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Antenatal Class Advise

ReBeCcA-90 profile image
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Hello, How are you all? hope all pregnancies are going well. sorry in advance for long post. But i need advise on antenatal classes... This is my first pregnancy (well after 12 weeks anyway) and i have my all day antenatal class booked for next Saturday, but i am having second thoughts as a lot of family and friends who have been said its a waste of time, i have also read a lot of the same on the internet. I am always on google finding out info about pregnancy and labor and do feel that i know a average amount, a lot of people who i have spoken to said just listen to midwife on the night. Also read on one forum that one woman said that in her group they were split into smaller groups and had to role play labor/breathing/panting this worries me as i hate getting up and doing things like this in front of people, or is antenatal classes just watching videos and listening to teacher/midwife? or did you have to do activities in front of class?

I feel i need advise on how to care for newborn rather than labor, as even though i am 26 i have never held a baby- is newborn care covered in antenatal class?

Also if i do go do i need to take my personal pregnancies notes?

Any advise on your experiences on antenatal classes would be greatly appreciated. Many thanks Rebecca XxX

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ReBeCcA-90 profile image
ReBeCcA-90
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Hiya! I did the block of NCT classes with my partner and we were both dreading it! :) I have to say it was the best thing we did. You get asked at the very beginning what you would like to learn in the course, you get to chat to women who are in exactly the same situation as you (which means you can have a proper moan and not feel guilty!) and we have all stayed in touch and meet regularly for catch ups. Four of the 8 ladies have had their babies and it's been fab getting their honest views on labour too!

During the course we practiced dressing and bathing a baby (doll) we learnt about the stages of labour, got to see all the medical devices (like forceps, the epidural needle, gas and air mouth piece) and yes we did do a bit in breathing exercises but all together not one at a time in front of each other.

I think you're meant to keep your medical notes with you at all times so I would bring them just in case!

Hope this helps!

Becca x

KellyTrip profile image
KellyTrip

I went to the hospital ones with my son and I was dreading them. We actually found them really useful. We were split into groups but there was no role playing thankfully!! That's a bit odd and I wouldn't have felt comfortable doing that! I am too private! Ours was do do a quiz. We were glad we went.

GingerAcorns profile image
GingerAcorns

Hi Rebecca,

Congratulations on your pregnancy, I hope you're enjoying all the new experiences and are excited about all that is to come.

I absolutely recommend that you attend your hospital antenatal classes for a variety of reasons:

1) You often get to have a look around the hospital (not the birth suite though as these are often in use and busy!). Even if all you see is the entrance and the route to the birth suite you'll feel more prepared for when you arrive in labour.

2) Whilst reading around the subject on the internet you don't get hospital specific information. In your hospital class the midwife will give you information such as which induction of labour process the hospital follows and whether they offer diamorphine or pethidine injections.

3) You'll get to meet more of the maternity team. By meeting more of your hospital's employees you will get more of an idea as to the maternity department's philosophy of care. This will help you prepare for your labour and develop your expectations of the hospital.

4) Whilst the class is only one day you may meet other couples who you go on to build a friendship with. You can then guide one another through the rest of your pregnancy.

5) The instructor in the class will also have equipment for you to handle such as forceps, catheters and suction cups. Whilst these may be initially scary, seeing them now and learning what they're used for is far better than being in labour, vulnerable, frightened about what is happening and not having the time to ask your questions.

6) Meeting another midwife will give you the opportunity to ask questions specific to your situation and your anxieties in an environment which is not limited to short amount of time. Remember, no question is silly. If you're thinking about it I promise at least one other person in that class is thinking about it too.

7) Going to the class with your partner also offers you both the opportunity to spend time together preparing for the birth of your little one. It's a judgement free area where everyone there is in a similar situation to yourselves and everyone wants to know the answers to the same questions.

