• 05Jan

    Allsop V NCT (again)

    Ok, I’m done with the spoof posts for now – glad they provided a smile for a few people reeling from yet another media hammering for volunteering for an incredibly important organisation. Try not to take them seriously – the tags on posts indicate whether they are or not!

    I thought I would add a few more sensible words about why it is that I find the attacks on the NCT so frustrating.

    Firstly, while teachers are paid (a pittance) to run antenatal classes and there’s a frugal head office, the vast majority of the NCT is run by volunteers. Volunteers who almost all have small children, yet believe in paying it forward to other families. It’s a charity which fills gaping holes in knowledge investment and promoting parents’ rights that are left by an underfunded NHS, and in many areas is frustratingly filling gaps left by local service providers.

    It also isn’t perfect. Like any healthcare related charity it needs to work hard to reach out to groups who don’t traditionally access support services. It has history (or baggage, depending on your perspective) of a reputation for attracting some with quite militant or alternative parenting views. But it has done a lot to overcome that. It trains antenatal teachers through an accredited university programme. It publishes and promotes evidence based research and engages with lots of new thinking. It spends time and resources canvassing views of parents.

    But most of all, it cares about parents’ experiences of pregnancy, childbirth and early parenting. When I think back to my experiences, if it hadn’t been for the NCT I would frankly have felt so uninformed and alone I would have had a completely different few years.

    Which is why, when I read that Kirsty Allsop attacked the NCT for providing her poor information about Caesarian sections and asked people to share their negative experiences, as a volunteer, I read them with great interest and concern. Questions were asked among NCT staff and volunteers, they looked again at the feedback from courses (thousands of samples – statistically more reliable than a ‘please share your anger here’ request on twitter). And the people of the NCT did talk about it. They were, I think, initially shocked, but invited Kirsty to engage. There was genuine concern. But once the moment in the spotlight passed, the loudly ‘caring for the underrepresented dissatisfied sample’, she just walked away. Nothing happened. This was two years ago.

    In the meantime, NCT volunteers got on with what they are best at. Not courting the media or being sensational, but trying to ensure, a day at a time, that we worked together to provide some support for people going through pregnancy and early parenthood.

    In 2012, there was a significant change which I blogged about here where the organisation decided to take a big step in moving away from ‘promoting’ breastfeeding to ‘supporting it. A subtle but significant change which matches the tone of the criticism from those who feel promotion is ‘pushy’ or encouraging judgment. Without Kirsty’s help.

    And until last year, I was among those volunteers working many unpaid hours, without big fanfare, to try to make a difference. I regularly attended antenatal classes (including with three week old twins) to greet expectant parents on behalf of our branch. I told them, with the teachers present and nodding, that I had a section and that I didn’t breastfeed. I highlighted that informed choice was great, but each person was different. Like many others do.

    I’ve given up now as three under four didn’t agree with the hours I wanted to do, but I don’t regret doing it no matter how many people are critical of the NCT. Because hers is a minority experience and I trust, I know, they are serious about helping solve any problems.

    Which is why when I read yesterday that after a two year silence between publicly slating the NCT and doing absolutely nothing with them, that Kirsty has once again gone to the press slagging them off, I ceased to give a hoot what she said. Because she said herself on twitter that she has a ‘chip on her shoulder’ about NCT. She’s unable to comment on the discussions and changes that have been going on since she last attacked them, because she didn’t want to do anything about it last time. Dealing with the fallout was left to the mainly unpaid networks to address.

    Changes HAVE happened. Brains have been racked. Debates have been held. But as far as a lot of people will be concerned, those things may as well not have, because someone who refused to even discuss it, says so on twitter.

    And this is why I also pointed out with yesterdays spoof, the irony of someone who sells aspirational lifestyles for a living, repeatedly slagging off a charitable organisation because she feels they put pressure on women to behave a certain way.

    JT
    *I should add I speak only for myself on this. I am not an employee or volunteer for the NCT. These views should not be taken to represent the NCT or any of its staff or representatives.

    (You might also be interested in my later post on broader issues with access to antenatal education, and in this much more detailed response from an antenatal teacher).

Discussion 35 Responses

  1. January 5, 2013 at 3:14 pm

    Thanks for this, Jane. As a long time volunteer and currently temporary employee of NCT, I cannot blog publicly and it be considered “independent”. However, I have had a very positive experience of them in the 8 years I’ve been involved with them.

    For various reasons, I did not do NCT antenatal classes but I would recommend them to anybody. I got involved with NCT through a new local mums-to-be group and the original mums met up with their babies, and then children for quite some time after their respective births.

    I regularly attended coffee mornings until my children started school. I breastfed to start with, but I also mixed fed and moved to formula when mine were both 4 months old. No-one batted an eyelid ever. People who bottlefed from birth attended, some of them quite sceptical that they would be welcomed with open arms. They were, much to their surprise.

    Coffee mornings were great – we turned up at someone’s house who was used to having babies and toddlers around, the children played and we had a chat. Sometimes, we shared experiences, sometimes we just passed the time of day but it felt like there was someone there for us.

    I started properly volunteering when my eldest was a few months old and within a few months, I became the treasurer of the branch. I remained treasurer for 4 years and I gave it up because by then, I was also the regional coordinator for the NW region and provided support to other volunteers from Carlisle to Nantwich.

