Monday, 21 February 2011

what has the nct ever done for us?

The Telegraph ran an article on Saturday about the stigma surrounding caesareans, with an interview with television presenter Kirstie Alsopp who has had two caesareans herself. The subtitle (unsurprisingly) doesn't really reflect what she said in the article and she didn't exactly "launch an attack on natural birth campaigners" via Twitter, but she is quite obviously upset about the lack of information parents receive antenatally about caesarean sections.

I've been there, done that. In fact, I was being there doing that six years ago tomorrow - almost to the minute as I write this. I responded to Ms Alsopp's tweets on the topic (whether or not they made it through the thousands of replies she must have received is another issue entirely), specifically, to her question about whether or not my NCT classes covered c-sections sufficiently. The article states:
Miss Allsopp, whose two sons were delivered by C-section, said many women were made to feel a "failure" after undergoing the procedure.
Although I never thought anyone else made me feel like a failure, I certainly thought that about myself. I felt duped; despite having read dozens of books about childbirth (including the fantastic Thinking Women's Guide to Better Birth by Henci Goer) I still just nodded mutely when the suggestion of an induction and then a c-section were presented to me. I've never been one to do what I'm told (apologies to my previous teachers, bosses, and parents), yet I didn't think to question what I was being told or ask for alternatives.The article continues:
She said more information should be provided by the National Childbirth Trust about C-sections in its antenatal classes.
In my case, I agree with this statement. To be fair, no one can expect a thorough explanation about every birth scenario in 8 evenings, but the coverage on this type of birth was very brief. Considering around a quarter of births are by c-section, it's a big one to gloss over. One of our evenings involved an overview of the surgery (including a "re-enactment" of who would be in theatre using Playmobil figures), and that was it. Out of 8, 4 of us ended up with unexpected caesarians. I knew nothing about it going into it, had no idea how difficult recovery could be, and had absolutely no information about breastfeeding after surgery (which is more a fault with the NHS, in my opinion.) The fact is, no matter what type of birth you'd like, preparation for other scenarios isn't a bad thing.

Belinda Phipps, the NCT's chief executive said:
If you've got a class of people who want home births then Caesareans aren't very interesting to them. Our teachers do a demonstration with Playmobil, but we don't force it on people. Our view on Caesareans is we would want to make sure women don't have a procedure if it could have been prevented.
This saddens me. My interpretation of this statement is that Phipps believes caesareans are simply not of any "interest" to some people and teaching about it would somehow be perceived as "forcing it on people". But how is the NCT teaching parents to avoid a procedure they may not need by not talking about it? Prevention, education, information - why isn't any of this covered? Those of us who did opt for home births most certainly didn't do so without any information about the alternatives. I wrote three birth plans: home VBAC, hospital VBAC, and a repeat section. Having experienced a section, I knew exactly what I did and didn't want if I needed another. When I had Jack, I didn't even know I could request anything or try to make the experience as "natural" as possible. It was only through experience that I could try and make the next birth better for me.

I am not anti-NCT or their classes and in fact, I've always told people how wonderful they are for making friends. Especially for us as first time parents, knowing others who were also having their first at around the same time was wonderful. Beyond that, I don't think I actually learned very much about pregnancy, childbirth, and breastfeeding.

As I mentioned before, there is only so much you can cover in a few hours, so I don't necessarily fault the course; it's far more informative than the one day Parentcraft classes offered by the NHS. I don't think we can put the entire blame on the NCT for not fully educating a small percentage of parents who opt to take (and pay for) their antenatal classes, but they can expand their material to cover more about caesarians. I did mention this to the instructor when she asked us for feedback about the class, so there's every possibility that the local course material has changed. On the flipside, there was no discussion about home births either. Although this could be because the instructor knew none of us were planning on having one at that time.

So essentially, Alsopp is right - the stigma surrounding caesarians needs to stop. No one's really talking about it, not just the NCT. Talking about it doesn't encourage anyone to opt for one unnecessarily or offend us mad hippy mothers. And while I'm here, can someone point me to the person who coined the phrase "too posh to push" so I can slap them?


Lisa said...

If it's not too cheeky/boastful, here's what Kirstie Alsopp said to me via Twitter when I sent her a link to this post:

@lisadurbin Wow! That's more than I've managed in last couple of days. Congratulations on saying so well, what is the experience of so many.


Helen said...

Eloquent as ever Lisa. I am so pleased Kirstie agreed too!

Stacey said...

The NCT coverage of C-sections sounds amazing compared to the Parentcraft class we took at Addenbrookes. Basically the entire coverage was a blanket statement that all doctors are pushy and just want to intervene no matter what. That's it, nothing about what happens, nothing about recovery, nothing at all. And don't get me started on her coverage of pain relief. "This is what you have to have in your back if you have an epidural. Yuck." Again, nothing about what they are actually doing, nothing about benefits or even about the drawbacks, just a tossed-off negative remark so she could get back to pushing her agenda. After that class, we declined to back for the next two sessions. Needless to say, it was not much help to me when I needed to have an emergency C-section with my first.

elderflowerpressee said...

Great post. Our antenatal classes made no mention of C-sections. I think the midwife was superstitious about them - if you speak the dread word out loud then you are inviting calamity. Mind you this is the woman who tried to put us off epidurals by waving the apple corer-sized needle before our horrified eyes and hissing 'See how big it isssss!!' Bonkers. I had two C-sections, and I am not the least bit posh.

Naomi said...

I'm always really saddened to hear about women having such awful experiences in relation to c-sections. Like you say, it's just not necessary: a bit of information would go a long way whether they have a c section or not. Preparedness for any eventuality can make you feel a whole lot better, regardless of outcome. I had an elective c section for medical reasons in Brighton and the hospital were AMAZING. It was an extraordinary event. I also made it v clear to my NCT teacher what my situation was (telling her, in other words: do not make me feel bad about this!) and to her absolute credit, she created a group that was open to discussion of all birth scenarios. No judgement basically. Tho' I have heard - from v close friends and my sister - of other NCT teachers in the area not being so clued up, misinforming women about c section births (e.g. telling them you won't be allowed skin to skin). And I offered to set up an elective c section meet for the NCT for women in my position. I suggested I go along to the VBAC group to get an idea of how these things are run, but was told I wasn't allowed to because my experience might upset people. Needless to say, I didn't set up the group.

Lisa said...

Naomi, that's terrible. How on earth are parents supposed to make informed decisions if they aren't "allowed" to learn about all birth scenarios? I'm sorry that you didn't get to set up the group; what a shame. It may be worth having a chat to your local midwives/health visitors and asking them if they have any mums who are scheduling a section and may want to chat to another mum who's been there. Maybe in a peer supporter type of role?

liz x said...

i cant say they covered much on pre eclampsia, forceps deliveries or what to do when your baby won't feed either. our class definately needed more on births with intervention, but yay to making new friends ;o)

Lisa said...

Very true, I think a lot of us were left a little shellshocked from the unexpected! And yes, it was so lovely to meet all of you and to have kept up these friendships since our oldest were bumps. :) xx