copies cost £4.95 and are available from fathers direct

Including New Fathers A Guide for Maternity Professionals

Copies cost £4.95 and are available fromFathers Direct.

Fathers Direct, a registered charity, advises Government onhow to adapt policy to the increasing role of fathers in caringfor their children. Fathers Direct is represented on theMaternity Services Implementation Advisory Group at theDepartment of Health.

Around 1,000 people with a professional interest in improvingtheir engagement with fathers attend Fathers Direct eventseach year. The organisation is the UK’s leading provider oftraining and consultancy to family and children’s services onfather-inclusive practice.

To learn more visit www.fathersdirect.com, in particular thesection on maternity, call our telephone helpline forprofessionals on 0845 634 1328.

Including New FathersA Guide for MaternityProfessionals

www.fathersdirect.com

Including New FathersA Guide for Maternity Professionals

Why you needthis guide

• An introduction from Fathers DirectChief Executive Duncan Fisher

• What the experts say about fathersand maternity services

_ 06

Why engagewith fathers?

• Six reasons why it is important towork with fathers

_ 08

How to engagewith fathers

• Preparing your team for workingwith fathers

• Creating ways for fathers toaccess your service

• Designing antenatal services tosupport fathers

• Supporting young fathers

• Tailoring the information yougive to fathers

• Involving fathers at scans

• Involving fathers at the birth

• Supporting the father after the birth

_ 14

References _ 31

Some importantterminology

_ 07• ‘Absent’ fathers, ‘good’/’bad’ fathers,families who need extra help, ‘hardto reach’ fathers

Author: Duncan FisherEditor: Simon Craft-StanleyDesign: boilerhouse.co.ukFor further copies: 0845 634 1328

© 2007 Fathers DirectFor further information andcontact details go towww.fathersdirect.com

Fathers DirectFathers Direct is the nationalinformation centre onfatherhood. We helpGovernment, employers, servicesfor families and children, andfamilies themselves to adapt tothe changing social roles ofmen and women.

We help institutions to base theirwork on the evidence fromresearch on the impact offathers on child welfare.

Our vision is a society that:

• gives all children a strongand positive relationshipwith their fathers

• supports co-operative parenting• provides greater support for

mothers as carers and earners • supports the role of men in

caring for children.

You can contact FathersDirect on 0845 634 1328or via our website atwww.fathersdirect.com.

“The Government believes muchmore can be done to release thepotential improvements inoutcomes for children throughbetter engagement betweenfathers and services for childrenand families. This requires a culturechange - from maternity services toearly years, and from healthvisitors to schools - changing theway that they work to ensure thatservices reach and support fathersas well as mothers..”

Aiming High for Children: SupportingFamilies (Treasury, March 2007), 4.34-5

We thank Rt Hon Patricia Hewitt MP, Secretary of State for Health,for launching this briefing in June 2007.

The Department of Health has provided funding to develop and writethis briefing through its Section 64 Grant Programme.

“Having a baby marks not just the creationof an individual life, but the birth of afamily. The RCM believes that maternitycare should reach out to and include allmembers of that family. Midwives shouldmake fathers feel welcome and involved.

They should include them in parentingeducation, offer them the opportunity todiscuss their thoughts and feelings aboutthe changes they are facing, and supportthem to support their partner and infant.”

Royal College of Midwives policy statement.

Including New Fathers: A Guide for Maternity Professionals


07


06

‘Absent’ fathers?A total of 86% of fathers arepresent at the birth and 95%of mothers declarethemselves to be in arelationship with the fatherwhen a baby is born -ranging from ‘just friends’ tomarried/living together(4).

Couples can be livingtogether or separately, or abit of both. This briefingconsciously covers all ofthese families, in line withthe NSF(5). When parents arenot living together this doesnot mean that the father isnecessarily “absent”. Evenamong the 4.4% of coupleswho are regarded, by themother, as being “not in arelationship”, 25% of thefathers are still in touch withtheir infants nine monthsdown the line(6).

Having said this, there areclearly occasions when thefather is not present at thebirth or in the baby’s lifeafterwards; and/or whenlabour partners or keysupporters of the motherother than the father playimportant roles during andafter the birth. In thisrespect, although thisdocument speaks aboutfathers, some of the ideas init can also be applied toothers among the mother’sfamily and close friends,where this is appropriate(7).

‘Bad’ fathers /‘good’ fathersSome fathers areoverwhelmingly positiveinfluences in their children’slives; others have a seriousnegative impact; the vastmajority are “good-enough”(that is, good enough for thechild to feel secure,competent and lovable).Some can change negativebehaviours; others cannot orwill not. In short, fathers arereal people (like mothers)and cannot be categorisedneatly into “good” and “bad”– and this briefing coversthem all.

Families whomay needextra helpIn this briefing you will seereferences to developingmore responsive services for‘families with additionalneeds’. These are defined inthe NSF to be the following:

• families where there areparticular health problems- mental, physical, genetic

• families with a disability

• families with relationshipproblems

• young parents

• families with a sick baby

• bereaved families

• families where a parent isin prison

‘Hard to reach’fathersSome fathers are frequentlyexcluded from accessingfamily and children’sservices, for example veryyoung fathers. Such fathersare often referred to as“hard to reach”, but webelieve this suggests theexclusion is their problem,when in fact the issue isgenerally that services arenot used to reaching out tosuch families.

“ Active fatherhood is a pent-upresource and we need to find a wayto liberate that resource.” Professor Michael Lamb, Professor of Psychology,Cambridge University

Fifty years ago few fathers inBritain attended the birth oftheir baby. Now 86% of allfathers attend the birth - 95%of parents who live togetherare together for the birth andthe same is true of 45% ofparents who live apart(2). Nohealth or family service otherthan maternity achievesremotely this level ofconnection with men in theirrole as carers of children.

The National ServiceFramework for Children,Young People and MaternityServices (referred tosubsequently as “the NSF”)and other key policydocuments from theDepartment of Health statethat maternity services needto be “women focussed,family centred”. The NSFspeaks of the need todevelop partnership withmothers and fathers(3), andother policy and practicedocuments state thatmidwives and health visitorscan have an enormousinfluence on fathers andhow they engage withmother and baby (seesection entitled ‘How toengage with fathers’ for afull list of relevant documentsand other resources).

So why is all this interest infathers happening? There isnow a compelling body ofevidence that demonstratesthe strong impact that fathershave on the health andwellbeing of mothers andbabies, especially as fathers’involvement increases duringpregnancy, at the birth andin babycare. For example, ona practical level, yourengagement with fathers canhave a big effect on yourservice’s ability to meet keytargets around smoking,breastfeeding and mentalhealth. (You can find thisevidence reviewed in somedetail onwww.fathersdirect.com in thematernity section).

But there’s more to it thanthat, and the significance offathers’ impact - positive,negative, or a bit of both -on mothers and children isnot just being recognised inthe field of maternityservices: across all healthand family services,engagement with fathers isbeing re-evaluated.

