The following summary of competencies needed by midwives in working with fathers is based on an analysis of Skills for Health’s framework for Maternity and Care of the Newborn, which can be found at http://www.skillsforhealth.org.uk/view_framework.php?id=7.

Fathers Direct’s review of skills required for working with fathers

Competence framework, Skills for Health, 2005: Maternity and care for the newborn
February 2006

A. Definitions

Fathers are referred to in a variety of ways in the competences – sometimes directly and sometimes using one of the following terms, defined in the preambles of the 25 sections.

Those involved in the care of the baby
Those who may be involved in the care of the baby including mothers and fathers, other family members, friends, informal and formal carers, and practitioners.

Key people
People who are significant to the health and well-being of the woman and her baby/ies. Key people may be the woman’s partner, the father of the baby/ies, other family members, friends, carers or others with whom the woman has a supportive relationship and wishes to involve in the care of herself and her baby/ies.

Birthing partner
The person(s) the woman chooses to support her during labour and birth.

Parents
Parents refers to the person or persons who have legal parental responsibility for the baby.
Mothers, fathers/father figures and others who have parental responsibility for the continuous care and well-being of the baby, whether biologically related or not.
Where relevant, other people such as non-resident fathers, siblings, grandparents, other relatives or friends significant to the care of the newborn baby/ies should be involved in the discussions.

Family
Family includes the mother and father, siblings and other relatives who are significant to a baby, including, as appropriate, birth parents, step-parents, extended families, second families, foster families, and adoptive families.

Individuals (in context of pre-conception advice and information)
Individuals may be women, men or couples seeking pre-conception advice and information.

97% of fathers attend the birth of a baby (NHS Maternity Services Quantitative Research, Department of Health, October 2005). These more general definitions, therefore, refer to fathers in the large majority of cases.

B. Review of competences

The competences that contain the following information are given as full quotations in the Annex.

Assess the role of the father in relation to the care of mother and baby:
„X Agree with mother if father is to be involved in her care – during pregnancy, labour/childbirth and postnatally. Discuss his role with the woman.
„X Evaluate his role in supporting the mother socially, emotionally and psychologically.
„X Assess whether he represents a potential risk and difficulty for the mother, through his behaviour or lifestyle.
„X Find out about the father’s lifestyle and assess how it can be adapted in order to support his own and the baby’s health and well-being. Explain the benefits.
„X Identify the requirements of the mother in relation to the father’s role – antenatally, in labour and childbirth, postnatally.
„X Take all this into account when developing a care plan.
„X Agree

Communicate with fathers:
„X In an appropriate, supportive and approachable manner.
„X Consistent with his age, role, level of understanding, culture, background, communication abilities, expectations, preferred ways of communicating and needs.
„X Establish level of knowledge about pregnancy, birth, postnatal period and parenting and any misconceptions he may have.
„X Show respect and due regard for his human rights; use discretion and balance rights of the adult with those of baby.
„X Recognise cultural and religious needs (and this will include how these define the roles of mothers and fathers).
„X Recognise how ones own feelings, beliefs and values may affect the communication process (and this will include feelings, beliefs and values about motherhood and fatherhood, women and men, young people, etc.).
„X Recognise how the feelings and wishes of the father may affect the communication process.
„X Communicate throughout the care process – during assessment, discussion of outcome of assessment, making a care plan, monitoring and reviewing the plan. Communicate the following:
o Assessment process, obtaining necessary agreement and consent.
o How to access appropriate information and advice.
o Encourage to seek clarification on procedures, information and advice.
o Encourage to express concerns, then respond appropriately.

