the Reaching Out guide

A publication was recently launched with the intention of encouraging dads involvement in maternity.

A new guide, called "Reaching Out : Involving Fathers in Maternity Care" and published jointly by the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, Department of Health and the Fatherhood Institute was launched on the 15th November. The 16 page document sets out to encourage maternity care providers to actively seek to engage and involve dads in their partners maternity care, thus laying the foundations for a more positive and supportive start to parenting and family life.

One of dadzclub's resident midwifes, Lorraine Berry gives her take on it.

Commenting on the guide, Cathy Warwick RCM Chief Executive stated "There is now substantial evidence of the benefits resulting from fathers being involved in their partner's maternity care. Most women want their partners to be involved in their pregnancy. Midwives play a vital role in engaging with men during the antenatal care, labour and birth and postnatal period"


It is hoped that the guide will encourage maternity units to revisit at their current maternity provision and reassess how well it engages and meets the needs of expectant fathers, as well as mothers to be. One area that can be assessed is when antenatal classes are being held, and what content they cover. Ensuring they are held at weekends or evenings, instead of the middle of a weekday, can make it easier for working dads to come along too. A maternity unit at the University Hospital of North Staffordshire NHS Trust, for example, even schedules classes to avoid clashes with football fixtures.


I am optimistic that the guide will have a positive impact not only on dads involvement during pregnancy, but also on how dads are supported emotionally throughout pregnancy and beyond.
I know that as a profession we are ideally placed to support both parents throughout pregnancy and birth, as well as during the often forgotten, but equally important, postnatal period. Adaptation to parenthood can be just as stressful for men as it is for women, with some more vulnerable dads being just as susceptible to postnatal depression as their female counterparts. Being involved fully with the maternity services throughout the pregnancy will hopefully see men feeling and being more supported in adapting to their new role as parent, as well as potentially identifying those who need additional support earlier on.


It will be interesting to see what novel ways maternity units come up with to engage men more fully and prevent the feelings of exclusion (one suggestion was to ensure mens interest mags were available whilst waiting for antenatal appointments. Personally, I can't see that just putting out a few old copies of FHM is going to be enough on its own to encourage men to rush along to their partners appointments! Maybe I'm wrong, but think it will take a bit more thought than that to show men they are welcome!) How maternity units identify, address and meet the differing needs and expectations of fathers to be will certainly be a challenge for some.

So how can Midwives and Maternity services make ourselves more accessible and more approachable to dads? What would you like to see us doing to help you feel and be more involved?

Lorraine Berry
BSc (Hons) Registered Midwife
Natal Hypnotherapist

www.birthaffinity.co.uk
For Calm, Confident and Relaxed Birth Experiences

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  • 17 comments

    We value your opinion. Here are some of our readers thoughts on this item.

    • Bill
    • Friday 18 November 2011 12:42 PM
    • It's about time that the role of the father in the maternity unit is recognised in this way, and I can only see it being a good thing. I was present for both of my children's births, and I know they are experiences I'll never forget for all the right, and some wrong reasons. You're right that it will take more than old copies of FHM to keep the expectants dads engaged, simply because that won't appeal to everyone, and also because they won't help. Things like guides on changing nappies, making up bottles, dressing a baby would be really useful. There's no worse feeling for a man than not knowing how to do something, so how-to guides would really help. I think simple things as well like a huge tub of Lego, or a marble run would help ease any tension. It might seem childish, but it will keep the dad-to-be busy and will be useful for future parenting.

      In terms of approachability, not being intimidating or assuming that being a man makes him a bit simple in the ways of babies would be a good start as some men have got experience with babies, or are just very hands on. We know that midwives have delivered and changed more babies than there are stars; what a dad will need (esp. a new dad) is Yoda-like insight and wisdom, and useful tips on how to keep mummy happy (specific creams for stretch marks, papering advice etc) and also genuine desire for him to be wanted and included in the birth process. Nobody in the delivery room will know how to talk to the mother like the father, so he could be allocated the task of maintaining calm. I did that both times and it worked a treat, not because I can’t stomach the business end, but because that is where I was most useful. Men thrive on fixing things, and the most important thing to fix in a delivery room is the mood and temperament of mother.

