Wednesday 16 March 2016

TEN THINGS I WISH I'D LEARNED IN ANTENATAL CLASSES

MY MIXED FEELINGS ABOUT THE NCT

You're here! Umm, now what?

I picked up the phone and left a shaky voicemail message in a voice I barely recognised. 

It was about two weeks after giving birth and I was a mess. After a difficult birth and an eight-night stay in hospital, I had barely changed any of my baby's nappies, breastfeeding was a struggle and my mind was shrouded in something dark that I hadn't experienced before. I felt numb and was struggling to see how things would ever get better. 

After a bit of Googling I discovered the existence of the NCT shared experiences helpline, which endeavours to put women in touch someone from their roster of volunteers who have been through something similar. So, one evening, I plucked up the courage to dial the number and leave that message. I'm so glad I did. After about 24 hours I was referred to a lovely lady with whom I had a tearful chat for a couple of hours who helped me to see - and hear in her kind yet confident voice - that the fog would lift. But this support was nothing at all to do with the NCT antenatal classes I had attended whilst pregnant, and I would have had access to the same support had I not forked out to attend them.

Since having Elliott I've been asked numerous times by parents-to-be whether or not the NCT classes are worth the money. And it's a lot of money (the course we did in 2015 was around £300, though prices vary depending on the type of course you do and by region). I always say yes. But primarily for the network of almost instant friends you're likely to accumulate. Beyond this, I'm truly torn.

Founded in 1956, the NCT (the 'National Childbirth Trust' name was scrapped a few years ago) aims to support parents through what they believe to be the crucial "first 1,000 days" of a child's life after conception. Which begs the question, why do their phenomenally popular antenatal classes place so much emphasis on the birth, rather than the 700 days that follow?

Whilst thinking about this blog post I asked mums from my local Facebook parenting community - Mummy's Gin Fund - for their thoughts. The volume of responses and took me by surprise, and almost all of them centred around a few key themes which were in line with my own thinking.

It would be unfair of me to suggest that it would be possible for the NCT to encompass all of the below in their classes. After all, there will never be an ultimate instruction manual for having a baby. And I did ultimately enjoy the classes - the teacher was friendly and a group trip to the pub at the end of the final one went down a treat. However, with the benefit of sleep-deprived, poo-stained and vomit-soaked hindsight, here are the ten things that I wish I'd been told...

1. How to actually look after a baby
Learning about the biology of the birth itself is undoubtedly fascinating, but I wish we'd learned more about the realities of day-to-day parenting. I do understand the NCT's probable thinking behind this. After all, different people "parent" in very different ways and the NCT course leaders try hard not to be seen to impose a certain style or method over others. In an attempt to overcome this their classes focus on evidence-based guidance as opposed to the teachers' own experiences. But it does result in a total lack of practical advice from someone who has been there, done that. Emma, a mum from the local Facebook group, summed it up by saying: "In retrospect it seems crazy to spend hours discussing the element of becoming a parent that we had the least control over. In our group we all had wildly different birth experiences - but the unifying factor was that we all had these tiny new humans to get to grips with at the end of it. A more practical focus on first aid*, winding, feeding (breast, bottle and the almost never discussed combination feeding), after care, child development, sex after baby etc would have been infinitely more useful."

2. Accepting medical intervention doesn't mean you've failed
Above everything else in the classes, I came away from them thinking that I should strive for as natural a birth as possible. You are steered towards the belief that natural births are good and anything involving intervention is bad, and to always question medical advice whilst in labour. Emma felt the same: "I felt totally unprepared for any scenario that was not a drug-free labour, healthy baby and a smooth breastfeeding journey and it took me a while to shake off that (irrational) sense of failure of not achieving that." And I think that point about failure is a crucial one. Another woman from the Mummy's Gin Fund, Claire, hits the nail on the head, by expressing that she wished the NCT would "empower the women, so they know that they can do it, whatever the scenario. And let them know they and their babies are a success and miracle however they come into the world." Sadly I didn't feel empowered after the classes. Instead, I came away thinking there was a "right way" and a "wrong way" to have a baby. So when my birth quickly went from a very natural scenario to a highly medicalised one, I felt an enormous sense of guilt for having fallen at the first hurdle as a mum. Which is ridiculous, given that the medical intervention, which I was in no fit state to question, saved my life.

