A small study from Ghana, involving interviews with nine fathers of preterm babies, has shown high levels of exclusion by healthcare workers and demonstrates how this directly encourages a traditional gender division of roles between women and men.
All nine fathers spoke negatively about their experiences of the neonatal unit – they were not supported with preterm baby care and were constantly sent away.
I went to the unit every evening after work to spend time with my child and wife but anytime I went there, I could not see and hold my baby for long. I felt like I was not welcome but I kept on asking questions. All the attention was given to the mother and I was left out. (Ben)
I understand the nurses were busy but a simple welcoming attitude would have been good. I was only called when they needed money for medicine or a consent for treatment. No one seemed to care about fathers in the neonatal unit, so I asked my wife for the baby’s progress every day. (Evans)
The charge nurse was very good. She took me to her office and explained things to me but that was very brief. My wife had all the attention. I do not envy her but at least they should accord us [fathers] the same attention. After all, when we came home, it was me, my wife and the baby so I should have been involved in the hospital so that I can support her but that was so hard for the healthcare workers to do. (Isaac)
They call it MBU…Mother and Baby Unit. So where is the father? That means I must stay away until my babies are brought home. (Bright, father of preterm twins)
The strict feeding routine coincided with the visiting hours. I entered there one day hoping to have a good time with my baby and wife only to see that all the women were breastfeeding their babies and I felt so embarrassed so I left and vowed not to step in at that time again. (Justin)
Although I couldn’t spend more time in the neonatal unit, I thought about my baby all the time and I prayed for her every single minute. (Kwame)
All the fathers reported being left out of the planning for care at home after discharge.
I wasn’t told anything by the doctors or nurses, my wife just called me one day in a happy mood and said they have been discharged…no discharge education whatsoever, but I trust my wife may have been given some tips. (Kwame)
No one told me anything. As soon as I paid the hospital bills, my baby and wife were released to me and no one said anything. When I asked if there was something I should know, one of the nurses said I should ask my wife. As if to say ‘your wife is more important to us’. Well, I learnt a lot by reading online. (Justin)
One of the fathers described how he stood up to the system so that he and his wife could receive the support they needed:
I used to ask a lot of questions so they told me all they had told my wife. I was in the neonatal unit very often and the nurses got to know me. I asked them questions regarding my baby’s health. I had no issues when my baby was discharged. My wife and I never assume, we always ask. (Ben)
After discharge at home, as reported in other studies of preterm infant care, fathers described high levels of anxiety and lack of confidence in caring.
I was afraid to touch the babies… scared of injuring them. In the end, I had to invite my mother to come and help with their care. (Bright, fathers of twins)
I am always scared that something bad will happen. (Evans)
I brought my wife and baby home…but that night was horrible. The baby cried throughout the night and I was so confused not knowing what to do. I finally took them back to the hospital. When we got there, we were told there was nothing wrong with her, she wanted a cuddle. A simple solution like a cuddle! But I didn’t know because my wife and I have never had a baby. (Simon)
I was never taught how to feed the baby so when my wife went for shopping and the baby was crying, I was scared to feed her with the expressed breast milk but I gathered courage and fed her. Later, she started vomiting from the mouth and nose. I was so scared. I took her to the hospital and they said I did not burp her after feeding… I know it wasn’t my fault because no one taught me how to feed or burp. (Don)
In some cases, this led to a reversion to traditional caring roles, with the father taking a step back and handing over to women.
I never thought of bringing my mother-in-law to help with the baby’s care. I had always wanted to care for my baby independently but unfortunately, he was born preterm and I had no idea what to do to support my wife so I brought my mother-in-law to help. (Kwame)
I wanted to help my wife but I felt very incompetent so I do the house chores and she cares for the baby. (Don)
In Ghana, roles of men and women are traditionally clearly divided. Direct care of infants, such as feeding, bathing and nappy changing, are the woman’s domain. The father’s role is to provide. Like in the rest of the world, this division is starting to come under pressure, as fathers become more involved in caring. In Ghana, this is visible particularly among more educated fathers.
There is no formal policy in Ghana for including fathers in preterm care.
Adama EA, Sundin D & Bayes S (2017), Ghanaian fathers’ experiences of caring for preter infants: a journey of exclusion, Journal of Neonatal Nursing
Photo: World Bank Photo Collection. Creative Commons.