8) Attending the class enables you to begin making decisions about your labour and baby in a safe environment. You absolutely should listen to the midwife on the night but if she offers you options or asks for your consent how will you know the answer? You'll be in labour and unable to research or discuss something at length because you can't hit pause on contractions or emergency situations.

I'd also suggest (if you can afford it) booking yourself some private antenatal education classes. As Bexicles2016 mentioned, the NCT ones are excellent for joining a small and local pregnancy support group who you can stay in touch with for as long as you wish.

Subjects covered in the class vary but often include - stages of labour, basic anatomy and physiology, pain relief in labour, foetal monitoring in labour, positions in labour and birth, when to contact the hospital, breathing during the different stages of labour, perineal trauma, instrumental deliveries, caesarean sections, your waters breaking, what happens immediately after the birth of baby, admission to discharge process and care of a newborn baby (nappy changing, bathing, care of the cord, feeding, heel prick testing). However, to fit all of this and more into a single day is a tall order so don't expect everything to be covered in the greatest of detail.

Whilst I do understand your anxiety about group participation, please do try to be as interactive as possibly. Being an instructor at the front of a class talking extensively for 8 hours is incredibly tiring. By being interactive and answering/asking questions, your instructor will be enthused and keen to give you more. By helping him/her out and being more interactive, the session will be better and everyone will benefit more from it.

Empowerment is most important. It is true that some women do well entering labour and giving birth having done little or no research, but for the most part it is the women who have done an amount of preparation that report more positive birth experiences. They have a better idea as to what is to come and feel that they are working in partnership with the maternity team. They've also already made informed decisions and don't feel that they've been pressured into anything. As the old adage suggests, 'To be fore-warned is to be fore-armed'.

And finally regarding your notes. Please, please, please carry them with you everywhere. This is so important, you should always have them with you. Heaven forbid anything happened to you but if it did the time saved by having your notes is crucial and may directly affect any outcomes from an emergency.

Hope that helps you make your decision.

KellyTrip profile image
KellyTrip in reply to GingerAcorns

We were lucky enough to see the delivery suite as it was quiet! It really put my mind at ease and made me feel better about going in when I needed to!! The classes were so helpful.

ReBeCcA-90 profile image
ReBeCcA-90

Thank you all for your advice! I think I will probably go, I have already been on the maternity hospital tour as I was not sure whether to have a hospital or home birth, I found this really helpful and it put my mind at ease enough to say that I will have a hospital birth. I am still really worried about the antenatal class as I am very shy and feel uncomfortable doing stuff like this, but having read everyone's replys I feel it's something I should do. And I am worried about how many people will be there as when I did hospital tour there must of been at least 40 people there and they do this tour every week, so I am thinking that because the antenatal class is once a month it will be packed! But I will just have to go and see! Will let you all know Saturday how I got on, thanks again for all replys! Becca

GingerAcorns profile image
GingerAcorns

Hi Rebecca,

How was the class?

