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.

i wrote that to be patronising, gracie, why on earth should the NHS spend its money putting out more paperwork that is already duplicated endlessly across pregnancy literature in the shops. as i say, some are written specifically for fathers (generally not too involved, if you've seen them, and featuring cartoons etc) if for some reason they don't want to read the more complex 'women's version'. there's clearly a market out there.

Personally, before they look at extending paternity leave, i'd much rather they paid the two weeks they get now properly- we'll be seriosuly struggling next month when dh's pay cheque is short by a good few hundred pounds- and I bet a lot mroe emn would take the offer of paternity leave up fully if they got paid properly.

Anyway.

Reagrdless of whether the men stay on the wards, its still possible to improve how fathers are treated- at my homebirth a week agio, the first MW turned to me (in transition when she arrived) and asked me Dh's name rather than ask him, who was right next to her! (thes econd MW was great tough, really complimenting him on how he coped). And one MW turned up the day after to do aped checks, and when he answered the door asked him 'Mrs Peachy?'- er no, she's inside, i'm Dh- didn't the beard give that away?????

peachy- ROFL@''Mrs Peachy?'- er no, she's inside, i'm Dh- didn't the beard give that away?????'

how is the new addition?

those hormones can do maaaad things, peachy.

No AitchTwooO - we say 6 months, as do the World Health Organisation

My ward was right by the patient's toilet, which had a big sign on it saying it was for patients only and would visitors use the public ones down the corridor. One dad, who visited often, used that toilet several times. Quite aside from the fact that it wasn't particularly clean to start with, some of us didn't have the option of hobbling elsewhere for the loo if we needed to go urgently while he was in there.
(By the time you've heaved yourself off the bed, got your slippers on and started carefully hobbling towards the door he'd already nipped in there. Why he couldn't read the signs I don't know)

eclusive breastfeeding Tom. ie, no solids or formula!

By the way, we've solved the problem of pregnancy information for men (which is considerably different than for women - it's about their partner's pregnancy, not their own, obviously).

We're distributing 125,000 credit cards with our web address on to midwives to hand out to dads. The cards are free to midwives and free to dads.

The maternity services that will be distributing the cards are listed here

And the info dads need is here: www.dad.info

By Tom on Mon 14-Apr-08 14:37:24
WHO/UK Target for breastfeeding is 6 months misdee

no tom, WHO target for bfing is 2 years, and for exclusive bfing 6 months. you should read your doc more carefully.

also according to WHO food is complementary to milk until 12 months so in order to support bfing women might easily need 12 mos mat leave.

milk is babies main source of nutrition for the first year.

isn't it funny how you haven't actually listened to what was said on the other thread, tom? or on this one, except to spread misinformation and to insult those of us who disagree with you? typical, er... male.

anyhoo, about those resources. why don't you just give the extra money you earn just thanks to being a boy to the NHS, that shoudl help even the score?

i'll be back later, i'm off to do a full school run, rainbows run and brownies run.

I find this quite difficult to comment on; as both a (very new) dad, and a doctor, I can see both sides of the arguement.

It is terrifically important for dads to be involved. I really enjoyed being part of my wife's pregnancy; the ante-natal classes were really good to go to, and I'd have loved to attend midwife appts if work had allowed. I'm also dreading going back to work next week when my paternity leave finishes; I've loved every second of being at home with my wife & DS.

Our local hospital were great with regards visiting; partners only between 8-3.30, with nil visiting over lunch to allow the mums to rest. Free visiting from 3.30 till 8; then dads only again till 10.

With my professional hat on, I think this is the right way to go. Mums give birth, not dads, and mums and babies need time for quiet and rest. It's also important to give the midwives & medical teams a bit of time and room to do the necessary

And with my old cynical head on, I do think that the majority of ante/post-natal midwife appts should be mum only. Pregnancy & the immediate post-natal period are incredably high risk times for domestic violence; whilst I have (and still do) ask partners to leave a consulting room to ask questions regarding DV, my primary relationship and responsibility is towards mum & child.

