Duncan Fisher: Stop ignoring fathers when babies are born

[Tom]

The Independent. Monday, 14 April 2008

The only time that attention to fathers is really exercised is when a father is violent.

Consider the new mother who has just had a Caesarean. She needs help to pick up and settle the baby, on a ward where the midwives are overstretched. Or consider the new mother who cannot walk and whose baby is on the special care baby unit, two wards away. She needs the baby's father to help her speedily transfer expressed milk to the newborn ? but he has access only during "visiting hours".

In the NHS you are either a "patient" or a "visitor". And 30 years after it became normal for a father to attend baby's birth, there are still no formal NHS-wide standards for what he needs to know. Nor is there any formal guidance on how he can provide extra support to a mother who is sick or incapacitated after the birth.

Perhaps the ultimate expression of the "nanny state" is when a couple have just had a baby and ? at this heightened family experience ? the hospital says "now you have to part company ? dad, go home". Setting aside any opinions about the father's right to stay with his family, regularly excluding fathers from maternity services in this, and many other ways, has a detrimental effect on mothers and babies.

The NHS does not even have a system of formally registering who the father is, let alone formally assessing his own needs ? does he smoke? Does he know how to support breastfeeding? When my two children were born, my partner was asked only one question about me ? does he have any genetic abnormalities in his family? I was not even asked my name. And yet research shows that, when it comes to the health of mother and baby ? smoking, breastfeeding, depression ? I am the biggest influence. I am uniquely able to support her and my baby and I am uniquely able to screw them both up. Despite the enlightened work of countless midwives and birthing units who genuinely see that a birth is a family event that needs as light a touch as possible from professionals, the NHS continues to commission a system designed for the 1950s. Every maternity unit is filled with fathers ? well over 90 per cent are involved at some point before, during or after the birth. And yet, high-level policy debates in the NHS can continue for hours as if men simply did not exist.

The only time that attention to fathers is really exercised is when a father is violent. A focus on violence is absolutely right, but what if as much energy was expended on mobilising the positive support that the vast majority of fathers provide, or could provide, to mother and baby?

Firstly, fathers would be registered into maternity services and formally engaged with. The failure of a father to show up would result in an enquiry ? no compulsion, just an informed conversation with the mother about what she wants and what is best for baby when it comes to making sure the father is informed and positively engaged.

All health information would be routinely communicated to both parents ? breastfeeding, smoking, mental health, vaccinations. Mother-only provision should always be available but as special provision for special needs, not the default. And if the father is a source of problems, it is no good the NHS just walking away from it ? that won't stop him causing problems the moment the baby is back at home. Fathers in this situation should be treated exactly as mothers in the same situation: extra engagement, not less.

At the heart of the problem is still the cultural expectation that babies are mum's business only. As one young black father said to a government group on children's services recently: "It is too easy for young dads to walk away from their responsibilities."

What happens when a father does not engage? Absolutely nothing. The moral panic only sets in later when the same father fails to pay child support ? then suddenly he is reclassified from a "nobody" to a "feckless father". In the US, where they trialled a simple process of midwives talking to young fathers when they visited their partners, child support payments went up.

Things have to change. When a baby is born, fathers are as responsible for the little one as mothers are. At every point in the process, an expectation of his full involvement should be communicated to both parents.

And this new vision needs to extend far beyond maternity services. Employers still expect that only women, and not men, will compromise work for caring responsibilities. The Government has just introduced a system where fathers get two weeks and mothers get 52 weeks ? the biggest difference in leave entitlement of any country in the world. If we keep going backwards: fathers will be excluded more and mothers will pay a heavier price for being left alone on the high throne of motherhood.

The writer is the chief executive of the Fatherhood Institute.

Well, until men can develop a secret uterus and bear children or a secret boob so I can sleep all night whilst he feeds, I'd like to have the maternity ward left to the patients at night.

I don't want a homebirth.

I chose to give birth in a hospital because I want epidural pain relief. Yes, I know I can give birth without it, I've done so. But I didn't enjoy it in the least so I'm glad the choice to do otherwise is there for women like me.

Another thing to remember, is that most of the time, a woman has not been very well-rested before she delivers. It's hard to sleep in very late pregnanchy for many of us and particularly trying on those of us who also work outside the home and/or have other young children in the home.

