Kirstie Allsopp in twitter row with NCT

[DuelingFanjo]

Sorry for the DM link.

what do you think about this?

Personally I think my NCT class covered C-sections very well, though there was an emphasis on 'natural' birth through-out the course. I was glad of the C-Section info when I was signing papers for the possibility, though in the end didn't need one.

Sadly my experience (Midwives not checkinghow dilated I was, No gas and Air for ages, Having waters broken, Spinal at 10 cm dilated, episiotomy and so on) has made me wonder if I would want to attempt a more natural birth next time - I am worried that I will be too scared to try.

Do you think she is right though, are women who have C-sections being made to feel like failures?

I trained and worked as an NCT teacher recently. I would make the following observations...
Teaching on C section is a crucial part of the teaching for all NCT classes, usually as a role play.
OFTEN feedback from classes suggests that there is little emphasis on the post natal period when in fact there is a good proportion of time (1/3 to a half) spent on this... it is my observation that parents only remember the certain things. They are mostly focused on the birth and can't see after. They tend to focus on natural birth and b/feeding and not necessarily on the parts of the course they think WON'T apply to them.
There is a tendency to try and keep a positive but realistic outlook on birth and parenting. The experience of birth has a huge psychological element to it and women do not need to go into it feeling scared and feeling that medical intervention is inevitable.
Reasons for choosing couples to come back are varied - the choice is based on personal qualities and how they will behave in the group. Again, it isn't good practice to invite back a couple who are likely to tell horror stories with relish, for example. Nor is it good practice to bring back someone who has had a traumatic experience - particularly so soon after the birth. The teacher cannot be sure that the new mother/father is in a position to speak about the birth without getting upset - not good for them or for the listening pregnant couples.
TBH pregnant women hear horror stories about birth all the time; the NCT classes can be a place to balance the cultural idea that birth is horrible painful and needs a doctor for it to happen. That's only ONe skewed perspective and pregnant women should hear other perspectives too - about home births, no intervention, water births, birthing centres, alternative pain relief etc. Not because that's the ideal but because that's also possible (not necessarily for all, but for some...)

The seemingly inexorable rise in medical intervention in birth is something that we should recognise but not necessarily accept...
TBH (again!) I think this idea that the NCT "seem" to give this particular message is a reflection of the messages absorbed and internalised by the person receiving the message, rather than anything else.
FWIW I had a C section followed by a VBAC (forceps) and got NOWHERE NEAR the birthing centre/pool

I was considering NCT, but glad I didn't now. We have 6 hours of classes basic on the NHS in my area plus possibly some extras.

The idea of covering C-sections by doing a role-play! Fills me with dread. I'd love someone to explain the thinking behind it.

I was also put off by the anti-social/anti-pregnancy hours in my area. All the courses included a full day - 9-5. So my husband couldn't go and I would be exhausted. If I could honestly pay attention and participate in anything for that long I wouldn't have had to be signed off/take maternity leave ASAP. So I didn't have a choice in the end really.

Loads of people I know have said it was fantastic for making friends. But I can find other groups for much less money than that.

Yes, role-playing the c-section scenario - wtf?

I'm kind of confused as to why people feel they've been set up for natural birth and not told the downsides or realistic odds.

The information is right there.

I am no fan of the NCT (I think it's done great work but the classes exist now as a status symbol - I would rethink this if they genuinely worked at providing education for those on low incomes) but apart from a few rogue teachers they don't give you a bad product. They aren't setting you up for anything. They try to give you tools to work things towards a best case scenario. Sometimes this is possible and sometimes it isn't (medical reasons or bad care get in the way) but I would be really surprised if any NCT teacher told you there was only one way to give birth and anything else was a failure. Where does the feeling that that's what they actually mean come from?

I disagree Ooid - I don't think the NCT is hugely evidence based (if that's what you mean by tools). They sell homeopathy kits in their catalogue!

IME - and I had a very good NCT teacher and a good experience in the classes and still in touch 2+ years later - there is a lot of discussion of the risks of intervention but very little focus on the risks of non-intervention or the benefits e.g. epidurals are said by NCT to increase the chances of a c-section - in fact the jury is out on this and there is strong research that says that it makes no difference. There is evidence that women who have had epidurals have reduced bladder & pelvic floor problems later in life - but this is not mentioned.

On a more positive note.

Re: role play - all the couples I've known who've had c-sections have found this really useful. You don't have to 'act' - you just are assigned all the different roles in the theatre and given an explanation why they are there. This is to reassure people that when 10-15 people in scrubs suddenly appear that it is normal procedure rather than a crash or emergency situation. And then they talk through what all the people do.

FWIW I think the homeopathy kits plays into the status symbol aspect of it. Alternative therapies being largely a matter for the monied middle classes.

(Cue post by person of little means who visits a homeopath weekly, MN being what it is...)

The idea of covering C-sections by doing a role-play! Fills me with dread. I'd love someone to explain the thinking behind it.

