What do you actually want from me?
By Zana Parker, Sep 9 2017 02:26PM
Ok, my hand’s up. I admit it. I’m an NCT Antenatal Teacher (amongst other things) and this blog concerns something that’s been building up over years and that I feel hurt and exasperated by. At the end you’ll have 3 options to choose from.
Recently, after a chilled and joyful weekend away at a music festival, I got home and caught up with social media. Such a mistake! My heart sank, and definitely not for the first time, as yet again I read how NCT antenatal classes are great for making friends but not much else. It seems that NCT teachers are “biased” towards natural birth and “negative” towards intervention. If some women have a difficult birth experience it somehow becomes the fault of the NCT teacher.
Don’t get me wrong; friendships are invaluable, particularly when you’re about to go through a major life transition with a whole set of new challenges. I’m really glad that most couples on NCT courses find a great group of friends who can relate to the same concerns about nappy contents, sore nipples and the effects of sleep deprivation. This truly is a massively important and worthwhile thing. But are you really paying a couple of hundred quid just to make friends? How is it that the educational value of NCT classes is so low on the agenda? Do we study for three years just to help people make friends?
I think it’s fair to say that most new clients I meet are somewhat apprehensive, at best, about what women’s bodies are expected to go through in order to produce their babies. Most people don’t know what a contraction actually is and what it’s achieving within the female body. “10cm dilated” might be compared to a Dairylea spread box and that really is a horribly alarming thought! No wonder that for many, giving birth seems an alien prospect, unreasonably demanding on the human body, excruciatingly painful and scary. Then there’s “reality” TV, your auntie’s best friend’s horror stories and the popular press who are always ready to perpetuate the whole “birth is dangerous, scary, agonising and damaging” mindset. Don’t even get me started on the birth video shown to 10-year olds in schools. With this kind of background and build-up it’s not like any NCT teacher is meeting a new group with a clean slate. Most people in the room come with birth baggage, even though they haven’t been there yet, and that’s not surprising. What is perhaps surprising is that NCT teachers might be expected to transform individuals’ perceptions and control their birth outcomes after a few short hours of classes; that somehow I can wave a magic wand and hey presto! - the perfect birth experience can now be yours! If only I had that much power!
Let’s face it; women have been giving birth for thousands and thousands of years and generally speaking it has worked pretty well or the human race would never have got this far. Even in countries without easy access to medical care populations are not in decline. Let’s face another thing; some women need medical intervention to help them and/or their babies have a healthier outcome. And sadly some women (and their partners) are left traumatised by the whole experience.
But how much of the “negativity” or poor experience on the day is down to what women and their partners learned in NCT classes? Why does the buck stop at the antenatal teacher’s door? At the end of a course, how can I be accused in feedback of being both anti-NHS as well as being refreshingly unbiased? How is it that NCT teachers are to blame for every birth experience that didn’t match hope or expectation? Is it maybe just slightly possible that some of how a class member views their course might be based on their own biases and beliefs, thoughts and feelings, hopes and fears, past experiences as well as how their experience unfolds on the day?
This isn’t about blame. I’m not blaming women, their partners, the NCT or me. It’s about ownership. What do you want from me? I’d like to present three options, three different angles, three different versions of perceived NCT class ethos. Take your pick.
Version A: “Lots of women have medical intervention in labour. It’s probably a good idea to take the advice and do as you’re told because the midwives and doctors are the professionals and they know what they’re doing. Sorry, what was that? You’re asking me what the evidence says and what the statistics are? And you don’t know what some of the medical terminology means? Oh, you don’t need to worry about things like that. After all, if there were any knock-on effects or other options you’d be told, wouldn’t you? Those caring for you have your best interests at heart so they know what’s best for you. You can always ask questions during labour. Everyone is always happy to help. If you don’t like the contractions you can have an epidural which is really effective for pain relief. Then you’ll be numb already if you need forceps. Most women and babies recover really quickly and hardly anyone has any lasting effects.” And this approach might be preferred by some women and their partners.
Version B: “Birth’s a breeze. Women have been doing it for millennia. All you need to do is light some scented candles, float about in a birth pool, stay away from the hospital and breathe your baby out. You’ll hardly feel a thing. You probably don’t even need a midwife with you. Interventions? Oh, don’t even think about them. Just stick some Hopi ear candles in your ears, waft some incense around and invoke the Goddess within. Focus on Mother Nature and all her wondrous bounties. Giving birth only hurts if you want it to hurt. Just close your eyes and think about unicorns and rainbows.” And this approach might be preferred by some women and their partners.