This briefing, which is basedon an extensive review ofinternational evidence,explains the many andvarious ways in whichengaging with fathers inmaternity services is soimportant; and it outlineswhat actions you can take tomake your service moreresponsive to fathers - andthereby to the families ofwhich they form such acrucial element. We hopeyou find it useful.

Why you need this guideAn introduction from Duncan Fisher, Chief Executive, Fathers Direct

Families are changing. Fifty years ago women did almost all thecaring and men almost all the earning in the vast majority offamilies in the UK. Now, even where children are under 3, womenundertake some paid work in the majority of households. Today,fathers do almost one third of the parental care of children (25%during the week, 33% at weekends): that’s eight times more than 30years ago - and more than is delivered by professional childcarers.Fathers undertake even more care when mothers work(1).

Some important terminology

Duncan Fisher,Chief Executive,Fathers Direct

www.fathersdirect.comIncluding New Fathers: A Guide for Maternity Professionals

09

There is a substantial body ofresearch relating to the influenceof fathers on the health ofmother and baby, whetherpositive or negative. Appealingto the needs of the baby can bea powerful motivator for gettingfathers to change negativebehaviours; and interventionsthat target fathers can havepositive results in terms ofimproving health for motherand baby.

A father’s mental health andemotional well-being, and therelationship between the motherand father, are both critical tothe emotional growth andunderstanding of the infant. Thedegree to which a mother bondspositively with her baby can beprofoundly influenced by thequality of father-infant bonding.

In terms of smoking, alcohol,diet, breastfeeding andcontraception, fathers cansupport mothers in healthychoices, or they can obstructthem. Mothers’ and fathers’behaviours tend to be highlyinterdependent in all theseareas. Research shows that thefather’s beliefs and behaviourneed to be addressed if themother is to succeed in makinghealthy choices.

If a mother is depressed, afather can provide vital supportto her and ensure the baby hasthe necessary care at all times.A depressed father puts a hugeburden on a new mother,particularly if she is alsodepressed. Depression in oneparent is a factor in stimulatingdepression in the other. Non-depressed fathers can “buffer”infants against the negativeeffects of mothers’ depression.

Domestic violence and abusehave very negative impacts onmothers and babies – and byengaging in the right way withfathers as well as mothers, thereis a lot maternity services can doto help stop the violence.

A full review of the research onthe effects of engaging withfathers on women’s and babies’health can be viewed in thematernity services section atwww.fathersdirect.com.

Fathers play an increasing rolein caring for babies. Babiesneed “confident parents able tobring up their children in a waythat promotes health,development and emotionalwell-being”(9). So a role formaternity services is to enableboth parents to care safely andeffectively for the baby after thebirth(10). Indeed, the NSF saysthat preparing parents forparenthood is as important formaternity services as supportingthe health of mother and baby(11).

Research shows that maternityservices have a key role inencouraging men to expandtheir caring roles. The moretraining, support andencouragement expectantfathers receive, the more likelythey are to be involved withcaring for their children later(12).The more fathers are involved ineveryday care during the firstyear, the more likely they are toremain involved throughout thechild’s life(13).

Research at the University ofBristol showed that some fathers– particularly young and/orblack fathers - experiencesignificant barriers to obtainingsupport within maternityservices(14). A pilot projectmanaged by Fathers Direct inLondon found the same(15).So there is evidence that someservices are not meeting needsbecause of gendered and racialassumptions; and that these aredisproportionately affectingvulnerable groups.

Why engage with fathers?

Reason 1.

Fathers have a profound influenceon the health and well-being ofmothers and babies (8)

Reason 2. The father is likely tobe a carer of the baby

Research shows not only that fathersare more involved in caring forbabies and children than in previousgenerations - but also that bothparents want fathers to be evenmore involved.

Fathers are also there: theirincreasing presence in antenataleducation and care, including atscans, at the birth and, thanks to paidPaternity Leave, at home immediatelyafterwards, means maternity servicesmust find new ways of engagingmore effectively with both parents.

The new Gender Equality Duty(Equality Act 2006), effectivefrom April 2007, requires allpublic authorities, includingthose commissioning maternityservices, to have “due regard”to the need to promote equalityof opportunity between menand women.

“Promoting” means being activeand not passive: the statutoryequality body and inspectorateswill look for action and positivechange as evidence ofcompliance. “Having dueregard” means prioritisingattention in proportion to itsrelevance – see the box belowfor how gender equality appliesto maternity services.

Gender equality does notrequire men and women toreceive the same service –there are circumstances,among which maternity isprobably the most extremeexample, where needs aredifferent. But gender equalitydoes mean that neither womennor men should be excludedfrom support they need.

The Gender Equality Dutyrequires public authorities“proactively to address theindividual needs of women andmen in all their functions”, toquote the official guidance onthe Duty published by the EqualOpportunities Commission (andavailable on www.eoc.org.uk).

Around the birth, mothers andfathers have different needs insome ways (for example atchildbirth one parent is givingbirth and the other is normallypresent and expected to beinformed and helpful) andsimilar needs in other ways (forexample both are facing a life-changing experience in thetransition to parenthood).

Under the law, bodies thatcommission maternity relatedservices, like other publicservices, need to publish anoverall scheme and action planfor promoting gender equality,covering all areas where genderequality issues are deemed tobe relevant.

More particularly, at the pointof commissioning any service, agender impact assessment isrequired, assessing thedifferential impact of the serviceon women and men. This willassess if there is evidence ofdifferent needs between womenand men and whether bothwomen’s and men’s needs arebeing met. It will also look at thegender norms and stereotypesthat are being assumed.

Compliance includesgathering information on howservices impact on women andmen respectively andconsulting with women and menwho use services in ways theyfind accessible.

11


10

Early involvement of a fatherpredicts longer-terminvolvement in the child’s life(16)

and levels of care giving byfathers show considerablestability over the first threeyears(17) and moderate stabilityover a 14 year period(18).Furthermore there is now asubstantial body of researchevidence that shows positiveinvolvement of fathers to beassociated with positiveoutcomes for children rightthrough their lives(19). Fathers’involvement cannot start tooearly! Infants of very highlyinvolved fathers are generallymore sociable and seem equallyattached to both parents; andtheir attachment to their mothersis also more secure.

Sensitive, supportive andsubstantial father involvementfrom the month following birthis connected with a range ofpositive outcomes in babiesand toddlers - from betterlanguage development tohigher IQs. For more aboutfathers’ impact on babies andchildren, see the researchreview in the maternity servicessection onwww.fathersdirect.com.

Because fathers are moreaccessible to professionals atthe birth of their child than atany other time, with asignificant proportion attendingantenatal classes, scans andthe birth, this is a time ofmaximum opportunity toengage with fathers(20) - andthey are also more open toreceiving information andsupport about general parentingissues from professionals at thistime than at any other in theirchild’s life(21).