OK I'll try
The idea is that rather than being told about what goes on in the OT, the people in the class are assigned roles and the teacher gives ideas about what the individuals might be doing in the OT during the operation.
It is one of the activities that I had the best feedback about - it was considered really useful to have an idea of what to expect in the OT when the time came; I personally found it very useful

HTH

The NCT's training is very much evidence based; the classes certainly should be. The products, though, are a different matter.

If it's going to be evidence based then the things they sell ought to be too, or they compromise their integrity.
There is no place for homeopathy kits within an organisation that wishes to provide evidence-based education.
If they're not that fussed, then fine.

But the NCT isn't just an education based charity. It provides education (which is evidence based) and it also provides a number of other products and services. As a charity it needs to raise money to reduce the costs (e.g.) of the classes it provides and one way is to provide a variety of (ethical, tested) products. FWIW homeopathy is also available on the NHS together with other CAT. The NHS funds such treatments because of the evidence that such treatments, despite being unproven scientifically, can nevertheless have therapeutic value for patients in terms.
The NCT (like other bodies) should be providing pregnant women and their supporters with the facts and letting make up their own minds. It's about empowerment - giving women as much control as possible over their birth experience, because that really DOES make a difference to outcomes, in every sense.

whats wrong with homeopathy kits? I am from an ethinic low income, houseing benefit claiming family in east london and i used aromatherapy in my hb and would reccomend it t others, as it worked for me.

for me going in to my first labour i had a see how it goes approach i didnt feel guilty or bad for using pain relief (pethadine) but i did have problems with bf and after researching i found out it could be due to pethadine, i also realised that the way they treated me in birth made it more difficult for me, such as constant monitoring, made to lie on back, lack of gravity meaning longer harder pushing stage, them wanting to cut me due to that, also they didnt let me eat and drink and stuff, i had read all the info, but i skipped out the parts that i thought wouldnt happen to me!

because of this i chose to have only gas and air with 2nd birth coz i wante to be awake! and 3rd i ended up with an unassissted hb, and tbh it was the most amazing magical thing i had ever done in my life, i never got why all these poeple were always going on about the wonders of natural birth until i experienced it! the thought of that birth makes me want to have another baby!

but the thing about going against medical advice, well sometimes you can and its for the best for you if you do. for example after my hb my baby weighed under 2.5k so they wanted me to go to hospital, but knowing i had small babys usually i had looked up hb's and small babies and read about causes of small babies and had decided before hand that because in my family the babies are generally small, and people of my ethnciity have a trend of having smaller babies that i woulodnt go to hospital in this case, the mw phoned the neonatal consultant to who advised me to go in, but i said no, and the mw secretly told me that she agreed with my decision, and could tell it was an informed decision, but she was required by her job to advise me to go to hosipital although her personal feelings were we were best of at home.

when it comes to birth following the medical advice is not always what is right for you.

Homeopathy and aromatherapy aren't the same things - homeopathy is water/sugar pills that are claimed to have a "memory" of molecules of a substance.

I thought that you might all be interested to see our latest film - the Natural Caesarean - a woman centred technique

It would be great to know your thoughts.

c-sections were not covered in my nct class at all. someone asked about what could happen if they did end up needing one but were told that was "very unlikely"

feel quite resentful at how little the classes prepared you for all eventualities. also a strange mix of people so we never really gelled with each other and didnt stay in touch after a few months.

no info on assissted deliveries or episiotomies or tearing etc and the only time i ever saw forceps was when they were about to be used on me.

no info on bottle feeding as obviously everyone will take to breastfeeding just like that.

all in all a total waste of money and would never recommend nct to anyone.

How strange, yummytummy, all those things were covered at out NCT class, though not necessarily in detail. Except for forceps. I saw those only because the midwife taking the hospital class offered to show them - dh and I were the only ones who took her up on the offer. Apparently most parents-to-be don't want to see forceps because they are so scared of them, but TBH it was reassuring to see them - they weren't nearly as large as I imagined, and had I had to have them used on me, I would have been less frightened for having seen them beforehand. I can imagine how worrying it must have been for you, not knowing what was about to be shoved up your fanjo.

My NCT class provided me with some useful advice and good friends. My teacher was clearly anti-caesarian though, almost boasting about having had her two children naturally, with only gas & air.

I ended up having a EMCS, after failure to progress. For my second baby I did lots of research about whether to have an ELCS. I chose to, because even though C-sections have their risks, I found that there are a number of long term benefits to NOT giving birth vaginally (e.g. lesser chance of incontinence & organ prolapse).

I did wonder some weeks later why only the virtues of 'natural' birth were ever discussed and a c-section was considerd almost a dirty word.

Ok, most people wouldn't choose a c-section for their first birth without trying for a vaginal birth beforehand, but that doesn't mean that there aren't benefits. Why can't birth discussions be more balanced and inform people of the positives and negative of all methods of childbirth?

hi prettycandle, sounds like you were lucky. maybe it just depends on the area you are in for the nct class and the teacher but i still feel like we didnt have half the info which would have been useful and it was a real waste of money and time.

also bluebutterflies i agree there should def be more balanced discussions and more info on all eventualities without a sense of bias towards one way or another.

makes me very sad that so many women are made to feel inadequate when they have had to have a section for whateever reason.

