), and in general understanding what is going on and being allowed to have an opinion and some choice makes a big difference to most people. My mother had my big sister in a big London teaching hospital and it sounded terrible. She was on her own for hours (no partners allowed then) apart from the consultant walking in with a bunch of students every now and then and telling her she wasn't trying hard enough. She had my middle brother and sister at home after that (independent midwife) and then me at a maternity centre. Even many many years later it's easy to tell that her first birth experience was pretty awful, whilst the second two were very positive.

That over time you will forget your bad experience is true, but why should it have to be bad if it could be better? I think that the NCT still has a lot of campaigning to do, especially to make sure that we don't slip down the same path as the States where I recently read about a woman who wanted to have a second VBAC and was told not only that that wasn't possible, but that the hospital planned to get a court order to make sure she had a c-section.

"Someone has to stand up against the explosion of medicalised births" er why?? I had two elective caesarians and am entirely happy that I did. I have two friends who had to have operations to deal with urinary incontinence following 'normal' births, and my GP in London told me that she saw many women with such problems, as well as other issues 'down there'. These on-going traumas and the medical treatment surrounding them should be added to the 'cost' of 'normal' childbirth. And then there are the women who suffer in silence. My complaint with the NCT is that, in backing calls for a reduction in caesarians, it is actively campaigning against the wishes of women like me. By all means be a lobby group with an issue to promote, but please don't argue that you are acting for the majority of women.

"Someone has to stand up against the explosion of medicalised births" er why??"

Because when women are having c-sections which are medically unnecessary then the end result is an increase in avoidable death and serious injury to mothers.

It's also the case that there are women in this country having emergency c-sections every day which could be avoided by providing better care in labour. Surely you can see that it makes sense to lobby for one to one care for women to bring the emergency c-section rate down? Or do you think it's ok that women have their labours mismanaged and then end up needing surgery to have their babies?

And by the way, it's not just the NCT who is raising the alarm about this high rate of operative birth. It's also the World Health Organisation, the Royal College of Obstetrcians and Gynaecologists and the Royal College of Midwives as well. They're all working together to find ways to reduce the rate of c-section from its current 25% of births in the UK.

Bellisima, would want to add that a lot of the perineal trauma and urinary incontinence suffered by women following vaginal birth could be avoided with better care in labour.

Would also want to say that it's important to balance out the risk of perineal trauma associated with vaginal birth, with the increased risk of bladder injury during surgery, hysterectomy, slightly increased rates of stillbirth in subsequent pregnancies, placental problems in later pregnancies etc etc associated with c-section:
rcog

How very annoying for you

if it helps, I avoided nct classes for this very reason. My classes were run by my GP practice. On the other hand, the midwife who ran our group said that she had never had a group who had had so many difficult births

Of the 9 of us we had

2 emergency cesarians (1 was done 6 weeks early as the baby was premature, 1 after a traumatic 36 hr labour where the baby got stuck at the end)

1 birth had the mother lose so much blood that she collapsed and had to have an emergency transfusion

3 very long drawn out one with epidurals and forceps used

Mine was quite quick but I ended up in surgery as I tore so badly and ds was born blue and ended up in the care of ICU for 5 days

The other two were no picnic either. The again I suppose if they had been told about raspberry tea things might have gone better for all of us

This is my first ever post! (Have read a lot).

In my experience the NCT brushed over epidural as less than ideal, which maybe it is, and merely gave pros and cons (weighting the cons, fair enough). But in fact, I think a lot more help and guidance could be given as to making them work actively.

There are epidurals and epidurals. I had my last (third) baby with a mobile epidural, sitting on a ball throughout. Exactly as I would have done in a 'natural' birth but cheerful and relaxed. With all three births I have felt the epidural was a help at the end as I wasn't panicked, could listen to the midwife and slow down and avoid bad tears.

I know cascades of interventions can happen but they don't have to necessarily and if people are equipped with knowledge/feel positive about it maybe they can help to minimise that happening by keeping active and the dosage low.

Whereas if the perception is 'epidural means you've failed' then you are more likely to flop back on the bed in guilty misery and give up.

Personally I felt having pain relief early helped me conserve my energy for pushing at the end. Maybe it HELPED me avoid intervention?!

Planning fourth epidural (pregnant with no. 4). Not at all abashed. Would even say that to an NCT class.

Bellissima - it's important I think to make a distinction between an elective ceasarian and a crash section. The two experiences are vastly different. it is acknowledged that a planned section carries fewer risks than an emergency one.
However, not all women WANT to have a ceasarian - so in this case, why should a woman have a section when she doesn't want and doesn't NEED one? Yes, emergency sections are sometimes necessary, but other times women are harried along and railroaded into a section that isn't necessary. There SHOULD be campaigning against this, because this kind of practice is not in the best interest of mother or baby. It is often about convenience for the medical staff involved. I read a birth story of a woman in scotland who was made to have a ceasarian because she was 'taking too long' she'd been in labour 14 hours!

