A newly published paper by Dr Holly Rominov (School of Psychology, Australian Catholic University) reports on a survey of 106 Australian midwives about how they engage with fathers and what could be done to strengthen this engagement. Training is a key recommendation.

The midwives responded to a call by the Australian College of Midwives to take part in the survey. The probability is that those who responded to the invitation are particularly interested in engaging with fathers and have given some careful consideration to what could be done to improve the practice. Of the 106 that completed the on-line questionnaire, 13 also did a phone interview.

The midwives made the following recommendations:

• Midwives in Australia should receive specific training on engaging fathers. 83% of these midwives had received no formal training at all. Some reported participating in one-off sessions, one of which was a single lecture as part of a midwifery degree.

“I think that it should become part of our education, how to integrate both parents when it comes to learning about pregnancy and delivery and childcare, so people feel a lot more confident. It would make us better midwives!”

“In my three years at University I don’t think I was taught a single thing about dads. We learn a lot about our role in ‘woman centred care’ but nothing about dads . . . what they teach you about your role as a midwife and the philosophies of midwifery really shape the kind of midwife you become in the future. Even just one lesson on what challenges dads face and how to help them would have been useful!”

• A continuity of care model, so that midwives can establish a rapport with the family.
• Appointments that are not so short it is not even possible to engage effectively with the mother, let alone anyone with her. Some of the midwives reported sessions as short as 20 minutes in public sector hospitals.
• Recording the father’s details on hospital paperwork.
• Better designed antenatal education that addresses the perspectives of fathers and that is scheduled to fit in with working hours.
• Overnight hospital stays.

“I currently work in a service where dads can’t stay after the birth. I just think that that time is so crucial and for us to be saying, “No, you have to go home,” I just think it’s wrong. It’s just so wrong.”

The midwives raised a wide range of issues from their own experiences, all things that could be included in new training.

• The role of engaging fathers in the practice of midwifery.

There is a fundamental problem in that the health system takes no account of the father – he is not the recipient of any service, there are generally no specifications about fathers, fathers are not covered by medical insurance and midwives and hospitals are not insured for engaging with them. And yet all the midwives in this study regarded engaging with fathers as a part of their role (78% – a large part of their role; 20% – a moderate part of their role; 2% – a small part of their role). The core competencies of midwifery practice in Australia also require effective engagement with families.

• Interpersonal skills – introducing themselves to the fathers making eye contact, asking his name, talking to the couple, understanding the learning styles of both mother and father, inviting him to appointments and giving him permission to ask questions, for example, by phoning.

• Teaching the father how he can support the mother.

“I don’t say their role is important, I say that their role is essential.”

“My philosophy is that mothers at birth are best looked after and cared for by the person that they love the most. That is almost always the father of the baby, so I tell the father that his role in the birth is to look after his wife or his partner and he is the main person who is going to do that.”

• Engaging fathers in particular health issues – breastfeeding, mental health.
• Working with difficult fathers/couple – relationship tensions, dominating men, hostility. Some fathers are very reticent/withdrawing and need to be pushed a bit.
• Dealing with cultural diversity.

Rominov H, Giallo R, Pilkington PD & Whelan TA (2017), Midwives’ perceptions and experiences of engaging fathers in perinatal services, Women and Birth 30.4

Photo: Bethany Petrik. Creative Commons.