Sure Start Children’s Centreshave the task of recruitingboth mothers and fathers –but they cannot possibly do thiswithout the help of maternityservices, who are the onlyservices that have almostuniversal access to fathers.

Mothers and babies needhealthy fathers, yet statistics onthe health risk-taking ofexpectant fathers giveconsiderable cause for concern.The Government is promotingpreventative health, forexample, the Life Checkprogramme. Becoming a fatheris a key moment when menreconsider their own health andreview possible risk-takingbehaviours.

In NHS research in 2005, only40% of mothers thought thatfathers were stronglyencouraged during theantenatal period; 62% offathers felt this. After the birth,the opinion of mothers andfathers converged – only 48%of mothers and 46% of fathersfelt that fathers were “fullyencouraged”(22).

Interestingly, mothers’assessment of how fathers weretreated strongly predicted themothers’ assessment of thematernity service as a whole –so much so in fact, that asubsequent NHS reportproposed engagement withfathers as one of the four pillarsof a good maternity service,along with providing continuityof care, offering choice, andproviding good information.

Research shows that whenmaternity services interact withfathers in ways that arespecifically designed toengage them, the results aregood for mothers as well asfathers. Support that is notdesigned with fathers as wellas mothers in mind has muchless impact.

Reason 6. The law requires it: the Gender Equality Duty

The purposes of the GenderEquality Duty are to promotea better understanding byservices of the different needsof women and men, topromote better quality ofservices, to achieve moreeffective targeting of resources,and to achieve better resultsand greater confidence inpublic services.

The Duty requires that publicauthorities prioritise actionsthat result in significant benefitsto gender equality.

The biggest single driver of thepay gap and inequalities facedby women in the workplace isthe fact that women do morecare of children and domesticwork than men (23) - and

research shows that maternityservices have a key role inencouraging men to expandtheir role.

Guidance to the Dutyis available onwww.eoc.org.uk

Reason 3. Early involvementby fathers helpsbabies

Reason 4. The birth of ababy offers thebiggest chanceto engage withfathers

Reason 5. Mothers want fathers to be well treated

Why the Gender Equality Duty is important for maternity services



“ We want the father to be part ofthe experience. We find himinvaluable. It is very differentwhen the woman does not havehim there. The midwives have todo far more. The father is vital,particularly if she has had acaesarean or stitches. He is alwaysbusy, running baths, gettingdrinks, helping her to thebathroom, lifting the baby, sharingthe responsibility. She has her ownhelper - the person who caresabout her more than anyone elsein the world.”

Caroline Flint, ex-President of the Royal

College of Midwives and founder of Tooting

Birth Centre, London


15


14

Invest in trainingA relatively small investment ininitial planning and training canreap major dividends indeveloping more father inclusivepractice, as has been shown byfamily and children’s serviceswho have successfully engagedwith fathers.

Organise training for all staff,including ancillary staff, in howto engage with fathers in aconstructive way, using the Skillsfor Health midwife competenciesas a guide. Any personcommunicating a negativeattitude towards fathers inmaternity services makes a bigimpact, particularly if the familyis vulnerable in any way.Training should include simplethings like making eye contactwith men and awareness ofappropriate body language. Seethe box on page 17 for ideasabout attitudes that need to bechallenged in training.

Consider the Brief Encounterstraining for health professionalsprovided by the charity, OnePlus One, which enablesmidwives and health visitors totalk to parents about parentalrelationships.

Involve both mothers and fathersin the planning of services; andask both to record theirexperiences on leaving hospital,using a separate questionnairefor each.

If there is a local MaternityServices Liaison Committee,follow the official guidelines andensure a third of its membershipis drawn from service users,including fathers; and make sureit reviews the needs of bothmothers and fathers andrepresents in particular familieswith additional needs and thosewho are often excluded(24). Localearly years services (for exampleChildren’s Centre) may be ableto nominate dads for the LiaisonCommittee(25).

Develop special strategies toconsult with mothers and fathersfrom social groups that areeasily excluded(26).

Set objectivesfor engagingwith fathersThese can relate to existing coredelivery targets. The followingare a possible set of objectivesaround which to organiseagreement and action:

• Enable fathers to be effectivepartners in caring for motherand baby.

• Support fathers in thetransition to parenthood.

• Prepare couples to facilitateand support each other’sroles.

• Ensure fathers are fullyinformed about key healthissues, such as smoking,breastfeeding and depression.

• Signpost fathers as well asmothers to other services thatmay support them, inparticular Sure StartChildren’s Centres.

1.Preparing yourteam forworking withfathers.

How to engagewith fathersFathers Direct has produced the followingrecommendations for ways of improvingmaternity services’ engagement with dads,none of which should cost extra money –although you may find that some of thesuggestions for specialised interventions withfamilies with additional needs and familieswho are frequently excluded, will cost more.

Confidentiality for dadsGood maternity practice requires confidential engagement withmothers (that is, talking to them alone at some point). Thisbriefing suggests an extension of this practice to provide fatherstoo with opportunities for confidential engagement - a chanceto reveal hidden resources or risk factors, or to raise worriesand concerns that he is reluctant to burden his partner with.


17


16

2.Creating waysfor fathers toaccess yourservice

Engage fathers inpre-conceptionadvice and supportProvide pre-conception advice toboys and men. Invite them toconsider including their sexualpartner in the consultation, andsimilarly when providing pre-conception advice to girls andwomen, invite them to considerincluding their sexual partner inthe consultation.

Register fatherswherever possibleGenerally create an expectationthat all fathers should engagewith the service. Some fathersshould not be included and yourservice should agree criteriadefining when this is appropriatefor example if he is threateningto staff or if the mother objectsto his presence - but otherwisework on the basis that theyshould be involved.

Communicate that your serviceroutinely engages with fathers aswell as mothers - and explainwhy this is important formaternal and child health, whichare greatly affected by theinvolvement of prospective andnew fathers in supportingmothers and directly caring fortheir children. It is important thatyour service offers fathers theopportunity to reflect on thechanges they are facing, and tobecome clearer and moreconfident about their new roles.Some fathers may also havespecific concerns that they wantto discuss - e.g. about how thepregnancy is going, their owncapacity to fulfil their new role,the mother's welfare, theirrelationship with the mother, andso on.

If the father comes into contactwith your service, record hisname, contact details and otherrelevant information. Explain whythis information is needed for thebest care of the mother andbaby, and explain the extent ofconfidentiality. If the father isuncomfortable with having suchinformation recorded, ask forjust enough to be able to stay intouch, such as a phone number.Emphasise that he can ask for itto be amended or removed atany time.

If the father is not present, it isimportant to explore routinelywith the mother, while enquiringgenerally about familycircumstances, the potentialbenefits to her and the baby ofthe father engaging withservices. There may be reasonswhy it is not safe or appropriatefor the mother to attend with thefather but, in general, researchshows that most mothers willwelcome the opportunity for thefather to receive support andinformation about his role in thebaby’s life, and in supportingthe mother. This is usually thecase even where mother andfather are not living together.

