We have been asked to comment on a story about claims that fathers are using an Edinburgh maternity ward ‘like a hotel’. Our position is a straightforward one: the NHS is failing to provide the ‘family-centred’ antenatal, maternity or health visitor services required by its own rules and desired by parents.
Since 2004, NHS policy has required maternity services to deliver ‘mother-focused and family centred’ care. This matters because pregnant, birthing and newly delivered women typically want their partner with them – not only because he is their closest companion but also because he provides continuity of care and support amid stretched NHS services. The NHS’ failure to follow its own policy is what leads to the kind of uncoordinated mess occurring at ERI.
To support our 2018 Nuffield Foundation-funded Who’s the Bloke in the Room? study, we partnered with Fathers Network Scotland to run an online survey of 1,873 men who had become fathers in the last five years. In it, we found that although almost all fathers were present in maternity services at each stage (94% attended at least one antenatal appointment; 99% ultrasound scans; 98% labour/birth (91% from start to finish); and 94% at least one postnatal home visit, large numbers felt ignored before, during, and after delivery, even though their involvement is central to infant and maternal well-being and is desired by mothers.
More than 40% of fathers surveyed said that hospitals had not allowed sufficient time for the new family to spend together after the birth. And only 17% reported that their hospital had facilities for fathers to stay overnight afterwards, even though the then Prime Minister Gordon Brown called in 2010 for hospitals to provide such facilities.
At the time of our report we made a series of recommendations for how the NHS could achieve the ‘family focus’ it should, theoretically, be offering. You’ll find the full report, exec summary and press release, including our recommendations on the research page of our website.
On the specifics of the Times’ story about ERI, here are some thoughts:
The extent of the difficulties sounds rather exaggerated (how many fathers are there, if it’s difficult to reach emergency buzzers?!) and the tone of the midwife quote suggests she is taking a narrow and negative view of fathers’ importance (using the place like a hotel…really?) – perhaps because she feels a lack of ‘ownership’ of the decision to open the doors to men?
The substance of the story seems to be that the hospital management has failed to plan for fathers to be made to feel welcome; hasn’t considered how men might be accommodated at night; and hasn’t created any ‘house rules’ they need to follow, to respect the communal nature of the space. Along the way, perhaps staff have not been consulted, and helped to understand that in fact, welcoming dads is ‘good news’: for mums, who feel better-supported as a result, for babies, who are more likely to attach more quickly with their dads as well as their mums; and for staff, who have an unpaid ‘helper’ in the background, to take the pressure off.
It seems highly unlikely that couples would be sharing beds on a shared maternity ward – but if we accept this as true, it would surely be much less likely if temporary beds or chairs were provided for men – whom midwives and others might view positively, as helpful, loving assistants at a time when new mums need all the help they can get?
As for ‘demanding meals’, again this seems unlikely, but if there were facilities for dads to buy food on site, especially ‘out of hours’, this would presumably help tackle the problem. Likewise ordering takeaways.
And in terms of women’s privacy, surely beds on maternity wards have curtains around them?
Our Who’s the Bloke in the Room? recommendations were all aimed at making fathers welcome throughout pregnancy, birth and early infancy, and valuing the role they play not just as supportive partners but also as independent parents with a unique connection to their baby.
How can it be that 15 years after NHS policy called for maternity services to deliver ‘mother-focused and family centred’ care, men are still being talked about as if they have no place?
We are sending a copy of this article, and the Who’s the Bloke in the Room reports, to the management of Edinburgh Royal Infirmary, NHS Lothian and NHS Scotland.