Working in partnership with fathers in the care of mother and baby:
„X Access the father as a potential source of information on the woman’s needs and expectations.
„X Establish open and supportive relationship.
„X Work in partnership with the woman and key people to develop a care plan. Negotiate and agree an individualised plan with the woman and key people taking into account their consent and wishes, abilities, needs and expectations. Agree roles and responsibilities of those involved in the care of the baby. Agree goals, which include healthy lifestyles, lifestyle changes, effective use of antenatal and postnatal services, attending classes, strategies for promoting family relationships including those with siblings and members of the extended families, such as grandparents and non-resident fathers. Then confirm details of the plan, including the process of review.
„X Implement the care plan in partnership with mother and father. Agree all actions to be taken with mothers and fathers based on their wishes. Obtain valid consent.
„X Provide effective support throughout, promote the wishes and beliefs of the parents.
„X Discuss the aims, implement and assess the outcomes of interventions in partnership with the parents. Minimise any discomfort of baby and parents.
„X Encourage the parents to take an active part in the review process and agree changes in partnership with them. Include in the review the needs of the parents.
„X Identify areas of disagreement and attempt to resolve them with those involved in the care of the baby in a way that respects different perspectives.
„X After the pregnancy, work in partnership with the parents to assess outcomes in relation to their previously agreed goals and preferences.
„X Explore with parents the nature of changes in their life following childbirth and discuss how they feel about it – physical, emotional and pxychological health and well-being of the baby and the family, family routines and procedures, family relationships, home circumstances. Respond to issues raised, explore what type of support the parents need or where existing support needs to be improved.
„X Encourage the father to give appropriate support to the woman at all stages.
„X Encourage the father and mother to assess the baby’s needs and discuss them with you.
„X Encourage the father to give appropriate support to the baby in order to promote optimum outcomes.
„X Respect the privacy, confidentiality and dignity of the parents. Clarify with the parents the information that needs to be shared with other practitioners.

Particular things to communicate to fathers:
„X Enable then to express concerns and seek advice and information – e.g. antenatal classes, relationship support, parenting programmes, information on preparing for parenthood, information on health and well-being, information on parenting skills.
„X Plans for pregnancy – actions they will take, support they will receive, targets, review points.
„X How to support the woman during assessment.
„X How to manage and participate effectively in all aspects of care.
„X How to communicate with the baby.
„X How to promote their own health and well-being.
„X Give evidence-based information about the effectiveness, benefits and risks of specific interventions.
„X Alternative or additional sources of advice and information.
„X Review and evaluate their experience of pregnancy and childbirth, encourage to ask questions and express concerns.

C. Knowledge required by midwives

The competences that contain the following information are given as full quotations in the Annex.

Legal/policy/evidence relating to fathers:
„X Legal rights of mothers, fathers and babies. Rights to make decisions for themselves and their babies and to take risks.
„X Roles and responsibilities of those with parental responsibility in giving consent.
„X Evidence based practice and its role in improving services. In the absence of independent large-scale research, the evidence base may be derived from smaller scale work or locally agreed good practice. [All this will include evidence about what works with fathers.]
„X Main issues, debates and policies relating to the health and well-being of women [this will include the evidence of how fathers do or don’t contribute to this]

How the health and well-being of mother, baby and fathers are affected by actions of fathers:
„X The benefits of engaging the father/partner in the care of the woman and baby/ies.
„X The benefits of engaging the father/partner in planning for and supporting the birthing process.
„X How lifestyle changes can promote the health and well-being of babies and their carers.
„X How the reactions of parents to their pregnancy and birth experiences can influence their emotional well-being, their relationship with their baby/ies and their future parenting relationships.
„X The normal health and well-being needs of women during labour and birth [this includes the needs from their birthing partner].
„X The main trends and changes relating to the health and well-being of babies [this includes the role of fathers].
„X The ways in which personal beliefs and preferences of parents, including religious and cultural beliefs, may affect the options which are open to babies and those involved in their care.
„X The strategies to promote or maintain optimal health and well-being of women postnatally [these will include the role of fathers in these strategies].
„X The impact of parenting capacity – mothers and fathers – on the health and well-being of babies.
„X The positive impact of family, social relationships and environment on the health and well-being of pregnant women and their babies.
„X The negative impact of family, social relationships and environment on the health and well-being of pregnant women and their babies, including the risk and impact of domestic violence.
„X Factors that increase the risk of significant harm to babies [this includes factors relating to the father’s role].
„X The actions to take in response to domestic violence [this includes how to refer perpetrators to sources of help].
„X The action to take in response to women who are not able to exercise their fights to make informed choices [this includes when the father is responsible for undermining the rights of the woman].