      I’m all done for now, but try me again in a few days ;)

    • David Inglis
    • Friday 18 November 2011 1:13 PM
    • Good article. However it seems odd that this is only being discussed in earnest in 2011. That suggests that Dads really have been viewed as very much secondary in the process. Bizarre.

      I agree that FHM will not help. Nuts on the other hand... only kidding :) I think Dads just need to feel more involved, be treated less like the stupid, useless man who apparently doesn't understand that things have changed and are going to change more once the baby is born.

      Most of us just want easy to understand, non-conflicting information how best to care for our baby, wife and ourselves. Understanding what our partner is going through and what they will go through is essential, but it shouldn't be one way only.

      Treat us all equally as parents, don't base how you speak to us or what you tell us on gender.

    • DaddyNatal
    • Friday 18 November 2011 2:12 PM
    • Unfortunately a leaflet is not going to change anything, it is a start, but unless there is a genuine will for change then nothing will. It needs policy not a leaflet.

      Fortunately there are some forward thinking midwives and Heads of Midwifery who truly recognise the value of dads role. They are all ready ringing the changes, we have Bristol that allows fathers to stay over night, this is also happening in Luton and Grimsby. We have a couple that are trying to run the Hit the Ground crawling program from Fatherhood Institute. We also have Peterborough and Stamford who have funded my own DaddyNatal classes.

      Times are changing, but even though we have a leaflet stating that fathers should be allowed to stay overnight after child is born, this cannot happen in majority of cases due to the open wards and single sex policy.

      There are huge benefits to having fathers more involved, from the simple fact labouring mums tend to present at hospital later and less likely to be sent home, to shorter labours and less interventions, all with properly prepared and informed partners. The benefits dont end there, they are far reaching for the whole family, bonding, reduced PND risks, higher breastfeeding numbers going to 6 months. We also need full studies to truly evaluate these benefits, many of us believe the benefits are there, but we need evidence based research to truly look at these outcomes. Ironically I truly believe that linked in with this are some very real and large cost savings for the NHS.

      Ok off my soap box, applaud RCOM for publishing it but it is a very small step in right direction.

    • Lorraine Berry
    • Friday 18 November 2011 2:25 PM
    • Thanks for your comments so far.

      Bill - your ideas re keeping mum calm and nobody knowing mum
      Ike the dad does are so true. The best birth plan in the world or a Midwife who is amazingly adept at building rapport and trust are really helpful, but they still don't match up to the support a well prepared and confident partner can give. I agree that some Midwives can be really quite patronising to men (have seen it and cringed!), but hopefully we are learning that to be more welcoming! I love the idea of tips to keep mums happy - being now pregnant with number four, I could definately write a post about that!

      David - i think involving dads has been on a backburner for some time, mainly because we have been so keen to improve and getthings right for mums and babies, that we have totally overlooked the obvious and potentially most valuable source of support for mums to be - the dads! Again, I take your point re Midwives treating Dads as equally important and on the same level as mums.

      I'd love to know your ideas re getting dads to come to antenatal appointments in the first place though - Lego and magazines aside, how can we make it clear that partners are encouraged and welcome to attend? I wonder about dedicating specific appointments to attend as a couple - 24 week appointment, for example, when midwives often start discussing place of birth etc, or will this just make dads feel excluded from other appointments?
      More ideas please!

    • Bill
    • Friday 18 November 2011 3:20 PM
    • I think making it possible for dads to attend all meetings is a good first place to start. Even if they don't attend, the option is available. You could run dads only meeetings, maybe giving a condensed version of the antenatal classes in the last trimester (so the dads don't feel like it's a long drawn out process), and they don't all need to be at a hospital, they could be at a pub function room or a library for example. The important group to catch are the first timers as it's a huge change for them. For No.2 we didn't go to any antenatal and felt fine with that, but No.1 we went to every one. Maybe antenatal classes could be combined with a mini product seminar, with a brand showcasing their latest gear, paying the NHS for the priveledge and maybe offering money-off vouchers. the dads will get clued-up on baby stuff, find out about the pregnancy and birth, the parents get money off and the HNS and company both earn, it's win win win! Got any jobs going for an 'ideas man'?!