    Although I’m no longer treasurer, I still help out at nearly new sales because I just know the money side of things. In fact, that is why I am currently working for them – helping other treasurers get to grips with their finances.

    Thanks to NCT, I still have a set of friends in the area I would otherwise not have had. We’ve looked after each other’s children, been to each other’s family events, helped out where we can, laughed and cried together. Without them, I would have had little practical support and that is why many people get involved so the majority of members tend not to have grown up within their branch’s area, having relocated to study and then to work.

    I know that NCT does have some members who believe there is only one way to parent your child. Speaking personally, I would never allow such a person to criticise another parent at any of our events. But parenting is an emotive subject and many people go in on the defensive and assume they will be treated negatively for having choices that don’t match with some kind of “ideal”. There is no ideal, the ideal is what is best for you and your offspring.

    I’m not going to comment on what Ms Allsopp has said for a number of reasons. This, however, is MY experience of NCT – and no-one can deny it is a hugely positive one.

    No organisation is perfect and there are many challenges that face an organisation whose public face is run by volunteers, largely those who are pressed for time and struggle to find time to attend even the shortest of training sessions.

    If anyone out there is thinking of joining the NCT – not just attending the classes, that is a small part of what NCT does – I say you have nothing to lose and everything to gain. If you are thinking of volunteering, please do ASK if you can help as you WILL be welcomed with open arms. It can enhance your volunteering to make time to attend a training session, which are either arranged in your region or at annual events like babble direct which has just been announced for September at Warwick University. I got involved to put back something of what I have taken from being part of NCT.

    However, do not feel you must join the NCT to attend anything. All events are open to all. Many of them are free or very low cost and are happening most likely in your area.

    End of essay!

    • January 6, 2013 at 10:41 pm

      Thanks Kate – it’s great to hear your story, which is in my experience the more common type. Different people will want different things from their involvement. Lots I know just come for a cuppa they haven’t had to make themselves and a friendly face, others purely for asking questions, others to find something to keep their brain active. But it mostly comes down to people. There are so many good kind people who are involved, it really is disappointing to see anyone label everyone involved based on a small number of experiences. It doesn’t mean they shouldn’t be addressed, but sweeping statements intending to cause damage are not helpful or indeed fair to everyone involved.

  2. January 5, 2013 at 6:48 pm

    I love the way you write, such a wonderful piece.

    I am so grateful to the NCT for the help I was given before I had my first and the knowledge that I gained that helped me through breastfeeding and my second pregnancy and birth.

    I think they do a very important job because if it was up to the NHS I would have been seen a handful of times only to be rushed out of the door as the next patient left and been left scared and unsure at a very important and stressful time of my life.

    x

    • January 6, 2013 at 10:48 pm

      You make a very good point; the challenges facing women as a result of poor or underfunded NHS maternity services are much more pressing and widespread. When I had my eldest (in a unit deemed ‘least well performing’ in the maternity review) they weren’t even running NHS classes. There was literally no service at all.

  3. January 5, 2013 at 8:54 pm

    I read Kirsty Allsop’s comments in the Daily Telegraph and was saddened. If it is indeed true that her particular NCT teacher (I am one of those too and also a breastfeeding counsellor) did not mention c-sections in her course, then she was remiss, it is true. But just like one swallow doesn’t make a summer, and one mistake doesn’t make a policy, so one teacher doesn’t make the whole NCT. I do happen to know that there are some teachers out there who are very passionate about their own version of birth and may fail to give a fair and balanced overview. But these few are not representative of the whole. It would have been more valuable if Kirsty had inquired of Head Office if it is a policy not to talk about caesarians, rather than going on the rant as the result of one experience. Personally, I talk about all forms of intervention in my classes and when I invite a couple from a previous course to come and talk about life with a new baby to the present course, I don’t stipulate that they must have had a positive experience of either birth or breastfeeding in order to qualify. It’s good for my classes to get a real life story from new parents and, as many discover, their births will probably not be as they had hoped or dreamed about. As long as they are fully informed of all the possible “by-ways” their births could take, I feel I have done my job.

    • January 6, 2013 at 11:06 pm

      Thanks for commenting. You’re right about it being remiss, but the NCT has systems for assessing teachers etc. as it also does for handling complaints. These are there for good reason, not least because service users have a right to have their complaint handled professionally, and employees have a right to a fair hearing. Kirsty is basically trying to hold a trial-by-twitter based on largely anonymous comments about actual people who are just doing their jobs. It’s not just bitter and unproductive and plain wrong. This isn’t how any organisation or employer is expected to manage feedback. She’s been invited to discuss it, she refused. Belinda Phipps is giving the same reply over and over to everyone ‘please get in touch’ which is the right thing to do. I hate the fact that teachers may be feeling stressed and harassed based on the rantings of one individual who has self appointed herself as some kind of entitled spokesperson. I do hope that staff will continue with their good work!

  4. January 5, 2013 at 9:24 pm

    My experience of the NCT was a bit mixed (although nearly 3 years ago now so might be out of date). The cost was very expensive so if the woman who ran them wasn’t paid much that is a bit rich. NCT parent and tots groups in my area are, on average 5 times the price of other groups. Where is the money going?

