Live webchat with NCT chief executive Belinda Phipps, Thurs 17 Sept, 1-2pm

[GeraldineMumsnet]

We're very pleased to welcome Belinda Phipps for a live webchat this Thursday.

Belinda has posted on threads discussing the NCT, eg this one in April. So we're glad she's coming on for a bit longer tomorrow and can respond to your comments and queries about the NCT.

We're going to send over any questions you've posted by the end of this afternoon for some advance answers, to leave as much time as possible for questions during the live chat.

Hope you can join us.

I'll write the MN/NCT column

I DO agree that Belinda seems very approachable indeed

I am little disappointed that the whole issue of the birth heirachy wasn't addressed though, and I think it's a HUGE problem for women's self-esteem, and unfortunately a lot of those women feel too crap about themselves because of it to speak up. That's why I think the NCT really needs to ditch the Childbirth part of it's name - as someone else said, if you didn't "give birth" then where do you fit in?

I missed the webchat but am going to wade in now anyway.

I want to do the BFC training but tbh have been completely put off by my experience of the NCT so far.

I was a birth partner for a friend a couple of years ago and went to both NCT and NHS antenatal classes with her. She was getting the NCT ones at a reduced rate (£20 for the course) as she was on a low income, and tbh the other parents there were quite evidently paying the full whack to avoid the 'commoners' at the NHS ones. One of the dads told us all about how he and his wife had attended one NHS class and found it hilarious how the men there knew nothing about pregnancy or birth. Oh and 'they were all, you know, black' (in a whisper).

I took that as an isolated incident and I am a member and volunteer locally as well now. The branch members are nice enough but still, it is so overwhelmingly middle class. I really wanted to do the BFC training, I bought and read most of the books on the reading list and got in touch with the nearest tutor but have been unsupported by the branch, who haven't helped with the funding so I can't start. I really don't enjoy the meetings, I come away feeling inadequate and that there is nothing relevant to me or my family in the NCT, and I am now resigning my volunteer role and letting my membership lapse.

IME it is run both by and for overwhelmingly middle class parents. Its a vicious circle I suppose. But I think they somehow need to become far more inclusive and accessible.

Anything that you have to pay for is economically (and hence socially) selective. The NHS is funded by taxation and free (for the time being) at point of delivery; the NCT needs to raise money in order to operate and must therefore charge for at least some of its services in order to cover its costs.

I live in France, though I did not give birth here because I was so very frightened of the horror stories of over-medicalised antenatal and birthing treatment. When I read the list that Belinda Phipps gave of all the areas in which the NCT has influenced the NHS in its approach to pregnant women and to childbirth, all I can think is that the NCT is sorely missing in France.

hi there, less of a question but more of a comment really, I have been trying to persue the antenatal training within the NCT for approx 2 months, after messages and emails I still am no further along than I was when I started.

message for minniethe minx. If you contact me via CAM I will see if I can help with NCT training

Queen....please don't give up on training to be a bfc. It does not depend on branch money and you need to bypass the branch if they are not supporting you in finding funding. You can go to your Region and explain what's happening. We so need more bfcs

Horrible to have unpleasant person in an antenatal class What can I say? You get pricks everywhere....

This is not my experience of antenatal class members who are mostly lovely!

Anyway....if you do become a bfc, the vast majority of the women you speak to will come from outside NCT

QOFE, we talked about training last night at our committee meeting. As I understand it, funding for training is central now, because 20% of that huge chunk of branch funding which goes to HO, is for the training fund. All the branch has to agree to fund are your expenses (paper, travel etc). I think you need to make a proposal to HO/ interview etc to get the funding for the training.

If your expenses will be high, then the branch may ask you to apply for grant funding to cover it.

There's a lot of confusion, because the process has changed. I would phone head office 0844 243 6000 and ask to speak to a training co-ordinator. This link might be useful to you update.nct.org.uk/guides/grant_docs/training-grants-factsheet-breastfeeding.pdf but you will need to be logged into Update Online on the nct website (using your membership number) to access it.

I woudl echo this, NCT knows there have been some problems in brnaches with applicants for training and we are looking at how to address this problem. We are very keen to train more specialist workers . Do call the office and ask for the breastfeeding tutor coordinators nnumbers (they are not based in the office)or ask for Branch Support Manager who wil contact the brnach for you.

