When I was pregnant, nearly everyone who’d had children asked me and my husband whether we’d booked our antenatal course with the National Childbirth Trust. Men tended to ask with a gleam of sadistic glee in their eye, and the question was almost always followed by a hurried disclaimer: ‘Ignore most of what they say, but it’s worth it for the friends.’ It seemed like an expensive and boring way to make friends: the courses are usually 17 hours long and they cost several hundred pounds. The NCT offers heavily discounted rates to people who can’t afford it, but for most of its pupils, the full fee is an accepted cost of having your first baby. Each course is different — it depends on the teacher — but it’s safe to assume you’ll be encouraged to give birth without any medical interventions, and then to breastfeed like mad.
The thing is, though, neither of those things is really up to you. Promoting them would be fine if the audience weren’t so vulnerable, but mothers are on a hair trigger to feel guilty — that’s why anyone who recommended that we go to NCT also recommended that we pay no attention to most of what we’d hear there. It’s not that the NCT gives false information or that the teachers aren’t well trained, it’s just that the emphasis is skewed towards the earth-mother way.
The type of people who are attracted to the job are often a little deluded about childbirth. As a senior obstetrician puts it, ‘If you want a very good discussion about politics, you can go to your local Communist party headquarters where they’ll be very well-informed, but they’ll be coming at politics from a particular angle. It’s the same with the NCT and natural childbirth.’ He says his patients have often been warned against epidurals, caesarean sections and induced labour, but not told that the drawbacks of these procedures are often outweighed by the advantages.
Let’s face it: all the ways of getting a baby out of a human are pretty awful. A totally straightforward birth sounds like it might be one of the least bad, but infant mortality has dropped because of medical interventions.‘We were told that everything should be very natural and wholesome and easy,’ says Becca Scott, a doctor who did the NCT course. ‘The role of the father would be to stand up for the wishes of the mother in not wanting any interventions.’ It might be comforting to write a birth plan, but it’s worth remembering that it’s also optimistic. A quarter of babies in Britain are delivered by caesarean and one in eight needs forceps or a ventouse. The last thing you want as you recover from an assisted birth is a wave of unnecessary guilt.
It’s the same with breastfeeding. NCT teachers can be a little gung-ho about ‘the latch’, the connection between a baby’s mouth and mother’s breast, but trying to learn how to breastfeed your baby before it’s born is a bit of a mug’s game anyway. Even if the child is a natural latcher, you really need someone to show you. ‘I was told that the baby comes out, crawls up the mother and latches on,’ says Dr Scott. ‘When that didn’t happen I felt like a failure and went completely mental.’ For four months she didn’t get more than an hour’s sleep at a time. ‘The NCT breastfeeding counsellors were very supportive of that,’ she says. ‘The message was always “Keep at it, it’ll be fine”.’ In fact, painful and difficult breastfeeding is so linked to postnatal depression that a lot of doctors advise women to stop after a few days if it’s not going well.
In London, the NCT’s benign propaganda has prompted some women to set up rival antenatal courses. Lulubaby, the Bump Class and others stay up-to-date with medical opinion by inviting midwives, doctors and other professionals to give classes. These days so much information is available online that if you’re going to pay for antenatal classes, you want some serious expertise in the room. You also want to know what to do with the baby once you get it — something that NCT teachers don’t always cover in detail. It’s worth having a bit of a grounding in nipple shields and birthing balls, but labour, birth and breastfeeding are really up to the baby. Knowing about which rashes to worry about, what colour a baby’s poo should be and how to put your baby in its cot are much more useful.
These other courses avoid some of the worst oversharing of the NCT by only inviting men to some of the classes. I was heartily relieved there were no men present at the Lulubaby class I went to that focused on the pelvic floor. In this time of intense communication, some subjects are still better consigned to dark hints. A male friend described an NCT class where the teacher drew the outline of a woman and each person had to go up and draw something that had changed during pregnancy. One woman scribbled furiously in the pelvic region and explained that her pubic hair was growing more luxuriantly than before. No one could really look at her after that.
At another class, men and women were asked to pick their favourite nipple from a collection of photographs. It seems strange to tap into such a rich vein of potential insecurity and marital strife, but perhaps it helped with something. Other husbands I know have sat awkwardly through hours of breastfeeding lessons, trying to be as inconspicuous as possible while the women ask about how to deal with engorged breasts and nipple thrush. Pregnancy and birth mean coming to terms with quite a lot of unwelcome anatomical detail, but there’s a lot to be said for drawing a veil over most of it.
Antenatal classes are useful and though the NHS provides lessons for free, it’s pretty patchy and the provision is getting worse. The NCT is a worthwhile and kindly organisation and there’s huge variation in the courses it provides, but some of its teachers need to remember that you’re a tiny bit mad after having a baby, so even the gentlest propaganda has an alarming effect.
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