    Secondly I did find there was a lot of focus on breastfeeding, natural birthing and how pain relief would lead to more intervention. When I told her I was thinking about moving to a midwife led unit rather than the hospital I’d originally planned on, there was certainly lots of “well dones”.

    I was lucky in lots of ways. I had a good birth but at least one of the mothers in our group didn’t and I know she felt bad about it. I don’t think the ante natal classes prepared us at all for the “what if…?” I also had a very long early stage which was painful. Since having my son I’ve learned this is not uncommon. The person running the class said it is “painless”. I had four days in pain but felt I should put up with it.

    That all said, the good experiences I had of NCT were attending a first aid course (again paid for but a more reasonable cost) and a 15 minute phone call to support breastfeeding when my son was having a nursing strike. The people I spoke through on both of these occasions were fantastic. Night and day from the woman who ran my antenatal group.

    I think with any organisation which is this big (irrespective of whether it’s a charity or not) there will be good and bad experiences. It’s important to listen to the bad and learn I think. I appreciate you tried to do that as an organisation with Kirsty Allsop but it’s not just her, it’s all the other people who have reported concerns. For any organisation / charity / company whatever, there will be 80% of people who are great and 20% who are bad, even if they’re volunteers. Also antenatal classes with NCT are REALLY expensive. It’s worth remembering also that it might be volunteers providing the service but the people have paid for it like you’re a company.

    • January 5, 2013 at 9:27 pm

      Thanks for the reply – I feel I really should emphasise though that I’m not part of or representing the NCT. Have you thought about raising it with them?

    • January 6, 2013 at 11:21 pm

      Hello, proper reply this time (sorry – have flu so dipping in and out!).
      Totally agree there will be good and bad of anything this large, but the problem with what Kirsty is doing is she is shunning the appropriate process for addressing it (as she did two years ago) but continuing to complain about it as though the NCT did and do nothing about complaints. This is stirring up dissatisfaction which is unwarranted, as of course they take complaints seriously! By publicly berating them, over and over with tweet after tweet she is suggesting to hundreds of thousands of people that the organisation fail to listen, when in reality she is refusing to have a sensible dialogue with them. She’s basically just publicly reprimanding them because she has a beef about her own experience. She’s presenting this facade of ‘I’ll take ‘em on for you!’ which is literally meaningless given they have been through this with her before and she just walked away.

      As for things not being covered – it’s a tricky one when its a while ago. Perhaps secondary feedback a month after the birth might help so people can reflect – there may be improvements and I’m sure they will be looking at it all the time. I know having sat though classes with second pregnancy as well as first it was interesting to observe how things were taken in by attendees. After our babies arrived the second time I heard dissatisfied voices that the course had failed to prepare for it, when I knew I had sat through a session on it with them. Perhaps more uniform printed notes would help… I am certainly no expert on the courses.

  5. January 5, 2013 at 9:32 pm

    Again, as I said. If an individual teacher doesn’t bring a fair and balanced view to birth (and I would *certainly* rank saying first stage labour is painless as unfair and unbalanced; very few women experience this!) then this is an individual teacher, and I’m sorry you were unlucky. I do talk about realistic births, long first stages, and pain, and how to manage it with and without drugs. However on the subject of midwife led units, there is no doubt that the higher tech the unit you put yourself into for your labour, the more likely you are to have possibly unnecessary interventions, so I would go along with the “well done” for moving to one. I would however recommend that any birthing centre should be close to, if not on the same floor as, a high tech labour ward so any mother needing intervention doesn’t need transferring by ambulance.

  6. January 5, 2013 at 9:36 pm

    As to the cost of the courses, these vary from area to area. In general an NCT teacher gets paid £30 per hour no matter how many class members she has. This may not be a pittance but it’s hardly “very expensive” either taking into account how many hours the classes take up. If you pay approx £200 for a 16 hour course, that is £12.50 an hour you are paying for a teacher who is highly trained and professional. I don’t think that is so expensive compared to some other private courses in other fields. You can pay upwards of £100 for a single session in some fields.

    • January 6, 2013 at 11:26 pm

      They are expensive courses. However to be honest I don’t think that’s relevant at all, they should be fit for purpose whether people pay £3 or £300 to go.

      • January 7, 2013 at 8:35 am

        I agree. But it’s easy to walk away from a £3 course just thinking “well, that was a waste of time”, less so when you’ve spent the equivalent of a month’s grocery shopping on it. The cost is part of the reason why people get so upset when they don’t find the courses of great benefit, especially as most women will be giving up a lot of their income to go on maternity leave.

    • October 10, 2013 at 7:33 pm

      Hi Ruthie
      A bit late in the day, but just to point out that it is misleading. You are in London, but outside London people will not earn this. I am an experienced teacher of over 15 years and I earn £29 per hour. People teaching in Standard areas earn less, and with less experience people earn less still. Given that we also pay for refreshments and any additional handouts ourselves, and the requirement to attend 2 unpaid study days a year, it is a good job many of us don’t do it just for the money! Those who do are limited to what they can earn by the fact that it is limited to weekend and evenings. I consider it a huge privelige to meet people during their journey to becoming parents, and love watching the development of a strong support group.

  7. January 6, 2013 at 9:46 pm

    This is a good post, thank you.