3. Your body - and your mind - will take a while to recover after the birth. Let it, and accept help.
Giving birth is bloody tough for everyone, regardless of how it ends up happening. And all women need to be given the chance to recover from that, physically and emotionally. I'm not saying that the NCT told me to crack on with things once the baby was born - I think western society as a whole has more to answer for on that front - but I really wish I'd been told that's it's OK to give yourself a break and, crucially, to accept help rather than try and be some high-achieving supermum from the outset. This blog post is a fascinating read in this regard, and makes some really strong points about the importance of mothers getting enough sleep when they return home, letting others care for them and their new baby, and not being made to feel as if they have to immediately carry on their lives as normal.

4. The realities of breastfeeding
There was an entire half-day session dedicated to breastfeeding in the NCT course I signed up to and I came away thinking my baby would climb up my chest once he was born and latch on to my boob straight away. It would also be painless and, if it did hurt, I was doing something wrong. Many women I spoke to reported that they had been told the same so, when they did experience pain, they thought they had failed (there's that word again). I've written more extensively about breastfeeding previously, but in terms of the antenatal session, a more truthful picture of some of the common obstacles you're likely to encounter to begin with - letdown pain, potential tongue tie issues, the symptoms of mastitis, cluster feeding, inevitable (and often unfounded) doubts about your milk supply - and how to overcome them would have been a more productive use of everyone's time. Instead, you are presented with a rose-tinted view of what it will be like, meaning that - as I've written before - many women probably give up breastfeeding because they believe their perfectly normal difficulties are unique to them. It's such a wasted opportunity. 

5. Formula: the basics
I think it's fair to say that most women intend to give breastfeeding a go if they can, but despite asking to find out about formula in our antenatal class we came away with no tips or insights beyond an acknowledgement of its existence. Understandably the NCT don't want to be seen to be promoting formula given their evidence-based approach, but there's a difference between talking about the practicalities of formula and promoting it. After all, some new mums don't even get the chance to try breastfeeding if they are separated from their baby in the beginning, as I was. I also think failing to discuss combination feeding as a perfectly sensible option for feeding your baby - especially if you end up having to recover from a traumatic birth - is a real shame, given that combination-fed babies still get all the advantages of breastfed babies in addition to being able to take a bottle, meaning you can share feeds. It's worth pointing out, however, that there is information about formula, bottle feeding and combination feeding on the NCT website but, in my case, this was something I had to seek out for myself. 

6. Wind
Oh those pesky bubbles of trapped air. They will cause most new parents such anguish, and their little babies such discomfort, yet the entire concept of wind wasn't, as far as I can remember, even mentioned. I do wonder if this is related to the strange myth that breastfed babies don't need burping after feeds, which isn't the case at all. 

7. *If* you have a tough birth, help is out there
It would be impossible - and pretty scary for parents-to-be - for the NCT to outline the many ways that giving birth can go awry, or how babies can get sick. I get that. But briefly touching upon the various sources of help that are out there, including the NCT's very own helpline, if you need any emotional support would have been so useful for me, and would have saved hours of Googling when I should have been sleeping. 

8. You'll never feel such extreme emotion
I think we learned more about hormones in the NCT classes than we did about anything else, but what we didn't learn was how those hormones would make you actually feel. For about a fortnight after the birth, my husband and I were flooded with oxytocin, except at the time we didn't realise that. We were in awe of everything and everyone, especially each other, and the world seemed hyper-real and about ten times as intense and beautiful as normal. Familiar songs took on deep, new meanings and average animation films were suddenly the most inspiring things we had ever seen. And, of-course, our baby was the loveliest baby in the world, without a shadow of doubt. We thought this was because of the dramatic birth and its aftermath, but looking back I think this is actually a pretty normal way to feel after having a baby. Oxytocin heightens all your emotions - good and bad - so be prepared for highs and lows like you've never experienced before, especially if you're just starting out breastfeeding, which gets the hormones whizzing around even more.