Needs of fathers:
„X The importance of being sensitive to the different experiences and needs of fathers.
„X The evidence-based information fathers need to make informed choices about health and well-being and during the planning of care.
„X Additional needs created by special circumstances – e.g. multiple births, mental health problems, bereavement arising from pregnancy.
„X How the needs of women during childbirth may affect fathers.
„X How assessments may affect fathers.
„X How the needs of babies may affect fathers.
„X The importance of the opportunity to reflect and debrief – separately if appropriate – on their experience of pregnancy and childbirth.
„X Local and national services, agencies and websites for people who want further information and support for labour and birth, and how to access these.
„X Agencies and services that midwives can access for expert advice and support on engaging with fathers.

Communication / building partnership with parents:
Principles
„X Why it is important to clarify and confirm with the woman who and to what extent she wishes to involve the father and others as key persons in her care.
„X The impact that empowering parents to manage the care of their baby/ies effectively has on the parents and their baby/ies.
„X How to recognise what advice and information individuals need if they do not have the terminology, confidence or skill to give an accurate specification.
„X The importance of acknowledging the feelings, beliefs and values of others as part of the communication process [this will include feelings and beliefs about men and women around babies].
„X The importance of acknowledging your own feelings, beliefs and values as part of the communication process, and avoiding inappropriate impact of these on communication [this will include feelings and beliefs about men and women around babies].
„X The importance of not making assumptions about the communication and understanding abilities of those involved in the care of babies.
„X How to provide information and advice in ways that are appropriate for different people, including male-friendly information for fathers.
„X The effects of environments and contexts on communication [key issue for fathers may be feeling out of place in the maternity environment].
„X The ways in which communication can be modified and altered for different needs, contexts and beliefs.
„X The importance of respecting diversity and values of mothers and fathers in relation to the health and well-being of their baby/ies.

General practice
„X Working with others towards a common goal, sharing power and responsibility.
„X The ways in which key people should be involved in communication.
„X Communicating effectively with those involved in care of the woman and baby/ies.
„X Negotiating.
„X Enabling expression of needs.
„X Enabling informed choice.
„X Enabling active involvement and how this relates to health and well-being.
„X The range of feelings that people may experience where there are communication differences.
„X The reasons why communication may fail to develop or break down.

Through pregnancy, childbirth and babycare
„X Changing lifestyle pre-conception: the difficulties people may have in maintaining lifestyle changes and how to work with them to identify and overcome these. The effects of cultural and religious beliefs on their ability to change.
„X Planning: how to help key people develop realistic and achievable plans for labour and childbirth; the purpose of agreeing goals at the start; the roles of people involved in the care of the woman; encouraging active participation in review of the plan; encouraging active participation in implementing the plan; encourage consideration of implications of changes in the plan
„X Assessment: assessing level of understanding of key people of assessment and related interventions.
„X Interventions: checking that carers understand the need for and the aim of an intervention; enable parents to be as comfortable as possible during an intervention; communicate the roles that carers need to take in an intervention; be clear about what information has to be shared with others as a result of an intervention; encourage carers to ask questions, seek advice and express concerns; encourage active partnership in implementing an intervention.
„X Caring for a baby: enabling carers to assess babies’ needs and why this is important; enabling parents to express feelings about changes to their lives and their fears about these changes; providing support to parents to manage the changes to their lives and relationships.

ANNEX

Detailed competences and knowledge

Some competences are repeated exactly through the 25 documents that make up the framework. In these notes, only the first reference to each skill is given.

All the text outside brackets is direct quotation of the full competence, except where several very similar competences from different stages of the process are combined – antenatal, labour/birth, postnatal – in which case this point is made in brackets.

Sometimes there is a note added by the editor to clarify relevance of the competence/knowledge to fathers – these notes are given in square brackets.