    I wasn’t overly happy with the NCT classes I attended a couple of years ago and I did give some feedback at the time.

    The issues we had were that we felt as though there was a bit of an agenda (natural birth without intervention, breastfeeding) and that the classes were expensive.

    My main irritation was with the BF teacher who had no experience whatsoever of expressing and had done very little research into it. She had borrowed a manual pump from a friend but professed to have no idea how it worked. I breastfed my son for 8.5 months in spite of her class – expressing kept me sane with a baby who otherwise fed for an hour and a half every 3 hours and who sicked up about half of his milk. We ended up with a workable system – half of his feeds direct from me and half expressed. He was less sick, he fed and was satisfied from expressed feeds much more quickly and I was able to take him to do activities he would never otherwise have done.

    I’m not saying that our teacher was in any way representative of other teachers – but we could only assume that she was, given that she was representing the NCT when teaching. I do think it is good to have these debates about people’s experiences because it does show that there are clearly some great teachers out there who do go through all the options and present a more balanced view of the world in all aspects of birth and early postnatal care. I have more faith in the NCT now from reading people’s public comments than I got from our classes.

    I do also want to respond to a couple of Ruthie Pearlman’s comments above:

    (a) however you like to distinguish the price of the classes from private classes, £200 is a huge amount of money for most people to spend. Also, to give a relative benchmark, my husband got paid around £10 per hour to teach a health course with the same number of attendees in adult education at the time we took our classes. I appreciate though that much of what the NCT does is either free or cheap and in theory a lot of support is made available to those who need it. But if people have lost faith in the organisation after their classes they’re unlikely to use the services or further support the organisation going forward. So I don’t think it’s a great response to course feedback to say that the NCT is a charity or that courses aren’t quite as expensive as private ones would be.

    (b) I’m afraid your very definitive comment about the correlation between high tech environments and unnecessary interventions is the sort of statement that makes people doubt that the NCT is all about evidence-based teaching. You really think there is NO doubt about the correlation? None at all? And what proven causal link is there? The thing is, studies do show that there is a correlation between lower numbers of interventions in “alternative” birthing centres but they make it clear that the reasons for the correlation are not fully known and it is not possible to compare like for like as each unit is different. Making sweeping statements about things like this can add to the perception that you are giving your own opinion rather than presenting objective evidence. It is a subtle difference but it’s an important one in a context like this where you are effectively earning people’s trust and educating them about possibly the most important (and terrifying) thing they will ever do.

    • January 6, 2013 at 11:30 pm

      Thanks for commenting. I won’t answer questions directed at someone else but I will say that I don’t think it is usual or desirable for a practical course to include comprehensive references, but I approached my antenatal teacher for more info with my first (who was breech) and got an extensive list of references to browse and make my own mind up. Most people don’t want that.

      • January 7, 2013 at 8:39 am

        Thanks. I agree that people won’t want comprehensive references. It’s the definitive, sweeping statements that I find problematic – things get stated as facts that aren’t actually facts. “studies show a correlation between” is much more objective and verifiable than “there is no doubt that….”.

  8. January 6, 2013 at 11:28 pm

    Thing is, this *wasn’t* a response to course feedback. This was a response on a blog. Course feedback goes to the NCT and is looked into, assessed and evaluated. This is once again trial by, maybe not twitter, but a blog.

    If your husband gets £10 an hour for teaching adults, then he is exploited. It doesn’t mean the NCT has to lower its fees to match. And of course if someone genuinely can’t afford our classes we offer concessionary rates which is basically whatever you can afford. I have often taught for no fee at all.

    On the whole most things in the NCT are free. All my work as a breastfeeding counsellor; all the many hours I spend with women helping them with breastfeeding issues, is completely free of charge. You try and find a lactation consultant who will offer the same service.

    People who want to slag off the NCT can always find reasons to do so. Like any organisation it isn’t without fault but on the whole it offers an antenatal course that is the gold standard compared to any other on offer, and free breastfeeding help from highly trained and experienced practitioners. I might not be the complete expert in research, but I would stand by my assertion that the higher tech your place of birth is, the more likely you are to have possibly unnecessary interventions. This is not only an NCT assertion but has been found to be true by many other researchers.

  9. January 7, 2013 at 8:55 am

    No, this isn’t trial by blog. My point was that the comment you made is very similar to things that were said at our classes and – by analogy – I was explaining why people react badly to those kinds of statements.

    (But, since you mention it, if you identify on a public forum as a qualified teacher of an organisation which you say offers the gold standard in its area, you are in a position of influence and people may well take you at your word and rely on what you say.)

    On fees, I’m not disagreeing that what much of the NCT does is free. But it can’t simply defend criticism of its classes by saying it’s a charity because the classes aren’t free or obviously discounted or subsidised. And the real point about BF services is that if people don’t have faith in the organisation they will just stop breastfeeding when otherwise they might have sought advice and carried on.

    I am not out to “slag off” the NCT and I don’t think there are many who would criticise it without a reason. I would love to have faith in it as an organisation that clearly and consistently does what it says it does – ie supports expectant and new parents – but I’m afraid that was just not the impression I took away from my classes.

  10. January 7, 2013 at 12:19 pm

    A really interesting blog. I loved my classes, my teacher was great, evidence based and we were given the information we asked for (and more) on pain relief, c-sections and bottle feeding without judgement. The breastfeeding consultant who led our session basically helped me so much later – in her own time, at no cost to me – that she is the reason I’m still breastfeeding.

