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.

Good question, MonkeyTrousers - I suspect it's a power grab/waaaaaaaah poor me do you not realise I'm the most important person round here.

my booking in appointment is at school drop off time. i will be going alone.

DH was fully included ante-natally and offered 'dad classes', came wit me to breastfeeding classes, scans, appointments etc.
Went in to be induced with DS, nothing happening up to 1am so they sent him home. I had some painkillers & went to sleep. They called him in at 7am when I was in established labour. Midwife fussed all over him througout labour (i'd had epidural and fell asleep ). Brought us both tean and toast after the birth at 1pm.
THEN he was sent home at 9pm and had to observe 'visiting hours' after that. But dads at our hospital have a 9am-9pm visiting window with other family restricted to 1pm-3pm and 6pm-9pm.

hospitals always asks if partner smokes, etc etc.

This is one of the reasons I had both dc at home. I'm so when i hear about how people are treated in hospital. It should IMO be a home from home experience, i'm not sure why hospitals have to be so uncaring emotionally, they are so gd at fixing bodies but not so good with holistic care. There should be a choice for men to stay and be more involved.

yes Edam, F4J taught us well, espcially the wailing part

• but I'd be interested to hear any other explanation of why such limited resourses in maternity care should be funnelled into paternity hospitality...Tom?? Anyone??

It doesn't have to be all about resources, manners and common curtiosy cost nothing and would be a great start.

Tha author is calling for "formal NHS-wide standards" - yes it's about resources.

the hospital took great care of dh when i had dd3. the porter even took him back to our car in a wheelchair.

I think 8-8 or 9-9 on the wards is fine for dads. Yes, it's a bit crap when they get chucked out at night but tbh better for one parent to go home and get some sleep while he can. Solution is to make sure that units are properly staffed so mws can care for new mothers and babies properly.

I suspect this is a "power grab" as edam says. It should be about the mother and the baby.

Also the idea that women have to be given an official "chat" if their partner does not attend antenatal appts is insulting to both parties.

In my area there is a whole (fairly detailed) section of the booking-in appt which includes the father. Lots of info and advice about smoking, diet, bf, SIDS etc is shared with both parents. Father's medical history is taken. There is also a bit where the father is asked to leave so that the mw can talk to the mother alone and I think that is entirely appropriate too.

It's a while since I had the need for maternity services (thankfully) but iirc DH was fully involved with my ante-natal appointments. My community mw involved him fully at the initial appointment, and although he didn't attend every appt with me, he did attend every hospital appt.

We didn't attend ante-natal classes, so no experience there.

I was hospitalised prior to all three births. Although visiting hours were in place, a quiet word with a mw meant he could more or less come and go as he pleased (shift worker). They even provided lunch for him on occasion.

I have no experience of giving birth overnight, but, given that few maternity wards have single rooms, it's very difficult to accommodate fathers wishing to stay 24/7 as it's far too intrusive for other mothers.

I would have loved DH to have stayed with me 24/7 whilst I was in hospital, but it's not practical. And what happens with 2nd and 3rd births? A family room accommodating DH and the siblings?

Sorry, realised it was MT who said power grab first

I was too high-risk to have my babies at home - it just wasn't an option.

The emphasis shouldn't be on fathers' rights imho. The issue here is maternity services as a whole and how the family is treated, particularly if the birth does not go as planned or if the mother has had a cs.

There are some shocking stories on this thread and on others. Surely though we should be asking what is best for everyone rather than saying fathers aren't getting their fair share?

A good start would be that side rooms should be reserved for the exclusive use of women who have had a cs or traumatic birth, who NEED (not want, but need) the constant help of their partner to help with caring for the mother and baby, to pick up, fetch, carry etc because they are not able to do it themselves. Those partners should then be allowed to stay 24/7.

Side rooms should not, imho, be used for people who are prepared to pay for the use of the room (go private or don't go private, no half-way house).

