Get the Fathers Involved

by Andrea Robertson

Many midwives complain that fathers are “useless” in the labour ward – they sit and read the paper, hang about nervously getting in the way, or get agitated and upset and create anxiety for the labouring woman. Some hospitals still insist on antiquated rules such as “only one support person with the woman at a time” even though the research is clear that good social support makes labours faster and less painful for women. In these hospitals, the woman often has to rely on the father because she cannot have a female friend, and the poor father finds himself thrust into the role of having total responsibility for her comfort and welfare – enough to make even the strongest of men fearful and insecure.

Many men (not all) want to help their partners during birth and welcome the chance to bond at birth with their child. If they are to make the most of this opportunity, they need insight and information so that they too can prepare for what may occur. It is unfair to expect them to provide practical help and emotional support if their own needs have not been met, and if they have no training in what to do.

Involving men in comprehensive pre-natal education programs makes good sense. Working as a team, the couple (and any extra support person the woman has invited) learn practical self-help measures, and take at look at dealing with their fears and expectations. If the program is carefully designed to include men and to acknowledge their particular contribution, not only can everyone have fun, but much valuable learning applicable to all aspects of parenting can also take place.

What works in pre-natal classes? Some tried and true ideas for specific activities follow. When you incorporate these into your program, think about how they fit your overall aims for the classes, and take time to present them clearly and evaluate them afterwards, so that you can refine your presentation based on the feedback you receive.

Men only group discussions

Try small group work where men work by themselves on topics that is relevant to them. This offers a chance for the men to support each other and discuss themes of mutual interest. Providing these opportunities is an acknowledgement of their special perspective as a male partner, and recognises their importance, at a time when the woman is usually the main focus of attention. Good discussion starters are:

• “The positive, negative and interesting aspects of this pregnancy for me”
• “Comfort measure I can offer her during labour”
• “Things I can do for my partner during labour”

Exploration of emotional needs

A “worry box” where anonymous comments or questions can be posted for later discussion in class can work well. The box can be emptied at the beginning of the class, and any concerns immediately addressed before starting into the main program.

A new father visiting the group to talk about his experiences will open up discussion about roles and responsibilities. Specific open ended questions can be posed by the leader to elicit discussion on specific aspects:

• “What did it feel like to be present during the labour?”,
• “What was the hardest thing you had to do during the birth?”,
• “How has the new baby changed your daily routine?”

Practical problem solving

Men like action, and taking charge in a situation appeals to their sense of protectiveness and responsibility. It also means doing something, which often feels a lot more comfortable than feeling helpless and vulnerable. There are many class activities where you can encourage men to get involved around the process of problem solving:

“What if” scenario cards that describe possible labour or parenting issues that need resolution.

Role plays can offer valuable practice in assertiveness and problem solving by “walking through” situations and rehearsing responses and experimenting with other strategies. Role plays don’t necessarily have to involve “acting” – any imaginary situation, even creating word pictures, in which people are asked to imagine a response or pretend participation, can constitute a role play. Be careful to make this involvement in the third-person to avoid setting people up with expectations. For example, creating a word picture around a hypothetical woman in labour and asking the man to imagine what her partner could do for her is safer than asking him to imagine his own partner in labour.

• Compiling lists of actions that can be taken in certain circumstances can be useful. For example:
• “What can be done if the waters break and there are no contractions?”,
• “What could help if she feels out of control in transition?”,
• “How can you tell when labour really has started?”

Visiting the labour ward to find out how it works, and where everything is. This is best done as a practical rehearsal, with the couple practising together how to use the chairs, bean bags and floor mats, where to find a bed pan, how to get refreshments for themselves, how to find and set up the bath and shower, how to move the bed, find extra towels etc. “Hands on” is important here – if we tell them to “look but don’t touch” we are treating them like children, and they will feel put down, uncomfortable and unwanted.

Often the biggest question for the men is “when do I take her to the hospital?” and this is one scenario you will need to address. Since this is probably one of the main reasons they have come to classes in the first place, if you can tackle this one early on, then the men in the group are likely to feel you have really addressed their needs and be ready for more!

Men are a wonderful addition to the pre-natal group. They offer different perspectives, valuable insights and bring a wealth of skills from other areas of their lives that can be applied to childbirth and parenting. The more we involve them during the pregnancy, the more comfortable they will feel in the labour ward, and this will be of benefit to everyone.

Published in The Practising Midwife Vol 2 No 1, Jan 1999