COMPETENCES

Assessing the role of the father in relation to the care of the mother:
„X Establish an open and supportive relationship with the woman and key people involved in her care as agreed with her (antenatally, during labour/childbirth, postnatally) [MCN2.1, 3.2, 4.1, 7.2, 8.2, 9.2, 14.2, 15.2]
„X Discuss and agree the role of the woman and key people in her life in achieving the goals of the agreed intervention [MCN14.10, 15.10, 16.10].
„X Determine the priority of the baby’s needs from the referral information and other sources (other sources defined to include “parents, carers, relatives and extended family of the baby”; priorities defined to include “potential risks and difficulties for those caring for the baby” and “the risks inherent in the context of the woman’s lifestyle and environment”) [MCN5.1, 14.1, 15.1]
„X Find out about the individual’s lifestyle and make a general assessment of whether and how their lifestyle could be adapted to enable them to manage their own pre-conception care, their own and their baby’s/ies’ health and well-being; explain the benefits [MCN22.3, 23.3, 24.3, 24.7]
„X Establish any specific requirements to achieve an effective assessment, including the services of a chaperone if required (specific requirements includes “physical, emotional and psychological support, including support from a birthing partner”) [MCN3.5, 4.5]
„X Make arrangements for the intervention [in pregnancy, childbirth/labour, postnatally] that are consistent with the woman’s priority and her specific requirements (specific requirements include “physical, emotional and psychological support”) MCN14.11, 15.10, 16.11]
„X Identify the woman’s preferences for the birth of her baby/ies (preferences include “social and psychological support during childbirth, including support from a birthing partner”) [MCN3.1, 15.1]
„X Assessment methods include: evaluate social support, including existing relationships with partner and significant others [MCN4]
„X Care plans: Clearly identify and explain the options for addressing the needs of the woman and her baby/ies, including any benefits and risks (options include those that “relate to the everyday life and personal, social and cultural circumstances of the woman and her family”) [MCN7.8, 8.8]

Communicating with fathers:
„X Communicate with those involved in the care of the baby in a way that is appropriate to their age, role, understanding and preference (antenatally and during labour/childbirth) [MCN1.6, 3.3, 14.4, 15.2, 16.4]; communicate with women and key people in a supportive and approachable manner consistent with their level of understanding, culture and background, preferred ways of communicating, needs [MCN23.2, 24.2, 25.1]
„X Ability to work with teenage mothers and fathers specified in the National Service Framework [Standard 11, 5.7, p.11; Standard 11, p.13], but not in competences.
„X Identify relevant information on the communication abilities of those involved in the care of the baby and record preferred ways of communicating [MCN1.3]
„X Establish their level of knowledge about pregnancy, birth, the postnatal period and parenting and any misconceptions that they may have [MCN23.5]
„X Explore the needs and expectations of the woman and key people in her life and their goals in the intervention [during pregnancy, labour.childbirth] [MCN14.5, 15.4]
„X Communicate with the baby and those involved in their care in a way that shows respect and due regard to their human rights [MCN1.1]
„X Use discretion and respect throughout the assessment, balancing the rights of the baby with those involved in the care of the baby [MCN5.6]
„X Demonstrate respect for people as individuals when interacting with them and acknowledge their cultural and religious needs and their rights to make their own decisions in the context of their lives (in relation to pre-conception care, during pregnancy) [MCN22.9, 23.8]
„X Recognise how your own feelings, beliefs and values may affect the communication process [MCN1.7]
„X Recognise how the feelings and wishes of those involved in the care of the baby may affect the communication process [MCN1.8]
„X Explain assessment process to the woman and key people and obtain the necessary agreement and consent (antenatally, labour and birth, postnatally) [MCN2.4, 3.4, 5.3]
„X Enable those involved in the care of the baby to access appropriate information and seek clarification and express concerns about assessment and about plans (antenatally, during labour and childbirth, postnatally) [MCN1.11, 2.8, 3.3, 5.4, 7.4, 8.4, 12.1]
„X Encourage the woman and key people to seek clarification of any procedures, information, and advice relevant to them and express concerns [MCN15.2, 16.4]
„X Check that the woman and key people understand the information given, and encourage them to ask questions and express any concerns about specific interventions [MCN7.10, 14.4]
„X Respond appropriately to any concerns the parents may have about promoting and protecting the health and well-being of their baby/ies [MCN24.11]
„X Discuss the outcomes of the assessment with the woman and key people in a way that is meaningful to them [MCN6.1]
„X Monitor and review the effectiveness of the care plan using appropriate sources of information (sources of information include “key people involved in the woman’s care” [MCN11.5]
„X Identify any significant changes which may affect the care plan and discuss the implications with the woman, key people and practitioners involved (significant changes include “the woman’s family or home circumstances”) [MCN11.10, 13.6]

