Private antenatal classes are a growing business, from evening classes, to one-day courses, to weekends in a luxurious hotel, writes Sheila Wayman.
AS SOON as your bump is visible, other women can't resist sharing birth stories - the worse the better, and they grow in the telling. Two days in labour; the drugs didn't work; pure agony and a Caesarean at the end of all that.
The more reliable and helpful version of giving birth is provided at antenatal classes, but women are usually recommended to wait until they are at least 26 weeks pregnant for those.
Traditionally, the hospital midwife, holding a doll in one hand and a model of a female pelvic girdle in the other, has helped first-time parents to understand that conundrum of how something so big is going to get through something so narrow.
While most couples attend hospital classes, others are seeking an alternative for which they are willing to pay. Private antenatal classes are a growing business, from evening classes, to one-day courses, to weekends in a luxurious hotel.
Yet the maternity hospitals recommend that expectant mothers go to their classes where possible. They say it is better to be familiar with the system, procedures and environment of the hospital where you are booked to give birth.
So why doesn't everybody avail of the hospital courses, which are usually free? Often because the time of the weekday classes does not suit working couples.
Women are entitled to take paid time off work to attend antenatal classes, but they usually want to go with their partner. Maternity legislation gives expectant fathers a right to paid time off work to attend only the two antenatal classes immediately prior to the birth of their first child.
Tara Vance and her partner, Barry Ryan, went to a private antenatal course before the birth of their first child six years ago, mainly because it was on a Saturday.
With a training background and an interest in natural remedies, they saw the potential in providing something a bit different for would-be parents. So, along with midwife and homeopath Mairead Conneely, they set up a training and life-coaching company in 2006. PlaygroundEarth offers one-day antenatal courses in Dublin, Cork and Galway, costing €175 for a couple or €100 for one person.
The morning session includes the midwife talking about preparing for labour, pain-relief options and hospital procedures during birth. Among the afternoon topics covered by Vance are feeding, what to look for in buying a buggy and "getting your groove back" after the birth.
What does she see as the advantage for couples taking their course rather than or as well as a hospital one?
"We cover a lot of the post-natal period, which they tend not to do in hospitals. There is an awful concentration on the day you're having a baby. We look at the relationship side of things, the human and emotional end of having a baby."
Participants are always keen to hear from somebody who has had a recent birth, so they can relate to Vance who now has a two-year-old as well. "I am also a member of the user group in Holles Street so I am aware of developments in hospitals."
While they offer the angle of alternative remedies, they are guided by the interest shown on the day. "We don't want to push it down their throats," says Vance.
The main aim is to give people more information going into labour, and what to expect afterwards. She thinks a birth plan is a good idea. "It focuses your mind but don't get fixated on it; if it doesn't work out, it doesn't matter. And don't go in waving your birth plan or you'll have them saying, 'here is another naive fruitcake coming in to have a baby'. Say what you want in a soft way - if your partner wants to cut the umbilical cord, for instance."
A part-time midwife at the Our Lady of Lourdes Hospital in Drogheda, Anne Delany does not see the need for a written birth plan. "There is plenty of time to discuss your wishes with the midwife, there is no need to write down a birth plan. A lot of people come in with one printed off the internet, American ones. One said, 'handle my baby with care' - we do that anyway."
Working at the hospital two days a week, she also runs private antenatal classes. Under the name Babysteps, she holds day courses in a local hotel on Saturdays once a month, as well as occasional one-to-one, evening consultations.
"I offer the Saturday class to suit people who have to commute during the week. It is more informal and more intimate than the hospital ones." Charging couples €160, she covers the topics that would be included in the hospital classes and is also able to give clients first-hand information about the procedures and layout of the local hospital. About half of them would be booked to give birth there, the rest would be going to Dublin hospitals.
"Some women don't want to know too much, some want it all. I try to find a happy medium. The process of labour and childbirth is not as scary as a lot of people have envisaged."
As the mother of a 16-month-old girl, she is often asked by clients what her experience was. But, as a hospital midwife, she's hardly typical: "I was going in to my workplace to have my baby, with all my colleagues standing around! But it was a good birth."
She also highlights the importance of the man's role at the birth. "Men can be very stressed through labour, and classes put their mind at ease, put things into perspective."
She tells men that they are definitely not "in the way", that women are reassured by their presence. They need to act as an advocate for their partner if she can't speak, support her all through labour and then provide practical and emotional support in the days after the birth.
Harriet Sheahan caters for commuters on the opposite end of the Dublin commuter belt, running evening classes in Gorey, Co Wexford. A midwife, she is also the mother of a nine-year-old and three-year-old. "You think you know everything when you've trained but it's a real eye-opener when you're on the other side. I would have more empathy now."
Charging couples €150 for an evening course over three weeks, she likes to share a lot of practical and self-help ideas. "Giving birth is a normal physiological process, not a medical condition. Fear can play a big part - the right information alleviates a lot of fear."
She is also starting to offer Baby Blooming weekends, where couples can combine their antenatal education with pampering at the Seafield Hotel and Spa beside Ballymoney beach outside Gorey. "It's an exclusive, comprehensive course, all you need. And there is time for people to absorb it."
As well as covering the usual topics herself over the two days, she runs a question and answer session for fathers and also has instructors in for sessions on pilates and baby massage. The €690 fee per couple includes two nights' bed and breakfast, one dinner, one lunch and use of the spa.
Another option is Cuidiú, the Irish Childbirth Trust, which has antenatal tutors around the Republic. Most of them are not midwives, but they are all mothers who have trained with the National Childbirth Trust in the UK.
Evening courses are held over six to eight weeks, ranging in price from €150-€180 for two, or couples can attend two day-long sessions on Saturdays for €185. Courses are kept to a maximum of seven couples and a post-birth reunion is always included, and often ongoing parenting and breastfeeding support as well.
"The problem with hospital classes is they don't give all the information, they only give what they want people to hear," says Sarah McCann, a Cuidiú tutor in northeast Dublin.
"We do a bit of assertiveness training and cover the guy being the advocate for the woman. We encourage them to do a birth plan, so they know together what she wants and so he can be her voice. But we also tell them to be very open, not regimented about their plans," she says.
Having given birth at Holles Street to four children, now aged between seven and 20, she says she only realised afterwards that they were good births.
"Dublin hospitals are so busy now they are caught between a rock and a hard place. But women can't be the ones to suffer because they are so busy."
Margaret Fanagan, clinical midwife manager in the ante-natal education department at the National Maternity Hospital (NMH), says active management of birth is often misunderstood and it is not about the busyness of a hospital but helping women not to have long labours. "Long labours can lead to more stress to babies and mothers."
When a mother is in labour, there's also a baby in labour and it's very important to remember that, she says. "Wishes can be met as long as mother and baby are safe."
The hospital has 13 different antenatal courses running each week, all free except for an "out- of-hours one" at 5.30pm, for which a nominal fee of €65 is charged.
She says it is important that people are well informed and know the procedures at the particular hospital they are going to.
"When they are well informed, they are more in control and more relaxed. It is a pity people are so afraid of labour, they should be more positive."
She also sees the benefit of people becoming familiar with the environment of the hospital as they attend classes. Both Fanagan and a midwife at the Coombe suggest that weekly classes are a better way to learn, rather than trying to take it all in on one day.
While the Coombe can no longer offer tours of the labour ward, the NMH does, as do most maternity hospitals. Even people who opt for private antenatal classes but are booked in at the NMH can make an appointment to be shown them.
For further information on classes mentioned above, see: www.playgroundearth.com; www.babysteps.ie; www.babyblooming.com; www.cuidiu-ict.ie; www.nmh.ie