Sabire - thanks to you and Violethill for constantly feeling the need to jump in to contradict many of the posters on here. You argue that you fundamentally support choice for women in labour. Well you are clearly not supporting my choice - presumably because you think that you 'know better'. Better than not only me but the significant proportion of female ob-gynaes who choose to have elective caesarians? Better than the female GP who told me that 'put it this way - it's the only way I'd have one'? Yes of course many midwives oppose caesarians - they feel that it reduces their own power and control of the labour ward (their representatives also have charming things to say about pain control and modern women needing to feel pain if I recall fairly recent statements). As I said before, you are absolutely entitled to your views but please don't lecture me - I'm reasonably intelligent and I did the research thank you. I would never criticise your chosen method of giving birth, and I really wonder why you are so obsessive about lecturing me and others on here. But whatever your need to hector others derives from, above all, don't claim that you are acting for me or women in general when you do your lobbying.

Adult learning - always tricky especially when trying to cover all angles for each individual!

Having observed NCT and NHS antenatal classes can I just point out that often individuals come with their own agenda and opinions and this has to be balanced within a group - individuals are not always respectful to one another if it means they have to be present when things that don't interest them (or even go against everything they believe) are discussed within the group they are attending.

Sometimes we have to accept that one mum may not want to hear about the risks associated with epidurals because she is fearful about pain/labour/birth etc whereas another mother wants all the risks to be known to make her preference for not having an epidural confirmed in her own mind. That is the balancing act that a lot of antenatal teachers have to cope with and sometimes depending on the individuals coming to the group that can be an extremely difficult thing to balance!

In the case of the OP I think she has been able to reflect back and consider the reasons as to why the parents-to-be acted in the way that they did without it being from a judgemental/dismissive POV. Only the NCT teacher may have some insight as to why they behaved as they did and then the needs of the whole group have to be juggled - sometimes doing this in front of whole group may be the best way to go, sometimes not.

This group may have even given feedback at the end of a course that they did not want to hear about a birth with lots of intervention for whatever reason, although as it has been pointed out, they may be more than grateful at a later date.

A lot of mums attend NCT groups because they would like a straightforward birth - because of the positive outcomes provided in evidence-based research.

Who then suggests there is a hierachy of birth? Who judges and feels guilty for not matching expectations? Clearly not the NCT - in all its policies and literature - it is all for supporting women in their choices - if it has an agenda it is in response to those parents who want something done about not having the choice of a home birth,a rushed unsupported labour or unnecessary intervention or did not have the ideal birth experience whether that was by elective section, c-section,straightforward birth etc.

And to those who want to dismiss labour and birth as a means to an end - ie a healthy baby then why the need for such excellent sites as those supporting women in PTSD and traumatic births.To some women it does matter.

Preparation for birth clearly requires an open mind but if the adults who attend classes do not want to consider other options, different points of view or stick there fingers in their ears when something they don't want to know about is discussed then they are entitled to feel this way but have to recognise that not everyone shares it. If you attend a class and say want an elective section having already taken the trouble to read up and obtained advice about it then fine - but other parents may want to discuss risks associated with a section - are you going to feel judged because they simply want more information?

And if parents to be feel the teacher is blinkered then they should challenge such views - after all in the case of the NCT classes they are paying to be there - at the very least they should provide feedback about anything they are unhappy about within the course.

Having taught children,young adults and adults the most difficult group is always IMO adults because they are always less open minded and less likely to raise a criticism to your face - but then I always like a challenge!!

Bell - although I fear you may flame me too - a lot of female ob-gynaes who would choose to have an elective section have also admitted that this may in part be down to their observed experiences - after all they don't witness that many straight forward births.

Very good post, LindenAvery.

Bellisima - the choice to have an elective section for non-medical reasons is controversial. There is no simple answer.

On the whole, women don't want to have sections.

On the whole, women want choices and to be listened to and respected, and to be supported to have the type of birth they prefer...yes, this does raise issues if the 'type of birth they prefer' is a section.

Because for most people, a section (including an elective) has downsides for mother and baby. These downsides need to be known and accepted by the mother - this is treating her as a grown up and ensuring she has all the information she needs. There is also a resources issue. Elective sections demand more in terms of staffing, accommodation, expertise and aftercare. So as a society, we need to assess whether they are 'value for money'.

It may be decided that in individual cases a mother's preference for a section can be accepted - maybe she has deep-seated psychological issues that over-ride anything else. On the other hand, if she is afraid of pain, then perhaps she can be assured that there will be an epidural service at whatever time she goes into labour, or given other pain relief to consider. So the mother wanting an elective section with no obvious medical issues needs to be listened to, as well.