If the mother consents, youshould record the sameinformation about him, notingthat he was not present. Thencheck what contact can bemade directly, or encourage themother to introduce him to theservice. You should explain tothe mother the extent ofconfidentiality - and that theservice will inform the father thatit holds data about him, explainto him why, and advise himwhom he can contact if hewants to check its accuracy orhave it removed(27).

“ The vast majority of fathers -whether or not they live with theirchildren day to day - have acrucial role to play in giving theirchildren the best start in life.

Their ongoing commitment,together with active interest andinvolvement in all aspects of theirchildren’s life and development,really matters enormously.

But I also think that many fathersfeel that their role is undervaluedand isn’t recognised by society asa whole; and that they do notfeel supported in this role bypublic services or receive thehelp they need.”

Rt Hon Beverley Hughes MP,Minister for Children

Attitudes aboutfathers to discuss infather-inclusivepractice training

Underlying attitudes towardsmen that may never bediscussed in the open canoften get in the way of aservice engaging with themconstructively. These aresome of the provocativelynegative statements thatstimulate debate at FathersDirect training courses forprofessionals.

Through them, participantsexplore what they really thinkabout men and women andhow this influences theirpractice:

“A father cannot cope withchildren without a woman tohelp him.”

“Fathers are not particularlyinterested in caring forchildren.”

“Men are not able tochange.”

“Men are worse at ‘multi-tasking’ and less cooperativeand so they are less good atparenting and cannot learn.”

“Men who are veryinterested have a secretfathers’ rights agenda.”

“A teenage father is notinterested in his child and isavoiding his responsibilities.”

“Men are intrinsically violentand cannot change.”

“Men are much more likelyto harm a child than awoman.”

“A man showing concern fora child in a public place issuspect.”


19


18

The Healthcare Commissionasks every maternity service inEngland every year, as part ofits mapping of maternitypractice, whether or not itprovides antenatal educationfor fathers.

It is best specifically to advertisethese services to “mothers andfathers” and to avoid using theterm “parent” which iscommonly understood by bothmen and women to meanmothers only. Also avoid the useof such terms as “group”,“education” or “class”:advertising your intervention as“how to” information sessionsfocussed on the future baby, forexample, is likely to attractmore dads.

Schedule antenatal sessions atdifferent times of theday/evening/weekend to involvemothers and fathers withdifferent working patterns.

Recognise in your antenatalsessions that fathers’ concernsand experiences may differ frommothers’, and provideopportunities to address theneeds of both, either separatelyor together. Adaptation ofantenatal education to theparticular needs of fathers hasbeen found by researchers to bevital for its effectiveness. Someservices provide men-onlysessions; others have sessionsfor both parents where men andwomen divide for a shortperiod; others always work withcouples, but are careful toaddress the needs andexperiences of both parentsthroughout.

Sometimes single-sex classesare necessary for mothers andfathers. Some minority ethnicmothers or mothers involved inviolent relationships may needclasses for women only. Somemen and women, particularlythe very young, can be moreat ease in a single-sexenvironment

Ask fathers whatconcerns them.Research showsthat commonly theyhave the followingissues uppermost intheir minds:• What happens if something is

wrong with the baby?

• What can I do to help mypartner through thepregnancy?

• What happens if somethinggoes wrong at the birth?

• What if I am not ready to bea father?

• What will happen to ourrelationship?

• How can we still earnenough money?

In relation to the question ofwho cares for the baby and whoearns money, considerstimulating discussion aboutwhether parents want to shareroles or not. For some ideasabout how to broach thissubject, see the next page.

3.Designingantenatalservices tosupportfathers

Antenatal education that hasbeen specifically designed toaddress fathers’ concerns iscorrelated with substantiallygreater likelihood of theirutilising support, undertakinghousework, being more likely to‘reason’ with their partners, andreporting better couplerelationships(28).

A brief, inexpensive US antenatalintervention, consisting of oneantenatal session with parents inseparate gender groups focusingon issues of first-timeparenthood, was associated withmothers’ reporting greatersatisfaction with the sharing ofhome and baby taskspostpartum(29).

A randomized controlled trial ofan antenatal intervention withlow-income fathers (two sessionsof factual information, practicalskills training and bondingexercises) found substantiallygreater information-retentionand parental sensitivity onemonth postpartum among theintervention group comparedwith the control group(30).

Where it is clear that there arerelationship difficulties, refer toappropriate local agencies, suchas Relate, on the grounds that apoor parental relationship is akey risk factor for the motherand baby.

Other issues, including fathers’mental health, use of violence,substance abuse and rejectionof the pregnancy should alsoinvolve referral: maternalantenatal stress is correlatedwith negative birth anddevelopmental outcomes.

With the mother or with thecouple, assess the role of thefather when developing thecare plan – e.g. the support/riskthat he represents, or hislifestyle and how this mightneed to change, or therequirements of the mother inrelation to his role(31).

Establish the father’s knowledgeabout pregnancy, birth, thepostnatal period and parentingand address any misconceptionshe may have. Awareness ofcultural and religious differencesbetween ethnic groups isimportant in this regard and canbe researched with localfamilies(32).

Access the father as a potentialsource of information on themother’s needs andexpectations, establishing anopen and supportive relationshipwith him(33).

Provide images of fathers in yourantenatal settings andappropriate men’s interestmagazines in the waiting areas.Use DAD posters, packs andcards, available at www.dad.info.

Consider specialist antenatalsupport for families withadditional needs or for particularminority ethnic communities.Examples of specialist supportmight include specialist workers,specialist sessions, specialmaterials. Larger services canconsider employing a fathers’worker to engage with fathers,in particular young, black andminority ethnic, other sociallyexcluded fathers, or fathersin prison.

Consider running smokingcessation classes for smokingcouples: not only are mothersless likely to give up if theirpartner smokes, but whenexpectant and new fathers areaddressed directly they are morelikely to give up or smoke out ofthe house. For more details onthis, see the research review inthe maternity services section ofwww.fathersdirect.com.

Ensure fathers are aware of thesymptoms of postnataldepression, know where to turnfor help, and have a goodunderstanding of new mothers’experiences: fathers are themost usual support persons.

“ Involvement of prospective and new fathers in a child’s life is extremelyimportant for maximising the life-long well-being and outcomes of thechild (regardless of whether the father is resident or not). Pregnancyand birth are the first major opportunities to engage fathers inappropriate care and upbringing of children.” National Service Framework for Children, Young People and Maternity Services 11, 5.6

Publicise and schedule antenataleducation to optimise fathers’ attendance

Be specific aboutmeeting fathers’ needs


• Talk about the vital importance ofmothers and fathers agreeing what therole of the father is in the first year; andof being prepared to re-evaluate this astime goes on.

• Consider whether the father has anychoice about whether he works or looksafter the child.