    But I know a lot of people who haven’t had that experience so it does seem there are some less balanced teachers out there, and this contributes to an ideal of ‘perfect childbirth’ and ‘perfect motherhood’ that can leave some people leaving like failures because X, Y and Z haven’t worked.

    I think this is what massively undermines the credibility of the NCT, which makes me really sad. The organisation does so much good but the word of mouth from those with teachers who refused to discuss c-sections, said they ‘weren’t allowed’ to talk about bottle feeding, etc makes people trust the organisation less.

    I’ve raised this issue with NCT, and basically get form replies saying that lots of training is done and teachers need the freedom to respond to what attendees on courses want to hear about. Which doesn’t really answer the concerns I’ve outlined above.

    That refusal to listen to or act on what seems to me like a real problem is why I took the decision to cancel my membership, despite the fact that my own experience had been nothing but positive. It wasn’t a decision that made me happy but I feel uneasy about supporting organisations that don’t respond to constructive criticism.

    On the question of feedback surveys, I think the crucial thing with these is that they are done largely before people give birth – mine definitely were, and I doubt I would have filled anything in afterwards.

    • January 7, 2013 at 1:29 pm

      Thanks for commenting Penny – really useful to hear the other side.

      Regarding the point at which feedback is collected I agree it would be helpful to get that pre and post-birth to get a fuller picture. Also if doing that there would be huge value in widening it out as a broader survey which asks people who received NHS classes and no classes as well to provide a more definitive picture of the value and impact of classes and potentially to tease out variations between course content and individual expectation. If only there was a huge pot of money or rich individual willing to sponsor it :(

      I do think it is hard to separate the issues between individuals personal expectations and what is actually the remit and role of the courses. On bottle feeding for example the NCT follows WHO guidelines – but the fact that some teachers will go ahead and teach about it anyway shows some are flexible when asked. Certainly the same rules apply (often even more strictly I’m told) with NHS courses.

      I have noticed that people berate the NCT for being pro-breastfeeding and pro natural birth when it is very very clearly part of its agenda. The word ‘agenda’ is bandied about like its some kind of secret cult when it is stating a fact which is openly available for anyone to read about. People who aren’t keen on that do have the option to take the NHS sessions instead. I think perhaps some people gloss over what the NCT is, and instead see it as simply ‘the private antenatal company’. Perhaps an issue of proper brand awareness – everyone’s heard of ‘NCT’, but how many people really understand what it stands for?

      • January 7, 2013 at 1:49 pm

        Hi, given that I used the word “agenda” in precisely that context, I felt I should respond to your point on it.

        On the NCT’s website , the “About NCT” page says this:

        “The NCT is here to support parents. We give them accurate, impartial information so that they can decide what’s best for their family.”

        Perhaps there are crossed wires as to what “impartial” means and the organisation would say that it supports particular things like natural birth and BF because those things are the best things for many parents based on the available evidence? But if so I’m afraid that’s not how it often comes across and many parents may end up in a situation where a natural birth or BF (or both) is not the right thing for them and the way in which some course leaders teach leave those parents feeling marginalised.

        • January 7, 2013 at 2:16 pm

          You have answered your own question there really. An agenda of giving info based on best available evidence does mean informing people what the current aggregate best potential outcomes are. Perhaps a problem is conflating ‘outcomes’ with ‘achievements’ – and I quite agree if people interpret it that way then they are misunderstanding the point rather.

          • January 7, 2013 at 2:45 pm

            Perhaps there is some confusion between outcomes and achievements.

            If the NCT does give those words the meaning I suggested above (1) there is potentially a difference between the way in which the NCT perceives itself to operate and how some course leaders teach in practice and (2) while the information the NCT provides in line with its agenda undoubtedly benefits many women, particularly those with low risk pregnancies, it doesn’t help everyone and the NCT’s claims to help each family decide what is best for them are harder to believe.

            I see potential for marginalisatoo From

          • January 7, 2013 at 3:11 pm

            Perhaps there is some confusion between outcomes and achievements.

            If the NCT does give those words the meaning I suggested above, it could be clearer by doing it all in one place – eg by referring to its policies and their basis. And I don’t think the wording sits particularly well with the claim to help *each* family decide what is best for them – only those who are in the mainstream.

            I see potential for marginalisation in three ways. The first relates to the feeling that others may disapprove and think you don’t intend to do the best thing for your child if you raise a point on a course that others disagree with. One of my friends asked in class about bottle feeding, which hadn’t been mentioned at all. I doubt anyone else there would have been brave enough to mention it in front of everyone for fear of what the leader and our peers might think. My GP didn’t tell her NCT class that she was a doctor until after the course had finished as she expected negative comments to be made during the course about doctors – she was right.

            The second is the approach of NCT volunteers after the birth. Like many new mums, I found BF hard in the early weeks but (given what i said in last night’s post about the approach of our BF course leader) I feared a lecture rather than practical support so didn’t ask for her help. Another eg – a friend went to her NCT BF counsellor when she had breastfed her son for a year and felt it was time to stop. The counsellor told her to carry on breastfeeding as long as she could rather than advising her on how to stop. So there is potential for marginalisation through not feeling able to ask for support or asking for it and coming away feeling like a failure.