Gosh - you are all still here chatting - I thought you might like something on the birth hierachy.

The evidence is that a straightforward vaginal birth is the safest birth for a healthy mother with a normal pregnancy. It is also the least likely to traumatise ? provided the mother has support ? ie one to one midwifery and that she is listened to and her wishes respected ? it is also the kind of birth most women say they want ? it is also the rarest sort of birth ? research done by Soo Down showed (scrapping head out for figures) that 16% (will need to check) of all first births are normal or physiological or straight forward. So like breastfeeding was it?s a disappearing thing.

So we campaign to create a system that makes it possible for this to happen and to happen for the majority f women ? because we know its safe ? and fulfilling ? or can be if the health service does it properly.

However for some women ? say 10 ? 30% they need medical intervention and will benefit from it ? and although this is often seen as horrible and traumatising ? you can make it less so by support and control for the woman and better environment and better techniques etc and NCT is interested in that too and making that happen ? we suggest birth plans to mums who are going to have cesarean section - and as a possibly to have a back up plan for those who look to be heading for a normal birth ? but again what we campaign for and how we support women get befuddled ? people think what I say in a newspaper is a judgment on women ? and guilt and sometimes error on our part means a woman feels judged in terms of the birth she has,

Anyone out there that can help us make sure this cross contamination doesn?t happen please speak up!

We also have the issue that we run classes ? but we don?t run the maternity service (now there?s an idea) ? so we can prepare a woman to have the sort of birth she want ? but the she gets left alone in a hospital in an unsuitable room etc etc ? and she feels she's failed ? when really the health service has failed her.

That?s why the next development for the NCT is to become much more effective at influencing ? training ? supporting workers in the maternity service to provide what women and their partners want.

Belinda

she talks a good fight, i'll give her that

but did not really address, as MP says the birth hierarchy issue, also my comment, that has been reiterated eslewhere about head office not being great at getting back to you and my davina mccall question

oh well

maybe belinda will look back over this thread and address the points, although she had clearly come prepared

i'm still leaving the NCT though

I have a confession and apology to make on training with us.

We have made a real mess up of the system ? I think students know once they are registered with the University of Bedfordshire and are with a tutor ? it is pretty demanding training ? but it?s a fairly simple system.

However before that getting on the training is a nightmare on wheels ? and its our fault (UKOffice). So we had a big session on Tuesday ? with long suffering students and tutors and the regional people and fundraising people etc ? and we thrashed it all out ? and we are going to start again with the system. Mean while if you are trying to get accepted onto training ? and are going round in ever decreasing circles ? please let us know [email protected] and we will see if we can get it untangled for you. I am sorry.

If you are about to apply ? hold for a couple of months ? we will have a fantastic streamlined system I hope by early in the new year.

Belinda

oh look, Belinda's back ! am impressed.

Daisy goodwin, take note.. this is how you do a webchat.

Thanks for that Belinda.

Surely the only important question is whether antenatal preparation can influence birth outcome?

If not, then there is no point doing anything other than educating women more about what to expect. The idea that you have any birth CHOICE is surely dependent on proving that women who have NCT antenatal classes will have better outcomes. If they don't, then the concept of choice becomes rather elusive.

I do worry a bit about the language used. How can only 16% have a "normal" birth? This isn't very nice for the 84% of women who are having "abnormal" births. Likewise the term "fulfilling" in this context... If you get something out of it, that's great. But if only 16% have a SHOT at "fulfilling" (assuming that not all women who have a vagina, unmedicalised birth feel 'fulfilled' by it) then we need to be realistic. More than that percentage are going to have god-awful tearing but I've yet to hear of an antenatal class that gives as much airtime to dealing with tearing as it does to dealing with a vaginal/unmedicated birth.

"she feels she's failed ? when really the health service has failed her." Hmm, I'm not sure this is always the case. I think you can feel you have failed when the health service has done all it can do for you. It is really our expectations that may have been too high in the first. Birth isn't really a consumer choice.

Sorry for banging on about it AGAIN. But you did ask for thoughts. Thanks for coming back.