9. Love feels different for everyone
My hypnobirthing CD subconsciously gave me the expectation that I would feel a huge "rush of love" for my baby when he was given to me following the birth, and the NCT placed a big emphasis on the importance of skin-to-skin contact in the first hours to help you bond with your baby. None of this happened to me. Perhaps if I'd had a less complicated birth it would have done - I'll regrettably never know. But in the days and weeks that followed I did feel as if there must be something wrong with me because I didn't feel like I was expecting to feel, and I believed I'd never get the chance to fix it because I'd missed out on that important skin-to-skin time. I wish I'd been told that everyone feels differently after giving birth and there's no right or wrong way to feel. For me, it was simply as if Elliott had always been there (when I look back at pictures of me from a few years ago I wonder why Elliott isn't in them!), and over time that sense grew and intensified.

10. And finally...don't stress too much if there's no poo
I couldn't write this post without talking about poo. We were told in the NCT classes that as long as they are producing lots of wet and dirty nappies your baby is, in all likelihood, fine. And you are given a useful leaflet showing you what the poo will look like and when. But when our baby took days to have his first proper poo we panicked, and we continued to worry when he often went a week (or more!) between bowel movements**. These days he has many, MANY poos a day. Every baby is different, and their nappies will produce many different types of surprises as the weeks and months go on. A heads-up about this would have gone a long way. 


In fairness to the NCT, it's important to note that they do ask attendees to provide feedback after they have attended the sessions. Crucially, however, they send out these surveys before you're likely to have had your baby, so any feedback you provide at that stage is from the perspective of someone who can't even begin to grasp what being a parent is actually like, and what you wish you'd learned. 

There are numerous other antenatal options out there beyond the NCT. The NHS run free classes, though they are often very large groups, and there are also other private providers (some of my local options in London include Doctor and Daughter at £380 per couple, and Within You, cheaper at £200 for a total of eight hours). But, the reality is, unless you attend a class within your immediate vicinity, you're sadly unlikely to see your newly-acquired friends very often once you have a baby, especially if you don't have a car. And because the NCT have such a firm grasp on the market, it's simply the best class to do if making friends is your priority.

My husband and I were lucky enough to meet six other couples who all live within streets of us. Throughout our maternity leave, the six other mums and I saw each other three or four times a week on average, sometimes more, in various permutations. And over the months our friendships became about more than just babies and parenting, although that's obviously a good starting point.

We've been through loads together over the last year. There's been so much laughter, as well as many tears. Not one of us had a "straightforward" birth without some kind of intervention. Sleepless nights were made bearable by Whatsapp banter and the amount of coffee we have collectively consumed could probably fill a larger than average lake. 

As everyone in the group begins to drift back to work, and the pool of local friends and babies I can pop out to see at a moment's notice gets smaller by the day, it's made me appreciate just how lucky I've been to have these amazing people in my life. We jokingly refer to each other as "bought friends" but, for me, this ready-made local support network of amazing women, and their partners, has been life-changing and truly priceless, and, despite the many improvements that could unquestionably be made to their antenatal offering, I will always have the NCT to thank for that.

* Regarding first aid it's worth acknowledging that this is a huge, specialist subject that could never be comprehensively covered in any antenatal class. However, a pointer to take a look at the excellent British Red Cross baby and child first aid app would have been helpful.
** Always speak to a medical professional if you're worried about lack of number twos.

7 comments:

  1. Interesting thoughts on the NCT, I wonder if other offerings are as comprehensive in what they cover, would the NHS classes cover everything you needed within their free classes? Thank you for sharing your experience. Just a note, The first 1000 days starts at the day of conception not the first day of welcoming your baby to your arms.

    ReplyDelete
    Replies
    1. Thanks for your comment and for clarifying that inaccuracy, which I've corrected. I truly doubt whether there's a "perfect" antenatal class out there, as there's always bound to be something that gets left out. I only have the experience of the NCT one to go by. As I say in the post, I think it would be impossible to encompass absolutely everything, but I ultimately wish I'd come away feeling empowered and open-minded, rather than have a set idea about how things should go.