• Discuss the huge variety of different waysthat mothers and fathers organise workand care - to demonstrate that coupleshave something to discuss and negotiatein order to find their own way.

• Stress the importance of practice inbabycare. Men are not inherently lessable to care for babies - some are goodat it naturally, some not so good - justlike mothers. The key is practice: 45minutes a day is sufficient practice toreach high skill levels with a baby.

• Greater father involvement in infant careand other household tasks is correlatedwith lower parenting stress anddepression in mothers(34) and withheightened parenting satisfaction(35) andresponsiveness(36) in fathers.

• Some mothers (particularly depressedmothers, or mothers who have fearsabout their own competence) want to bein complete control of the father’s caringactivity; other mothers (or fathers) workvery long hours; some fathers who wereinitially highly involved may reduce theirinvolvement later. Such situations, whichmay develop slowly without the parentsnoticing, can lead to real unhappiness.Help parents set up systems for talkingwith each other regularly about theirroles, without blame or hostility.

• Discuss the negative impact on fathersand on couple relationships of extremeskill differences developing betweenmother and father through which thefather may become marginalized, and themother overburdened, in the home.

• Statistics show that some sharing ofresponsibilities is correlated with greatersatisfaction for both mothers and fathers,including in families with traditionalbeliefs about motherhood andfatherhood. And research has shown thatduring the first year, it is common formothers and fathers to becomeincreasingly dissatisfied with their ownrole and with their partner’s roleperformance(37). It is really worth raisingthese issues with parents in advance ofthe baby being born.

Discussingparentaldynamicsafter thebaby is born

20

The following are issues that can have a profoundimpact on the quality of care of the baby and onmaternal health and wellbeing in the first year.



23


22

4.Supportingyoung fathers

It is widely accepted that teenagepregnancy requires targetedservices, and the inclusion ofyoung fathers in these services isof particular importance.Interagency working is vital here:young fathers, like youngmothers, also need to bereferred, as appropriate, toagencies such as Connexions,for help with housing,education, employment andhealth issues. These agenciescan also refer young fathers tomaternity services.

At Fathers Direct we havereviewed the evidence onteenage parents; below aresome of the main findings. Therest, and the references for thefacts cited below, are availableat www.fathersdirect.com in thereview of research accessiblefrom the home page.

• Young men are in general lessknowledgeable about sex andrelationships than youngwomen, but they rate sucheducation when they get itmore highly than the youngwomen do.

• Young fathers often face familyrejection and believe they areunwelcome and inadequate asparents. The roles of fatherand adolescent can conflict.

• Young fathers are a highlydisadvantaged group andare far more likely to bedisadvantaged thanolder fathers.

• Young fathers' experiences ofmaternity services are oftenunsatisfactory, and this maybe particularly true foryoung fathers from minorityethnic groups.

• Young fathers are much moreinterested in fatherhood thanservices think they are.

• Young fathers are much morelikely to be in a relationshipwith their baby’s mother thanservices think they are.

• Most young mothers want theirchild to have a positiverelationship with his or herfather: to assume the father isnot interested and to fail toaddress him usually ignoresthe mother’s wishes.

To fail to assess and address thebaby’s father may, indirectly,increase risk to the infant. Forexpectant teenage mothers, lackof perceived support by thefather of their baby is a keycorrelate of high scores in theChild Abuse Potential Inventory.Decreased involvement by thefather is also associated withincreased stress on the part ofthe mother.

To fail to assess and addressthe baby’s father may increasethe direct risk to the infant fromhis own psychopathology orfrom risky behaviours in whichhe is engaged.

The relationship between theyoung parents is key to thecontribution that young fathersmake to the wellbeing of thebaby. Fathers are more involvedif the mother has greaterrelational capacity.

Vulnerable children (as thechildren of young parents aremore likely to be) are in thegreatest need of ongoing positiverelationships with their fathers.They tend to do worse thanbetter supported children whenfather-child relationships arepoor or non-existent; and toexperience greater benefits fromthe ‘buffering’ effect of a positiverelationship with a father whenexposed to a wide variety of risksand problems.

Try these good ideas forworking with young fathers whichwere put forward by midwives ata conference of teenagepregnancy midwives in 2002.

• All-male antenatal sessions,or part-sessions, work well -men talk a lot more abouttheir feelings and worriesamong men. A frequentphenomenon in mixed sessionsis fathers remaining silentduring them, and then queuingup to ask questions individuallyat the end.

• The fundamental purpose ofantenatal sessions is not toimpart knowledge, but tocreate the opportunity forsocial support and the buildingof confidence.

• Where the parents are veryyoung indeed, or there is a bigage difference between themother and father, one-to-oneengagement with both of themis particularly advisable.

• Use laminated pictures. Placeface down on the table andturn them over as a stimulusfor discussion. Pictures can bevaried - funny, sad, sexy,pictures of food, alcohol,unusual situations.

• Some services useincentives for mothers andfathers to attend. They maygive £10 vouchers fromlocal shops to fathers attendingat least four antenatal sessions,for example.

• The gender of the personworking with the father doesnot much matter to thefathers – genuine interest andrespect is the key. However, aman “modelling” positive,involved fatherhood can be ahuge benefit.

• When working with youngparents it can be important towork also with their friends(peer pressures may detach ayoung father from his child)and with their wider families:young fathers’ engagementcan be helped, or hindered, bytheir own parents and by theyoung mother’s parents.

• Mothers have notes they takehome and fill in duringpregnancy. Fathers shouldhave them too as this helpsthem recognise and reflecton their own experience ofthe pregnancy.

• Start antenatal support byasking what fathers (andmothers) actually want fromgroup, couple or one-to-onesupport. Keep checking in onthis as time goes on: newissues are sure to emerge.

• Young fathers really do want toengage – almost all of them.

• Sometimes young couplesneed to be seen on their own,without the presence of theyoung mother’s ownsupporters, for example hermother. Her friends or familycan get in the way of hissupportiveness. Sessions withyoung dads may work best outof hours and near to wherethey live.

Recognise that young fathers, particularlyteenagers, may have different needs

“ If our country recognises that (parents sharingroles) is a worthy goal, then we should make iteasier for fathers to do so through a legal andcultural expectation of substantial involvementwith their children from the earliest stages.”

Kathleen Marshall, Scotland’s Children’s Commissioner


2524

Difficult fathersWhat can you do with fatherswho present as hostile, ‘difficult’or reticent?

Recognise that such behaviourmay represent a sense ofalienation or other problem thatcould obstruct the health andwelfare of mother and baby.Sensitive practice, perhapsworking with the father alone,may resolve more minor issues.When the problem is one thatexists between the parents, it isimportant not to align with oneagainst the other: if you do notfeel skilled in handling coupleconflict, you may need to referon. If you need to exclude afather whose attitude orbehaviour is disruptive, seek toensure that his needs are met byanother route, for the sake ofthe mother and baby.

