Gaining Knowledge and Confidence

“Yes, and they‟ve made me kind of confident in that like you know „you can do this‟ because when I originally found out I was pregnant this time, em, my GP said to me, you know your most likely to have another section because they‟re so close together, and you know I kind of thought that it wasn‟t an option, originally to have a VBAC, but now I do and I kinda think, „ok they‟re gonna try and help me have one‟, you know? Help me as far as possible and sure if it doesn‟t work out it doesn‟t work out, but at least I can go and give it my best shot.” (W3, Interview December 2014)

Throughout my attendance at the second antenatal classes (n=16) I could see that by participating in the class and asking the OLs questions, women‟s knowledge attainment grew leading to increased confidence in VBAC as a method of giving birth and their preparedness for having a repeat CS, if needed, without fear.

“no the second one I actually, I‟ve been telling everyone about it since I came out that I found it really, very, em, beneficial and very interesting. Just to know the facts” (W11, Interview August 2015)

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By attending this class, women were being prepared for labour, were given the education to both cope with labour pains and to know what the clinicians are giving them medically to cope with contractions. The class also provided the women with information and understanding as to why they might have a repeat CS so that they can fully understand this and the process surrounding it. A perfect example of this gain in knowledge is that many of the women thought that because they had a CS that, for their current pregnancy, they could not have an epidural14:

“[The MOL] tells the woman that “you‟re like a first time mum in labour”. The woman then asks “so there is no problem having an epidural?” to which [the MOL] shakes her head and tells the women “no, none at all”. The woman looks confused and tells the class the she “thought that the muscles would be weaker”. [The MOL] again shakes her head at this and repeats that “no, you‟re like a first time mum”. The woman looks relieved then at the fact that she was wrong about the epidural and that she can have it.” (Field-note, April 2015)

For many of the women who attended the class, it was the practical knowledge that they gained that was extremely important to them and gave them the confidence about having a VBAC and knowing what was going on during labour and birth. This can be seen with the conversation I had with W9 below when I asked about the second antenatal class and her thoughts on it:

W9: Really good, yeah, I think everything that was given was just practical and to the point, there was no „airy fairy‟, you know? (Laughs). You know, „this is what‟ll happen‟ and you know „we‟ll check in on your date‟ and „we may give you an inducement‟ and if not…

Int: Yeah.

14

Epidural is a form of pain relief whereby pain relief is “obtained by blocking the conduction of impulses along sensory nerves as they enter the spinal cord” (Fraser & Cooper, 2009, p. 503). The epidural is administered to the lumbar region of the back by an anaesthetist under strict conditions.

170 W9: Do you know? I think it was practical.

Int: Great.

W9: You know that‟s what you want really, you don‟t want someone saying, you know that everything is going to be roses either, you know? Yeah. (Interview, May 2015)

It was having the healthcare professionals facilitate the class that helped women to be sure about VBAC and have the confidence to give VBAC a try as is demonstrated with W8:

Int: And then just with the then with the OptiBIRTH classes, what did you find

most beneficial about attending them?

W8: Em I think it was such em… any question you had was answered.

Int: Mm hmm.

W8: Any question now, and I thought [the MOL] was very em, she would give you all the information she had, everything, all the knowledge she was able to tell you, she‟d tell your there and then or she‟d say; „I‟d have to come back to you on that‟ it was straight to you, I like that. (Interview, April 2015)

W11 also had similar sentiments about the second antenatal class:

W11: No I found that they covered, em, everything I wanted to know anyway. . . I

was really delighted when I came out and it was really about what I wanted to know about which is the comparison of caesarean section and all the things you‟d be worried about. The risks that are associated with and what may happen and if this does happen, you know like. . . for me it was the fear if my scar if, you know. . .

Int: The breakdown?

W11: Yes, what would happen there and it was all very well explained by [the MOL]

and [the OOL] so I was yeah, I was delighted with the class. . .

Int: Great.

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Throughout the classes, the women felt comfortable to ask the OLs about different aspects of labour and birth that they were unsure of or were even fearful of.

Asking questions and listening to the information that OptiBIRTH provided them about labour and birth gave them the opportunity to achieve authoritative knowledge on both VBAC and repeat CS. After the women had left the class and during my interviews with them, it was clear that they felt knowledgeable about VBAC and having both

OptiBIRTH and access to the OLs gave them the confidence and support that they needed when it came to making the decision about birthing:

W12:Very informative. Em, I found the personnel who did it were great at answering questions if you did have any to ask. They were informative and interesting. My husband was unable to attend with me, he would have attended the antenatal classes with me, so I can come away with me now with a few interesting facts and figures, you know a few interesting things to talk about. What it really did do though was raise my awareness around, you know that, I assumed that a C-section, you were almost destined to have another C-section. What it really raised my awareness around is that every birth is different and that you kind of have to go with the experience. I think that has

prepared me for the next delivery.(Interview, August, 2015)

W14 was in the position of attending with her husband:

“Yeah he thought the information was so kind of unique to our situations, rather than the antenatal classes, where a lot of it is common sense that you already know, whereas we thought that this that we learned a lot. Yeah he‟s asked a lot and one of my friends, she had a section the last time and she wants to have another baby so she‟s like „what?‟ So when the time comes, I know she‟ll be coming asking questions, so…” (Interview, August 2015)

With her partner attending the class with her, it could be seen that they both benefitted from receiving the intervention and the class enabled them to support each other when planning a VBAC as well as others around them.

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As the OOL stated when he was asked about his outlook on the women achieving a VBAC “You have education and can make the decision about your care” (Field-note, July 2014)

. Combining the women‟s achievement in gaining authoritative knowledge, in the second class a demonstration of power by the OOL occurs which I now discuss.