Fathering

A few days ago, I was on the train on the way to Sydney. A well dressed couple with two little boys got on and sat down at the seat ahead of me. The boys were about 2 and 3 1/2 years old. The father sat down on the seat and immediately opened his newspaper. The children sat by the window and asked endless questions all the way. The mother was fully engaged, answering questions, explaining fascinating things like why the water was blue, where did the boats go, what did frogs do when the train came and so on. The conversation indicated that they were on their way to a day at the zoo and the boys were obviously very excited.

The boys were interested, full of life and questions. The mother was calm, attentive and engaged. At one stage, one little fella said he was hungry. The mother said kindly, that he had a chance to eat his breakfast and that he had chosen not to do that. She explained that he would have to wait until he got to the zoo when they would have morning tea to have something to eat. The way the mother handled the situation was very impressive and the young boy did not 'carry on' so clearly knew his boundaries.

I enjoyed watching the mother with the boys and when I got off the train a stop before they were getting off, I commented on the way she interacted with her children and congratulated her. She was very engaging with me and we had a good interaction in those few moments. The father put his paper down slightly and smiled warmly at me as I said goodbye, then looked back at his paper. As I saw the train pull away from the platform, I waved at the little family; he was head down reading and she was pointing, waving and talking with the two excited boys who smiled and waved at me. 

A couple of days later I was talking with a very proud new grand father.  He was telling me how his son helped with the 'crap work'!  This 'crap work' is with the one week old baby.  I asked what the 'crap work' was with great interest. The grand father told me with great pride that his son bottle fed the baby while his partner caught up with sleep. I knew the woman was breastfeeding and must admit that I was shocked and the look on my face must have made my reaction obvious.  I said I was surprised that feeding was considered 'crap work' and was told, in a defensive tone, that "it is when you are sleep deprived". I found that a very difficult conversation because there was no entry point to have a discussion about newborn needs and the importance of finding ways to protect, support and promote optimal breastfeeding.

Father and newborn

After these two recent experiences, I find myself wondering about fathering and how and what we midwives can do to encourage optimal engagement of fathers. We know that men who are fully engaged during pregnancy and birth are more engaged as fathers. We also know that men who have skin to skin with their newborn children have oxytocin (the love hormone) surges and decreased testosterone (the war hormone) and are more attentive fathers who are less likely to spank or hurt their babies and children. Those of us who work one on one with childbearing women and their partners have seen that in action. These two experiences indicate to me that we still have a way to go. Finding creative ways to engage fathers and perhaps grand fathers too, more right from the start will help to unravel and rejig those unhelpful myths, negative attitudes and disabling practices that still abound in our society and disrupt men's ability to be the kind of fathers that is their potential.

BBC News - Post-natal depression in fathers 'often undiagnosed'

Modern day pressures on men have escalated in the last couple of decades as men seek to find relevance in a world that is rapidly changing their role in society and the family.

At last researchers are turning their attention to men's experiences of birth and early parenting. Researchers from the Eastern Virginia Medical School team looked at 43 studies involving 28,004 parents from 16 different countries. The countries included the UK and the US. In a news item in the BBC news, the researchers were quoted as saying:

"One in 10 new fathers may have the baby blues, US researchers believe - based on their trawl of medical literature. While this rate is lower than in new mothers, it is more than currently recognised, they told the Journal of the American Medical Association. Lack of sleep and new responsibilities, or supporting a wife with post-natal depression can be triggers, they say".

Childbearing and early parenting are stressful experiences.  New roles, new experiences and general unfamiliarity with babies provide a catalogue of changes that both women and men are having to deal with and integrate. A new reality for many along with smaller family sizes and the nuclear family phenomenon is that a vast majority of young parents have never even held a baby before they hold their own. Many men are inadequately prepared for being present at the birth of their baby and parenting.

BBC News Article

Midwives have a real role in including fathers-to-be in their work with childbearing women. Many men feel left out and sidelined during antenatal visits and during the birth process. Feedback from women on their experiences of midwifery student follow through often contain comments about how the student included their partner. The women always say how grateful they are that their partner was included and made to feel important by the student. The fact that the women feel a need to comment on this aspect of the student's involvement in their childbearing experience indicates to me that partners are not generally included in the care given by midwives and doctors.

Midwives and other health professionals have to recognise that childbearing is an emotional experience for men too. Working with women across the continuum of childbearing is enhanced when their partners are included in the woman centred focus of the midwife. Respect, kindness, inclusion and relationship building are core attributes of midwifery practice and set the foundation for women's feelings of being well cared for and valued during their experience of maternity care. Engaging fathers in the same way obviously has implications for how men emerge from their experience of maternity care too.

John Heron (born 1928) , a wonderful man who pioneered a participatory research method called cooperative inquiry, provided (for me) the first clear understanding about the importance of emotions in human interactions and wellbeing. John Heron identified three core emotional needs:

1. To love and be loved
2. To choose and be chosen
3. To understand and be understood

Heron said when these core emotional needs were not met, people develop defense mechanisms. Defense mechanisms are often counter productive to optimal relationships; optimal interactions on both cellular and social levels and overall mental and physical health and wellbeing.

If midwives and other health practitioners make a clear goal to ensure the emotional needs of women and their partners are met in their work with them through the childbearing year and beyond, many of the ills that plague new parents may be 'headed off at the pass'.

BBC News - Post-natal depression in fathers 'often undiagnosed'