NCT v NHS antenatal classes

[snowboarder]

cross post with keef...

Have to say some of the experiences some seem to have had of NCT sound SO different to my own I can't believe it!! There was no 'guilt' or 'pressure' re drugs/epidurals/c sections on my course - but an intelligent run down of the implications good and not so good - of all medical interventions.

[Keef]

For the record, I'm not anti NCT either, I was even at their weekend confrnece in Telford last week!!! (now that is commitment ... Actually, I was just holding the baby with a lot of fed up dads, whilst the missus went to all the talks)

I think they do great work in lots of areas, but there are too many stories about these classes for it to be total myth. It obviously depends who you get, which is wrong really, as the information received should be uniform wherever you live IMO.

[sillywoman]

it's unhelpful because it's unsubstantiated and unprovable. For every midwife friend of yours who doesn't like the NCT, I could produce one who does, but where's the benefit to the OP in that? It's one thing to post your own experience - that's helpful - but to post the views of a friend who thinks that some women she's cared for in a professional capacity have experienced x, y or z attitude from the NCT is entirely unhelpful. She doesn't know for sure, can't back it up with any proof - it's just her interpretation of how she thinks they feel. As a basis for any decision making it couldn't be more vague.

It's interesting to note that she's a C&W midwife. They're know as one of the most obstetrically inclined NHS hospitals in London with a horribly unnecessarily high Caesarean rate, without doubt this will impact on her view of the work the NCT does.

I'm not taking it as a comment about my classes Keef - I know that it's not. But,it is a comment on the charity I work for & so does impact on me. As you say, you haven't done the classes and yet you do seem to always pop up on these threads with a negative comment or opinion about the work we do. I aim to balance this and feel I should defend myself & my colleagues where I can. Misinformation is never a good thing.

[sillywoman]

I was at the conference too - wish I'd known you were there!

[Keef]

Ignore my post then, and stick to the ones that follow it, as they are personal experience, thus helpful and valid ;-) My point is simply, that in a large charity with teachers from different backgroinds and beliefs, it is going to be pot luck what your local teacher favours.

[Fuschia]

new mother Wrote:

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> Friend of mine has one answer to the mere concept

> of "guilt" re epidurals.

>

> "show me a footballer who gets his broken leg

> reset without state of the art anaesthetic"

On the other hand...

To pinch your analogy..

if you were offered the chance to stay upright and hop about a bit while they fiddled with your leg, and a pretty good chance it would all be over quickly and you could be home next day.... vs take the drugs but have to lie down on a bed and the possibility complications will arise that will require major surgery and staying in hospital for up to 5 days... personal choice of course but I think I'd go for the keep yourself mobile see how you go with the gas and air option!

[Keef]

Surely everyone sees how they go with gas and air for a bit don't they?

[Ko]

snowboarder Wrote:

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There was no 'guilt' or

> 'pressure' re drugs/epidurals/c sections on my

> course - but an intelligent run down of the

> implications good and not so good - of all medical

> interventions.

yes that was my experience too. good run down of pros and cons of different options.

[Fuschia]

Keef Wrote:

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> Surely everyone sees how they go with gas and air

> for a bit don't they?

I think if you're lucky and it's fast and you have a pool etc, not necessarily.

[Moos]

I'm just extrapolating from my own experience here, but I think a lot of people do the stay mobile / pool / gas and air approach and in a long labour then just crack when they aren't seeing progression and go for the epidural.

Fuschia is absolutely right - I would never have wanted to choose an epidural (and with it the increased likelihood of c-section which did in fact follow, although I'm told that it probably would have happened anyway). But at some point, you reach the end of your endurance and if that's before the baby arrives, pain relief it is.

[sillywoman]

Yes, I think you're right Moos. For me it was just the knowledge that I hadn't progressed at all in 4 hours, and I knew I couldn't do another 4 like the ones that had just gone so it was off-to-Kings-and-call-me-wussy for an epidural for me. The G&A wasn't helping at that stage either.

Actually, if anyone dares to call me a wuss then I may just have to poke their eyes out. :))

[The Nappy Lady]

Errr.....no, didn't have gas and air (or any other pain relief) with either of mine.

My view was see how I go on my own and luckily enough I went just fine.

Keef Wrote:

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> Surely everyone sees how they go with gas and air

> for a bit don't they?

[Keef]

Sorry, to be clear, I know some people have NO pain relief at all. What I meant was that surely someone would give G&A a go before moving on to the epidural, much as Moos said above. Mrs Keef was similar, and like Moos, was told after that the baby just wouldn';t hav come out wihout help, so there would have been little point in ongoing suffering.

[Fuschia]

The point I was trying to make is that one of the previous posters implied that a woman who refused an epidural was a bit mad (like having a leg set with no anaesthetic) which rather failed to appreciate that there are many woman who eschew any pain relief they feel may slow labour down and bring its own complications. There is nothing mad or stupid about this...

Obviously there are other women who by choice or necessity go with an epidural. But there's nothing that says it's bizarre not to go that route.

[Keef]

I think you're quite right, but to be fair, I think there has been some misunderstanding on this thread, as I don't think anyone implied that you're "mad" if you don't have an epidural.

Friend of mine has one answer to the mere concept of "guilt" re epidurals.

