What do parents want from classes?

[primrosepip]

Hi, I have been asked to look at designing evidence based antenatal/parentcraft classes for the local NHS Trust.
I would like to know what parents would like to see in these classes; normally there is the normal birth, when things don't go according to plan, and breastfeeding/taking your baby home.
I would be interested to hear from both Midwives and prospective parents (or prospective parents who are Midwives :)) plus what do dads want.
I am a Midwife, Psychologist and Mum so would like to involve all angles. Thank you for your interest.

I can tell you what I don't want and that's to see forceps! The midwife who ran the AN class I attended showed us them and scared the bejesus out of us! In the end I didn't need any intervention but the worry was something I could've done without.

all I remember from mine was dh coming out and the first thing he said was 'What's a cervix?'

Food for thought!

A much more realistic view of how hard breast feeding can be!!!
You are setting women up to fail by not highlighting possible problems - by showing lovely videos of settled and content breast feeding babies it just instil the idea that that is how perfect and natural it will be. Women need to know the reality of breast feeding so that when they come across difficulties they know that it's normal. I think the breast feeding sessions should have guest speakers, women who have gone through hard times with their breast feeding but made it through and came out the other side. Empowering and realistic information, not a portrayal of an idyllic and blissful experience....

or maybe those who didn't come out the other side because breastfeeding does not always work out.

Definitely!

There should be a session focusing on FEEDING - Breast feeding, Formula Feeding, Mixed Feeding. All of it. I did NCT Ante-Natal and all we got was Breastfeeding.... then I had my DS 4 weeks early with tongue tie and all went wrong with breastfeeding. Also needs to include something on how to spot feeding is not going well.

In terms of parentcraft I would have liked to have learnt:
Sleep Safety
How to bath a baby
Baby CPR
baby proofing a house

Breast Feeding/Formula Feeding:
I did NCT. The breast feeding info was great but the policy was not to explain anything about bottle feeding at all. I thought that was short sighted seeing as how dangerous wrongly made up bottles can be

No doubt there's some kind of red tape though that means formula feeding can't be discussed...

It should be though - there are so many posts on the parenting section about how to sterilise, what to sterilise, the preparation of bottles etc. women have to learn this from somewhere so why not antenatally?!

Women are meant to be shown how to safely prepare formula in a 1-1 demonstration postnatally if required.

There is research to show that the necessary information is not retained as well if given antenatally or in a group setting.

So less 'red tape' and more evidence based!

I think there is, writer. I asked about formula in my NCT class as we had already half made that decision, and the tutor took me aside and said she wasn't allowed to talk about it!

OP, I really appreciated a talk through of an emcs and the amount of people in the room, so I wasn't scared when it happened. Breathing and relaxation exercises were very useful too. I do think more talk of mixed feeding is needed though - many women don't do any breast feeding at all because they don't appreciate that you can try and mix the two.

balance is the word but as poster above points out there are probably rules against that.

Women need to be treated as adults who are able to make informed decisions for themselves and their baby. In their own context and situation without one choice being pushed as better.

Surely if the evidence shows that natural birth/ breastfeeding are beneficial women will tend to choose them where possible anyway?

Also practical stuff - where and when are local weigh in clinics? I wasn't told until the HV visited two weeks post birth. Knowing that sort of info could have prevented a couple of midnight arguments on feeding / weigh loss / whether to formula feed etc., followed by frantic internet searches. This was not helped by DS born out of term time (August) when there were less weigh in clinics on than normal. Urggghhh.

Clear billing about what they will cover and in which session/s (assuming it'll be a short course, not covering everything in one).

The processes of natural(ish) labour, but why interventions might be needed and what to expect if you need one (like just how many people will crowd into the delivery room/theatre if you need a CS). The pros and cons of tearing v episiotomy plus care of stitches.

A good info sheet on local postnatal services.

The biology of normal birth and things that you can do to help keep it normal in a hospital environment.

Procedures at the local hospital/MLU. Stuff like parking, how to get there, when to go, what to bring, visiting policies, eating in labour etc.

The advantages and disadvantages of different forms of pain relief and common interventions and how they can affect things like breastfeeding.

How to plan for breastfeeding in your birth plan with things like skin to skin and breast crawl - how the birth can impact on breastfeeding and what to if things aren't straightforward. Common reasons for women to stop breastfeeding and what you can do if you find yourself in those situations to keep on breastfeeding. Where to find help.

What your body might be like after the birth. What's normal and what isn't. Tips for recovery.

How to change a nappy/ feed a baby/ tell if the baby is getting enough milk.

When to call a midwife/doctor if you are worried about your baby.

common reasons for women to stop breastfeeding and what you can do if you find yourself in those situations to keep on breastfeeding. Where to find help.

yes, this. including at least a mention of tongue tie, and relevant contact details.

reasons a young baby may cry and how to soothe a crying baby.

Reasons to seek medical attention in the early days - eg signs of severe jaundice.

