I’ve been asked to write about my involvement with NCT. When and how I got involved with research and maternity services activity. I’ve been asked how NCT has gone about having influence, so have been sharing this kind of information with women in other countries recently. And I will add more. Let me know if you have any questions or feedback.
- When and why did you first get involved with NCT?
My mother was an NCT member in 1958. (She just missed out for the birth of my older sister who was born in 1956.) Mum talked about labour and birth to her young daughters quite a lot. There were two more babies after me, so pregnancy and breastfeeding were fairly prominent in our lives. I recall my mum explaining to me, aged about six, how useful pelvic rocking on all fours can be for a back ache during labour. Mum had all four of her babies at home. Erna Wright was her NCT antenatal teacher. I am very proud to say that Erna Wright, who later wrote a book about her approach to labour preparation The New Childbirth (1964), was present at my birth. To some extent I guess she was taking the role of what we know call a doula.
Although Erna lived until 2004, I regret to say that I never met her. It turns out she was cooking and running a restaurant in Camden Town in the 1970s. She also trained as a psychotherapist. She came to Britain as a Jewish refugee and gave so much. Her Guardian obituary is well worth reading. https://www.theguardian.com/news/2004/sep/08/guardianobituaries.health My own mother, and other women like Erna Wright, inspired me to get involved with NCT. At 16, I chose Sheila Kitzinger’s book Some women’s experiences of childbirth as one of my end of post-GCEs prizes. I was hooked on childbirth as a women’s issue and exciting process from then onwards.
- When and how did you get involved with NCT research and/or maternity services activity?
I had my first two babies while I was still in my teens and then, aged 20, in 1979, I started training as an NCT antenatal teacher. This involved reading research. I remember reading radical works such as Marjorie Tew’s statistics on the outcomes for babies born at home (or in planned home births) compared with those having all their care in hospital. I was very moved by the work of Doris Hare, the American Childbirth Educator who wrote The Cultural Warping of Childbirth. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1893087/
I was also exercised about breastfeeding having had difficulties feeding my firstborn. I devoured The Infant feeding Survey. My NCT antenatal teacher training introduced me to all of these reports. I was fascinated and inspired. (I have done a quick internet search to check when the Infant Feeding Surveys started. Sure enough, I discover that “The Infant Feeding Survey (IFS) has been carried out every five years since 1975 and the 2010 survey was the eighth time the survey has been conducted.” So I was reading the very first of these fantastically valuable reports.)
With another local woman, a breastfeeding counsellor who moved into the area already qualified, we set up the Grange over Sands Branch of NCT. I guess the first activity we undertook to influence maternity services locally was to contact the Community Health Council about the quality of support for breastfeeding.
Much later, after taking A levels at an adult college and six years at university, first reading Sociology at LSE and then working on social research at Essex University, I joined NCT staff as National Secretary Elect in 1988. Hanna Corbishley was the retiring National Secretary and I recall how every Friday afternoon when the British Medical Journal was delivered she would sit and read all the relevant news and articles. Having read a lot of social research and some epidemiology during my university years, I started to become a frequent reader of biomedical research.
NCT had it Research and Information Group at that time, a committee of volunteers, some of whom had health professional training. Members were carrying out a survey of women’s experiences of dirty hospitals and postnatal infection. The study was used for lobbying and is referred to in the Health Select Committee Maternity Services inquiry of 1991. I produced a good deal of the evidence that NCT submitted to that inquiry, and have worked for NCT using evidence to improve maternity services, and producing evidence, ever since.
- What have you learnt from the different projects you have been involved with?
I have learned that there is much to be gained for NCT by doing research which it leads and has freedom to design according to the priorities of women and families, and its members. There is also much to be gained from working collaboratively and being a co-investigator with eminent researchers and representatives from many different disciplines and perspectives.
I value the research I carried out with an NCT colleague on postnatal care (Left to your own devices: The postnatal care experiences of 1260 first-time mothers, Newburn and Bhavnani, 2010) This was ‘service user-led’ research and important for that reason. Sheila Kitzinger established that precedent in NCT with Some women’s experiences of episiotomy, and we followed it in the 1990s with an NCT study of Rupture of the Membranes.
I was also pleased to research NCT’s antenatal education from the perspective of women and men using NCT services (Preparing for Birth and Parenthood: Report on First-Time Mothers and Fathers Attending NCT Antenatal Courses, Newburn, Muller and Taylor, 2011). I wanted to communicate to the world something more about what NCT courses were all about, as well as demonstrating how women and men experienced the courses and the preparation using statistical data and testimonies.
I also value very highly having been a co-investigator on studies run by leading researchers, such as:
- The National Sentinel Caesarean Section Audit in 2001 CS National Audit, and
- The Birthplace in England Programme 2007-2007, including the prospective cohort study (2011) in (Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ 2011;343:d7400. http://www.bmj.com/content/343/bmj.d7400 see also https://www.npeu.ox.ac.uk/birthplace/results )
I’ve learnt from contributing to these influential studies, and to the Parents of premature babies project (POPPY), Cochrane reviews (pain relief in labour) and NICE guidance and The Lancet Midwifery series that service users really can influence and fundamentally shape the development of new evidence-based knowledge by being involved in the design, analysis and the writing up of studies. The image above is from an interview for the international launch of The Lancet Midwifery series (see link above).
4. How do you feel they have contributed to improving care for parents and families?
I feel that I, and the work of NCT generally, has contributed substantially to maternity care that takes account of the social and psychological impact as well as biomedical ‘outcomes’. The way services are structured and delivered, for example offering choice of place of birth, providing support for breastfeeding no longer separating mothers and babies and now encouraging skin-to-skin care, aiming to provide continuity of midwifery carer, are some examples.
The ideas of ‘woman-centred’, ‘family-focused’, ‘family-centred, and ‘personalised’ care are so important. These concepts are now very widely used in the literature and evident in practice, even though there is still so much more to achieve. The principle of ‘patient and public involvement’ in research, in policy and in planning and monitoring of maternity services is embedded. We at NCT have helped to do that, working as a movement, sharing our knowledge and passion. Supporting each other and new generations of activists and parent advocates.
5.What would you say to anyone who is feeling nervous about becoming a user rep?
You can do it! You will enjoy it! Find a few contacts who you can talk to – both those who have a bit more experience and new-comers going through the same kind of steep learning curve you will experience. Join the Facebook group NCT leaders. Network, browse the web, sign up for alerts, make a group of influential friends, look out for training opportunities. Know your limitations and practice saying ‘No’. You don’t have to be Superwoman. As well as making a difference for other women and families, it’s great for your own personal development and for your CV.
My thanks to Rachel Plachcinski, NCT Research Engagement Officer, AKA @stroppybrunette, who posed the questions and prompted me to write this. The questions have been sent out to many other NCT activists and I look forward to hearing their stories and reflections. I can’t make it to the NCT’s annual gathering for volunteers and practitioners, where they will be shared this autumn, but maybe more of them will be posted online. I do hope so.