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.

[Hazchem]

primerosepip it would be lovely to have some feed back on things you are thinking I fear while I'm enjoying the debate greatly I might be really stirring your thread off course

[ThatBloodyWoman]

S'ok catherine (smile)

I knew all these things, but still.....

But, yes, I agree that there should be a lot more information re:what is par for the course on breastfeeding, and what isn't.

[beccajoh]

Feeding, and not just breast feeding. I know it's best, but life just doesn't work out sometimes. HCPs where I live are not allowed to give info about bottle feeding. WTAF? I bf my first v successfully, but with my second it was all kinds of wrong-ness and we got most of our info from the frigging tub of formula.

Stop calling formula feeding 'artificial'. It might not be natural, but artificial makes it sound like you're feeding your baby plastic carrier bags. Just call it formula like everyone else.

Realistic info about breastfeeding, not just some serenely happy mum and baby waffling on about how natural it is and how lovely it all is. Most people don't have that experience. Breastfeeding came very easily to my daughter, but it was still a huge shock at how hard it was.

[beatingwings]

I agree Catharine, it is quite rare for women unable to make enough milk, yet it is a common reason for giving up breastfeeding.

Many HVs lack the technical skill to support breastfeeding women who have babies who are not gaining well.

[RedToothBrush]

It's so sad women feel their bodies have failed them when in fact they haven't.

Its not just about that though. Even if you feel completely fine with how things have gone or your decision, its not hard for women to have their confidence knocked or feel like you are being judged from a particularly shitty comment - particularly from someone in a position of authority (eg HCP). The problem is a vb and breast feeding are often linked with 'real women' shit.

[ThatBloodyWoman]

Thats exactly it Red.

I knocked myself about all over the place because of it.

[Hazchem]

The problem is a vb and breast feeding are often linked with 'real women' shit. then "we" need to challenge people that spout that shit a bit like calling out sexism and racism when we see it. We also need to demand our HCP, as a whole system, do a better job to support us and empower us.

[TheSarcasticFringehead]

Feeding. Some early signs of problems in breastfeeding- it SHOULDN'T feel painful for a prolonged amount of time and so on, and what can be done (a basic outline, so you don't feel like there's no help). Expressing. A basic outline of safe formula feeding, even when you encourage breastfeeding (as should be done), statistically quite a few of the women in the classes will be FFing and knowing the facts is very important.

How to question and ask. Tell parents that you can complain by doing this, but not to scare them with negatives so outline what should happen- not the perfect birth, but 'if there needs to be medical intervention, they should explain x, y and a' and 'you can ask for this and that', because with my eldest, I went in without any idea how the midwife should have behaved towards me- she was cold and indifferent and my choices were dismissed and very little was explained so people were doing things to me which I had not much control over and had no idea what they were doing in the first place.

[TheSarcasticFringehead]

Also, a bit about illness and normal problems in babies. Tongue tie- signs and what can be done to help, how this will affect feeding. Colic, reflux etc; and a lot of ordinary problems which will affect a lot of babies and could be dealt with a lot better if the parents aren't terrified that they are failing to breastfeed or that their baby is dying!

[ShineSmile]

Colic
Reflux
Silent reflux
Mastitis
Tongue tie
Pain relief
Assisted birth
C-section
How tough it is after birth
Sleep deprivation
Burping

[beatingwings]

Colic - I agree
Reflux - Not very common
Silent reflux- ditto
Mastitis- a brief mention perhas
Tongue tie- fairly rare
Pain relief - in birth?
Assisted birth-
C-section
How tough it is after birth- is it?
Sleep deprivation-- not everyone experiences this
Burping- many babies especially b/fed ones need burping

[Hazchem]

This is totally random but maybe important depending on your client base.
Ambulances in the UK are free. I come from Oz and was fully expecting a 1000 pound bill after the ambulance took us to hospital (DS was having breathing problems when he was about 12 months old). I would have been less hesitant to call the ambulance had I known it was free. I tried the NHS direct website and then phoned them to really check we did actually need an ambulance. I am sure there are lots of countries were ambulances aren't free.

[beatingwings]

Welcome to the UK hazchem.

[Hazchem]

Thanks! I've left again after 8 years and developing a mumsnet addiction. I do miss the NHS and am now facing birthing in the Australian system I'm really missing.

[beatingwings]

Are you a chemist hazcem?

[Hazchem]

No nothing that cool. it's a terrible throw back to my mid 00's raver life :)

[beatingwings]

I had a life like that in the 90s'. Flew too close to the flame.

[addictedtosugar]

Beatingwings. I wouldn't call up to 10% of babies who may have a tounge tie fairly rare?

[beatingwings]

10% is a disputed figure. Other estimates put the figure at 3%.

In the absence of decent breastfeeding support there is a current fashion to attribute breastfeeding difficulties to toungue tie.

There is no doubt that some babies have a short or closely attached frenulum.
THis does not always cause breastfeeding problems.
Even after having membrane snipped many babies still continue to have difficulties.
The danger is lots of unneccesary procedures- often performed without anaesthetic- are being carried out.

[Thurlow]

There is only so much you can cover in an antenatal class though. I would put a lot of the issues - colic, tongue tie, reflex etc - in a category where they are briefly mentioned so you're aware they exist, but postnatal support should be better and you should be told how to access it easily.

The problem at the moment is that so many PCT's seem to no longer be able to afford antenatal classes so a lot of people go to NCT classes. Which are great, but as other posters have said they are actually about 20 hours of how to hopefully have a pain relief free, intervention free vaginal birth. Which is probably what the majority of women want - but if you do end up having an emcs, elcs etc you suddenly realise that you've been to 20+ hours of classes that weren't remotely relevant!

We had a fantastic bit of cs's and what to expect in the room, how many people will be there etc, which was incredibly helpful when I did have an emcs - I wasn't worried that there were a dozen people in the room with me. But with hindsight, we had a 3 hour class on how to manage the pain and discomfit of a vaginal birth, but no mention of what you could do if you'd had a cs. 10 minutes on how the try and sit up after major abdominal surgery would have been useful!

[addictedtosugar]

Thurlow: I think you've got the right compromise there.

Beatingwings: I'm bias. I have 2 kids, both of whom have benified from a tt division. personally, it would have saved a lot of heartache if DS1 had been diagnosed earlier. Maybe therefor it is a midwife training issue? But SOMETHING needs to be done re tt, afaic

[beatingwings]

addicted- there is no doubt that tt does exist, can impact on breastfeeding and division can help.

It is often underdiagnosed. It is however over diagnosed too, and other breastfeeding difficulties attributed to tt which could be solevd in other ways.

[Hazchem]

I'm wondering about a sort of cause for concern session? So not going into detail about all the possible problems but signs or signals that you might need a bit more help/support. It could also cover cause for concern for mum so things like PND, aftercare of wounds.

[Thurlow]

A cause for concern session sounds a great idea. You wouldn't need to go into too much depth, and you could do a hand out too, but just flagging a dozen or so things to do with you or the baby that could indicate a problem would be enormously helpful.

[Hazchem]

And it would be a place to point out how to get help to. So NHS direct, GP, HV, midwife, a&E, drop in clinic.