Reflux and Colic - that it is normal and not a result of the mother doing any thing wrong!! Also how to address it

There should be a section on common illnesses (for want of a better word) in young babies - how to deal with diarrhoea/sickness etc. When to seek medical help....

All great suggestions.
I don't know if it should all happen at the same time but something about the next stage eg how and when to introduce solid food, potty training, sleep, behaviour etc. I felt I got support through the birth and first few months and then nothing.

The reason that formula feeding isn't explained in classes is that the evidence is that parents don't retain the important safety information about making formula. BFI hospitals should have practices in place so that parents that choose to use formula are given one on one information from a midwife after the birth.

I would like our NHS trust to actually run classes. They have now done away with them and have only supplied short (3min) videos on YouTube. This is great if you need a bit a refresher but not so great if you are a first timer .

I just had a thought what if the classes were split so the parent craft happens after the birth. I struggled to take in any information about actual parenting before DS arrived as I was so focused on how to get him out. Having say 3 or 4 birht classes before birth then 2 or 3 parent classes after birth might be really useful

dont you dare call it normal birth... sorry, its a bugbear of mine is language, but again you are setting up parents to fail. it can be a very traumatic experience for mums who have c sections especilly because of the way the NHS focus on natural labour.

If I hadn't had already done my research and had my date for my section booked I would have been made to feel pretty bad with what little they bothered to cover on C sections.

When the intervention rate is so high surely it is important to be realistic and prepare women?

I agree pea - there was nothing about c-sections in my classes either. I was so nervous as the date for my ELCS was looming as I didn't really have any idea about what was going to happen in terms of the procedure and the aftercare.

Why is it we aren't allowed to be prepared like the women expecting "normal births" are?

Signs of pre-eclampsia. What to do if you think you may have it.

What actually happens in a c section. If someone had told me that baby doesn't always cry straight away as they had to help get the fluid out their lungs it would have saved me the longest minute of my life.

And don't make me feel like I failed for having a c section. We both nearly died. And I did 44 hours of labour so it wasn't for the lack of trying.

Some info on formula feeding - not just its the devil food and you must bf like I got. Great feeling it is remembering those words when the drugs to keep you alive will not be good for baby.

And practice on how to change a nappy would be good - and don't make me feel bad for using wipes not cotton wool balls when I can barely stand up.

Oh a girl babies can have a mini "periods" so get blood in the nappy checked out but don't need to panic and take them to a&e at 3 am

Bringing up bottle and colic.

Rant over.. Sorry and good luck..

I am currently considering my options regarding antenatal classes.

And whilst, I wouldn't put it quite it as strongly as peeapod, I do have to agree with the sentiment.

One of the things that is really putting me off, is language like that, and I wonder how relevant a substantial amount of the course will be to me if the focus is on a VB. I find it incredibly loaded and yes I do worry that I will be judged for it as a result.

When you term things as either a normal birth or 'when things go wrong', you immediately are doing that. Why not say a VB or CS? Or refer to it as a surgical birth. Or refer to things as being complications or emergencies. I am, and I think most women are, capable of understanding either of those words rather than rather than the rather childish phrase 'when things go wrong'.

Given that 25% of women have a CS these days I don't understand why a CS is not termed 'normal'. It IS normal to have a CS. I find your omission annoying ESPECIALLY when you use the phrase evidence based in your opening statement.

Sometimes this isn't due to 'things going wrong'. Its planned and things haven't gone wrong. Amazingly, sometimes having things go right by having a CS. If I end up having a VB then it will be a case of things going wrong, not right.

Given that you are a psychologist, I really do think you need to adjust the way you think about this, and take on board, how language can have an effect on women at this time. I actually find it quite appalling that you don't considering you are a psychologist.

The same goes for breast feeding if I'm honest. I just want practical, helpful information, rather than information about whats better/worse or good/bad or otherwise loaded.

I have no idea which I am going to do, and how I am going to cope with either. I would like information on both, so if I am struggling with breast feeding for whatever reason, I at least know where to start or at the very least know where to go for help - which includes a very basic over view of formula feeding - rather than being left with a feeling that its a subject that is off limits.

Above all else, I think I want to be treated as an adult without being patronised or treated as a child who needs to be taught values.

I would agree with not calling it 'normal' birth. Natural is better. Vaginal is what I would say is the best terminology.

I find it quite sad that so few people had sections covered. I did NHS and NCT classes with DD1 and both covered it. At the NHS classes we did a role play where one woman lay on the sofa and then the midwife running the class started calling other people up and sticking sticky labels on them. "Right, you are the consultant. Stand here" That was good. And relevant to planned sections too.

One of my NCT group knew she needed a section and that it might have to be under general (for various pre-existing medical reasons) so we covered the differences (e.g. partner not allowed in theatre) too, both for emergencies and planned sections (As an aside, in the end they were able to do a spinal and she saw her lovely son being born).