Another example of misuse - the story of two women who had babies at the same time and in the same hospital as I had dd, one of whom I met on the ward, the other I met later at a BF group. The former had an emergency cs. She was in the bed next to me on the general ward. She couldn't pick up her baby (who was 11lb+) without help and she was trying to establish bf. Her wound wasn't closing properly because she was having to care for him herself at night. Conversely, the second woman is a nurse at the hospital. She had a straightforward natural delivery however she got a side room because she knew the Bed Manager (or whatever they're called). They were both on the same maternity ward at the same time. That's the sort of thing that needs to be addressed, rather than whether the father has been to every antenatal appt.

when I had dd she was born by emergency csection at 2 in the morning. Dh was with me at the birth, went with dd when she was cleaned up and weighed, and stayed with us in the recovery room. He then went home, left us to have some sleep, and came back in later in the day.

I wanted to sleep , as I'd been awake for most of 2 days!

I then went back to the ward where we had the family from hell on site 9-9. Had the dp/h been on site all night as well, I'd have gone bonkers!

I sold the idea of a homebirth to dh on the basis that with dd he missed her first ten days commuting to a hospital 35 miles away. He was treated very much as an annoyance whenever he rang the bell to get onto the ward .

oh god, men are such moaners aren't they? it's not all about them.

the thread last week said it all 'i'd have loved for DH to be there all the time but not anyone else's DH'... so... how's that going to be workable then? it isn't, so stop bleating men and go and buy expensive fruit salads for your wives who are baking in that hospital.

btw i thought that the NCT ante-natal classes were weighted far too much in favour of the male partners, the assumption seemed to be that we females would have read the books and the males wouldn't.
now, that assumption was correct when it comes to my DH but i don't see why he should have been rewarded with special attention for it.
and his name, smoking status and approach to bfing was discussed. rather too fucking much for my liking, tbh, with too much time being spent walking him through the importance of bfing and not enough on the practical of How To Actually Do It for me.

The author actually says "there are still no formal NHS-wide standards for what he needs to know"

Surely widening information sharing isn't that resource heavy, treating both mothers and fathers as parents can't be that hard in this day and age. Or am I in a major minority in feeling that my DH has as much rights when it comes to my children as I do?

Agree with your point about side rooms Tigerfeet. And if there were proper resources then mws would have the time to take proper care of women who had had a cs etc so the partner wouldn't need to do it.

I think clamouring for dads to be on the wards 24/7 because their partners need them to help with practical things just masks the real issue - which is sorting out staffing and other resources.

can your dh not read, graciefer? there are loads of books out there, some even written in easy short bursts so that men can understand them.

AMEN, doggie.

'the thread last week said it all 'i'd have loved for DH to be there all the time but not anyone else's DH'... so... how's that going to be workable then? it isn't, so stop bleating men and go and buy expensive fruit salads for your wives who are baking in that hospital.'

Agree with you 100%.

I really wouldn't have wanted other fathers around, at night, when there was limited staffing.

Graciefer, your dh might be an equal parent but he is not the one who gets pregnant and so he doesn't actually need healthcare when you are pregnant or giving birth. Plus there are some horrifying stats about the proportion of domestic violence that starts in pregnancy - so you have to structure any approach to involving fathers in such a way that doesn't actually prevent a woman who is being beaten getting help, or aid and abet controlling men.

"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."

There is something in this but it's motre complivated than it seems.

Yes employers ought to be more flexible with men fior caring responsibilites - even just more slightly than they are now as men do report wanting to have a better work life balance.

But enforced 'equality' in this area just doens;t work as fathers, even wanting more quality time with their families, still (on average) do not want to spend as much time with newborns than mothers do.

And this apparent parity would really fuck thing up finacuially. Most women depend on their partners going to work in this time, as her earning capacity is hammered. Some will think that it maybe shouldnt be like that, but that's how it is non the less.

It's neither biologically or economically sensible to force a gender blind policy into this area. Doing that will only end up with more people feeling forced into roles they don't actually want - compromising the family unit again.

There needs to be much more research done on how to get this balence right.

I think unless there are circumstances where the dad needs to be there, like gracifers then they should go home at night. My first born was in scbu from birth and dh stayed overnight with her there. I was alone on maternity ward flat on back after suffering a dural tap etc etc and even having my own visitors was a trauma to be honest