Family inclusive maternal healthcare is when fathers and other family members are actively engaged by healthcare workers in a partnership of care for a woman during her pregnancy, during labour and childbirth and in the care of the newborn.
This Charter is work in progress as we learn from further experience.
1. Communicate to women that partners and other family members are welcome.
When women seek care they should be informed that partners and other family members are welcomed if this is what she wishes. Opportunities include the welcome process for pregnant women to the service, giving them invitations to take home, putting posters in waiting rooms, training midwives and nurses to tell the women that the service likes to engage with fathers and/or other key family members. If in the early stages this requires changing long-standing norms, women may wish the maternity service to invite their family members directly until enough are routinely present in the service to make it normal for others to attend.
2. Use all opportunities to welcome family members and ensure that they are considered partners in the care of the pregnant woman.
For example, posters showing fathers and family members in waiting rooms, nurses trained to make eye-contact with family members and know their names (which should be recorded in the health notes), providing two chairs for all appointments in case a family member also attends. Make it possible for family members to ask questions at all times.
3. Communicate directly with family members.
It is not appropriate to make the woman responsible for informing her family about all her needs. Organise antenatal education classes for women with their chosen family members (this may require organising the classes at times more men can attend), provide an information pack to family members, organise a digital information service for both the women and her key family supports. Provide fathers and other family members with an opportunity to ask questions, including privately (this could be on-line or by text). Topics should include how family members can effectively support mothers antenatally, during labour and birth and postnatally.
4. Respect the woman and her family.
Offering a woman to help her family support her better, and treating her family with respect and kindness, is an expression of respect to her. Engaging with families does not mean reducing the opportunities for women to receive confidential individual care.
5. Encourage birth companions.
All women have the right to a birth companion of their choice. Most often they choose a family member. A woman in labour responds positively to a birth companion she knows and is comfortable with. Health care providers may have to be sensitized to manage birth effectively when a birth companion is present.
6. Encourage bonding between father and baby from the earliest moments.
This triggers hormonal changes in men, and subsequently neurobiological changes, that permanently sensitise them to the needs of babies and children. Attachments formed at this time can lead to a lifetime of greater commitment to the child. Meanwhile babies thrive on attachments with several loving carers. Active help by family members can reduce the demands on midwife and nurse time.
7. Support the family in early care for mother and baby.
This may include, for example, teaching the father/family member about breastfeeding and how best to support it. Mental health is another important focus.
8. Organise social support for families where problems are revealed.
When maternal health services engage with families they can discover that support for the mother is poor, or that a father is unable to cope, or that the pregnant woman is in danger. Processes are needed to access additional support for these vulnerable women and families.
9. Embed family inclusiveness through education, training, policies and management.
Effective engagement with families requires a change of attitude and this comes about through (i) an understanding of the importance of family support to a woman, and (ii) a clear expectation on the part of management at all levels that family engagement is essential.
Photo: Sean. Creative Commons.