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.

[addictedtosugar]

Can you also consider timing of the course, and giving out enough notice?

I got part 3 at 39 weeks, and, then was supposed to go to part 1 at 40 weeks. I had a baby at that point.

Could really have done with starting earlier, and starting at the beginning.

[longtallsally2]

I would have loved a section on having a baby, rather than delivering a baby. I felt fabulously prepared for the birth by my NCT classes, but then felt as if I had been taught to take off in a plane, and not how to fly the bloody thing!

A discussion about how battered your body may feel (or not. I felt such a failure, having to explain to people for weeks afterwards how ill I felt, and having faces back at me. I needed to have much more support from those around me - husband, parents, friends but I was left trying to explain this to them, whilst grappling with a new baby and all that entails.)

A discussion on how your baby will impact on the father. How important it is to take time off for paternity leave; ideas on how to cope without sleep as a couple; how to put in a car seat. Maybe my dh was particularly clueless, but again, we both went to the classes, he took on board the parts about labour, back massage etc, so could have taken on some more ideas about life afterwards.

[PenguinsHatchedAnEgg]

Oh, also interactive presentation. It is true that people often tune out the unpleasant information (eg instrumentals, post birth bleeding/piles/swelling). I heard people swear my NHS course didn't cover stuff that I know it did (because I was on the course too). Drawing onto a big life-size outline of a woman was a good exercise on 'post birth'.

[KatharineClover]

My NCT classes were great - they asked us as a group what we wanted to cover, I found the info really balanced and the teacher covered the types of births in sufficient detail.
My NHS class in contrast was a 90 min Q&A that spent most of the time on epidurals and c-sections. No mention of active birth other than it was 'good' -so no examples of active positions etc. BF was 'there's a cd over there if you want it', lansinoh samples were explained as 'for sore nipples, but also good for dry skin on your feet'! The midwives talked about the pain relief they had used in their own births - but very little info on how these might affect you or the baby. Held in the day, no timing choice.

I'm currently going to free antenatal classes for mums run by a doula - they are amazing! Really balanced, supportive, non judgemental.

[Hazchem]

I disagree about normal. Vaginal birth is the normal way of birth for human. C section maybe common but they are not the normal birth route for a baby. That does not mean any has failed. Maybe referring to c sections as Atypical.

[RedToothBrush]

The trouble is when you refer to normal, then the assumption of anything that is not normal is abnormal.

And that has negative associations.

There are plenty of ways of describing various ways of giving birth in a way that doesn't create such problems.

[Hazchem]

But that is to ignore the fact it is normal biologically normal. If we are talking about designing a birth classes I would hope part of the mission is to change or challenge some of the misconceptions about birth. Normal birth can be discussed and c sections can also be discussed in non judgmental ways. Which would be a positive.
The closest hospital to me has recently started a csection class because the head of obstetrics has decided the women coming to the hospital are to old and fat and should not expect to use there vaginas. So referring to c cections can also have negative connotation.
Discussions around birth are important and essential and can also be super charged with emotions and historic meaning. it requires a skilled educator but it also requires that as a society we stop hiding and start talking about the realities of our bodies. Pretending it isn't normal for babies to come out of vaginas is just as damaging as saying c section births are failures.

[AnythingNotEverything]

My NCT classes were great. Non pushy, not too earth mothery, non judgemental, no breastapo etc. They did however really help me to place myself and my needs at the centre of my experience.

I felt able to negotiate with the midwives, both in labour and during a long stay on the postnatal ward because at my NCT class I was constantly reminded to question what was happening and to ensure DH could effectively advocate for me when I couldn't.

I think having enough knowledge to query your midwife/consultant (obviously not when you're being rushed to theatre!) is important.

[RedToothBrush]

Biologically normal childbirth also means dying.

Its uses upsets some people and whether its 'correct' or not is not the point. It is still loaded and still psychologically has an impact on women.

[Hazchem]

What if it upsets and undermines women when we don't talk about normal birth and all that entails? what if the use of natural is poo pooed to because are drugs natural? What if talking about normal birth empowers women to understand their bodies and how they work?
Working to re normalize the processes a women body goes through shouldn't detracted from other methods of birth. In fact work is being done to make c sections more similar to normal birth because it has a positive outcome for both mums and babies.

[peeapod]

If i heard natural childbirth being referred to as normal i would have to question it. Normalized childbirth now includes an allowed set of medical interventions. If you want to discuss normal birth i assume you'll be labouring drug free at home without the help of a medically trained midwife?
i would argue that all birth is medicalised. All pregnancy is, unless you don't have the ultrasounds and the blood tests? It is just a shame that some medical interventions st childbirth are seen as more normal than others.

[PenguinsHatchedAnEgg]

The issue I have with the term 'normal' is all the loaded connotations. I think you have to be very, very skilled as a teacher to get away with using that term without the women who end up with unplanned sections, instrumental deliveries, etc often feeling that they are abnormal failures.

I agree with everything Hazchem says about education and information and empowerment, but 'normal' still grates (and I'm someone who has never had a section and has had two homebirths).

[ThatBloodyWoman]

I think there should be a whole lot more on c sections.

