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Fathers at birth

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One of the subjects debated at the recent RCM student conference was on whether fathers should be present at childbirth. The prevailing view is that fathers provide vital support for mothers, but some say they should be banned from the delivery suite as their presence causes a longer, more difficult birth.

Have you generally found fathers' presence a help or a hindrance?
Topic created By - Rhea Johnson (29 January 2010 - 15:12:10) One of the subjects debated at the recent RCM student conference was on whether fathers should be present at childbirth. The prevailing view is that fathers provide vital support for mothers, but some say they should be banned from the delivery suite as their presence causes a longer, more difficult birth. 
 
Have you generally found fathers' presence a help or a hindrance?

Responses

Submitted By - Guest 29/01/2010 17:47:03 I am old enough to remember when fathers were certainly not "allowed " to attend the births of their babies in hospitals and we certainly shooed them out of the room at home births, and I remember the fight that fathers and mothers had to have the father present at the birth. Mothers and fathers who wanted fathers to attend were thought to be somewhat weird.  Now the whole situation has changed and the father who does not attend is thought to be unfeeling and the woman who does not want the father present is thought odd.   It is such a personal decision and it should be equally acceptable for the father to attend or not as the couple decides and there should be no condemnation of either decision, and having made a decision to attend both should be able to change their minds.  In the home situation the man can leave the room to, feed the cat, take the dog out, lock the garage and find lots of other domestic reasons to have a break.  In the hospital it is much more difficult for him to leave the room and he is stuck there, sometimes getting more and more upset.  So acceptance of fathers presence or absence should be a couple's decision and the men who want a break should be able to leave the hospital labour room without condemnation.     
Mary Cronk 
Submitted By - Guest 01/02/2010 09:03:47 Although recently retired I have had my doubts over the presence of fathers in the delivery room. 
 
One man stands out, he wanted his baby to be born without any drugs as he had read that they had an effect on breastfeeding and he was very keen on this. His partner was at the end of her tether and when he went to the toilet she begged us to give her something. He was very annoyed to find this out and left the room for a long time. When he did return he was extremely unpleasant to the staff. I do think this woman would have had a better experience without him. 
 
This was an extreme case but happens quite often that the man tries to impose his will on the labouring mother and the midwife, it is always very difficult to deal with and the poor woman does not get the birthing experience she expected. 
Submitted By - Guest 05/02/2010 16:44:00 I have also had this experience- where the partner wanted a 'drug free' birth, even when the lady become distressed in early labour he still insisted on having the last word! 
 
I now use my antenatal classes to discuss the partners' concerns and explain how the ultimate decision is the woman's, as she is the one experiencing the labour pains. 
 
I actively encourage the men to be present in all aspects of the pregnancy and birth.
Submitted By - Guest 01/02/2010 09:05:50 I used to encourage fathers to be present, until I learned from Dr Michel Odent about the negative effect their presence may have on their partners. Then I began encouraging women to have a female birth companion along with their male partner, and found this worked well, as the father could go out if he or the mother felt his presence was not needed or desired. I do not think that men should be expected to take an active role as birthing partner, as many find it hard to witness labour pain, and tend to suggest ways of alleviating it rather than riding it. 
 
I now suggest that parents discuss beforehand what they both wish to do, with the mother's wish and instinct being the more important. I also urge parents to consider the baby first of all; he or she needs the mother's closeness for some time after birth. Uninterrupted contact with the mother is more conducive to easy breastfeeding as it keeps the baby's stress responses low. The father is invaluable as a back up if the mother is unavailable, but otherwise it's better for the baby for Dad to wait to hold the baby until after the first feed. 
 