Working in partnership with fathers in the care of mother and baby:
„X Agree and use appropriate sources of information about the woman’s needs and expectations to inform care planning (source of information include “the woman’s partner, the father of the baby/ies and/or other family members”) [MCN7.5, 8.5, 9.5, 12.3, 15.5]
„X Establish an open and supportive relationship with the woman and key people involved in her care as agreed with her (antenatally, during labour/childbirth, postnatally) [MCN2.1, 3.2, 4.1, 7.2, 8.2, 9.2, 14.2, 15.2]
„X Work in partnership with the woman and key people to identify her needs and expectations and agree the goals for the individualised care plan [MCN7.7, 8.7. 10.7]
„X Negotiate and agree an individualised care plan with the woman and key people which takes account of her needs and all relevant factors [MCN7.12, 8.12, 9.12]; (relevant factors include “the consent and wishes of those involved in the care of the baby”, “the parent/carer’s abilities, needs and expectations”, “the effect of the baby’s condition on their carers” [MCN12, relevant factors])
„X Help the woman and key people develop plans to manage the pregnancy, including specific actions they will take, agreed support they will receive, intermediate targets and review points to measure progress [MCN23.13]
„X Work in partnership with those involved in the care of the baby to agree roles and responsibilities for meeting the baby’s needs (roles and responsibilities includes those of “parents/carers and others involved in the care of the baby”) [MCN12.7]
„X Agree with the woman and key people, achievable targets for optimising the health and well-being of her and her baby/ies during and after pregnancy (optimising health and well-being includes healthy lifestyles, lifestyle changes, effective use of antenatal and postnatal services, attending classes, managing common symptoms of pregnancy, early recognition of problems and accessing appropriate help, strategies to promote the father-baby relationship, strategies for promoting family relationships including those with siblings and members of the extended family, e.g. grandparents, non-resident fathers) [MCN23.12, 24.12]
„X Confirm details of the care plan with the woman, key people and other practitioners involved, including processes and timescales for reviewing progress [MCN10.6]
„X Implement the agreed care plan in partnership with those involved in the care of the baby [MCN13.2]
„X Discuss options and agree goals for the interventions to meet the baby’s needs (including transfer of a baby) and the expectations of those involved in the care of the baby [MCN17.3, 19.4]
„X Agree the actions to be taken with the woman and key people based on the information gained from the assessment and other relevant factors (relevant factors include “the consent and wishes of those involved in the care of the baby/ies”) [MCN6.2]
„X Establish concordance with family concerning medication plans [for the baby] [MCN21.4]
„X Obtain the valid consent of those legally responsible for the baby for the actions to be undertaken (including transfer of a baby) [MCN12.8, 17.7, 19.8]
„X Provide effective support for the woman and key people throughout, promoting their wishes and beliefs, addressing their concerns and encouraging them to promote their own health and well-being [MCN7.14, 8.14, 9.14]
„X Discuss the role of those involved in the care of the baby in achieving the aims and goals of the interventions and agree these with all concerned (including around transfer of a baby) [MCN17.5, 19.6]
„X Implement the agreed intervention in a safe and effective manner, using evidence based practices and processes that encourages effective participation of those involved in the care of the baby [MCN17.9]
„X Work in partnership with the woman and key people to assess the outcomes of the intervention in relation to the goals agreed at the outset [MCN14.17]
„X Minimise any discomfort to the baby and those involved in the care of the baby within the constraints imposed by the intervention method (including transfer of a baby) [MCN17.10, 19.11]
„X Actively encourage the woman and key people involved in her care to take a full and active part in the review process [of the care plan] consistent with the woman’s wishes [MCN11.4]
„X Agree and implement the necessary actions to address any significant changes in partnership with the woman, key people and other practitioners involved [MCN11.12]
„X Ensure the baby’s needs, and the needs of those involved in the care of the baby are re-assessed at suitable intervals [MCN13.5]
„X Monitor and review the implementation of the care plan at suitable intervals in partnership with those involved in the care of the baby [MCN13.4]
„X Identify any areas of disagreement and attempt to resolve them with those involved in the care of the baby, in a way that respects different perspectives [MCN12.6]
„X Work in partnership with the parents to assess the outcomes of their pregnancy and childbirth in relation to their previously agreed goals and preferences [MCN25.4]
„X Explore with the parents the nature of changes in their life following childbirth and discuss how they are feeling about it (changes include “physical, emotional and psychological health and well-being of those caring for the newborn baby/ies”, “the health and well-being of the family”, “family routines and procedures”, “relationships within the family”, “home or family circumstances”) [MCN25.5]
„X Respond to any issues raised and identify any issues that have not yet been resolved [MCN25.7]
„X Explore what type of support the parents require to cope with the changes [MCN25.7]
„X Identify and agree any areas where support for the parents may be improved [MCN25.8]
„X Encourage key people/birthing partner(s) to give appropriate support to the woman throughout the intervention (antenatally, during labour/childbirth, postnatally [MCN3.10, 14.15, 15.14, 16.11]
„X Encourage and support those involved in the care of the baby to make an assessment of the baby’s needs and to discuss this assessment with you [MCN5.7]
„X Encourage those involved in the care of the baby to give the appropriate support to the baby to promote optimum outcomes [MCN17.6, 19.12]
„X Identify and respect the privacy, confidentiality and wishes of these involved in the care of the baby [MCN12.2, 14.2, 15.3]
„X Clarify and confirm with the parents the information which may be shared with other practitioners as a result of the interventions [MCN17.2, 19.3]
„X Ensure the environment used for the intervention is suitable, and that the privacy and dignity of the baby and those involved in their care is protected [MCN17.8]

