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?
Hi :-) I have just started my level 4 birth and beyond foundation degree with the NCT and your article could not have popped up in my Facebook news food at a better time:-) my husband and I were only discussing the other day about how influential the antenatal teacher can be (and what a privilege to be included on the parents to be journey of course!!) But it got me slightly nervous about my future as a NCT ANT - your article has truly helped me put it all in perspective and I have no doubt I'll be using the idea of "what would you like from me" in years to come!! I'll be sharing your article with my core group now. Many thanks again :-)
I think you raise some interesting points. I think one of the issues, from the perspective of a client, is that we are (often) naive and vulnerable as first time parents and are likely to take the opinion of an NCT leader as fact. I remember the 'women have been giving birth for thousands of years...' speech and I'm not sure it is very helpful, since they have also been dying as long. We are lucky, though, to have an incredible NHS that will work in our best interests to ensure a safe outcome for mum and baby, wherever possible. Whether it was intentional or not, I got the impression from NCT that medical intervention was to be avoided and was generally for pain relief or convenience, rather than safety, which led to a lot of guilt post-birth. I think a more rounded approach to teaching, as well as a more objective view (for instance, not letting the birth experience of the leader affect the course content), may go a long way towards participants valuing the course as much as the friendships. Hope this is helpful.