As necessary, liaise withappropriate other services – forexample youth services, drugs &alcohol services, Brook Advisory,mental health services,community organisations,employment, education andtraining, domestic violenceservices.

Some pregnant womenaccessing local maternityservices will be experiencingdomestic abuse usually fromtheir partner. Advice for healthprofessionals on how to engagewith women and childrenaround these issues is containedin Responding to domesticabuse: a handbook forprofessionals (Ref:www.dh.gov.uk/assetRoot/04/12/66/19/04126619.pdf). Most domestic abuseis carried out by men againstwomen. However, theHandbook states that much ofits guidance can also beapplied to men and those insame sex relationships whoexperience domestic abuse,who deserve the same respectand support if they turn tohealth professionals for help.

Where the pregnant woman isexperiencing domestic abuse,this puts her and the baby atrisk. Services have anobligation to provide all supportpossible, so that she is not leftto deal with the problem alone.

Express a zero-toleranceposition about domestic abuse.Make everyone using the serviceaware that domestic abuse isunacceptable and can lead tocriminal convictions. Thiscommunicates to all mothers,fathers and staff that domesticabuse is absolutely wrong,dangerous and must be tackled.

You need to know where tosignpost anyone experiencingdomestic abuse for furthersupport. The handbook containsa list of useful contacts. If thereis a disclosure of abuse, makesafety issues the first priority. It isvitally important that informationand accurate recording ofabuse is kept confidential.Without confidentiality, peopleexperiencing domestic abuseare less likely to talk about theirexperiences. Their physicalsafety can depend upon it.

However there are limits toconfidentiality and there will beoccasions when safeinformation sharing will benecessary to appropriatelysafeguard adults and children.

In individual antenatal sessionswith mothers and fathers (wherethese are happening), givespace to each to raise the issue.Training in asking sensitivelyabout domestic violence isavailable, and is more likely touncover it, where it exists.

Men who are looking for adviceon how to stop their abusive orviolent behaviour towards theirpartners should be signpostedto Respect, a national charitywhich has a database ofprogrammes for maleperpetrators of violence.Their helpline number is0845 122 8609.

Be aware that most fathers arenot abusive and, indeed, canoften be a source of protectionfor mothers and babies insituations of risk (e.g. where thethreat is from a third party).

Dealing with difficult and violent fathers

Domestic abuse is defined by theHome Office as "Any incident ofthreatening behaviour, violence orabuse (psychological, physical, sexual,financial or emotional) betweenadults who are or have been intimatepartners or family members,regardless of gender or sexuality."

Fireworks fizz all around, when hecomes into my eyes.

He makes me laugh, with his smile!

He’s my flame in my life, and guided mewhen I was young through the world.

One shoulder to cry on when I’m sad,someone to rely on when I’m BAD!

My only man who’s truthful, cunning and kind.

A special person who’s as cuddly as a bear.

A shining sun who looks out for me anytime.

A flowing river that will never stop.

My guardian angel in the sky, that fliesabove me all the time

The bestest man...he’s my knight in shining armour.

When I win I do him proud, he smiles andsmiles and cuddles me now.

Guess…Guess… who is this AMAZING man?…..Who else but my DAD!!!

Jenny (Yr6)

If you look at the sky at night

You will see that there are no more stars.

And it’s all your fault.

Because every time I miss you a star falls from the sky

And I have missed you so much that

There are no more stars in the sky

And soon no moon

Dunia (11)


Domestic abuse in the perinatal period

“Messages to Dad”

from a Fathers Direct poetrycompetition for primary schoolchildren, held in 2004


27


26

5. Tailor theinformationyou give tofathers

Provide informationto both parents thatis responsive totheir needs, non-directive, andsensitive todevelopmental,cultural, social andlanguagedifferences(38). Makeinformation youprovide sensitive togender differences.

Ensure that fathers have goodinformation about key healthissues: smoking, diet, drugs &alcohol, breastfeeding, mentalhealth, including post nataldepression.

Provide both parents withinformation about servicesavailable to mothers and fathersbeyond the maternity service.

Consult with mothers andfathers about their informationneeds through the MaternityServices Liaison Committee.

Give the DAD card to all yourfathers (see inside front coverfor more details).

Promote the Department ofHealth’s Life Check programmeto both parents.

Express zero tolerance todomestic violence in informationtargeted at mothers and fathers(for more ideas on dealing withdomestic violence see page 24).

Provide targeted information forfamilies with additional needs orfamilies that are frequentlyexcluded (see note ondefinitions on page 7). Inparticular consider specialinformation for very youngfathers. Their expectations maybe so reduced that many do notknow what they need to knowand do not expect to beinformed at all.

6. Involvingfathersat scans

Make a specialeffort to get fathersto attend scansFor both parents, the scan is animportant step in thepreparation for parenthood,with the father’s presence oftenvery important to the mother,particularly if the news is notgood. Consider a designatedtime and place for youngmothers’ scans, and encouragethe dad to be there.

Here are two typical storieswhich illustrate how importantthe father can be at this point inthe pregnancy:

“ When I was pregnant for thesecond time, I attended a 14week scan without my husband(he was looking after our sonwho was ill). At the scan I wastold there was no heartbeatand the baby had died. It wasthe most horrific moment ofmy life and I needed myhusband with me more thananything. He has never misseda scan since and has beenthere to support me when asecond miscarriage wasdiagnosed at scan and when,in my current pregnancy, apotential problem wasidentified. I think it is essentialfor the father to be there, it ishis baby too and importantnews affects him as well.”

Julie, 37

“ Two weeks later we wenttogether for the follow upscan, where it was confirmedthat the foetus was notdeveloping. I was not able tosee the screen, but Ed saw itall, and asked them to showme (I wouldn't have had thecourage). That was the singlemost important thing inunderstanding and copingwith my miscarriage - seeingthe sad, sorry state of the tinyfoetus. But without Ed there Iwould not have been able tosee that.”

Emma, 35


29

8.Supporting thefather afterthe birth Provide opportunities for the

father to bond with the babyand encourage this – forexample, holding the baby for asustained period while themother sleeps or rests. Allowparents to stay together with thebaby as long as they like,day and night.

Provide opportunities for bothparents to de-brief on theexperience of the birth, evenbirths considered normal fromyour perspective.

Ensure that the father, as well asthe mother, gets first lessons inbabycare, such as bathing andnappy changing. Be aware thatsome fathers are afraid of beingclumsy and stupid and mightthink that being a man is theproblem. Give them privacywhile learning and reassurethem that big hands can carefor a baby as well as smallhands! An intrusive and criticalcoach, be it a professional orthe mother, will cause manyfathers to withdraw.

Breastfeeding provides motherswith a ready-made form ofintimacy with the baby. Supportfathers in finding forms ofintimacy with the baby, lest thisbecome a temptation for thefather (and mother) to try tohasten the end ofbreastfeeding (see page 30).