Particular things to communicate to fathers:
„X Enable the woman and key people to express their requirements for advice and information (information includes “community resources available, e.g. antenatal classes, relationship support, parenting programmes”, information on “preparing for parenthood”, “promoting the health and well-being of the parents and the family”, information on “parenting skills” [MCN23.4, 24.4]
„X Enable those involved in the care of the baby to seek advice and express concerns about the assessment process [MCN5.4]
„X Help individuals develop plans for pregnancy, including specific actions they will take, agreed support they will receive, intermediate targets and review points to measure progress [MCN22.14]
„X Encourage the birthing partner(s) to give appropriate support to woman during the assessment [MCN3.10, 15.14]
„X Provide sufficient and appropriate information, guidance and support to the woman and key people to enable them to manage and participate effectively in all agreed aspects of care [MCN10.8]
„X Provide advice and offer support to the woman and key people to enable them to manage all aspects of care [MCN9.13, 13.13]
„X Support those involved in the care of the baby to communicate with the baby [MCN1.12]
„X Provide effective support for the woman and key people throughout, promoting their wishes and beliefs, addressing their concerns and encouraging them to promote their own health and well-being [MCN10.10; MCN7, options]
„X Provide the woman and key people with any available evidence based information about the effectiveness, benefits and risks of specific interventions (including transfer of a baby; risks include non-compliance by the parents/carers) [MCN7.9, 8.10, 9.10, 14.7, 15.6, 16.7, 17.4, 19.5]
„X Refer the woman and key people to alternative or additional sources of advice and information as appropriate to meet their needs [MCN7.11, 8.11, 9.11, 22.10, 23.9, 23.10, 24.9, 24.10]
„X Encourage and support the parents to review and evaluate their experience of pregnancy and childbirth [MCN25.2] „X Encourage the parents to ask questions and express concerns about their experience of pregnancy and childbirth [MCN25.3]

KNOWLEDGE

Legal/policy/evidence relating to fathers:
„X The legislation which related to your work including…..the rights of mothers, fathers and babies [MCN1.K1]
„X The rights of parents to make decisions for themselves and their babies and to take risks in the context of their own lives [MCN24.K7]
„X The legal framework for consent in childhood and the role and responsibility of those with parental responsibility for the baby in giving consent [MCN1.K7, 17.K8]
„X Evidence based practice and its role in improving services [this will include the evidence about what works in working with fathers] [MCN1.K13]
„X The best current research information available based on a systematic analysis of the effectiveness of a treatment, service or other intervention and its use, in order to produce the best outcome, result or effect for the individual. In the absence of independent, large scale research, the evidence base may be derived from smaller scale work or locally agreed good practice. [MCN14, 15, 16, evidence based]
„X The main issues, debates and policies relating to the health and well-being of women prec-conception, during pregnancy and postnatally [this will include the evidence of how fathers do or don’t contribute to this] [MCN2.K19, 4.K19, 22.K15]