Alison Blenkinsop, former midwife and lactation consultant 
Submitted By - Guest 01/02/2010 09:09:24 Having worked in the UK and in South Africa with a variety of cultures from all over the world, I agree that it should be a personal decision for the woman and her partner. We are all individuals with individual relationships, and what works for one does not for the other. It is not our (midwives’) decision who should be in the room or not, and surely not our place to judge the decision a woman and her partner makes. Yes, I agree sometimes partners make it more difficult for women as they see their loved one ‘in pain’ and /or expect more medical intervention (cultural expectations), and often we (midwives) bear the brunt of their fear/worry/stress. I feel effective communication is key in such a situation - we need to keep promoting the normality of labour and birth!! It could be as simple as ensuring he has a ‘a break’ from it all by giving him something to do- go get drinks and provisions, fetch the baby bag from car; or get him to do something so he ‘feels part of it all, involved and useful.’ E.g. show him how to massage her back, or get him to run the bath, or be in charge of the music. We provide holistic care - that includes the other part of this family to be- the father of the baby; especially if the couple has decided for him to present at the birth. Antenatal classes should be geared for partners as well -on what to expect realistically, with advise, information and ideas on how to cope.
Submitted By - Guest 01/02/2010 09:11:55 As a mother before anything else, (waiting to become a student midwife) I would not have wanted the choice taken from me. I wanted my husband there and he wanted to be there. You cannot take a woman’s choice or the father’s choice away. This will only push people into not having a midwife present at the birth. My husband was a godsend at my hospital birth and both my home births. My previous partner to my oldest child too was a godsend. Don’t take couples choices away.
Submitted By - Guest 01/02/2010 09:18:00 The woman has the right to choose her birthing partner. DOH 2004 STATED 
''Small changes in the choices people make can make a big difference. Taken together, these changes can lead to huge improvements in health across society. But changes need to be based on choices, not direction. We are clear that Government cannot - and should not - pretend it can 'make' the population healthy. But it can - and should - support people in making better choices for their health and the health of their families. It is for people to make the healthy choice if they wish to.'' 
 
I believe this statement is literally an umbrella for every option presented to a woman by the health professional. 
 
So if fathers are a hindrance at birth - we need to start educating them of the likely event from antenatal clinic when accompanying the women and brief again with the women at the onset of labour. 
 
How can a father’s presence cause a longer, more difficult birth? Are they the one assisting the delivery or delivering the baby? NONE of the above. 
 
CHOICE still remains the woman's RIGHT. I dare to believe women are coerced into allowing birth partners who are not of support to them.   
 
From A.B   
Submitted By - Guest 01/02/2010 09:23:44 There is a flight or fight response which can be stimulated in every labouring mother. This response is located in the old lizard brain, which is out of date. Labouring mothers do not usually labour in a very hostile or dangerous environment. 
 
Many people can activate this in the laboring mother. It can be a mother who has unfinished business with her daughter, and she will be viewed by her daughter's unconscious part of the brain, as a predator. 
 
It may well be a kind male partner who of course has no hostile intentions to his partner, but we are talking about a very primitive response, which does not respond to reason.  In this situation an anesthetic will be required for labour to recommence. 
 
It usually takes a very experienced midwife to detect this, and who has the skills and compassion to deal with this response sympathetically, and professionally. 
 
If the fight or flight response has been activated, in my experience, using the upper body only, strenuous exercise has been found to discharge the surplus adrenaline. This can be done, kneeling or in a supine position. , and then labour can recommence with out undue pain and distress present. 
 
In my view a male partner is no more likely to activate the fight or flight response, than a woman, if he has been trained to assist his partner in how to discharge the adrenaline. 
 
If physical exercise is not undertaken, in my experience the cervix will cease to open, and if action is not taken to discharge the adrenaline, the labour will soon react with failure to progress. Labour will then become painful and protracted.
Submitted By - Guest 01/02/2010 09:28:37 I am a third year student midwife and having just completed my dissertation on fathers’ presence in the delivery room I was able to conclude that they should be able to make the decision and not be ridiculed for whatever decision they make.  The evidence suggests that their presence not only impacts positively on the birth process by providing support but there were no negative implications to him personally.  The main findings highlight the need for individualised support offered to fathers particularly in the antenatal period whereby the parent education classes are predominantly focusing on the woman (which is a good thing), but the need for father only classes, facilitated by men, may be of benefit.  These classes would be realistic of expectations and true experiences, as well as providing them with methods of support that they can provide to their partners.   
 
The choice to attend the birth is one that should be respected by staff and not assumed that because he is not there makes him an unsupportive father. For those who do attend, they should be included as a part of a labouring couple and included in discussion and decision-making. 
 
Jennie Pickering  
Submitted By - Guest 17/02/2010 12:56:34 Jennie 
 
I think you make some very valid points and something I am currently working on. Would it be possible for you to email me as I would like to discuss your dissertation? 
 
Thank you 
 
Dean Beaumont 
deanbeaumont99@aol.com
Submitted By - Guest 03/09/2010 10:05:46 Hi Jennie 
 
I will try again and see if I can get hold of you. I would love opportunity to discuss your dissertation with you as your comments are very close to my beliefs. We have recently gained full FEDANT approval on a training course that will allow us to train men to run men only classes for expectant fathers. I have been running my courses for a year now and they have proved to be extremely successful and the feedback has been excellent. 
 
I am currently the only qualified male childbirth educator in the UK. 
 