Offer additional support tofathers of premature babies, inthe same way that additionalsupport is provided to thesemothers. Premature babiesincrease parental stress anddepression, but supportinterventions work well.

Some larger services puttogether a pack for fathers,with a variety of items towelcome him to fatherhood.

If you run postnatal sessions,revisit the issues of parentaldynamics discussed onpage 20.

Have special strategies forfamilies with additionalneeds and families that areeasily excluded.

Make sure you know if thefather suffers depression in thepostnatal period and ensurethat it is treated. Paternaldepression is not good for thebaby or the mother. If themother suffers from depression,ensure that the father’s needsare met so that he can be asource of support for the motherand infant. He is at increasedrisk of depression himself if themother is unwell.

Create a partnership with thelocal Sure Start Children’sCentre and specifically refer thefather onto the Centre when yourefer the mother.

Engage with fathers duringhome visits routinely. If thefather is non-resident orfrequently away, make specialarrangements with the motherto ensure he remains included.


28

7.Involvingfathers atthe birth It is important to enable parents

to discuss whether the fathershould be at the birth or not.Find out from the mother andfather what kinds of roles theywould like the father to provide.

If the father is to be present,prepare him in advance for apositive role in providingsupport to the mother duringlabour. Research shows thatwhat makes a difference tomothers is practical supportfrom the father(39).

Provide special preparatorysupport to families withadditional needs.

Be aware of cultural differencesbetween families and how thismight play out in the labourroom in relation to the presenceof the other people. Butrecognise that in every ethnicminority group there isconsiderable diversitybetween families.

When fathers or other labourpartners know a lot about paincontrol, women have shorterlabours and are less likely tohave epidurals(40). Mothers whoexperience support from theirbirth partners (including theirbabies’ fathers) during labourand delivery are less distressed,experience less pain, receiveless medication and feel morepositive about the birthexperience(41) and aboutmotherhood(42).

A positive birth experience for awoman is strongly linked withfeeling in control of the birthprocess, and this is correlatedwith feeling supported by herpartner(43). Fathers who havebeen prepared very well toparticipate productively in thelabour process tend to be moreactive participants, and theirpartners’ birth-experiences tendto be better(44).

Studies repeatedly show highlevels of satisfaction postpartumfor both mothers and fathers insharing the experience of labourand birth, even where fathershave been only minimallyprepared(45). These positivefindings may be associated, insome cases, with the father’scontribution as a generalfactotum on an understaffedlabour ward(46). Fathers’presence has been shown tohelp compensate for poorquality obstetric services(47) andmothers consistently rate theirpartner’s presence to be morehelpful than that of manymedical staff(48).

It is really important to make thedelivery room or birthing suite aplace where fathers arewelcome. Engage with fathersand/or other birthing partnersthroughout the process andoffer practical help to them tobe useful and supportive duringlabour and childbirth. If surgeryis required, reassure the fatherand encourage him to askquestions and understand whatis going on.

Consider encouraging fathers tocuddle the baby skin-to-skin justafter the birth. CatherineCummings, senior midwife atForth Park Maternity Hospital,Fife, says: “Going skin-to-skinwith new babies is a relativelynew thing for fathers and noteverybody approves. But it’sonly cuddling your baby, so whynot? It’s something dads wantto do. And it’s what they’ll bedoing if they’re up half the nightholding the baby. Men havetotally changed in the course ofmy career. When I started out asa midwife 23 years ago,holding the baby in the deliveryroom was not where men weresupposed to be. Now it’s turnedon its head. It’s wonderful andskin-to-skin contact does help tobond fathers and children.”

If, immediately after the birth,the father gets a camera out,suggest that at least one picturehas him in it(49)!

Prepare fathers forbeing at the birth

Make the birthenvironmentwelcoming tofathers

Ensure the father hassupport after the birth


1. Gershuny J (2001) Changing Times.New York: OUP. Equal OpportunitiesCommission, 21st Century Dad(June 2006)

2. From a high-quality analysis ofMillennium Cohort data. Kiernan, K.,& Smith, K. (2003) Unmarriedparenthood: new insights from theMillennium Cohort Study. PopulationTrends, 114, 26-33. London: Office ofPopulation, Censuses and Surveys.4.NSF, Standard 1, p.31; Standard 1,3.25; Standard 3, p.88

3. NSF Standard 1, p.31; Standard 3,p.88

4. See Ref 2

5. The NSF defines the word “parent” tomean “mothers, fathers, carers andother adults with responsibility forcaring for a child”. [Setting the Scene,p.18; Standard 2, p.65]

6. Kiernan, K., & Smith, K. (2003)

7. See Ref 5

8. See the research review in thematernity services section onwww.fathersdirect.com

9. NSF Standard 2, p.65.See also Standard 1, 4.4

10. NSF, Standard 11, 9.1

11. NSF, Standard 11, page 4

12. See studies cited by Lamb, M.E.(1997). The Development of Father-Infant Relationships. In M.E. Lamb(ed) The Role of the Father in ChildDevelopment (3rd edition). New York:Wiley.

13. Flouri, E. (2005). Fathering and ChildOutcomes. Chichester: Wiley.

14. Quinton, D., Pollock, S., & Anderson,P. (2002). The Transition toFatherhood in Young Men: Influenceson Commitment. Summary of KeyFindings. Bristol: University of Bristol,School for Policy Studies.

15. Pollock, S., Trew, R., & Jones, K.(2005). Young black fathers andmaternity services. London: FathersDirect.

16. Flouri, E. & Buchanan, A. (2003).What predicts fathers' involvementwith their children? A prospectivestudy of intact families. British Journalof Developmental Psychology 21, 81-97.

17. Aldous, J., Mulligan, G.J., &Bjarnason, T. (1998). Fathering overtime: what makes the difference?Journal of Marriage and the Family,60, 809-820; Beitel, A.H., & Parke,R.D. (1998). Paternal involvement ininfancy: the role of maternal andpaternal attitudes. Journal of FamilyPsychology, 12, 268-288.

18. Hwang, C.P., & Lamb, M.E. (1997).Father-involvement in Sweden: alongitudinal study of its stability andcorrelates. International Journal ofBehavioural Development, 21, 21-632.

19. For a recent summary see Pleck, J.H.,& Masciadrelli, B.P. (2004). PaternalInvolvement by U.S. ResidentialFathers: levels, sources andconsequences. In M. E. Lamb (ed)The Role of the Father in ChildDevelopment: 4th edition. Hoboken,NJ: John Wiley & Sons.

20. NSF, Standard 11, 5.6; Cowan, C.P.(1988). Working with men becomingfathers: the impact of a couplesgroup intervention. In P. Bronstein &C.P. Cowan (eds) Fatherhood Today:Men’s changing Role in the Family.New York: Wiley

21. Lewis, C. (1986). Becoming a Father.Milton Keynes: Open University Press;Lupton, D., & Barclay, L. (1997).Constructing Fatherhood: discoursesand experiences. London: SagePublications.