I absolutely agree that maternity services are horribly overstretched; our local (and multi-starred "flagship" foundation trust) had 2 midwives between 30 beds on the post-natal ward. Absolutely disgusting.

Dads are important. For me, better funded & supported maternity care, which allows midwives time to involve dads has to be the way to involve us safely. Despite Dads' obvious importance, mums do have to come first.

amen, spanky. and congratilations on your new arrival.

95% of Icelandic dads spend 4 months looking after their baby on their own while the mum works - net result is that 95% of Icelandic babies have TWO parents who know what they're doing, not one.

My dh knows what he's doing, despite only having 2/3 weeks off after dd was born (do you know, I can't remember how long he was off )

4 months for Mum and Dad, fine, great, but if maternity/paternity pay stays at £100 p/wk or whatever it is now, how many could afford that? Resource needed.

I would have loved to breastfeed dd for two years but stopped about a month after I returned to work when she was 7 months old. In our case, for me to have a whole year off would have resulted in the best outcome for our family.

DH is a very hands on dad, and I believe that any father who wants to be hands on won't let his job stand in his way.

the first step to improving mothers and fathers experiences in ante, intra, and post natal care would be more midwives

everything else will have to flow from there

there are enough books aimed at dads to be , but the dads have to pick them up and read them

i find it a little galling that this is becoming more about what the father's rights are, and that they are feeling sidelined.. surely the mother and the baby are of paramount importance.....

dads can get involved , but the NHS just cannot accomodate a ward full of mothers, babies and fathers....

staff are overstretched enough, i hope tom has read that other thread posted by SueW

From your lips, Spakydad, to God's ears.

and you are so right when you say that new mums and babies need rest!

Not only did I have the family from Hell when dd was born, but I had two mums, whos babies were in the scbu chatting away into the early hours when ds was born! About Hoovers ffs! I cried a lot at that point, and given that I'd had a section I was moved into a side ward, where I did manage to get some rest

Unless all women could be give a room of their own, I don't see how the needs of the dads to be preset at all time can be ballanced agains the wishes of some mothers for a degree of quiet and privacy. What would you suggest, Tom?

Great post Spanky Dad.

Said all this in other thread but I wholeheartedly support father's in this - or rather - not mother's or father's needs taking preference but needs of the family as a whole ...

... not workable in most NHS hospitals as has already been discussed ... but something to aspire to

Graciefer, really sorry to hear about your and your Dh's horrendous experiences. While I'm personally happy with the 8-8 visiting hours, there's just no excuse for the way your husband was treated at all.

Tom, I appreciate your post clarifying your intentions, but the original article demanded women be questioned if they turned up to antenatal appointments without a man, and that 'mother only provision' should be regarded as a 'special need' not the default.

More involvement of fathers is fine (and campaigning for post-natal wards to be organised so that dads can stay without imposing on other women who are trying to sleep/want some privacy when they are dealing with drips, catheters and stitches would be very helpful).

But not let's get carried away - it's the woman who is having a baby. And let's not create extra risks at a time when women are more likely than any other, sadly, to be the victims of domestic violence.

or 'let's not', even!

ah. have just read gracciefer's long post, i'm sorry for offending you before. i thought when you were talking about information-sharing etc you were saying the same as the article, that there should be material in place for fathers.

but if you were referring to the fact that when your baby was born with DS he was ignored by the system then that isn't acceptable and tbh it surprises me that an ongoing issue like that would be seen as the preserve of the mother.

when it comes to general ante-natal care, however, the option is there for men to attend (and imo they are pandered to as if they know nothing which is patronising in itself) and there is acres of literature for them. much of it in cartoon form...

also, some women only want women around them when they give birth

what about fathers who do not want to be at the birth?

it is insulting and patronising that women have to have male input, harks back to the days of having to get married to avoid the staring if you were pregnant

great post, spankydad - and congratulations!

Tom, I really think you could learn from Spanky. The hostility you've shown on this thread is really off-putting and adds to the impression that this is about father's rights, me, me, me and not about supporting women and babies at all. IMO you need to think about your attitude to women.