How the health and well-being of mother, baby and fathers are affected by actions of fathers:
„X The benefits of engaging the father/partner in the care of the woman and baby/ies [MCN6.K27]
„X The benefits of engaging the father and/or the woman’s partner in planning for, and supporting, the birthing process, including the impact of this on future parenting relationships. [MCN8.K42]
„X How adapting lifestyle can enable a woman and key people to promote their own health and well-being and that of their babies [MCN23.K33]
„X How the reactions of parents to their pregnancy and birth experiences can influence their emotional well-being, their relationship with their baby/ies and their future parenting relationships [MCN25.K35]
„X The normal health and well-being needs of women during labour and birth [MCN8.K26]
„X The main trends and changes relating to the health and well-being of babies [MCN12.K24]
„X The ways in which personal beliefs and preferences, including cultural or religious beliefs, may affect the options which are open to babies and those involved in their care [MCN12.K39]
„X The strategies and interventions to promote or maintain optimal health and well-being of women in the postnatal period. [MCN9.K26]
„X The impact of parenting capacity (mothers and fathers) on the health and well-being of babies [MCN1.K18]
„X The contributing factors that increase the risk of significant harm to babies [this needs to include harm that fathers can bring about] [MCN1.K21]
„X The positive and negative impact of family, social relationships and environment on the health and well-being of pregnant women and their babies, including the risk and impact of domestic violence [MCN1.K19, MCN2.K32]
„X The symptoms and presentations of domestic violence, how to recognise these and the actions to take in response to these [this will include recognising signs in perpetrators – usually the father – and what actions to take in relation to the perpetrator] [MCN2.K47]
„X How to recognise when women are not able to exercise their rights to make informed choices and actions and the actions to take in response to this [this includes if the father is responsible for undermining the rights of the woman] [MCN2.K9]

Needs of fathers:
„X The importance of being sensitive to the different experiences and needs of mothers and fathers/partners, and providing opportunity to debrief separately if appropriate [MCN25.K36]
„X The evidence-based information parents need in order to be able to make informed choices during pregnancy and after the baby is born about the care of their newborn baby/ies [MCN13, MCN23.K30, 24.K29, 25.K37]
„X The information that the woman and key people are likely to need in relation to her antenatal care plan (and postnatal care), and any concerns and/or particular needs they may have [MCN7.K43, MCN9.K45, MCN12.K41]
„X The strategies and interventions that may be required by parents and families with additional needs (e.g. multiple births, mental health problems, bereavement arising from pregnancy) [MCN25.K22]
„X How the needs of women during childbirth may affect others [MCN3.K31]
„X The potential impact of assessment on the woman and her baby/ies and key people (ante-natally, during labour/childbirth, postnatally) [MCN2.K42, 3.K40, 4.K47]
„X How the needs of babies may affect others [MCN1.K20, MCN5]
„X The importance of offering parents (mothers and fathers/partners) the opportunity to reflect and debrief on their experience of pregnancy and childbirth [MCN25.K32]
„X Local and national services, agencies and websites for people who want further information and support for labour and birth, and how to access these [MCN8.K49]
„X The range of services available locally and nationally for people who need information and support in making and maintaining changes in their lifestyle, and how to access these services [MCN22.K40]
„X Practitioners, agencies and services you can access for expert advice and support when required [MCN25.K38, K42]

Communication / building partnership with parents:

