140 is not enough for NCT

8 Jan

I’ve finally found a situation I can’t deal with in 140 characters, so this is my first blog, sorry for the lack of pictures and fun stuff, I will get to that.

Yeh! I just have, quite good for gone midnight.

Firstly, I do know that lots of good is done by the NCT and that it is not all about Antenatal Classes, I would not like anything I do or say to take away from that, though it must be conceded that many people come to the NCT via their classes and they are the ‘Shop Front’ of the organisation in many ways.

Secondly, to those who have suggested I am “kicking off” a fight with the NCT because I am “promoting a project” please note this blog is not being placed on my website, it is free of any  promotion of any kind, and Bless you for thinking me that business minded, lots of people I work with do wish I were more that way inclined.

My first contact with the NCT came two years ago when I raised a question on Twitter “Anyone doing NCT classes? Can you tell me what prep you get for possible C-Section?”.  I was house hunting with a new Mum who was feeling confused and guilty about her C-Section and when I asked her what she knew about C-Sections from her antenatal classes she said she had done NCT but “just been given a leaflet about C-Sections”.

The tweets that flooded in knocked me for six, many said things like “We role played an operating theatre” or “We were shown with playmobile figures how many people would be in the room” but other tweets arrived saying things like “I had a C-Section, I was the only one in my class not invited back to talk about my experience” or “I was told if I gave in to “the cascade in intervention” I’d end up with a C-Section and wouldn’t bond with my baby”

I then received this email, originally sent to Miriam Stoppard and then forwarded by the author to my agent.

From: Nicola Ryan
Sent: 23 March 2011 11:01
Subject: For Miriam Stoppard from NCT

Hi Miriam,

I felt I had to write in response to your piece about NCT yesterday – and the Kirstie Allsopp caesarean story.

NCT does not want women to feel guilty about the way in which they give birth either. We do provide information about caesareans in our classes. And yes our classes are led by parents, so if they want to spend more time talking about home birth or pain relief for example, we follow the wants and needs of the group.  But you’re right to point out that 1 on 4 women will have a caesarean, and herein lies the struggle. Do we teach what women will experience for their first birth in an NHS hospital or what we hear women would like to experience?

If we teach to option 1, do we increase the likelihood of that happening, by dashing any confidence a woman has in her own ability to give birth normally? Or do we ensure that she is happy with the outcome that she might end up with?

And if we teach to option 2, are we setting a woman up for failure?

There is no easy answer but we believe it would be preferable for people to end their classes thinking ‘yes, I / my partner is capable of achieving the birth we would like’, than ending it thinking ‘birth is a scary and inherently dangerous experience and we need to be rescued by professionals’.

NCT takes its work – and this conundrum – very seriously, and is in the process of undertaking an extensive evaluation of all those who attend its classes. The latest phase of feedback suggests that around nine out of ten of all those who attended NCT classes across the whole country have found discussions about medical procedures useful, and over three quarters of both men and women feel that at the end of their course ‘know all I need to know’ about caesarean. Only five per cent left claiming they ‘know a little and want more’.

‘Empowerment’ is a word oft-bandied about in NCT circles. We want to empower couples to achieve the birth they want. Listening to those who attend our classes, we understand that for the vast majority, that’s a straightforward vaginal birth with the minimum of pain relief and medical intervention.

But the only ‘right’ birth, as far as the NCT is concerned, is a birth where the parents feel in control and well looked after. And NCT on a national level campaigns not only to attempt to reduce the rate of interventions such as caesareans, but also on behalf of parents who have had one, to ensure that their experiences is a positive, uplifting birth.

Best regards,

Nicola Ryan

Media Relations Manager NCT

Failure?! The only failure is not having a baby delivered safely into your arms.  It is patronising in the extreme to imagine that Twenty First Century women can’t focus on the positive while being aware of the negative, and goes against all medical advice that knowledge of what a procedure involves can reduce trauma.

Nature does not always know best, some births happen “naturally” others don’t.  Anyone with an interest in maternal health and the work of organisations like The White Ribbon Alliance knows this.http://www.trust.org/trustlaw/news/maternal-mortality-fistula-on-the-rise-in-rural-zimbabwe

The same is true of breast feeding, sometimes it works, other times it doesn’t, it is not just a case of trying harder or being braver and we have to be honest about that.  If the NCT were still the “Natural Childbirth Trust” and campaigned openly for births free from medical intervention it would be OK, but that is not the case, they are now “National” not “Natural” and branded as “The UK’s Largest Charity for Parents” this means they want to be seen as the go to place for all parents, this is how the NCT describe their antenatal classes on their website.

From where to give birth to knowing when your contractions are really getting underway, NCT antenatal classes are a great way to find answers to all your questions about labour, birth, being a very new parent and looking after and feeding your new baby

I remain angry at the unhappy, confused, disappointed tweets I have received, following my initial slightly petulant “Bollocks” tweet on the 3rd of January, and amazed at the discovery that the NCT website has 53 mentions of “Homebirth” and only 8 of “PND” (sadly, if you don’t know the abbreviation PND and just type Post Natal Depression into the NCT website you get no information).  I know the NCT cannot be the whipping boy for problems across the system; we do need an honest, open debate about the realities of giving birth in a western society, with a much higher average age for having a first baby than 20 years ago, and an ever increasing rate of medicalised conception, but telling women that accepting pain relief  means you are beginning a “spiral of intervention” which means you are more likely to have a C-Section, which means you are less likely to bond with your baby and more likely to struggle to breast feed is something that you do with great, great caution. The idea of a woman labouring for hours and turning away pain relief for fear of being a bad mother is barbaric, for some the pain of labour is almost a pleasure, for others it is profoundly disturbing and there’s no knowing how it will take you.

God knows there’s enough guilt further down the line, like when you realise that for most of the Christmas holidays your child’s five a day has been five chocolates a day!

I am not yet sure where to go from here but I know that unlike two years ago, when I failed to reply to a second letter from the NCT (a more considered take on things from NCT President Sue Saxey) because I was exhausted by the whole debate, I will continue to search for evidence that the NCT are helping all mothers towards a calm, realistic understanding of what can happen when you come to give birth.

PS This is essential viewing  you will laugh and laugh, if this link doesn’t work Google Dara O’Briain NCT

It’s only been a few hours since I posted this and I have had so many comments, unless the comments are very abusive I will approve them, regardless of whether or not the contributor agrees or disagrees with me,  I want this debate to be open and honest.  Please remember that “approval” in a blog sense does not mean I agree with a statement.  Thank you SO much for taking the time to post a comment on this blog.

Friday night, actually it’s Saturday morning, perhaps I should have analysed how much time I had available for a blog before I started, Anyhow this is my chat with Sheila Kitzinger


Sunday Night – Again I just want to say Thank you, Thank you, Thank you for taking the time to post comments.  Every single one helps towards establishing what we all want from all antenatal classes.  One interesting point, in an NCT feedback survey of 2010 it was established that 31% of those women attended the NCT classes surveyed had given birth by C-Section.  If at the start of any class this figure was made known like this “I know many of you are hoping for an uncomplicated birth, but in a recent NCT survey 31% of Mums delivered by C-Section, so perhaps a good chat about what that actually involves, and maybe even an examination of some of the upsides, will be something you might find reassuring” wouldn’t that represent real progress? (Ditto breastfeeding, which so many of you seem to have found a struggle)

Just a thought, Kx