      Delete
    2. Check out the Daisy Foundation 😊

      Delete
  2. I'm wondering if you set an agenda in the first session of your course, and whether there were a lot of questions about birth on it and how to prepare for birth. There usually are, which is why the courses spend a lot of time discussing it - it's because it's what parents ask to do.

    BTW - I'm an NCT teacher and I've observed a few NHS classes. In my experience they cover exactly the same ground as NCT classes, just much faster (more chalk and talk), and with much less discussion.

    I hope you don't mind me saying - I think it's unfair of you to complain that your NCT course didn't cover first aid. You must have been aware of this fact when you signed up. It's like signing up for a swimming course and then complaining because it didn't cover scuba diving! First aid needs to be taught properly by a fully qualified first aid instructor, and it's really not a good idea to do it weeks or even months before your baby arrives. Having a baby appears to have a serious impact on people's recall of antenatal preparation, which make antenatal infant first aid learning a problem. This is why midwives and antenatal teachers don't do demonstrations of how to make up formula feeds before a baby is born - research has shown that people who learn to do it in this way have very inaccurate recall and may make a bottle up unsafely. The ideal is to be shown one to one after the birth.

    It probably accounts for why as an antenatal teacher I often sit with my head in my hands at reunions listening to people tell me things like 'we wished we'd covered colic' on the course, when actually we HAD, at length! Accompanied by diagrams, information on flip-charts, handouts (unread), audio tapes of crying babies, follow up emails (never read)...

    "We were told in the NCT classes that as long as they are producing lots of wet and dirty nappies your baby is, in all likelihood, fine."

    Sorry - but having seen newborn babies being readmitted to hospital with severe feeding problems evidenced, but not acted on, by parents unaware that a lack of wee and poo often indicates a feeding problem that needs addressing ASAP, I think antenatal teachers need to encourage parents to consult a health professional if a baby is not pooing in the first week. In any case, the handout ('what's in a nappy') which all parents are directed to is very clear - the first sloppy yellow poos are seen on about day 5/6. The sheet is also very clear that older breastfed babies may poo much less, but that in the first week sloppy yellow nappies are a sign of good feeding.

    Re: 'having a set idea about how things should go' - did your classes not cover emergency c-section? NCT classes are ALL supposed to cover this - how it happens, how frequently it happens, recovery from c-section etc.

    Finally, this: "but I really wish I'd been told that's it's OK to give yourself a break and, crucially, to accept help rather than try and be some high-achieving supermum from the outset." as a comment in an article about what you did or didn't learn in your NCT classes? Are you saying that your NCT classes left you with the impression that you shouldn't rest and allow yourself all the time you need for recovery after the birth?

    ReplyDelete
    Replies
    1. Thanks so much for commenting. I did hear from numerous NCT teachers when I was researching this post but none were willing to be quoted (which I totally understand). So it's good, and important, to get another perspective. I tried really hard when writing this post not to be seen to be having a go at the NCT because the charity does brilliant work, for which I'll be forever grateful. As I mentioned, overall I enjoyed the classes, and was glad that I had done them. And all of the above is written with the benefit of tons and tons of hindsight, and it would of course be impossible for any antenatal class - NCT or otherwise - to cover EVERYTHING. But to address you points: yes, in our group we did set an agenda at the start, and I think above everything else we specifically didn't want to focus on the birth, but it still did. We did go through c-sections but nothing about recovery. There was nothing (that I can remember) about mothers needing time to rest and getting help after giving birth, but this was more of a broader point about the pressure women put on themselves in western societies when they have a baby, and how I wish *someone* - not necessarily the NCT - had told me it was OK to lie down for a fortnight and to let someone else look after the baby. I do definitely appreciate your points about the first aid (which was someone else's view rather than my own) and poo - I will add in editor's notes as soon as I can (currently manhandling a squirmy post-nap baby whilst typing one-handed!) to redress the balance here. Thank you again

      Delete
    2. I've now made some edits and additions to address your points.

      Delete
  3. This comment has been removed by a blog administrator.

    ReplyDelete