Dads have made the headlines this week. The Department of Health and others have published a 16-page guide telling midwives to involve fathers more in maternity care, and there have been reports of a pilot scheme in Bath that allows new fathers to stay on maternity wards with their partners. Staying in a maternity ward a moment longer than necessary may repel as many new dads as it appeals to, but both initiatives should be applauded for encouraging fathers to engage with their partners and children.
To that end, I spent Monday evening at the Chelsea and Westminster hospital in west London, with around a dozen expectant fathers, talking about sex, drugs and the relative benefits of an oxytocin injection during the third stage of labour. The "Dads-to-Be" workshops were set up five years ago by a local charity called Insights for Life and are free and open to anyone whose partner is about to give birth at the hospital. They're run by a midwife and volunteer dad (me) with the aim of giving fathers the most open and honest forum possible to talk and learn about pregnancy, birth and the following months.
We talk about a range of issues, from hospital car-parking to cutting the umbilical chord (think less "opening a supermarket" and more "cutting pork chop rind with a spoon"), through to how to stop a baby crying. But the key thing is that attendees get to ask questions. These can range from the practical ("what taxi firms won't take a woman in labour?") to the more complicated ("what are the risks of a premature birth") and the frequent and eternally optimistic "how many days after childbirth can women usually have sex?".
Some questions can be answered outright, some won't have answers, and some of them only have one safe answer ("Did your wife regain her shape after giving birth?…"). But the aim of the workshop is basically the same as the Department of Health guide and the pilot scheme in Bath: to help engage fathers with their partners and offspring.
This should be a no-brainer. Both intuition and evidence point towards benefits, from reducing crime to mental health, for children whose fathers are involved from the start. Every few years, governments release a new report on the importance of fathers. Every few weeks, a columnist berates their feckless disengagement. And if all else fails, the NHS's national service framework explicitly demands that trusts "include targeted provision of information and support to fathers as well as mothers". So despite all this, why does a charity like ours – accessed for free with universally excellent feedback, in an area of clear need – happen to be almost unique in the UK?
The problem is that the NHS is a sickness service: it's a problem-solver. Childbirth is a messy, far from risk-free activity and quite rightly the NHS focuses all its energy on making sure that mother and baby survive the pregnancy and birth. While the benefits of paternal engagement may be immense down the line, there is nothing that immediately needs fixing for dads, so there's little incentive for the NHS to get involved. The list of potential problems needing swift intervention for mother and child during pregnancy and birth are huge, whereas for a father it's mostly limited to passing out on sight of a placenta.
This brings us back to the Department of Health's edict demanding that midwives involve fathers in maternity services. The sentiment is a brilliant one and the content of their guide may be fantastic, but put in the context of the real NHS, it is as useful as an episiotomy before a C-section. Budgets are tight, staff are limited, and at a time of ever-more reform the desire to initiate new services is understandably low. A guide such as this will join similar others, gathering dust on a shelf.
If the government is really serious about engaging fathers – and it should be – a 16-page guide for midwives is simply not enough. Either it needs to step in and fundamentally change the way the entire service views fathers, or take that role away from the NHS and give it to people, groups or another department who have the time and money to do it justice.
