I fully support the NCT and their aims, but I do sometimes wonder whether at least some of the teachers (recognising that this is just the experience of my group of friends/relatives) want so much to "discuss straightforward birth as the default situation" that it doesn't always prepare women for the realities of birth in a hospital.
I recognise that homebirths are the best way to avoid interventions but many first time mums, myself included, were not confident to go with that. In any event, by the time you get to NCT classes it is often too late to change (even leaving aside availability with staffing shortages in some areas).
So that leaves a hospital birth. Whilst my NCT class warned me for the fact that first labours could be long, and whilst I thought my teacher was great, I think she was perhaps so keen not to scare us and to keep us feeling positive that she undersold how likely a long first stage was and the pressure that would be placed on your in hospital. For two of us in our five person group, that was the reality. We both ended up with a number of interventions. The 'natural' births were the ones which went quickly and so there was no external pressure to 'manage' the birth process (and mothers with a bit more energy!).
In hospital, there is often a lot of pressure to keep things progressing and I think it's very hard for a first time mum, even if she has learned all about the 'cascade of intervention' to deal with pressure to take interventions like having your waters broken and syntocin. I remember lots of "well, if X hasn't happened in two hours, we'll need to Y". You simply don't have the personal experience to judge whether your situation is one where you could safely say no and push (no pun intended) onwards, or whether you really are one of those situations where things like this are needed. Particularly given that many women will have missed (in full or in part) at least one night's sleep by that point.
I am not sure that there is an easy solution to this, except perhaps greater use of doulas where it is financially viable. However, I do think that perhaps there is a case for the NCT pushing mothers harder to consider the 'long and slow' scenario so that, if it happens, you are more prepared about how you're going to deal with it. I would also have welcomed my class being a bit more upfront about the 'stopwatch culture' of many maternity wards, which I was led to believe (both by NCT and NHS classes) had pretty much died out.
For my next one, I will think long and hard about a homebirth. If I do go for a hospital birth, I feel I will be far more prepared for how to deal with it and hope to avoid more intervention. However, I feel that most of that will come down to having 'been there, done that', and I don't know how the NCT could supply that.
Hmmm, didn't really give any answers there did I?