"show me a footballer who gets his broken leg reset without state of the art anaesthetic"

I just read that as saying there are no other instances in western medicine where a person would be in great pain, but there is some question as to whether they should have pain relief they want, should they ask for it.

If they don't want it, then good for them.

I do like a thread that gets a good debate going, but sorry to the OP, if I'm responsible for completely taking your thread off topic. :-$

[Fuschia]

I don't know, I did read

'"show me a footballer who gets his broken leg reset without state of the art anaesthetic"

as implying there was something downright weird about any route through labour that didn't involve an immediate request for the maximum drugs necessary...hence my response that there can be a playoff in labour where you take the pain, in order to keep mobile, in the belief the outcome will be better, and that's a valid choice... just as it's a valid choice to have an epidural. I don't really understand the reference to guilt, is this something people feel guilty about, really?

Edited to add the info about mobility and length of labour: http://www.telegraph.co.uk/health/healthnews/5153441/Walking-around-in-early-labour-better-than-lying-flat.html

[Belle]

I found my course to be well balanced but my teacher (not in ED!) did at one point rather annoyingly tell us we shouldn't talk about labour in terms of 'pain' - she was very into Ina May Gaskin. I remember telling my mum and she was like 'but it is bloody painful I'm afraid'. Which actually I found more helpful in terms of preparation! But in general the course was good, covering all options etc. I think my husband found the bits addressed to men to be a little patronising but that's maybe just him being defensive!

I haven't become fast friends with anyone on my course but found lots of friends locally plus existing mates who had babies etc, so have never felt the gap in that sense. I know people talk about the bond of having babies the same age, but in my group there was 3/4 months difference between mine and the youngest, so that was never going to happen with us.

[new mother]

Keef, exactly. You got the point.

[buggie]

if you were offered the chance to stay upright and hop about a bit while they fiddled with your leg, and a pretty good chance it would all be over quickly and you could be home next day.... vs take the drugs but have to lie down on a bed and the possibility complications will arise that will require major surgery and staying in hospital for up to 5 days... personal choice of course but I think I'd go for the keep yourself mobile see how you go with the gas and air option!

Guessing you've never seen anyone with a broken leg needing manipulation!!

... ok the broken leg thing was a bad analogy to take so literally (I see the idea though and agree Keef :)) - without some kind of pain relief/sedation you wouldn't get near a leg or arm needing manipulation... and is really wrong to suggest that pain relief/sedation could cause further complications - if anything they prevent it (ie aid getting full circulation/sensation back to the limb).

I dislocated my knee (while at work - oh the irony) several years back and it stayed out of place - had to have entonox and IV morphine before they manipulated it back into place (i was asking for a full anesthetic!!).

When I told my friend (who a few wks earlier had had a 36hr labour with her baby's back against her spine which ended in an emergency c-section) her reaction was "OMG that's the most painful thing you can do!" which kind of gets us back to labour pain being a bit different to other types of pain.

One of the few quotes I can remember word for word from my nurse training is "pain is what the patient says it is, when they say it is, and as bad as they say it is" (can't remember who wrote it, and may have fudged the final bit of it!).

Think that fits labour and broken legs!!

[Fuschia]

buggie Wrote:

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is really wrong to

> suggest that pain relief/sedation could cause

> further complications

Not sure if you're arguing an epidural can't cause complications.. I presume not and you are talking just about broken limbs and what have you... because my main reason for not wanting an epidural (for eg with our twins) was becauae I felt once I was immobilised, there possibly would be complications or at least things would be slow, and my main wish was to be upright and mobile and see if that was enough for a speedy easy labour...

[Belle]

buggie Wrote:

>

> One of the few quotes I can remember word for word

> from my nurse training is "pain is what the

> patient says it is, when they say it is, and as

> bad as they say it is" (can't remember who wrote

> it, and may have fudged the final bit of it!).

>

> Think that fits labour and broken legs!!

i love this quote! Worth remembering isn't it.

[kerry.finlay]

"can"

"worms"

[kerry.finlay]

so getting back to the question... ;-)

does anyone have any direct experience of the NHS courses at King's College hospital?

thank you to everyone for all the input so far - it's enlightening/terrifying!

[Bishberro]

Hi - I did the Kings NHS ones a couple of years ago. Then it was three evening classes at Dulwich Hospital. I thought it was really useful and was mainly about the choices of pain relief and what happens during labour - not much about after the birth/looking after a new baby. There were about 20 people there and all very informative and factual but it wasn't really a social thing. You just sat there while a midwife talked at you.

I also did two weekends of NCT classes. To be honest, they didn't offer that much more in terms of info about the birth that I hadn't already learnt at the NHS classes and we didn't do anything much about caring for a newborn that I hadn't read in books etc. It was a much smaller group (6 couples) and more of a chance to socialise. However, because the NCT classes are so over subscribed the people in my class were from all over the place - South West London as well as Crystal Palace etc. So consequently we didn't get together regularly after the births anyway. I found I made more friends through the local NCT tea groups in Forest Hill and just by going to local mum and baby groups. I would definitely go to the NHS classes as they're free and then just see how you feel about the NCT ones.

[buggie]

Fuschia - yes was talking about the broken leg rather than epidural. Fair-do's on why

you didn't want an epidural... It's near the bottom of my ideas for pain relief in labour

for similar reasons, but not going to rule it out (got a feeling my birth plan will be more like

a choose your own adventure style flow chart with all the differentials I'm thinking of!!)