In some respects, this is a side issue. Good care for all women will mean the ones who really want a section for non-medical issues can be accommodated, just as the women who really want a home birth can be accommodated, and everyone can be sure of having good midwifery care.

I think your stance - the one that gets all offended and aggreived because you think that campaigns to reduce the section rate is somehow judging you and getting at you, personally - is misplaced.

All professional groups agree the section rate is too high. I think it can easily be lowered by ensuring sections happen as a result of need, not of poor care. The very few women who really want a section could be designated as 'needing' one, too.

Fantastic post LindenAvery - thank you

Linden - not flaming you at all. As I said, I support any woman in her birth choices. But please don't oppose mine. As to the resources argument then fine - but don't then support home births, which divert two scarce midwives away from the maternity ward for hours (and in the case of two out of four women I know who went for this option, resulted in an ambulance rushing to hospital). Also, as I said, please include the cost of treatment for post-vaginal birth trauma and complications, as to the psychological misery this can cause. Yes of course greater support for labouring women would be a fantastic thing, but the idea that this will stop all tearing/incontinence/trauma is shown to be ridiculous simply by the tales of 'what happened to my friends in the ante-natal class' on this thread. Labour is not a highly controlled process by its very nature. Great things happen and bad things happen. I got exactly what it said on the tin - I'm happy (not flaming anyone), so be happy for me. I don't know anyone who has had an elective caesarian and regretted it. However I can virtually guarantee that if you walk into ante-natal class and recommend completely natural births at least one (in fact, statistically looking at this thread rather more than one) will have a truly horrible time and regret it. I'm sorry but that's the truth. So you recommend your favourite birthing method and I won't argue against it - but allow me to recommend mine.

"The again I suppose if they had been told about raspberry tea things might have gone better for all of us"

So I take it you've simply not seen the research on the improved outcomes for mums using raspberry leaf tea then?

Here it is:www.babycentre.co.uk/pregnancy/labourandbirth/planningyourbabysbirth/raspberryteaeaselabou rexpert/

I'd say that even if the research isn't conclusive, doing something that is a) cheap b) easy and c) may reduce the likely of a forceps birth by about a third and shorten your second stage must at least be worth a try!

"Well you are clearly not supporting my choice - presumably because you think that you 'know better'."

Only you can know the birth you want. However, in the NHS, when a particular operation or treatment (in this case caesarean section is proven a) more hazardous to health and b) many times more expensive than the alternative, then it's generally the rule that it's not made freely available. My view is that as long as the NHS remains under resourced to the point that mothers and babies are ending up quite ill from a lack of one to one midwifery care (which contributes to higher rates of emergency c-section), then it's inexcusable to be diverting resources into unnecessary surgery. On the other hand, if you were willing to fund surgery yourself........

Would want to add that I do think women should be offered the option of surgical birth if they have tokophobia.

"Better than not only me but the significant proportion of female ob-gynaes who choose to have elective caesarians? Better than the female GP who told me that 'put it this way - it's the only way I'd have one'?"

Well - ob/gynaes will only be seeing 'car crash' labours. of course that impacts on their feelings about their own births. They're only human! Midwives on the other hand overwhelmingly choose not to go the surgical route for their own births - actually a much higher percentage choose to give birth at home than among the general population. And yet overall they see more of a variety of labours than obstetricians - they are involved in both high risk, difficult births and straightforward labours. I suspect this means that they have a more balanced perception of the risks involved in normal birth than obstetricians.

PS - The notion that I am aggrieved by campaigns to reduce the section rate on the grounds that they are judging/getting at me is entirely misplaced. Firstly I couldn't care less what you think of me - as I said I'm happy. Secondly I have two lovely children and no plans for a third. Who you are getting at is the other women for whom you seek to deny this choice. Please don't pretend that you campaign for all women, that's all.

bellisima - home births are cheaper than hospital births, as a number of studies have shown, in the UK and other countries. Limiting or refusing home births on the grounds of costs is a non-starter.

Costs of vaginal birth do include the after-effects of perineal trauma.

Argue for the right to choose an elective section by all means, but don't bring health economics into it because it's clear you are under-informed in this area.

Home births tie up two midwives (well not literally!, but you know what I mean) for hours. The current overwhelming resource constraint in any maternity ward in this country is a lack of midwives. The fact that - (if you had the midwives available) - giving birth in your own bed and staying at home might be cheaper in pounds and pence than doing so in a hospital when all marginal costings are taken into account is irrelevant - you are depriving the ward, and other labouring women, of two 'units' of its most precious commodity. Should anything go wrong an ambulance rush to hospital is at least another £100 more - depending on time of day and overtime costings - than the cost of a private car or taxi run.

