October 20, 2002

NHS Preparation for Parenthood classes

The state of prenatal classes in the NHS is, on the whole, pretty poor. Many of the midwives in the group I am facilitating here near Nottingham talk about programs of 2 sessions of 3 hours plus a labour ward tour! Most classes are for women only, although the few evening couples classes that are offered are very popular. There have been some attempts at innovation, such as aquanatal programs, drop in programs for teenagers (not very successful) and weekly, shorter sessions of a “rolling” nature.

Fathers seem to be regularly excluded. The typical program is 3 or 4 sessions: one on labour, another on “pain relief”, one on “infant feeding” (that always includes bottle feeding so that women can make an “informed choice”) and another on post natal. It is run as a lecture session with questions at the end.

The midwives are usually told they have to “do the classes” , usually with no training, or even warning in some cases. Many said they didn’t like doing them, but it was part of the job and they were obliged to put in appearance. In this group of 30 midwives there were only a few who had expressed any real passion or even interest in childbirth education - most did it as a duty, with reluctance.

On the other side of the equation, the women often only came because they were paid to come. Apparently women can get paid time off work to attend pregnancy care, and it seems that some take full advantage. Stories were told of one employer who puts on a company bus to take the women to their antenatal clinic check-up, aquanatal classes, parent education etc and with a bit of organising women can get 16 paid hours a week off work for pregnancy related appointments!

I get the feeling that here, although there is recognition of the role of education and some midwives are keen and anxious to do a good job, the model that I am proposing is so far ahead of their thinking that it will be a struggle to make any changes. I can see the reactions: “there is no time for this group work; how will I fit this into the current program; the women won’t want this; I don’t want to have to deal with fathers” etc. At the end of the day I get the strong impression that many won’t want to be bothered with making any changes - too much like hard work.

Parenthood education is so important for changing attitudes, increasing confidence in parents, developing their skills and giving them hope - if the health professionals they meet are just going through the motions, it is no wonder that so many expectant parents either fail to turn up or don’t come after the first session. A wasted exercise all round. I will try and enthuse them today......

Posted by andrea at October 20, 2002 06:01 PM

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Andrea, am a midwife with strong desire to give motivating reassuring and empowering message in forthcoming antenatal classes. Only four slots scheduled so any idea's? group work with partners too a must. Thanks K

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