            The third is the attitude of our peers going forward, including those who we meet through our NCT classes who, for so many of us, are such an invaluable part of our lives as new parents. At the time when we give birth we tend not to know them very well yet and may worry about how they perceive us and our births / feeding arrangements. The concern that we have failed in one or both of those things in the eyes of our peers and the large organisation that has taught us all on the basis of an agenda that doesn’t work for some of us can leave the “some of us” feeling rather excluded.

          • January 7, 2013 at 7:53 pm

            Agreed – I looked as well at the info and people might not understand it.

            Regarding marginalisation… all of the examples you give are of nervous preconceptions service users might personally have: fearing disapproval from peers in class, fearing a lecture from a professional (who is frankly least likely to in my experience), and fear of how peers may perceive them. I completely understand all three possibilities to a certain degree, but I don’t honestly believe that this is the average woman! We aren’t all massively outgoing and confident, but I’m wary of a depiction of pregnant women as helpless fearful drips too nervous to voice an opinion or be seen disagreeing with their ‘peers’ – this absolutely isn’t the type of women I have come across!

            But, agreeing to disagree on that, I also can’t see how any of these sugestions can be attributed to NCT marginalisation – or indeed to an ‘act’ by anyone at all. Are you suggesting service users genuinely hold the organisation in fear and awe? I really don’t think this is the reality; an organisation that strikes fear into people is hardly going to have waiting lists and thousands returning for additional services and to volunteer! I totally grant that the NCT professionals must put people at ease, but to assume the service users come racked with insecurity would seem horrifically condescending.

          • January 8, 2013 at 8:37 am

            Well, that’s all very straightforward then.

            Except it isn’t.

            Psychologists and political theorists have long been trying to figure out the relationship between individual and group behaviour – the dynamic is actually very complex. It’s perfectly possible for individuals who are confident and tenacious in their everyday lives to behave differently – eg more deferentially – when becoming part of a new group, especially one that relates to something outside their comfort zone. First time parenthood, for example. I don’t think I’m the only one who’s held their tongue in an NCT class in case a judgmental answer comes back. In fact I know I’m not because when my own group discussed what we thought of the sessions we realised we had all found the BF teacher pretty unhelpful. But nobody really challenged her approach in the class. After all, she was a qualified professional who had raised several of her own children without the need for bottles or breast pumps. And once she had responded negatively to a couple of questions it was pretty clear that she disapproved of a number of things.

            Also, we’re not talking about the *average* woman. After all, the average woman will be the one who comes to the classes with no existing doubts about the NCT or its impartiality, find them very useful and give positive feedback, have a straightforward natural birth with no intervention and be happy to pay for membership of the NCT and use its services after the baby is born.

            What we are talking about is the minority who for one reason or another didn’t feel they got the most out of their classes and who have been put off the NCT by one thing or another. In all of this I am just trying to explain a different viewpoint. All of this is very personal to each individual and – criticise them for having preconceptions or being drippy or whatever else – their views are stil valid and the NCT needs to decide how to deal with them. If it wants to wash its hands of a minority who it thinks will never be satisfied that’s up to it, but equally individuals are entitled to express their personal opinions in person, in blogs or through other types of social media, within the boundaries of the law.

            One final thought – if women aren’t drippy etc they’re hardly likely to be influenced by what celebrities like Kirstie Allsopp say. On your reasoning I’m particularly drippy as I worried a lot about being judged by my NCT teacher and peers but I’m certainly not influenced by KA’s views.

          • January 9, 2013 at 8:20 pm

            Sorry for the delay – your comments on this have given me reason to pause for thought, which is always a good thing 

            On reflection I think I’m just uncomfortable with the idea of potential vulnerabilities which pregnant women may experience (whether due to it being a first time pregnancy, group mentality etc), which are common to all women to different degrees, explaining why some are dissatisfied with courses. I’m not sure someone is more likely to be marginalised in the sense that KA is discussing (ie feelings of guilt) by being any of those things – not least because she herself doesn’t come across as any of those things!

            It’s a common view that ‘maternity’ in general can be very disempowering and stressful experience, but I know of lots of women who have been highly confident and NOT attended NCT courses who feel racked with C section or bottle feeding guilt, and people who I would class as much more reserved who have no qualms whatsoever about either but stress about something else. It’s not simple at all. That’s where, I guess, I have trouble with it being correlated to the NCT exclusively, and not a broader issue of ‘women’s experiences of pregnancy and early motherhood’. There is a duty to try not to marginalise people whoever they are.

            Similarly everyone comes to pregnancy from such different directions, be it their relationship status (and condition of it), employment circumstances, economic circumstances, whether the pregnancy was planned, wider familial or community support, experience with babies and young children elsewhere in their lives, disability, medical issues, cultural background… I’m sure the list could go on and on. For some people, confident or not, they find a window within the NCT that they don’t get anywhere else, others just decide it isn’t for them.
            The courses (and any teachers reading please correct me if I’m wrong) are usually group-lead, in that the teachers have some flexibility to follow what the group is interested in on top of the core information. This was openly promoted on both the courses I did in different parts of the country, with different teachers. Surely there is some onus on course participants to put up their hands or speak to the teacher to say ‘yes I’d like more on that’ if the teacher offers just that service? Mine covered c-sections in depth (and I know of another who does a comical role-play with lego characters showing how many people are in the room at a section). There is choice in the sessions – if people don’t exercise that despite being asked, are we giving too much away to blame the teacher?