For what it's worth, I gave the NHS hospital in which I had my first child a generous donation. The second child was born overseas on gold-plated medical insurance, so you will be relieved to know, cost the NHS not a penny. But I do not believe that poorer women should be denied choice. In fact I think that's a highly dangerous path to go down. What next - why not discourage women from having more than one or two children? If you mean by 'funding' my caesarian then funding the NHS with your taxes (and believe me, I've paid plenty of those over the years) then why not offer only a very basic service to those who haven't funded the NHS? Is that how your health economics works?

But enough. To the original poster - we have at least brought the NCTers out in their true colours. Nope, they don't want you back in that class with any tales of difficult or traumatic natural births. And nor do they want me in there smiling and recommending my way.

Belissima, homebirth reduces the incidence of operative birth by about a half, compared to hospital birth, according to latest studies. An the cost of midwife hours is bugger all compared to the cost of providing a theatre staffed with medics plus high dependency care for the small number of mothers and babies who have serious complications following c-section.

And usually only one midwife attends a mum in labour - the second is called in when the birth is imminent and often she only stays for an hour or so. The first midwife is usually only in situ for a few hours too, because she only comes when the mother is fairly well entrenched in active labour. Prior to that she'll come and go, while she gets on with her other jobs as a community midwife.

Also, many women who transfer in to hospital do so by private care - your 'blue light' scenario is not the norm.

Seriously, as Tiktok says, it's pointless getting engaged in arguments like this when you are so poorly informed of the facts.

Sorry - that should read 'private car'!

This whole thread has really made me think. I was firmly in the epidural camp with DS. I beleived that denying me of my right to have one was inhumane. I had heard enough horror stories and had it in my head that birth was going to be a nightmare, take them drugs. And
the more pregnant I got, the more nervous I got. Then when the day came, I was on my back, induced, on a 2 drips, unable to move etc, so in the end I did have my longed for epidural. But of course I could not push, enter ventouse, then add in 6 weeks or pain from the stitches.

As time goes by, I am begrudgingly realise I DID have the cascade of interventions, and maybe second time around I would try and tough it out, and try and have a more natural birth. Time shall tell......

I think that we are very very very lucky to have the choices we have, so lets not forget that ladies.

bell - you have it wrong about the relative costs. What can I say? Do the reading about it. Plenty of studies, all saying the same thing. This is something that has to be organised - if there is literally no provision for home birth, if services are organised as if there is no need for home birth, then removing midwives from the hospital labour ward is not a good thing and may cause problems. In areas where it is organised, this does not happen. A conscious policy decision needs to be made to resource home birth properly (as in Torbay, for instance) and savings are made.

I don't know why you have adopted a sneering tone with me. I haven't said that people should somehow pay for having an elective section. I am talking about health policy and health economics, where difficult decisions about resources and choice have to be made...one good thing about supporting women's choice is that it is likely to be cheaper, so enabling better midwifery care for everyone,including people who need more midwifery care because they have had a section.

You can't have been reading the thread properly. Many posters have taken a sensitive view of what went on in the class described by the OP - she felt uncomfortable and that was not good. But this might have been because first time mothers of any hue, NCT or not, may feel uncomfortable about a birth story that was not fluffy and rosy.

I think it is sensible to be careful about bringing birth stories into a class - why would you not agree with this? It's a question of good manners and consideration for the feelings of others. I happen to think people should know about all the possible outcomes and to think in advance about what they might choose or negotiate, but a direct 'this happened to me' is not the only way to go about it.

No one wants anyone going into a class and 'recommending' something, anyway...that's not how a class works. 'This made me happy, so you should have it, too' - which is your approach.....NO!

It's also pointless getting engaged in arguments with the NCT obsessives. The facts are that I am very happy with my choice of birthing method and I know many women who had awful 'natural' births, a number (not a huge number, but a number) of whom still suffer from the after-effects. I don't seek to deny you your choice, please don't seek to deny others theirs.

No one wants to deny you your choice, bellissima. My goodness....it really isn't all about you, you know! I have no idea why you had an elective section - I'm assuming you and your doctors decided that this was the right choice for you and your baby, and hurrah for that.

I've been trying to broaden out the discussion, to get it further away from bellissima and her elective section, to speak about policy and resources and costs, but you keep bringing it back to you being happy and smiling and recommending (FGS) your choice to others. Bloody hell...how egocentric can you be?!

Of course 'natural' birth can be awful. Your sole answer to this is 'I recommend an elective section 'cos it made me happy'. Naive and blinkered.

NCT campaigns for birth to be properly supported with sufficient medical and midwifery care at a level which research shows is more satisfying for more mothers, safer for more mothers and babies, and, as it happens, cheaper. I cant see that this is remotely controversial, except to people who decide they want to 'recommend' their own personal choices to others.