ReBeCcA-90 profile image
ReBeCcA-90

It was ok, loads of people there couldn't make friends must of been nearly 40 people, and I found it hard to sit still as I was uncomfortable. They went through stages of labour, and pain relief. Which I knew about, but I wanted info about active and natural ways of placenta removal, which they didn't cover. They spent most of the day talking about the advantages of skin to skin and breast feeding which I had already decided to do. However did take info on breathing, when to call hospital (as I planned to only call when I was getting contractions every 5) but my hospital like you to call when waters break even if contractions aren't regular. Also learnt that baby has a cord clip on cord till it falls off where as I was expecting a small band or something, now I am paranoid they it's going to catch all the time and cause problems. Also they showed us how many and who the staff are if you need a c section, didn't realise that there would be so many people In the room. Didn't cover newborn care, cot death, stitches, didn't touch on forceps but did talk a bit on the vontouse thing, but I think I would prefer forceps, maybe my hospital tends not to use them, maybe that's why we weren't shown. Yeah so when I first come out I was a little disappointed but when I go home and thought about what I had learnt I was pleased I went, my partner said he learnt quite a bit so he was also happy we went. Which is what I was worried about because class was 9-4 and he had to be in work for 4.30 so was late, and he had a busy night (he's a chef), but he was ok with it. The only bad thing is I am scared of hospitals and have always wanted a home birth but being a first timer no 1 in my family like that idea, so I said I would have a hospital birth and now I am re thinking it, but I feel like I need to make mind up really! The only thing putting me off a hospital birth is you are in own room for delivery and 1-2 hours after baby is born your moved to a ward with other people and once in the ward there is no visiting between 10pm - 10am which I can understand, so if I have my baby anytime after 3 in afternoon I will have to stay overnight on my own without partner really not happy bout this, but if I have baby at about 8 in morning when I am moved to ward he can stay and we can go home before 10pm, the thought of me being left alone worries me so much I can't sleep and night just thinking about it, mentioned it to midwife but she didn't say anything, what can she do its he same rules for everyone.I have worked out that I can only have baby between 8-3, which isn't a very long period. Sorry about any spelling mistakes, and long post! Becca

GingerAcorns profile image
GingerAcorns

Hi Rebecca,

Apologies in advance for what is going to be a longer post!

I'm sorry the class was so busy and you were uncomfortable. However, at the same time I am glad that you and your partner found at least some of the class was useful. It appears to have clarified some questions you have. I'll try to answer some of these for you.

1) The delivery of the placenta.

There are three ways for the placenta to be delivered; active, physiological and manual.

i) Active delivery of the placenta involves your midwife administering an intramuscular injection (often into your thigh) following the birth of your baby. She will also clamp and cut the umbilical cord although this should not be done before your baby is at least 1 minute old.

The midwife will than palpate your abdomen to ensure it is contracted prior to placing one hand at the bottom of the abdomen to guard the uterus whilst pulling on the cord with the other hand to remove the placenta and membranes. The recommended drug is an uterotonic drug called syntocinon which is a man-made form of the hormone oxytocin, otherwise known as the love hormone.

An active third stage is often shorter than a physiological third stage and should be completed within 30 minutes of the birth of your baby. There are reports of nausea and vomiting in approximately 10% of cases. The risk of a post partum haemorrhage (significant bleeding) is approximately 13 in 1,000 and the risk of requiring a blood transfusion is approximately 14 in 1000.

An active third stage is the recommended method for the delivery of the placenta.

ii) Physiological delivery of the placenta involves your midwife supporting you in delivering your own placenta. She will not administer an injection, cut the cord straight away or touch your abdomen. After a period of time the umbilical cord will stop pulsating oxygenated blood to your newborn baby and come away from the wall of the uterus naturally. You will then feel a weight in the birth canal and have an urge to bare down/push. The placenta is then delivered by your own effort. Sometimes, when the cord has stopped pulsating and depending upon the situation, the midwife may offer to cut the cord for you. This will allow you to handle your baby without restriction and to move freely into more comfortable positions.

To speed up a physiological third stage there are a few things you can do. Breastfeeding your baby increases the amount of naturally occurring oxytocin in your body which will make your uterus contract. Moving around allows gravity to help your placenta move to the birth canal where you will have an urge to push and expel it yourself. Finally, if things are going slowly, sitting on a toilet with your knees above your hips also assists with gravity while aiding you with your pushing technique.

A physiological third stage should be completed within 60 minutes of the birth of your baby. There are reports of nausea and vomiting in approximately 5% of cases. The risk of a post partum haemorrhage is approximately 29 in 1000 and the risk of requiring a blood transfusion is approximately 40 in 1000.

A physiological third stage is often not recommended where a deviation from an uncomplicated pregnancy, labour or birth has occurred or where you have an increased risk of post partum haemorrhage already. You should speak to your midwife if you think this applies to you. Also, if your midwife was to become concerned regarding post partum haemorrhage during your third stage of labour she would administer the drug as part of emergency life saving procedures.