Could you email me at deanbeaumont99@aol.co.uk 
 
Thanks 
 
Dean 
Submitted By - Guest 01/02/2010 09:29:42 In my experience to date as a 2nd year student midwife and as a mother too, fathers should be allowed to be present at the birth of their child, unless of course they are extremely squeamish and feel unable to do so.  Occasionally when things deviate from normal it can be difficult to manage both the questions from the woman and her partner, however the building of a good relationship between the midwife and the prospective parents is key, thereby helping in difficult situations. 
 
However on another note I find that when both a partner and mother of the labouring woman are present, problems arise due to conflicting opinions and this may well be attributable to a longer, more difficult birth. 
Submitted By - Guest 01/02/2010 09:31:19 I agree 100%, it should be the couples choice, but if the husband does not want to see the actual birth he can stand where he can not see it, hold the woman’s hand. I had one dad who I literally pushed onto the chair, as he was about to pass out as the baby's head was coming out. So it is up to the couple, but there should be someone of the woman's choice in attendance to support her.
Submitted By - Guest 01/02/2010 09:33:04 I have found that on the whole fathers at the birth are supportive, loving and gentle. However some fathers who feel they have to be at the birth can be aggressive, threatening and judgmental which impacts on the whole birthing experience. It takes a very confident and experienced midwife to manage this situation. I agree with Mary that it should be a decision the parents make together, however having the alternative of a female support during labour can help, both taking frequent breaks, mutual support and encouragement. 
Sharon 
Submitted By - Guest 01/02/2010 14:02:20 As a midwife of nearly 2 years, and a soon-to-be mother myself, in my professional opinion I would never take this choice away from any mother or father to be. Although from a personal perspective, I seriously doubt whether my husband will be able to support me. 
 
Within all relationships there is inevitably one partner who will ‘cope with crisis/pain etc’ better and sadly that is not my partner. I would never take his choice away to be there after all it is his child, but I will be taking another friend with me (also a midwife) as my birth support. 
 
I think there is value to be had in having the support of someone who won't be phased or scared by what they are seeing (which is surely what the midwife is primarily for) and the only way to ensure men are prepared for this is with antenatal education and getting them involved more antenatally. 
 
You can prepare a man to witness labour, but you will never prepare him for the emotional toll of seeing all of that with his partner in the centre role. But by ensuring they are aware of that as a couple BEFOREHAND, they can make decisions about whether the partner will to be the main support or a secondary. 
Submitted By - Guest 19/04/2010 09:45:26 As a 1st year student I have not yet had any negative experiences with fathers being present, but my concern is the long-term effects on the couple's sexual relationship.  There are so many mixed messages in the media regarding sex, pregnancy and breastfeeding etc… and I wonder if some fathers find it difficult to see their wife/partner as a sexual partner after witnessing birth, and whether this has any impact on the rising rate of divorce/separation, as more men feel it is the norm to be present.
Submitted By - Guest 04/05/2010 10:19:31 Hi All, 
 
Most partners in this country are probably not prepared adequately or appropriately to be present in the birthing environment, let alone to be of much tangible use to their partners. I was present at the births of all four of our children and other than the odd bit of back rubbing when instructed and allowing parts of my anatomy to be crushed intermittently, I thought I served no purpose. My wife, however, disagrees. Witnessing the births of our children was brilliant. However, no one had told me what would happen or how I could effectively help my wife through the birth process. I became angry when my wife was obviously in excruciating pain and the midwives could not fix it. From this angle I can understand where Mr Odent is coming from with his comments. However, he had no research-based evidence with which to base his opinions. 
As part of my midwifery degree I looked at the subject of fathers for my dissertation. Part of my findings highlighted that in a small study some years ago it was found that where partners were trained appropriately, their presence at the birth of their respective partners produced comparable results to those of doulas, in that they kept birth normal, reduced pain relief etc. Surely, especially in the current climate where midwifery numbers may well be depleted even more, trained partners may well be the relatively untapped resource our profession needs. 
 
Very interesting thread. 
Ian Kemp 
Midwife. 
Submitted By - Guest 07/05/2010 10:01:51 I have two comments to add to this debate. 
 
Firstly I have found a supportive father a huge help to both the mother and the midwife!! However I totally support the Gordon Ramsey view that it is not for every father and they should never be ridiculed for not wanting to be there. In addition to this not everyone male in the room is a father.  On several occasions I have found that the male is a new partner, a friend or a male relative. Who are we to decide who the woman chooses to support her? 
 
My second comment is more of a concern. The word ‘banned’ has no place at any midwifery conference let alone a student one. Women are in hospital giving birth-not in prison. We have no right to ban anything or anyone. If we feel the person is not being supportive or looks very uncomfortable then surely as a competent midwife we should have the skills to do that in way that benefits everyone?