    • Bill
    • Friday 18 November 2011 3:56 PM
    • I think making it possible for dads to attend all meetings is a good first place to start. Even if they don't attend, the option is available. You could run dads only meeetings, maybe giving a condensed version of the antenatal classes in the last trimester (so the dads don't feel like it's a long drawn out process), and they don't all need to be at a hospital, they could be at a pub function room or a library for example. The important group to catch are the first timers as it's a huge change for them. For No.2 we didn't go to any antenatal and felt fine with that, but No.1 we went to every one. Maybe antenatal classes could be combined with a mini product seminar, with a brand showcasing their latest gear, paying the NHS for the priveledge and maybe offering money-off vouchers. the dads will get clued-up on baby stuff, find out about the pregnancy and birth, the parents get money off and the HNS and company both earn, it's win win win! Got any jobs going for an 'ideas man'?!

    • David Inglis
    • Friday 18 November 2011 4:00 PM
    • Lorraine - I have no idea what would make more Dad's come along to antenatal appointments. I for one assumed I would be treated like a "daft man", but that didn't stop me going. I went because I am part of the process and half of the partnership.

      I'm sure there are lots of men who assume it's a women's business and don't want to know about how her cervix is doing, or what way the baby is lying. You can't help men like that. But those men shouldn't affect how those who want to be involved are treated.

      In saying all that, I felt fully involved and welcome at all the appointments and scans I attended (couldn't make them all - I ran out of holidays). I think the Dad just needs to make it clear he has an interest and has put some effort into finding out how the whole thing works.

      In short, don't be patronising (I imagine it's only ever a minority that are), but other than involving us in discussion and decisions, I don't think you need to do anything more. It's down to us to change our attitudes.

    • Lorraine Berry
    • Saturday 19 November 2011 10:19 AM
    • Think there are some interesting suggestions here - like the idea of the pub meeting rooms!!
      Sponsorship is a great idea, but Midwives are not supposed to be seen to endorse one product / person over another, so can foresee some complications with this, although in theory is a great idea. Reps are allowed to approach midwives / doctors as a group, provide refreshmenbut during meetings etc, but can see that there would be issues with them being present / advertising during antenatal classes. Is an interesting point, though, as many hospitals have patient TV etc which show paid advertising etc.

      David raises a good point regarding using holiday up to attend appointments - women are entitled to take paid leave for antenatal appointments plus anything specific that has been identified to be of benefit to mum and baby's health (some women have managed to get paid leave to attend yoga classes for example). However, the same does not extend to dads to be at the moment, and is a key issue to be addressed if we truly want dads to play a bigger role in maternity provision. Providing antenatal clinics during evenings and weekends is one option, but becomes problematic when referrals to other specialties are necessary (eg scanning, or maternal and fetal assessment units) which don't operate outside normal working hours. Although it is a 24 hour service, staffing is pared down at night time, and additional admissions / referrals out of hours could cause an issue with staffing etc.

      Dean - I agree there are some hosps and antenatal classes, such as daddynatal and Natal Hypnotherapy, which acknowledge importance of dads and actively are seeking to involve them / meet their needs already, but there are also some whido not place as much priority on this. A leaflet on it's own isn't going to change things overnight, but as you point out the benefits are huge. Making changes in the NHS is a bit like trying to get a massive carrier ship going full steam to make an about turn at sea - it takes a lot of time and effort to get it to slow down and move in the right direction! Every small step does help though.

      Bill - the ideas man! You have put an idea in my head re getting dads involved on Maternity Service Liaison Comittees. My experience is that these are largely consist of women who've had babies, antenatal teachers, midwives and doctors - but don't know that dads are often members. I can see no reason why there shouldn't be dads on MSLC boards - they are all about getting information from "stakeholders" to make positive changes and improvements to the maternity service locally and are a very direct way of approaching Heads of Midwifery and those responsible for managing change. Why not join your local MSLC? Would love to hear any dads experiences if they have joined already!