            However I come back to the same thought; it is a given and obvious requirement that NCT classes should be taught by people who are tactful, sensitive and intuitive (and I accept this isn’t always the case, I assume everyone complaining specifically about teachers has reason). There is no dispute, if a teacher isn’t up to scratch it has to be addressed. However, a certain percentage of people will always be disappointed with their experience, and not all of that is always going to be down to the NCT at all.

            And I am probably putting myself up to be shot down, but I have a theory that a certain percentage of those dissatisfied people will have had negative experiences in health services too and associate everything to do with the birth, including classes, as having failed them. And many will be right, but also many will be projecting back what wasn’t really a failing. The reason I say this, is because I have heard mothers who have had particularly painful births complain that a course which spent a fortnight of sessions covering pain relief ‘failed to tell them it would hurt’. I’ve heard mothers say they ‘hate NCT’ because they personally didn’t click with peers on their group, or because one person attending one NCT event (not even a volunteer) said something which offended them. And I’ve heard fathers complain that the courses were ‘girly shite’. All of which give the NCT a bad name by word of mouth, all of which are illogical unwarranted criticism. But most of all, I’ve never had a conversation about ‘guilt’ at a new mother’s group with anyone there who didn’t have their own list to share. It’s not exclusive to mothers from the NCT, or any particular class, or anything else.

            Anyway, all very interesting indeed. Which is partly why KA labelling the biggest organisation which aims to support parents as failing on that is a damning reputational allegation to make; it’s an area that is more complex than a Daily Mail article, five minute debate on radio 4, or even brilliantly written and massively underrated blog can accommodate ;-) xx

          • January 9, 2013 at 8:56 pm

            Hi, you raise lots of good points and I agree with a lot of what you say though I would approach it from a different angle.

            On women feeling vulnerable, disempowered etc I agree, lots of women have those feelings and it’s certainly not exclusive to those who’ve not enjoyed NCT classes. But I think there is one factor which could exacerbate it in the context of NCT classes

          • January 9, 2013 at 10:49 pm

            Hi, you raise lots of good points and I agree with a lot of what you say though I would approach some of the points from a different angle.

            On women feeling vulnerable, disempowered etc I agree, lots of women have those feelings and it’s certainly not exclusive to those who’ve not enjoyed NCT classes. But that doesn’t mean there isn’t a problem with classes… Feelings of guilt and marginalisation can come about due to eg pressures we put on ourselves to do the best we possibly can, general social (and media) pressure that certain ways of doing things are better than others and disapproval from particular individuals like relatives (disapproving in-laws seem to feature quite a lot). I think disapproving NCT teachers (by which I mean the minority who aren’t as impartial or supportive as they should be) fall into that last category. I would argue that the opinions of individuals who you know and who have made their disapproval clear can be more damaging than other factors as it’s more personal and possibly harder to dismiss their opinions than eg things you read in the press. This is probably overstating it but perhaps it’s a bit like a betrayal of trust. Add a big fee and it’ll upset people further.

            The group-led point is an interesting one. I know the NCT is trying to use group-led sessions to try to help people find out more about particular areas of interest, but it does rely on people knowing a fair amount in advance (in order to ask the right/sensible questions) and on people putting themselves out there to ask about topics which are pretty visceral and personal – not everyone’s cup of tea. I would have preferred a clear underlying agenda (and preferably a bullet point list of topics to be covered on the website in advance of booking & spending the £200) and an open invitation to ask questions at any point during the course. Having a decent idea of what the course should cover in advance could also help to manage people’s expectations (and possibly some scepticism) and would make it easier to raise a topic if it’s been missed out. This could also help to improve consistency between teachers – it’s much harder to skip a topic (like CS) if it’s there on the agenda for everyone to see. It might also lower the incidence of attendees later claiming that something wasn’t covered when it was.

            I think you’re spot on in what you say about health service issues. If someone has a negative or traumatic birth experience, of course they may be thinking about it all more and trying to work out what went wrong. And you must be right in saying that a small minority will always be dissatisfied with the courses – ’twas ever thus!

            I don’t agree entirely on the throwaway comments by peers though. It goes both ways – word of mouth will bring lots of people in to the classes too. And of course we know our peers – I would filter my friends’ comments on the basis that I know who I’m most likely to agree with on particular things and may take their comments more seriously than others’. A friend who’s quite conservative in their general outlook raved about the NCT to me and tbh that made me more sceptical than anything!

            Similarly, I do think people worry too much about the KA effect. But what puts me off more is the v defensive and negative reactions from NCT teachers to things like that. I know the good teachers are going to be upset about sweeping negative generalisations but it would be more productive to explain gently how well-balanced and supportive they and their classes are – in effect they could turn a potential threat into an opportunity. The defensiveness just perpetuates the impression that there are two sides fighting some sort of battle and reinforces perceptions that NCT teachers can be judgmental (some have made some unfortunate comments about KA and CS, for example). If I spoke to my clients or potential clients in a similar way I’d expect to be hauled up for misconduct, not just bad business development. And no it may not seem fair to put the onus on the NCT teachers but ultimately they are service providers and need to do what they can to keep people coming through the door so yes there will be more hassle for them than those on the other “side” of that battle.