No dea about NCT classes as didn't know anything about them when I was pg.

Did go to NHS classes at the hsopital and they did not cover c section, apart from very very fleetingly in passing. No information at all and not that much done on induction either.

Made me very much unprepared for my failed induction resulting in c section.

How refreshing to hear someone speak their mind re the NCT!

I attended NCT classes ahead of the birth of my first child some 2 years hence. A word of warning to all out there - many people giving out advice at the NCT have limited (if any) medical training and so it is important to seek out medical reasoning behind procedures. I left NCT classes believing that staying on my feet during labour would increase the speed of my dilation - I was informed by my midwife after 24 hrs of labouring with baby going nowhere that this had in fact caused my cervix to swell and prevented dilation. Whilst NCT has it's place - please don't take their word as gospel - be open minded and have the safety of yourself and your child at the forefront of your mind during labour. Bad advice led me to have more medical intervention in the long run NCT be warned!

If anyone from the NCT is reading this I would strongly advise either medically trained professionals should be running your courses or should at least have a greater degree of input. As the courses are lead by what mums want to know often key areas of advice are missed leading to a skewed and potentially badly advised knowledge base.

Weirdly that afternoon we made a new baby that we're expecting in a couple of weeks...possibly by c-section due to positioning but hey...!! (and still no NCT classess)...

At our NCT course for parents-to-be, the instructor did her level best to promote whalesong, aromatherapy and ethnic throws draped around the delivery suite as the optimum method for pain relief during labour.

So much so that I was compelled to pointedly comment on the hippy bullshit in order that Mrs V didn't get guilt-tripped into a painful and potentially dangerous birth aided only by essence of lavender.

But saying that, the instructor was very knowledgeable about all the other forms of pain relief so when things started to go wrong at hospital as the birth plan went out of the window we weren't scared about what was happening around us.

All in all, you have to be aware of what their ideal is. They may be hippies but they're a damn sight more useful than that vile Tory harridan any day of the week.

NCT lost me when they kept referring to my cervix being a Rose bud and as I would dilate it was the bud blooming ......

NCT lost me when was told pain in labour could be just perceived as a state of mind. Both my pregnancies ended in c sections, and thank goodness the technology exists to deal with that. I laboured, and bore my babies myself, and 50 years ago, none of us would be alive. Why would I feel guilty? I had the whole birth experience, my birth experience, no less valid than any one else's.

My NCT class (London, 7 years ago) covered c-section pretty well, together with all the pain relief options, and the instructor gently suggested to us as a group of rather gung-ho first-timers that we shouldn't rule out the possibility of drugs in advance because we didn't know how we'd feel when we got there. She'd had two drug-free home births herself but never even mentioned that in passing until the very end of the last class when we more-or-less dragged it out of her.

Out of the six of us four had c-sections (one planned for breech baby, three unplanned) and one had a ventouse delivery; there was only one fairly uncomplicated vaginal birth. No one was made to feel like a failure, in fact quite the reverse.

I think there are good and bad NCT instructors.

NCT info that I have seen tells women that many c-sections are probably avoidable. The Royal College of Midwives, the World Health Organisation and the Royal College of Obs and Gynae are largely with them on this.

They also point out the link between induction/epidural and hospital births and higher rates of instrumental and operative delivery.

As far as I can see, knowing this doesn't stop many of their clients trotting along to the labour wards of hospitals with colossally high rates of c-sections and a poor mother/midwife ratio, 'just in case' they need an epidural. Or having an induction they probably don't need. And then they have every intervention going and blame the NCT for being natural birth nazis and making them feel like a failure.

I didn't do NCT classes but I'm blardly grateful for the campaigning and research they've done to make birth more humane for women in the UK. If fewer than half of women in some hospitals are getting through birth without the aid of surgery or instruments then thank god someone is stepping up to the plate and pointing out that it's fucking madness and it doesn't (usually) have to be like that.

"I laboured, and bore my babies myself, and 50 years ago, none of us would be alive."

Can't comment on your particular case, but the c/s rate in the 1950's in the UK was 2%. It certainly wasn't the case that one in four mothers or babies died in childbirth.

"I would strongly advise either medically trained professionals should be running your courses "

That would be a bit pointless, given that they are not giving medical advice.

"I left NCT classes believing that staying on my feet during labour would increase the speed of my dilation - I was informed by my midwife after 24 hrs of labouring with baby going nowhere that this had in fact caused my cervix to swell and prevented dilation. "

Well - it does generally speed dilation. Which is why the NICE guidelines on intrapartum care advise that all mothers should be supported to mobilise in labour. What usually causes a cervix to swell is unproductive pushing on an anterior lip. Not being upright per se.