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.