    • Danielle Adams
    • Sunday 20 November 2011 6:12 PM
    • I am very much in support of any publication which sets out to involve fathers more in maternity.

      I was very lucky when I had my son in that my partner's place of work allowed him the time off to come to my maternity appointments and my classes were in the evening. I think it was extremely benficial to us that he was able to attend for many reasons such as, he was able to learn more and empathise with how I was feeling and he learnt about how best to support me both during pregnancy and post.

      I think the main point was that we both felt he had a key role throughout rather than just feleing like the financial support. And I felt like I wasn't alone and just on cooking duties! It's quite a testing time for both parties and looking back I think I could have quite easily slipped into post natal depression had I not had my partner clued up and there very step of the way.

      I think some of the legislation in place at the moment need a big shake up and being made to reflect the times. One main issue for us was the 2 week paternaty leave...it would have helped to stagger the return to work to ease us back in rather than that last day feeling like a farewell.

      I can't really relate to the idea that some fathers wouldn't want to attend the antenatal classes and need to be lured in with FHM mags? Surely if they want to be involved they would be there regardless? I think if I were an expectant father I would feel rather offended by this.

      I think what need to be addressed is allowing more channels of involvement for the fathers such as time off, and re-vamping the classes/appointments to include the needs of both the mother and father.

    • Dave Wood
    • Sunday 20 November 2011 7:55 PM
    • I hope the publication accounts for men being different.
      We're all different aren't we?
      I doubt a magazine would have made the smallest bit of difference to my feelings at any of my kids' antenatals.
      I think we were lucky because the midwives and nurse were all receptive to me and how I felt.
      At our first birth I was quiet and happy to do as I was told.
      By the time number 4 came along I took part fully and the midwives asked me about the birth plan when my wife was 'indisposed'.
      To think of us all as reluctant attenders and as we attend second and third births our confidence and involvement will change.

    • Lorraine Berry
    • Monday 21 November 2011 2:35 PM
    • Dave and Danielle - pleased to see I am not alone in my feelings re the magazine idea!

      I think you are also right, Dave, in your observation of Midwives paying you more attention, and your involvement increasing as you added to your family. I guess some of that comes down to confidence and familiarity on your part - but perhaps we as Midwives don't give first time dads much credit for having the skills etc needed to effectively support their partner and so don't involve you as much during the birthing process?

      Danielle you raise a good point about postnatal depression and how having both partners involved as a team from early on does help ease parents into their new role. I agree, legislation is what is lacking here, as without some formal recognition and allowances for partners to attend antenatal appointments, I suspect it will remain difficult for many fathers to attend with their partners. Even if it were possible to reschedule all antenatal appointments for weekends or evenings, I am sure there would still be sometimes when leaving early from work to attend would be necessary.

      Men are all different and there are definately some dads to be that are more keen to be as involved as possible than others. I hope we can become more welcoming, so that all dads can feel reassured that classes etc are as much for them as they are for their partner, and that we do work harder to ensure we are meeting their needs too.

    • Tony Elliott
    • Thursday 24 November 2011 3:26 PM
    • Hello Lorraine,

      The key to success is for the healthcare professionals to understand our (fathers) motivation for being there. Not meaning to labour a point, but the magazines are a suggestion that we are there because we are expected to be and need a distraction to see us through it. I remember sitting in the waiting room for the scans, taking time out from work and being held up for over an hour before the appointment was ever met. If I had popped my nose into a glossy at any point I would have been disregarding my wife’s needs for comfort and support. Scans as an example are a beautiful moment, but they are also frightfully daunting when irregularities start to appear and the frequency of expected scans more than doubles.

      The initiative is a step in the right direction, but to understand our motives for being there requires seeing the process from our perspective, which I do not believe a midwife is programmed to do. I say this from my own experience of them, admitting now that they are a valuable asset to women and as important if not more so during the process as any doctor, anaesthetist or surgeon, but no more than tolerant of “dad”. I understand why, because we are not under the physical change, but on the same hand we are also not emotionally brittle. We do not need pampering and coaxing through in a hand held manner.