Just checking I have picked up everything - one more here.

Davina is an absolute star and has been a huge help in changing the image of home birth from something that mad people do as a dangerous pastime while knitting yoghurt ? to something that all sorts of people do ? that is safe and sensible and possible and even lovely ? the walls are not sprayed with blood as per Holby City etc ? and people who are the antithesis of yoghurt knitting do it as well as those who have a range of less common lifestyles ? but nasty Nestlé has its tentacles everywhere ? and we don?t pay Davina ? she helps us out of her passion and commitment ? so we don?t have a say.

we all love Davina on here.
were trying to get her on for a webchat and to tlak about her odd last night of Bb outfit...

I really am going now - but will sneak a look at any more comments

last point

Normal is a difficult word ? but what do we call it ? physiological birth ? straight forward birth ? natural - wish there was a good non judgmental word ? but there?s not ? this is a 5 hour debate ? to save for another time.

There is work going on, on outcomes of antenatal education ? no good quality cast iron studies published yet ? again a long debate and much data to share here ? but can?t today

Last point ? for antenatal education to be truly effective ? health service has to have services to match what parents want ? and they don?t ? again much debate to be had on that ? but not tonight?parents evening calls?

Belinda

ok, thank you for that re Davina. i think we need to ask her then, re her association !! thanks for addressing that

Thanks Belinda!

MOP - the only important question is one about birth outcome? And women's experience, perception, satisfaction and long-term memories of the whole thing don't matter? You can't mean that.

'better' outcomes, you say....a good example of the perils of language, and the way they can trip us up! 'Better' outcomes are not solely 'birth without intervention'.

A 'better' outcome for a woman with high blood pressure and (say) a breech presentation of a 5 kg baby might well be an elective caesarean, prepared for and supported etc etc - she'll go down on the stats as a section, which in public health terms is something we should be trying to reduce, but as an individual she might feel confident, joyous, relieved, supported and all the rest of it.

So putting all 'NCT births' through a statistical mincer and seeing how many are normal is not very helpful.

The words 'normal birth' form a technical term, not a judgment of worthiness. It's ufortunate that in English the opposite 'abnormal' happens to have negative connotations...not sure what the answer is to this one

Attention paid to vaginal/unmedicated/supported/confident birth is part of dealing with tearing...surely? 'God awful tearing' can be (not always) a risk with unsupported, poor perinatal care...and NCT is campaigning for better staffing, more midwives, continuity of care in labour and all the other stuff we know, from research, enables women to have a better experience...not necessarily always a birth without intervention, but a birth where the interventions are understood and safe and which make the experience more, not less, satifactory, whatever she feels has had to be 'done'.

MOP = MP!!

I think that in antenatal classes, if there is no difference in birth outcome (which I would guess is the intention of 99% of attendees) then we need to be honest that there is not much in the way of birth choice.

I think that 90% of births have tears - we can't blame ALL of that on poor care.

But tears in themselves are not a terrible thing - some tears are tiny, need no repair, and heal by themselves with no pain or long-term effects.

It might well be 90 per cent of women tear in some way (though that sounds high to me....), but we need to know how many tears are a real problem. The skin of the perineum is fragile and stretchy - it withstands small tears just fine.

I dont know what you mean 99 per cent of attendees at a class want to have a difference in their birth outcome, sorry.

A good proportion of them know they are having a section, and don't want to change from that - they do want to have a good, safe, fulfilling experience with it, to make new friends and to think about postnatal issues, too.

MP, tearing of the extent you describe and i am presuming you mean 3rd & 4th degree tears that need suturing in theatre under spinal and might well need more work in the future are something, certainly in the trust I am involved with, that trigger an incident form and then bcome part of teh trend/risk analysis, so it can be seen if a partic. MW or doc seems to have more incidents than otehrs.

i really do agree with what tiktok says about better outcomes..it is so individual

the women i support re birth trauma have a common theme. ...feeling unheard/ignored in labour and not having information, being pushedinto a course of action and then not being debriefed fully in the postnatal period

listening and supporting non judgementally adn removing the 'my birth was worse than yours/as long as your baby is ok' contest that can creep in is so vital and that ties in with the hierarchy of birth