Version C: “Most women’s bodies are designed to give birth and women have been doing this for millennia. It’s not a walk in the park; it is damn hard work, but it usually works well, given the right conditions. Can we ask about....? Of course, you can have a meaningful discussion about anything that concerns you. Do you “have” to accept certain things? No, not unless that feels right for you. How do you help your body to labour best? Let me show you some things you can practise. But some people need intervention, you say? Yes they do. And sometimes that’s absolutely the right thing. I’ll help you understand what the common interventions are and what their impact might be. If you have a greater understanding of the workings of the human body and mind, what the evidence says and what your options are, as well as what medical help is available, and if you and your partner also practise all the breathing awareness and physical skills that you learn, you’ll both be armed with a lot of stuff that could really help you in any situation.”
So what do you want from me? Version A, B or C?
Brilliant Zara you have put most eloquenty into words what I have been thinking .
This should be published as a right of reply.
I might start agenda setting with "What do you want from me ?"
Well done for blogging your reply, great words, really speaking the truth. Maybe hit the press with it? X
A very elequent piece of writing. I agree this is a good way to start the classes.
Spot on. I threw Grazia in the bin after a recent article and I won't be buying it again.
No one wants a woman's journey to motherhood to start with guilt, however I would like to see some of the NCT-blamers asked, calmly and non-confrontational, did you fill in a feedback form, both at the end of your course and after the birth? Did you reply to the request for online feedback from the evaluation team? Did you make an official complaint? For all these things help us to identify issues and plan to improve things. And also, does everyone in your antenatal group feel the same?
This is beautifully expressed, Zara. It's tough when a complex situation like birth preparation, which has multiple influences (internal and external), is reduced to a single judgement statement.
Making friends is the simple, most straightforward aspect of what we offer, so there tends to be consensus on that. Birth preparation on the other hand is influenced by everything you outline above, including individual beliefs, hopes & fears, society's expectations, and the local maternity services.
Maybe it's important to be explicit with the three options you outline - using tongue-in-cheek humour as well as plain speaking to agree the agenda from the start? I'm sure different ANTs have their own ways of dealing with this challenge - are there ways of exploring this further, and sharing experiences and good practice?
Thank you for posting this - it's such an important question.
I am a Childbirth educator in New Zealand for 29 years and I have been facing just this dilemma head on , in the past week since I have done a poll / invited post birth feedback from 4 of my recent classes. End of course feedback has been pretty positive , but this has been a real eye opener ! It has been helpful in some ways I have to say , but also creates such a dilemma exactly along the lines of the three scenarios you have given above ! I am not sure where to go with it to best serve families , but I like the idea of asking the group at the outset "What do you want from me?"
I'm an NCT teacher too from my in box today....."Once the dust settled on Saturday (my partner) and I did have a laugh that NCT had prepared us for every possibility which could go wrong, which did! Thanks to your sessions we were familiar with the terms being used therefore the options presented to us became a little clearer in the heat of the moment therefore we are very thankful."
This raises some really pertinent points - thanks for sharing.
I'm just a little concerned that because the phrase 'breathing your baby out' is used in Hypnobirthing, your summary in option B suggests Hypnobirthing is airy-fairy, head-in-the-clouds and isn't preparing women and their birth partners for birth.
It couldn't be further from the truth. The KG Hypnobirthing method that I am familiar with (FYI I am not a Hypnobirthing teacher), focuses hugely on choices in birth, empowering people to make choices and speak up when they want more info/want to know the risks and benefits. This method does not preach about 'pain free birth' *at all*.
Really value these issues being put out for discussion, but I would just caution such sweeping generalisations, stereotyping of Hypnobirthing, and actually making it out to be totally ridiculous ("think about unicorns and rainbows"), although I do recognise that you didn't actually label option B as Hypnobirthing, one can only assume that it what it refers to. Thanks for starting a discussion here. All really positive.
Thanks for your comment, Frances. I just wanted to agree with you that I have no issue with women "breathing their baby out". In fact I very much encourage women to do so, whether I'm working with my NCT hat on or my Hypnobirthing hat on! (I teach both, as you'll see from the rest of my website, so am definitely not ridiculing hypnobirthing.) I was merely illustrating the point, in a slightly tongue-in-cheek way, that some NCT teachers are accused of being "too biaised" towards natural birth. "Breathing your baby" out was just a small part of the whole paragraph and intended to be taken with the rest rather than isolated. I also stated that this might be a preferred approach for some. Equally, in Version A , I said that epidurals are really effective pain relief. Well they are in most cases! But NCT teachers are often accused of being too negative regarding interventions so I was deliberately offering a version where I've skimmed over all the pros and cons. Whatever hypnobirthing approach you are familiar with, and whatever approach to stress/anxiety reduction women and their partners use to help them in any situation, focused breathing is, of course, an extremely useful tool! The thrust of the whole piece is very much focused on NCT classes (as distinct from hypnobirthing classes or anything else), hence the references to NCT throughout.. I hope that clarifies.