Partners in antenatal care: the 2021 NICE antenatal care guideline for England

NICE antenatal

The NICE Guideline for Antenatal Care, which specifies all public maternity care in England, was published in August 2021 after three years of analysis and consultation. The Guideline notes that involving partners is “an important part of antenatal care”, and that “the World Health Organization has emphasised the importance of engaging with partners during pregnancy, childbirth and postnatally.”

What the guideline says about engaging partners

Who are partners?

“The guideline uses the term ‘partner’ to refer to the woman’s chosen supporter. This could be the baby’s father, the woman’s partner, a family member or friend, or anyone who the woman feels supported by or wishes to involve.”

Rationale for engaging partners

The guideline makes the case for engaging partners in three ways:

  • Mothers-to-be want it.
  • In the past, partners have often been made to feel like bystanders and have not been well informed.
  • There is a lot of information in the public domain but not all evidence-based, so maternity services have a guiding role.

A welcoming environment

Create a welcoming environment for partners, for example, seating in consultation rooms and positive images in waiting areas. [1.1.16]

Antenatal appointments inclusive of partners

Inform the mother-to-be that she is welcome to bring her partner to antenatal appointments and classes. [1.1.14]

Consider the possibility of a partner attending antenatal appointments virtually. [1.1.6]

At the first antenatal appointment, if the partner is present, explain to both mother-to-be and partner how antenatal care will be offered, including a schedule of antenatal appointments. Explain how mothers-to-be and their partners can support each other during the pregnancy. [1.3.7]

Ask about the family history of both biological parents. [1.2.1]

Ask the partner if he/she has any concerns they would like to discuss. [1.2.10]

Explore the understanding of the partner of topics under discussion. [1.3.5]

If the mother-to-be or her partner smokes or has stopped smoking within the past 2 weeks, offer referral to NHS Stop Smoking Services. [1.2.4]

Information about parenting, relationships, support

Provide information to the mother-to-be and partner together about pregnancy. This information will be high quality, use clear language, be well-timed and be adapted to the needs and preferences of the mother-to-be. It can be offered face-to-face or in group sessions. Information needs to be available in other languages and accessible to those with disabilities. [1.3.4]

Include information about relationships and parenting:

  • emotional and relationship changes that can take place
  • how the mother-to-be and her partner can support each other
  • resources and support for expectant and new parents
  • how to access local and national peer support services
  • how the parents can bond with their newborn baby and the importance of emotional attachment. [1.3.11, 1.3.19]

“Bonding is the positive emotional and psychological connection that the parent develops with the baby. Emotional attachment refers to the relationship between the baby and parent, driven by innate behaviour and which ensures the baby’s proximity to the parent and safety. Its development is a complex and dynamic process dependent on sensitive and emotionally attuned parent interactions supporting healthy infant psychological and social development and a secure attachment. Insecure attachment styles, by contrast, predispose to chronic psychosocial problems. Babies form attachments with a variety of caregivers but the first, and usually most significant of these, will be with the mother and/or father.”[Terms used in the guideline]

Antenatal classes

Offer antenatal classes to all first-time mothers-to-be and their partners, also to other women if there is a particular need. These classes will include discussion about:

  • How mothers-to-be and partners can support each other
  • How to care for a baby
  • How parents can bond with the baby and the importance of emotional attachment. [1.3.19,20]

Consider timing the antenatal classes so that a partner can attend. [1.1.15]

 

National Institute For Health And Care Excellence (2021) – statement about the guideline.

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