I also happen to think there should be more on both establishing breastfeeding, but also on bottlefeeding.

Bottlefeeding seems to have been hushed to almost non existance but the fact is that some women are unable to breastfeed and some chose not to.

If it weren't such a bloody taboo, perhaps some of us wouldn't be sitting not knowing a thing about sterilizers etc, feeling like complete failures, especially if you also 'failed' to deliver your baby vaginally like 99.99% of the content of the ante natal classes focus on....

[Hazchem]

Would physiological birth be better?
I don't like natural because it implies no medical intervention which is of course a valid choice.
Penguins I would hope that anyone teaching an NHS trust was that skilled. It is also worth debating the use of language in the design stage of any educational course.

peepod having the right to have an unmedicated pregnancy would be very good.

[Writerwannabe83]

Why can't the terms just be vaginal birth and surgical birth?

That way there are no implications that one is normal and one is not - they are just different methods.

There are no insinuations about vaginal birth being being natural and CS not. It highlights that vaginal births may also require medical intervention be it the pain relief being at one end of the scale and an assisted delivery at the other.

[ThatBloodyWoman]

In fact I would go as far as saying that since I had an emcs under ga, and bottle fed because I was unable to produce a good enough supply, with my first, ante natal classes not only taught me very little, but also contributed to a real sense of failure during the first few days post natally.

All I needed to know was that my birth experience was 'normal',and becoming absolutely beside myself trying and failing to establish breastfeeding, wasn't me failing my baby because I couldn't do it.I just needed to be given 'permission' to not beat myself up, and give my baby the bottlefeeds that were needed.

I'm quite angry about it.

[peeapod]

Surely all birth is physiological? Rejecting medical intervention is a choice b people do make, but i doubt those peoples would be going to sntenatal classes.
all birth choices should be equally valid and treated on a level playing field imo.

[Writerwannabe83]

bloodywoman - I understand what you mean. DS had to have formula twice in hospital due to me struggling to breast feed and as I watched the midwives give it to him I felt like a total failure. I actually just sat there and cried which in hindsight is actually quite an extreme reaction.

I think there should be more antenatally and why, in some circumstances, formula is needed for the best interests of the child and that if the baby does have it then it's just another variation of feeding, not something to be ashamed about or something to make a woman feel so bad about it.

[ThatBloodyWoman]

Nearly a decade later and it still reduces me to tears

[HumptyDumptyBumpty]

Agree with longtall that some info on having a baby rather to than just pushing it out would be useful.

Also a detailed run down of inductions: types, how long each bit goes on, what pessary pains are, pain relief, choices etc. I knew none of that and was scared shitless going in for mine. And not offered pain relief, and didn't know I 'could' ask (assumed I was being pathetic). Since so many women are induced, simply dismissing it with 'oh it leads to a cascade of interventions' isn't instructive enough.

And a carefully handled session on possible difficulties (tearing, PPH, in my case, but I'm sure there are many others) would be helpful. You'd need not to scare women though! Tough balancing act...

[catherinemm]

Breastfeeding is essential to cover but you have to be very careful to give the right info. So many of my contemporaries gave up because they believed that because their baby wanted to feed all the time they didn't have enough milk. I think one of the reasons I carried on was because I had read this amazing called food of love so I expected this and new the constant feeding was required in order to ensure I had enough milk. It's so sad women feel their bodies have failed them when in fact they haven't.

[ThatBloodyWoman]

With all due respect, catherine,its posts like that which don't help.

I was almost begged by the hv to give bottles.I loved breastfeeding, my baby did, we tried every strategy going.

Some women do not produce enough milk.

I did not give up.

It's not that I didn't read the right bloody books.

[catherinemm]

Sorry didn't mean to offend, it just made me sad when I heard friends say 'he wanted to feed all the time so I obviously wasn't giving him enough, I had to stop'. Maybe giving up was the wrong phrase, should be more 'forced to stop'. Also I know many people who were told incorrectly that feeds more than every 2 hours = issues with milk supply which is not true

I would also say people should warn you some babies don't really want to feed in first 48 he's after birth. After a long long labour my little one would not suck. The midwives didn't want me to go home as I still hadn't fed him. They were suggesting formula, but I just wanted to go home so We did, against advice. When We got home I watched this you tube video sent by the midwife whose ante classes I went to. In it another midwife explained that some babies won't want to feed much immediately and that babies have enough energy in their livers for 48 hrs. I felt a bit more relaxed, slept for the first time in 4 days(!) and when me and my son both woke up I managed to feed him

[Hazchem]

writer8 would you uses vaginal non-instrumental, vaginal instrumental and surgical?

thatbloodywomen That is so shitty that you were supported around your birth and breastfeeding. How we give birth and feed our babies is important but so too is how we feel about the experience. If you still feel sad about your experience you can still seek help to work though how you feel. In fact information about where to get support after birth should be included in antenatal classes.

peeapod I don't think a c section is. You'd be surprised at who doesn't want medical intervention and what other aspects they would be engaged with.
I think catherine's final sentence is important "It's so sad women feel their bodies have failed them when in fact they haven't" and we I think we should be working toward health systems and after care that support women to feel proud of their experiences.