      I believe men require a detailed lay-of-the-land so we can work out where we need our tanks. Might I be so bold as to suggest that men need their own class amongst those booked. For this one class the mums would be excluded because invariably we keep our concerns to ourselves in the antenatal classes because we don’t want to share our fears with our wife when she is already carrying two armloads of her own. One day out of those nine long months, preferably towards then end, where we can fire our questions at someone and get answers that mean something to us would be invaluable.

      I’m not sure how many men would agree with me…

      Tony.

    • Lorraine Berry
    • Thursday 24 November 2011 4:08 PM
    • Tony - I know that Dean of DaddyNatal will be nodding his head in agreement with you as he offers men only antenatal! I do understand that in much the same way men have difficulty understanding what women want, the reverse is also true. One evening session, purely for men, once a month certainly doesn't sound like an unreasonable suggestion - especially when some units used to offer granny parent craft sessions! (these were actually very popular and were loved by parents and grandparents, as it taught a how much things have changed, stopped a lot of the "in my day, we didn't do it like that" etc, and also made grandparents feel involved too). I can see that there are many reasons why a men only session would be beneficial BUT I still think that there is a need for men and women to work together, talk, communicate and work as a team. Sharing your anxieties is part of that. I know some men are not really "touchy feely" in that way, but understanding each others fears is how you support each other to manage them more effectively. So yes, men only parent craft sessions do sound like a feasible and positive idea.

    • Dean Beaumont
    • Thursday 24 November 2011 4:45 PM
    • Tony, Lorraine is quite correct I am nodding away. It is the whole reason I trained and now specialise in working with just expectant fathers.

      The courses are specifically male orientated, covering topics from male perspective and male only. Lorraine is also so right in respect of communication and working together. I think this is one of greatest outcomes of DaddyNatal is the men go home armed with their new knowledge proud of what they now know and cant wait to share and talk to their partners about it.

      We also conduct them in an environment men feel comfortable in, but trust me no time for magazine reading, there is to much for us to cover.

      Tony, would love you to look at website and see what you think, and please make comments. And who knows you obviously passionate about it maybe you would like to think about training to run the courses.

    • Dean Beaumont
    • Thursday 24 November 2011 4:49 PM
    • As added comment to Tony and Lorraine, the sharing of fears is very importnat, but difficult for most men. Once we have done the discussion around typical male fears and the dads have all talked, the fact they realise their fears are totally normal and its not just them allows that discussion to take place. Also men need to understand that their fears and their partners tend to be very different. For men typically they are mostly what i call functional fears, surrounding praticalities, finance and there ability as dad. Womens fears tend to be a lot more around health, theirs and the babies. Once both partners understand this they can be a lot more supportive of each other.

    • Lorraine Berry
    • Friday 25 November 2011 10:21 AM
    • Dean - :-D

    • David Inglis
    • Friday 25 November 2011 1:10 PM
    • Lots of interesting comments here. Cracking discussion :)

      I have to say though, at the end of the day I think it all comes down to communication.

      Yes there's the whole midwife thing, taking into account that not all men are useless or are there because they feel they are supposed to be (although there are plenty out there who are like that I imagine), but I think it's also important for couples to deal with this stuff together - I think it's important for parents to be to share their fears and concerns with *each other*. What good is it if your other half doesn't know how you're feeling?

      Location is, to me, irrelevant. It's almost a little offensive to say that men need to be in a pub to have a decent conversation - all that does is reinforce the male stereotype which we are so desperately trying to get midwives to stop using.

      To me the most important thing is that couples discuss everything, it's selfish to think that one party is more important than another when it comes to emotions. Yes, the pregnant woman goes through more changes than we do, but if we're all screwed up inside with worry and confusion and have only shared it with other guys, what use are we going to be when the baby comes? If your partner doesn't know how you're feeling, that's where the problems start.

      Since this discussion has started it's become clear to me that midwives aren't the issue. It's us as men. It's our attitudes (and maybe some women). Yes, if we could get decent time off for the visits, and not be treated like we know nothing, that would be great. But the rest of it is down to us to man up, do things we're not necessarily comfortable with, talk, open up, share, learn and prepare for the best time of our lives.

      Rant over.

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