Principles
„X Why it is important to clarify and confirm with the woman who and to what extent she wishes to involve others as key people in her care (and to check and confirm this periodically [MCN7.K14, MCN10.K14]
„X The impact that empowering parents to effectively manage the care of their baby/ies has upon the parents, their baby/ies and their families, and health services [MCN24.K34]
„X How to recognise the sort of information and advice that individuals may be trying to request when they may not have the terminology, confidence or skill to give an accurate specification (relating to pre-conception) [MCN22.K26]
„X The importance of acknowledging your own feelings, beliefs and values and those of others as part of the communication process [this will include feelings and beliefs about the respective roles of women and men around babies] [MCN1.K29]
„X How to avoid inappropriate impact of your own personal feelings, beliefs and values on communication with the baby and those involved in their care [note as in previous point] [MCN1.K31]
„X The importance of not making assumptions about the communication and understanding abilities of babies and those involved in their care [this will include the different ways in which men may communicate, particularly if not confident in the environment] [MCN1.K36]
„X How you would provide information and advice in ways which are appropriate for different people, including male-friendly information for fathers/partners [MCN7.K46]
„X The effects of environments and contexts on communication [key issue for fathers who may be feeling out of place in maternity environments] [MCN2.K17]
„X The ways in which communication can be modified and altered for different needs, contexts and beliefs [MCN2.K18]
„X The importance of respecting the diversity and values of mothers and fathers in relation to the health and well-being of their babies [MCN5.K15]

General practice
„X Work with others towards a common goal, sharing power and responsibility [MCN11, 12, partnership]
„X The ways in which key people should be involved in the communication in order to deliver the most effective outcomes [MCN2.K14]
„X How to communicate effectively with women and babies and those involved in their care [MCN6.K14]
„X How to effectively negotiate with women, key people and other practitioners [MCN10.K23]
„X How to encourage and support the woman and key people to express their own needs and the reasons for doing this [MCN2.K44]
„X Methods of supporting those involved in the care of the baby to make informed choices [MCN17.K39]
„X Methods of encouraging those involved in the care of the baby to be as actively involved as possible and the relationship of this to the promotion of health and well-being [MCN17.K48]
„X The range of feelings which people may experience when there are communication differences [MCN1.K38]
„X The reasons why communication may fail to develop or break down [MCN1.K41]

Through pregnancy, childbirth and babycare
„X The difficulties people may have in maintaining lifestyle changes and how to work with them to identify and overcome these (in relation to pre-conception) [MCN22.K30]
„X How an individual’s cultural or religious beliefs could affect their ability to adapt their lifestyle in certain ways and how to respond to this (in relation to pre-conception) [MCN22.K37]
„X How to help women and key people to develop realistic and achievable plans for labour and birth [MCN8.K50]
„X The purpose of agreeing goals with those involved in the care of the baby at the start [MCN17.K38]
„X The purpose of determining during the planning phase how and when the plan will be monitored and reviewed, and the role of women, key people involved in her care and practitioners in this process [MCN7.K50]
„X The ways of encouraging women and key people to take a full and active part in the review process and to offer their views as equal partners [MCN11.K50]
„X How to encourage and support those involved in the care of the baby to take an active role in implementing the care plan [MCN13.K41]
„X The purpose of encouraging those involved in the care of the baby to consider the implications of any proposed changes to the care plan [MCN13.K46]
„X How to ascertain the levels of understanding that the woman and the key people have of assessment processes and related interventions (antenatally, during labour/childbirth, postnatally) [MCN2.K39, 3.K38, 5.K41]
„X The importance of checking that families and carers understand the needs and aims of the intervention [during care of the baby] [MCN17.K43]
„X Methods of enabling the baby and parents to be as comfortable as possible given the constraints of the particular intervention and the setting [MCN17.K49]
„X The roles those involved in the care of the baby may take, and may need to take, if the intervention is to be successful and how to explain and agree these with them [MCN17.K40]
„X The information which it may be necessary to share with others as a result of the intervention [after the birth], how to make sure that those involved in the care of the baby are clear about this [MCN17.K41]
„X The purpose of encouraging women and key people to ask questions, seek advice, and express any concerns about the intervention [during pregnancy, labour/childbirthy] [MCN14.K42, 15.K39]
„X Methods of encouraging women and key people to work as active partners in implementing the intervention [during pregnancy, labour/childbirth] [MCN14.K48, 15.K45]
„X How to encourage and support those involved in the care of babies to assess the babies’ needs and the reasons for doing this [MCN5.K44]
„X The importance of encouraging parents to express their feelings about changes to their lives following childbirth [MCN25.K40]
„X Fears and concerns which parents may have about the changes [MCN25.K41]
„X Methods of providing support to help parents to manage the changes to their lives and relationships [MCN25.K42]