If you did choose a physiological third stage you can still change your mind later and request the injection if you would like for the process to be speeded up following the birth of your baby. Choosing a physiological third stage during your pregnancy as part of your birth plan does not rule out an active third stage should you change your mind in labour.

iii) Manual delivery of the placenta is only performed in emergency situations where the placenta or part of the placenta remains inside the uterus. A retained placenta is a significant risk for a post partum haemorrhage and must be managed in an obstetric unit.

2).The umbilical cord clip. Please try not to worry about this. There isn't really anything that the clip can catch on as your baby's nappy and vest will prevent this. Also, it isn't on for long. The cord dries and shrivels up really quickly. Almost all cords are off by the time your baby is 2 weeks old. I'm sure many others members in this community will be ale to reassure you with this too!

3) What is it that you wish to know about newborn care?

4) Cot death, otherwise known as sudden infant death syndrome (SIDS). The risk of SIDS is relatively low, in 2014 there were 695,233 babies born in England and Wales, and 212 cases of SIDS. Unfortunately we do not know what causes SIDS but research suggests that there are a number of things you can do to reduce the risk of it happening to your baby. These are:

i) Don't smoke during pregnancy or near your newborn baby. It is important to prevent friends and family from smoking around your baby too.

ii) There is an association between co-sleeping with your baby and SIDS. Co-sleeping on sofas and in chairs should be avoided and co-sleeping in a bed should be avoided where either parent smokes, either parent has consumed alcohol, either parent has used any drugs or where the baby was born prematurely or with a low birth weight.

iii) Never place your baby on their tummy or side to sleep. Always place your baby on their back to sleep. This is because weight of your baby's body pushes down on their lungs and restricts their ability to breath.

iv) When placing your baby into a cot, crib or Moses basket always place them at the bottom of the mattress with their feet touching the bottom. This is often referred to as, "feet to foot". This prevents your little one from shuffling to the bottom of the mattress beneath any blankets and suffocating.

v) When using a blanket to cover your baby place the top of it at about the line of their nipples. Again this is to prevent them from shuffling down beneath the blanket and suffocating.

vi) Have your baby sleep in your bedroom near you for at least the first six months of life.

vii) Maintain a room temperature of somewhere between 16 and 20 degrees. If you have a thermometer it is best to keep it as close to where your baby sleeps as is possible. Drafts and radiators in other areas of the room may not give you a true indication of the temperature your baby is experiencing.

viii) Breastfeed your baby.

ix) Use a firm, waterproof mattress which is in good condition for your baby.

5) What is it about stitches that you would like to know?

6) Forceps vs. ventouse. There are a number of reasons which indicate whether a forceps or ventouse delivery should be performed. These include; the position of your baby, how low your baby is in the birth canal and your ability to push in terms of how tired you are. You should discuss your concerns and preferences further with your midwife to alleviate your anxieties.

7) Homebirth vs. hospital birth. Have you looked at the birth place study completed in 2011? This provides some of the most up to date information and will help guide your decision. Regarding discharge from hospital and your partner staying, have you asked them about being discharged directly from the labour ward? This depends greatly upon which hospital you are going to and is only applicable to women who have an uncomplicated pregnancy, labour and birth. Some hospitals offer a discharge a few hours after the birth so it doesn't make sense to transfer you to a ward. This means that you stay in the room where you give birth until the midwife has completed the discharge paperwork and sends you on your way. Also, have you considered attending a midwife led unit rather than an obstetric ward? This tends to be a half way house between a homebirth and a hospital birth. A few thoughts for you to consider. Let me know if you have any questions or if I can help further.

Again, apologies for the long post, I hope it helps.

ReBeCcA-90 profile image
ReBeCcA-90

Thank you!