            Sorry – v long and rambly (again) but I hope that makes sense.

        • January 7, 2013 at 2:21 pm

          I would also add that there is a big difference between an objective assessment of whether content is appropriately covered (clearly its not ok if CS never discussed, but again the research indicates it is), and the much more subjective assessment of how parents feel their experience is in relation to others. I’m interested in the comments about how people can feel ‘marginalised’, as generally the classes precede birth and are not held afterwards.

      • January 7, 2013 at 3:49 pm

        Thanks for the reply – I tend to agree that bottle feeding is a very thorny issue but there does need to be a recognition that there isn’t a binary breastfeeding-or-formula decision. For most women, the chance to express milk means they can have the odd night out (I did this literally three times in my son’s first six months, but it was important to my well-being with a baby who fed every two hours during the day. I then returned to work when he was seven months old and my husband took paternity leave. If we hadn’t had the option of expressing and giving bottles, he would have been straight on to formula.

        At the moment, a lot of women are being left with the impression that there is a clear choice between breastfeeding or bottlefeeding, with no middle ground. More women may be persuaded to breastfeed for longer if they get decent information on how (and crucially when) to introduce expressed milk if that’s a route they want to go down to help them continue breastfeeding, and also around the fact that breastmilk and formula can successfully be combined in some cases.

        WHO guidelines are around breastmilk, not breastfeeding, so providing information about expressing and bottle-feeding expressed milk isn’t at odds with the a pro-breastfeeding approach – and indeed my very qualified breastfeeding consultant recognised expressed milk and introducing the occasional bottle as a valid strategy to promote longer-term breastfeeding. If I hadn’t had that advice, it’s doubtful I’d still be breastfeeding my 16 month old.

        I’ve got no problem with the NCT having a pro-breastfeeding agenda, or a pro-natural-childbirth agenda. But when people are paying very significant sums for courses preparing them for childbirth and early parenthood, they do need to be realistic and crucially they need to be non-judgemental – and if they’re not going to provide that *universally*, they need to be up front about it and tell people before they sign up that these courses will not tell you about c-sections, or will cover pain relief in X amount of detail, or will refuse to give you information on epidurals. Because I’ve no reason to doubt my friends when they say their NCT teachers didn’t cover those subject.

        The reality is that some women will need interventions. I’ve no doubt the number who get interventions is too high, but there are a lot of social and conditioning reasons for that as well as medical pressure. But equally, I’m a fan of women not dying in childbirth and for those who end up needing interventions, I really want them to have had pre-birth support that doesn’t make them feel they’ve failed as a woman or as a mother for not having acheived the ‘perfect’ birth.

        I ended up giving birth on my back, in stirrups, with continuous monitoring. It’s not the water birth I’d campaigned for but it was the right option to deliver my son, who was in distress due to the true knot in his cord, and I had midwives who worked with me to try other options but this is what worked to deliver my son safely. There are NCT teachers out there who’d have had me think I didn’t have the right birth, which isn’t right.

        I think there are inevitable dilemmas in being any organisation with a dual purpose – such as campaigner and service provider/educator. Both roles are really important, but they need to be balanced.

        Sorry for the essay! It’s a really interesting discussion and I’m bemused on where I’ve ended up in this debate as someone who, two years ago, would never have questioned how the NCT operated.

  11. January 11, 2013 at 7:16 pm

    [...] Jane at In a Different Voice has been speaking out about the Kirstie Allsopp/NCT discussions which reared up again this week on Twitter – Allsop V NCT (again) [...]

  12. January 13, 2013 at 9:38 pm

    My Twitter timeline was full of comments regarding the NCT and I was really pleased with my one NCT class (we opted for one day course due to hubby working away at the time) . The teacher asked what we’d like her to squeeze into the short time we had and as one couple had to have a c-section and it was a maybe for me she explained all about it. It isn’t great if some parents are being shunned due to c-sections but as with any organisation, these things do happen when people put their own beliefs before others. The NCT cannot be held responsible for births which don’t meet expectations. The modern way of birthing is (amongst other factors).

    Completely agree that if you start an attack then surely you have a moral obligation to follow through and help improve something rather than bringing it up, damaging reputations then slinking away again.

    The NCT is a brilliant charity and doesn’t deserve to be judged on a few negative experiences and hearsay on Twitter. If you have issues, go through the correct channels.

  13. March 18, 2013 at 9:43 pm

    Having attended NCT classes on my first pregnancy, I was left totally unprepared for the possibility of a c-section. Had an emergency c section due to aspiration of baby. NCT classes were great to meet similar people but no good for preparing me for the potential of the stressful labour I encountered. Therefore I totally agree with Kirsty Allsop and I am not a celeb. Had an elected c section on second birth and did not attend follow up courses as I had already made a group of NCT friends first time around and felt that my choice for an elected second birth would not fit the NCT mould. Also felt that NCT did not support pregnant mums who had encountered a miscarriage previously and felt the odd one out and a bit jaded compared to rest of group and unable to be honest in the discussions.

Leave a Reply