Then there's labour and delivery.

Getting as much rest post delivery, particularly when you're going home to a house with other children in it, is crucial to a good recovery - and that definitely includes mental health.

Oh, my fantasy maternity unit will also have psychiatric consultants and counsellors trained to work with women with PND.

Yeah, there's A LOT of changes I'd like to see before we open up maternity units to men.

OH i agree expat. Entirely.

What irks me is that women are shuffled along, as if on a conveyor belt, and made to feel like hospital birth is what they should do. Continual monitoring is what they should have. Coached pushing is the only way to push a baby out. Etc etc etc.

I think women should have the choice, and be made aware that they do have the choice. They can have pain relief if they want. They can stay at home if they want. They dont have to have monitoring. They dont have to rely on the capability or outlook of the mw who happens to be on duty. And so on and so on and so on.

'got about four hundred grand off the government in 2006 plus extra funds off the Lottery and people like Lloyds TSB. '

Wow, dittany! Think of all the midwives and BF counsellors we could hire for that!

or, maybe we should sort this out first maybe?

I have sent a link to the thread to the FI

the title really bugs me

'Stop ignoring fathers when babies are born'

Get a grip, it is not about you at that precise moment.

I wouldn't want men be on the ward, when i had dd1 i was a single mum and as i didn't have a dp i had to sit alone all day until my mum could visit me at evening visiting times. I now have a dp and i wouldn't have wanted him there after dd2 & dd3 i wanted to rest after giving birth not sort him and a newborn out.

I'm not convinced that many women would want to have their older children staying in the immediate post partum period.

I know that dd would have been very clingy and would have wanted me and not dh to comfort her, and I was in no state (with morphine drip and catheter) to cope with her needs.

At that precise point in time I rather wanted the world to be centered on me and the new baby! Not my Darling dd or my very much loved dh.

sorry if this has already been said.
DH laughed at this. He was glad to go home! My dd was born 6.30 am by ECS after 2 nights of labour. We were both knackered. The hospital had a policy of no visitors between 1 and 3pm and after 9pm. He was glad to go and get some sleep! My view is that there was no point in both of us being totally knackered. It didn't occur to us to be bothered about him getting attention from any of the staff: we both knew how involved he was going to be. We are both self employed so it was up to us how long we could afford for him to take off work.

If there is a lack of courtesy towards the father it is lamentable and unprofessional, but surely when the maternity services are so overstretched, the mother has to be the focus of attention? We hear all the time about lack of BF support, TBH if there were more resources, i would rather BF support was better than that the father was given more input. DH came to both my NHS and NCT antenatal classes, the rest we read up on. And, i don't think that any amount of reading or education is going to adequately preoare you for the reality.

So let me get this right - I've been in labour for forever with a badly positioned baby, not able to sleep, vomiting constantly and exhausted. Then I deliver DD and lose a load of blood. I now have to try to persuade a reluctant DD to breastfeed and recover from a large wound in a very personal area. And I'm supposed to care about how DH is bonding with DD?!!?!? When they have the rest of their lives to have a good relationship?

I have read a few more of the posts and see my point has lready been made.

I have just had a flashback- trying to BF my screaming baby with my huge breasts hanging out. The man visiting his DW opposite staring at me through the chink in the curtains. Horrid

x posts mrstittlemouse

You know, I'm actually agreeing with most of expat's points here, but I am very amused by the mildly paranoid accusations being flung at Tom (who did not aquit himself well in the earlier parts of the discussion, but has since improved).

There is a happy medium between 'Men are the measure of all things, including maternity care' and 'Men are the enemy, come to steal children from their mothers'.

suey - we originally thought that DH would stay with me (in a private room), but then they found a space on the ward and DH went home. He was very relieved. He was exhausted, and one of us needed to get some rest ready for DD coming home.

I think that almost all of us are in agreement here - if there is magically more money available for maternity services, what we want is more midwives. Forget fancy suites so that the whole family can stay, I would much rather know that when I push the button a professional will arrive to help me, and she/he will not be completely run off her/his feet and will have time to help me.

Tom, I agree with the overall thrust of your message that fathers should be recognised as having, expected to have and given a bigger role in bringing up a child at all stages.