I wanted a physiological third stage, however the more i think about it, i think there's more risk to it so now i want a active third stage, but they said in class that as the head is coming out they inject i do not want this i want to have baby then give the cord at least 2 minutes, then get partner to cut it, once baby is separate from cord i want the injection, but it doesn't seem to be done this way.

not sure what i wanted to know about newborn care, i guess i thought they would of shown how to hold baby, how to burp but maybe this is more of the midwifes job when baby is born, guess i will just learn as i go. My main concern with newborn care is how/when to burp a breast feed baby, as i have a huge phobia of sick and although people say baby sick is only milk it still was swallowed and coming back up.

thank you for your info about cot death, i dont smoke, would never have baby in bed as both me and my partner are big, i had read about putting baby on back to sleep and foot to foot, just brought a room temp, plan to breast feed, and we have just brought a brand new cot-bed and mattress, and we only have a one bedroom house so baby will be in our room until we move probably in a couple of years, so i am convinced that we would be doing everything we can to prevent it!

regarding stitches i wanted to know who sorted them? like a midwife in delivery room or maybe a doctor?

haven't looked at the study from 2011 but i will after i have sent this. when i went for hospital tour and class they both said they have a 6 hour minimum discharge, so i wouldn't of thought they would discharge directly from labour room, but will ask midwife on Friday. Yes have considered a midwife unit but the nearest to me is 25 miles away not that thats the issue, when i went on their website it said that they had to shut 3 times last year due to staff being ill, which is obviously the right thing to do as you cant be around newborns ill, but i dont want to plan it all then get a call as i am about to go into labour saying that they are shutting for the week due to staff illness, i feel like this will really panic me.

one last quick question if you dont mind (its a embarrassing one though)... best way for pubic hair to be? is it best to be shaved or natural?

many thanks for all your reply's you are so helpful! Rebecca

GingerAcorns profile image
GingerAcorns

Don't worry about it, I'm glad I can help.

If you were considering a physiological third stage why not go for it and then if you or the midwife have any concerns you can just switch to the active third stage as required. It won't change anything major and will give you and the midwife both a bit of time after the birth of your baby without rushing onto the next clinical job.

Where are you having your baby? Injecting as the head is delivered is an old technique and is now against guidance. The injection should be administered either when the shoulders are delivered or immediately following the birth. The cord does not then need to be cut immediately. You can specify any time frame you wish and the midwife should follow your request, she/he should then offer to guide your partner in cutting the cord.

Regarding baby care, for the most part it is a matter of learning as you go. With all the doll practice in the world, when you have your little one it will be completely different. Your midwife and the maternity care assistants are there to guide you with these things, try not to over think it too much. Your maternal instinct will kick in and guide you.

Breast fed babies tend to need less burping as they don't swallow as much air as bottle fed babies. I'd advise to only burp if you've fed baby, changed the nappy, cuddled your baby for a while and he/she is still unsettled. Regarding the vomiting, all I can offer is that once you've met and fallen in love with your little one this concern will no doubt appear insignificant. I have been amazed time and again by new parents overcoming anxieties in the blink of an eye when they've met their baby for the first time.

Any stitches required will be completed by the midwife in the birth room unless the trauma is significant. If this were the case you would be transferred to an operating theatre and a doctor would do the stitching, however, this is rare and not something I want you to worry about now.

Finally, pubic hair. It honestly doesn't matter, whichever you are comfortable with. Years ago there was an opinion that by removing the pubic hair the risk of infection to both the mother and the baby was somehow reduced, however this has since been disproven. Some pregnant women have anxieties about being embarrassed or judged by professionals, this simply doesn't happen. Maternity professionals see thousands during their careers and I doubt any of them can recall a single one specifically. They're distracted by so many other factors during examinations and/or birth that other than a cursory glance to rule out STIs, genital mutilation or varicosities they're paying no attention to how you keep your pubic hair.

Let me know if you have any further questions.

ReBeCcA-90 profile image
ReBeCcA-90

thinking about it she may of said when shoulders were coming out, but won't the drugs still go through placenta and cord and effect baby? Thank you again for all your advice! X

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