22. NHS Maternity Services QuantitativeResearch (2005)

23. Watson, J. (Nov 2005). ‘Sex equalityfit for the 21st Century: a keynotespeech by the Chair of the EqualOpportunities Commission’.London: IPPR

24. MSLC Guidelines 1.2, 1.10, 3.12,3.15

25. MSLC Guidelines 3.13

26. MSLC Guidelines 4.6

27. This guidance complies with dataprotection law.

28. Diemer, G. (1997). Expectantfathers: Influence of perinataleducation on coping, stress, andspousal relations. Research inNursing and Health, 20, 281-293.

29. Matthey, S., Kavanagh, D. J., Howie,P., Barnett, B., & Charles, M. (2004).Prevention of postnatal distress ordepression: an evaluation of anintervention at preparation forparenthood classes. Journal ofAffective Disorders, 79(1-3), 113-26.

30. Pfannenstiel, A.E., & Honig, A.S.(1995). Effects of a prenatal‘Information and insights aboutinfants’ program on the knowledgebase of first-time low-educationfathers one month postnatally. EarlyChild Development and Care, 111,87-105

31. Skills for Health National WorkforceCompetences for Midwives.



34. Fisher, J.R.W., Cabral de Mello, M.,Patel, V., & Rahman, A. (2006).Maternal depression and newbornhealth. Newsletter for the Partnershipof Maternal, Newborn & ChildHealth, 2. Geneva. Documentavailable at www.pmnch.org.

35. Barclay, L., & Lupton, D. (1999). Theexperiences of new fatherhood: asocio cultural analysis. Journal ofAdvanced Nursing, 29(4), 1013-20.

36. Donate-Bartfield, D., & Passman,R.H. (1985). Attentiveness of mothersand fathers to their babies’ cries.Infant Behaviour and Development,8, 385-393.

Zelazo, P.R., Kotelchuck, M., Barber,L., & David, J. (1977, March).Fathers as men: an experimentalfacilitation of attachment behaviours.Paper presented at the meeting of theSociety for Research in ChildDevelopment, New Orleans.

37. Killoran Ross, M. (2001). Promotingthe transition to first-time parenthood.British Journal of Midwifery, 9(6),562-566; Lupton, D., & Barclay, L.,(1997). Constructing Fatherhood:discourses and experiences. London:Sage Publications.

38. NSF, Standard 3, pp.88 and 93;Standard 2, p.65; Standard 11, 7.3

39. Ip, W.Y. (2000). Relationship betweenpartner’s support during labour andmaternal outcomes. Journal ofClinical Nursing, 9, 265-272.

40. Studies cited by Enkin M.W., Marc,J.N.C., Kierse, M.J.N.C., Renfrew, M.,Neilson, J., Enkin, E., et al. (2nd ed.)(1995). A Guide To Effective Care InPregnancy And Childbirth, (2nd ed.)Oxford: Oxford University Press.

41. For review, see Tarkka,M.J,,Paunonen, M., & Laippala, P. (2000).Importance of the Midwife in theFirst-time Mother’s Experience ofChildbirth. Scandinavian Journal ofCaring Science, 14, 184–190;Anderson, B.J., & Standley, K. (1976).A methodology for observation of thechildbirth experience. Paperpresented at the meeting of theAmerican Psychological Association,Washington, D.C; Henneborn, W.J.,& Cogan, R. (1975). The effect ofhusband participation in reportedpain and the probability ofmedication during labor and birth.Journal of Psychosomatic Research,19, 215-222.

42. Mercer R.T., Hackley, K., & Bostrom,A. (1984). Relationship of the birthexperience to later motheringbehaviors. Journal of NurseMidwifery, 30, 204–11.

43. Gibbins, J., & Thomson, A. M.(2001). Women’s expectations andexperiences of childbirth. Midwifery,17(4), 302-313.

44. For review see Diemer, G. (1997).Expectant fathers: Influence ofperinatal education on coping, stress,and spousal relations. Research inNursing and Health, 20, 281-293.

45. Chan, K. K. L., & Paterson-Brown, S.(2002). How do fathers feel afteraccompanying their partners inlabour and delivery? Journal ofObstetrics and Gynaecology, 22(1),11-15.

46. Hayward, J., & Chalmers, B. (1990).Obstetricians’ andmothers’perceptions of obstetricevents. Journal of PsychosomaticObstetrics and Gynaecology,11(1).

47. Levitt, M. J., Coffman, S., Guacci-Franco, N., & Loveless S. (1993).Social support and relationshipchange after childbirth: anexpectancy model. Health CareWomen International, 14, 503-512.

48. Spiby, H., Henderson, B., Slade, P.,Escott, D., & Fraser, R.B. (1999).Strategies for coping with labour:does antenatal education translateinto practice? Journal of AdvancedNursing 29, 2, 388; Klein, R.P., Gist,N.E., Nicholson, J. & Standley, K.(1981). A study of father and nursesupport during labour. Birth and theFamily Journal, 8, 161-164;Llewellyn-Smith, J. (2006). HardLabour. First Person. July. London:The Observer Newspaper.

49. The author of this briefing remainsforever grateful to the midwife whothought of this at the birth of his firstdaughter, complete with the fetchingblue hat required at the emergencycaesarean section!

References


30

Five ways fordads to getclose to theirbabies

1. GazeFathers, like mothers, can enjoymutual gaze with a baby for theshort periods before the babybecomes tired. This is part of thedevelopment of the baby’s brain.

2. Cuddlingand settling

Almost all babies can stretchtheir parents beyond endurance!Having two people who haveacquired the skill to comfort thebaby can be an enormous reliefand a source of great personalachievement for both parents.And it may help to preventShaken Baby Syndrome.

3. MassageThere is a whole technique formassage, well described inbooks and DVDs.

4. PlayThere are appropriate forms ofplay even for the smallest ofbabies and fathers can learnthese. Some fathers think play isa key role for fathers and canfind their newborn babyunresponsive before they knowhow to play with a baby.

5. BathingMake sure the baby does notleave the maternity wardwithout the father having had alesson in bathing.

Including New Fathers A Guide for Maternity Professionals

Copies cost £4.95 and are available fromFathers Direct.

Fathers Direct, a registered charity, advises Government onhow to adapt policy to the increasing role of fathers in caringfor their children. Fathers Direct is represented on theMaternity Services Implementation Advisory Group at theDepartment of Health.

Around 1,000 people with a professional interest in improvingtheir engagement with fathers attend Fathers Direct eventseach year. The organisation is the UK’s leading provider oftraining and consultancy to family and children’s services onfather-inclusive practice.

To learn more visit www.fathersdirect.com, in particular thesection on maternity, call our telephone helpline forprofessionals on 0845 634 1328.

Including New FathersA Guide for MaternityProfessionals


copies cost £4.95 and are available from fathers direct

Documents