Although in the area of maternity services, newborn babies and their post-partum mothers, I believe that the focus should be on babies and mothers first and foremost and their needs.

You asked: "- How would you feel if the unit was along the LDRP model - a private on suite room for every mother, instead of the ward model?"

That would be great. But if there was going to be more money, it should be thrown at more and better trained midwives first (which I know you also support), not private rooms. If women are better supported post-birth (and I speak as a woman who has had 2 cs, one emergency and one elective, where I was supported and not-supported after birth), there would be less need for fathers to fill in the care gap, as it were. I was practically begging for the hospital to let my dh in outside visiting hours because my baby was crying in the cot and I could not lift him out to nurse him, and I appealed to the midwife and then the head of the ward, they adamantly refused to make an exception. So I had to discharge myself early.

I sent my otherwise very hands-on dh home overnight in both cs. Because him and I needed the rest and only I had the ability to bf my ds. All I needed was for a midwife to give me my baby and arrange him on my chest when he cried.

Once the staffing and support issues have been sorted, then a private room would be a nice-to-have. But it is not suitable in all cases, particularly high risk ones, where it is safer for women to be in an open ward and constantly monitored. Nor necessary, as some women with natural births want to be discharged as soon as. Otherwise the number of midwives would then have to increase exponentially to cope with single rooms.

If there is money for single rooms, then the issue of having fathers around is a no-brainer because they don't disturb other women by being there.

You also asked: - "How do people feel about "fathers/partners only visiting hours", with key care skills (washing, nappies, cord care etc) covered in those times?"

Absolutely, for first time fathers and mothers particularly, would be great. But seeing as not all hospitals even give this training to mothers on the ward, it is another icing on the cake.

As for the specialness of a mother, as opposed to a father, to a newborn baby, I do think that a baby is biologically programmed to sniff out the milk in the mother - it is called survival. You only need to see how a young baby automatically turns its head to a lactating woman (does not even have to be the mother) to know this.

I am all for SAHDs and think they can do a brilliant job at childcare, in many ways, better than a mother (my dh has his strengths, and I have mine). But in the care of newborns, the mother has the biological edge due to bf-ing. Though that can quickly be evened out by a participative father. Agree that skills like bathing and soothing (beyond bf-ing a very young baby) are not special to the mother.

dunno sue, any man who, when challenged, immediately makes recourse to 'you are clearly working out some issues with men' has lost my respect, full stop. an apology for being 'a bit short' doesn't cover it.

for all the lovey-dovey 'it's about SUPPORTING women etc' business, that knee-jerk response to being criticised by women gave me the measure of the man. well, that and the fact that he and his mate Duncan didn't bother to ask any actual women before asking for more attention during the birth process.

i asked dh what he thought of the whole thing btw and he said he felt like a total spare part at the hospital... because he was. he said it might have been nice for him to have been more central to what was going on but given that he wasn't in labour he couldn't see how he could possibly begin to moan about it.

(actually the apology made me lol a bit. like none of us are working from home and looking after children, oh no. and it doesn't give us the right to come and lord it over people on a forum. )

It wasn't so much the apology, Aitch, it was more the slightly measured tone in later posts.

I don't actually disagree with the points you've been making, and no, honestly, having my Dh with me for a great length of time a) wouldn't happen with 4 already at home and b) isn't something I'd want, I like having the mama-baby quiet time once the dust has settled.

And damn right, were there more funding, I'd want it spent on more midwives.

But my husband was the first one to hold two of babies and for quite some time, because of my condition, and I just find the suggestion that he did so to get leverage in a custody hearing utterly ludicrous.

aye, typical man. if you're sorry, just say so, you big jessie. don't piddle about being 'nice'.

dh was so stunned after dd was born that if anything my brother (dd was born just before visiting time) held her more in those first few hours. i wonder if he'd have a claim for custody?

roffle. Actually, despite my recent marriage bleh, one of the most endearing things about Dh is the way he talks about the time he had with Dd2, just gazing into each other's eyes for ages. [soppy sod]

apparently that first hour or so they're the most awake they'll be for weeks, all to get them to bond with their parents.
as i say, we've got great photos of dd working her charms on db and dh sitting looking mostly stunned in a corner.

sorry to hear about marriage bleh, hope it's just a wee hillock to get over.