On Friday I completed the second full day course in our NCT ante-natal training. Therefore, I am now complete with my knowledge and ready to tackle a real baby. Oh yeah?
The day was started with detail into forms of pain relief on the B Day and the choices open to the mums. From full epidurals to the 'Harmony Room' at Watford General there is a wide range of options on how to relieve stress and pain and make the birth experience do-able. The concept of a Harmony Room was mildly intriguing and is apparently a dimly lit room with bean bags and disco ball rotating, incense and aromatherapy candles, soft music and the mid wife wears a Afghan coat and tinted glasses while the assisting doctor looks like a 1970's porn star - I assume. Quite why that would rid a mother-to-be of the excruciating pain of child birth I don't know but each to her own, I suppose.
I think what got to a lot of mums was that there was a wider choice than they expected and that it was pretty much within their control as to what they could use and when. This countermands our concept of a hospital where we go in expecting to be told what's wrong with us and then prescribed treatment to get better. In the process of childbirth, the mother effectively tells the medical people what she wants. The information available on this is actually both bewilderingly wide and bafflingly indecisive. What I mean by that is there is no shortage of information on each option but there is nothing that helps you tailor it to you. Many of the mums had stories of friends or family members who had used this or that and the others listened avidly but then sucked in their breath and concluded they had no idea. In the end, the course leader, Kim, basically said that often mums left it flexible - saying that you can opt for say gas and air but tell the staff you will let them know, in screams presumably, that you need something more as you go along.
This brings up the concept of the Birth Plan. This is some kind of document which states what you have planned in terms of medication for pain relief during the birth. It seems a might definitive and that's where Kim suggested that it is wise to have it written on the plan that this is what you would like but that you reserve the option to ask for more as you go along. Should you write that your plan has no other options to it and you feel as if you need it, often the mid-wife will argue with you at the most inconvenient of moments and persuade you that you really don't want it as you have written previously that you don't. It's the sort of decisions under duress thing that medics don't like and spoils their ethics. My take on the subject was that mums should not be too definitive in their Birth Plans and keep some 'wiggle room' for those moments when the pain gets pretty unbearable.
We got to learn about 'Gas & Air' which is the gas administered during the birth famously breathed by Del Boy in Only Fools & horses as his partner, Raquel, was in labour. It is a mixture of 50% nitrous oxide (or Laughing Gas) and 50% oxygen, called Entonox. It is also used by paramedics when you have had a nasty accident like a broken limb. The trick with Entonox is to time the breathing with the contractions so that its mild analgesic effect is at its peak when the contraction is at its peak. While it is popular in births, it is only a short lived pain relief and it is only mild which means all sensations are really still there and the whole thing is self administered and self-regulated - you breath more when you want to. The downside is that it is only short lived and only mild. The upside is that it only takes a short time to work and can be combined with most other forms of pain relief.
Pethidine is another common drug to be used. It is an opioid analgesic and as such is quite strong. As most druggies would tell you, opioids work by mimicking endorphins in the brain - the natural painkillers the body produces and so effectively cuts the brain off from the source of the pain. It's pretty effective but can produce drowsiness and lightheadedness which my sister tells me probably prolonged the birth of her child unnecessarily which is a common theme with the drug in childbirth. Your mid-wife can tell you more but it is generally administered as an injection into muscle such as the bum or thigh by the mid-wife.
Epidural is the 'Mama' of pain relief strategy during birth. It is a mixture of drugs administered by a trained anaesthetist by an injection between the third and fourth vertebra in your back. It is then controlled by a tap and bag hanging beside the bed. The mum can even have a button to press to administer more but it is a time release valve so pressing it more than once or in between doses does not actually do anything. Depending on your choice, the epidural can numb the entire bottom half of the body and so you don't have to feel a thing or you can have a setting less than that. If in labour the mum has remained flexible on pain relief, it's important to give the staff enough time to administer the epidural as only trained people can do so and it has to be done before 8-10cm of dilation, otherwise it's pointless as it will miss the most intense period of pain.
Epidurals are one of the most hotly debated areas by mums as many don't like the idea of having their spinal chord being invaded or having the sensation of paralysis, which totally restricts movements and birth positions. Also, the epidural can take away the entire sensation of pain which also makes the act of pushing hard as nothing is felt so there is no gauge as to how hard the push is being done, you literally watch it on a monitor. However, it is a highly effective form of pain relief.
The pain relief discussions over, we got onto how to deal with a baby. Here came the hilarity of watching grown men handle a plastic doll as if it was a baby, to change its nappy and to bath it. Naturally there was a good deal of fun and banter in the room and the sight of one girl holding her doll in a 'chin hold' while she wrote and men attempting to change positions of the baby without supporting necks or chests. Putting the clothes back on caused problems for me but generally I concluded that changing a baby was a doddle until Kim pointed out that real babies squirm and cry while you do it and often pee or poo at the most inconvenient moment in the process. I noted to myself that I should have a list of rules I would read to my baby shortly after birth which I will pin to the cot wall but my wife seemed to think that may not work.
Finally, we got to the best part. Everyone had brought along a piece of equipment or something else which had been bought for the early days of the baby. One lady brought half the wardrobe of great stuff bought from the highly recommended TK Maxx, while her hubby demonstrated a Tomy intercom device to monitor the baby from afar. That stole my thunder as by the time it got to me, two of those devices had already been demonstrated and the second was the 'Which?' magazine top pick, the BT model. At £55 it was the bees knees, so my Philips version was £77 from Amazon and not as good - I was gutted. Still ours was yellow and my sister had bought us a battery charger unit so I felt more prepared - plus ours had a handy travel bag. My wife demonstrated the bargain changing bag she bought for £44 (down from £88 in the sale) from Blooming Marvellous in St Albans. It outclassed the 'Baby K' one from Boots (this is the range with Myleene Klass' name on it) from another couple and was less practical for the dad as it was very girly and had a mock leopard skin interior. At least I could be seen with ours and look only mildly effeminate. Seriously, there are some good ones on the market with pods for wipes, creams, nappies, even a little nappy bin, bottle holders and changing mats - our sister-in-law tells us they are essential and our one was her choice too (hers is a more girly red, ours is a metro-sexual black).
Our final NCT session is on Wednesday evening and it is on breast feeding. Kim is planning that we all get together for before the first birth due in early February and already we have bonded well with all the couples in the group. Afterwards we plan for a swift drink at a pub. My wife has planned to meet two of the wives who work close to her in London and the guys I would gladly have a walk, pint or coffee with each other any time.
I think that is the best part of ante-natal classes - the people you meet are discovering about child care at the same time and there is a real kindred spirit. Whatever their backgrounds there is a common link and a feeling that we are going into this daunting and exciting experience together and we were all prepared to make a fool of ourselves in the interests of learning a bit more. The network of friendships formed this early will be there for some time, possibly for life. NCT was well worth the money, I cannot commend Kim Hay, our course leader, more highly. It was money well spent and we are looking forward to Wednesday evening immensely.
If you had asked if I would be thinking that way before the course started - I would have laughed at you. Then again, there are many aspects to parenting that have surprised me by my own reaction. They say it changes your life.
It does.
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