Blog: Why maternity services must modernise and take fathers seriously

12 June 2018

Jeremy Davies writes (this blog first appeared on Huffington Post UK):

OK, we get it. Maternity services: the clue’s in the name. Mums are the ones who give birth. They matter most.

But the UK is a wealthy country with a raft of gender equality legislation, where we’ve had statutory paternity leave for 15 years, and give all dads the right to attend antenatal appointments. Is it really too much to ask the NHS to treat fathers like they count too?

Our new survey, How was it for you?, completed by more than 1,800 men who’ve become fathers in Britain in the last five years, confirms what we already knew from previous research: that almost all men in Britain are ‘around’ in the period before, during and after the birth of their children:

  • 94% of men surveyed went to at least one routine antenatal appointment;
  • 99% went to ultrasound scans;
  • 98% attended the birth and 91% were there from start to finish;
  • and 94% met healthcare professionals at a home visit after the birth.

This is not a new phenomenon: upwards of 90% of dads have been attending births for three decades. And yet, 30% of fathers in our survey were rarely or never talked to directly by medical staff during routine antenatal appointments; 55% weren’t addressed by name; still more (65%) weren’t invited to talk about their impending role as father. Engagement with dads was even less likely during ultrasound scans.

Michael Bunting, whose son Alfie was born at Pinderfields Hospital 17 months ago, told us how it felt to be ignored by staff delivering the news that an earlier pregnancy had miscarried:

“The nurse not only didn’t speak to me, she didn’t even look at me once throughout the whole conversation. While my concern at the time was focused on my wife, on reflection, I was appalled and offended.”

Some dads felt shut out during and after their baby had arrived: almost three quarters (74%) said the hospital had no facilities for them to stay overnight, and nearly half (44%) felt the hospital visiting policy led to them spending less time with the mum and baby than they would have liked.

One father who preferred to remain anonymous told us:

“After the birth I was treated as a nuisance and was in the way. I was told to leave immediately after my wife was brought to the ward with the baby. She was high on medication from a forceps delivery, exhausted and full of wires and a colostomy bag hanging out of her. She was starving because she hadn’t eaten in more than a day. I felt like a spare part but I could have helped her and the baby while she was establishing breastfeeding after being in labour for 18 hours. The midwives told my wife I wasn’t allowed to stay to respect the other women. I drove home after the birth and nearly crashed my car.”

Another, civil servant Wayne Gorman, whose son was born in Dundee’s Ninewells Hospital in 2013, said:

“My treatment was utterly despicable. I was tolerated only, never asked how I was managing, even though, due to my partner being in hospital for six days with our son, it was me doing all of his primary care, and most of hers, apart from medical procedures/responsibilities. I was at the hospital, with their grudging permission, every hour I could be, basically doing 10-11 hour days at her bedside, looking after our boy. The other mums on the ward, commented to my partner that I was being treated very poorly and could not actually believe how rude some of the nursing staff were.”

Why does any of this matter? Well…apart from wanting to be there for themselves, fathers say their presence can be helpful: almost half (48%) believe the birth was safer because they were present, and 96% feel that staying after the birth can be helpful to mothers. Four-fifths (81%) of dads believe they can help staff too.

And Who’s the bloke in the room? – our comprehensive review of research into fathers during pregnancy and birth, published this week – provides plenty of evidence that fathers have a huge impact on the very outcomes one would imagine maternity professionals most care about, like safe births and healthy mums and babies. It’s surprising to find, then, that fewer than a quarter of dads surveyed had been asked about their physical health (22%) or diet and exercise (18%), despite evidence that these impact on the mother’s and baby’s health. Even though a father’s mental health is closely correlated with a mother’s, only 18% of dads surveyed had been questioned about it. Around half (48%) had not even been asked about smoking, despite the risks of passive smoking to babies, and fathers’ key role in supporting pregnant mums to give up.

So what’s the problem? Why does the NHS still not know how to deal with dads? Our report suggests two main reasons: an exaggerated belief in the number of ‘single mums’, and a similarly exaggerated belief in the risk of domestic violence. These two, combined with a lack of basic procedures that could turn expectant and new fathers into engaged and valued participants in a family-centred approach to maternity, result in what many fathers experience as a hostile and even inhumane environment.

The fathers we surveyed acknowledged the importance of the work doctors, midwives and other professionals do in the UK’s maternity services; many heaped praise on them and almost all stressed that mums and babies should absolutely be the priority.

But herein lies the problem: involving dads should surely be intrinsic to providing the best possible service for mums and babies – as the NHS’ own guidelines already state by calling for services to be “woman-focused and family-centred”. This is not a question of maternity services distracting themselves from their main purpose, so as to accommodate the needs of men for the sake of it. Rather it is one of services doing better their core job of supporting women to have safer births and healthier children, by valuing and harnessing the crucial roles that men can and want to play.

Mothers and babies aren’t created in a vacuum. Let’s start recognising that. Happy Father’s Day.

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