Being a Dad

I’m not a fathering expert. I’m not an expert in anything, really. I’m a general nurse. I have a Masters in THE MOST general health area you could think off. I am average, ordinary and general in many, many areas. I am a father, an average, ordinary one and my kids are challenging, but pretty ordinary and average really. This is just some thoughts – take it or leave it. No expert. Just a Dad.

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Doing cross country with my two boys

Being a Dad can be a tough gig. Now – mothers, I know yours is a special kind of hell. You carry a child; accepting numerous changes to your bodies; birth a child in a variety of different manners, none of them gentle; feed, or not feed a child with milk that your body produces, while having to cope with the judgement and shaming of doing it/not doing it/not doing it long enough/doing it too long. You have to do the bulk of the heavy lifting, are the one your child is predominantly attached to in the early years and more often than not give up a career for the privilege. Or put it on pause. Or go return to work with your kids in day-care, while being judged for your time away from work and doing it/not doing it/not doing it long enough/doing it too long. Or have a stay-at-home Dad help you in return to work, who will be held up as bastion of selflessness for doing what the majority of mothers do with zero praise or adulation. Its balls. I get it. I really do.

Being a Dad is different. It is confusing at times and there are challenges. You don’t have anything to do with the gestation of a child beyond the fun part at the beginning. Unless your child has been conceived through IVF, where your fun bit was in a dark room, alone. Come the birth, you’re really a spare wheel. No matter how doting, caring and empathetic you are – you’re never going to get it. The midwife knows this intrinsically and will pay you no attention, beyond scoffing at any minor complaint you may make, no matter how quietly you thought you were voicing your concern about being tired or stressed. Save it for later. There will be no sympathy here.

The baby is born and you are largely forgotten. Child health nurses will largely ignore you, regardless of how involved you are. Friends will ask how the baby and the mum are going. Workmates don’t care, but will ask. They don’t care. They’ll pretend they do, but really, they’re only asking to be polite. Stop explaining what is happening and go back to work so everyone else can move on. Seriously, no-one cares. If they’ve got kids, they’re just waiting for you to finish talking so they can share their story – if they don’t have kids they are purely waiting for you to finish talking. Its not new to everyone else man. You are not the first Dad on the planet. Move on.

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Being a Dad is a challenge. Being a Mum is more of a challenge, and we should cut our whining and consider ourselves lucky and be more supportive, but it is still a challenge.  You feel like a spare part – but society expects you to be a major player. You feel like there is something you should do to help – but it isn’t very obvious. You want to be involved, but workplaces don’t support that really. Oh yeah – the department has got a family friendly policy, but don’t ask your boss for a morning off to attend an assembly. You’ll get laughed out of the office.

You’ll want to get involved and you’ll want to be supportive and you’ll also want some recognition from society that you are more than a walking inseminator – but none of that is probably going to happen so just try and keep yourself busy and engaged and for God’s sake, don’t complain. DO NOT COMPLAIN.

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Here are a few things you can do, to make yourself be less annoying and improve your life, and the lives of those around you:

  1. Forget about sex. For now anyway. Seriously, forget it. Just move on.  For the next few months just sort yourself out. You know what I mean. But even do that quietly and respectfully. You might feel great, and now the baby is sleeping a little more, your feeling a little more like you should try it on and look for a little bit of action. Your partner, despite having grown a 4.5kg parasite for nine months, looks amazing. You’ve never thought she has looked more beautiful. That incredible thing she has gone and done in growing and delivering a child has led to you thinking she is probably the most amazing human being on the planet. She’s also had an unexpected, chest related bonus you weren’t planning on. She is amazing. She looks amazing. She’s the sexiest creature ever. The issue is – she’s lactating.
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    Yep, those massive fun-bags you want to pounce on don’t belong to you any more (not that they did), they don’t even belong to your partner any more either. She is a walking food source and no amount of sleep, back rubs or gifts are going to change that. She’s also had massive body changes, is feeling incredibly responsible for a brand new, super needy human being and has more things to think of than you’ll ever know. Eventually (I hope for your sake), she’ll bring sexy back and you’ll be back in business – but until then, cool your expectations, be incredibly loving and supportive and focus on being useful.
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  2. Focus on being useful. I spent six months as the stay at home parent when my first son was 3 months old. This was in another country, with an incredibly supportive Aunty helping out around the place, but primarily, child rearing was my gig (during the day). IT WAS HARD. Harder than work. Harder than manual labour. Harder than deciding whether to have a macchiato or a latte at lunch. SERIOUSLY HARD.
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    So, when you come home from an INCREDIBLY stressful day at the office, doing whatever the hell it is you do; or get in after a really solid day on the tools and your back is throbbing – get useful. Now, this may not mean coming through the door and helping out by cooking. If you cook dinner, your partner is still looking after your kids. You need to ASK what is the most useful thing to do and muck in and do it. Then, when its sorted and baby is sleeping – turn your attention away from the couch and take on the next most useful thing you can tackle. You need to help the hell out. Raising a child is a full time job. Cleaning the kitchen and doing the laundry is ON TOP OF THAT. It is not an all inclusive deal, my friend – you need to do you share (as in an equal share) of the housework on top of the invaluable work you do earning money, because your partner is doing the invaluable work of raising your child for nothing. It is sometimes called domestic foreplay. If point one really resonated with you and you’re in a massive dry patch right now, try point two on for size. See if you can launder your way back to loving. Try to scrub your way to sex. Seriously, worst case scenario, you’ll actually help out by doing a small portion of the amount of housework you should be doing. Best case, you might gain some appreciation.
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  3. Don’t baby-sit your kids. Don’t do it. And don’t let ANYONE say that you are. You’re not babysitting. You’re not a desperate teenager saving money for next weekend’s binge drinking (or responsibly buying a car, or uni text books). You’re parenting. You’re fathering. You’re not doing a favour or taking on some additional task. You’re being involved in the most important thing in the world to you, aside from your partner. If someone asks if your babysitting your own kids. Tell them to go away (in much more colourful language). If your partner says your babysitting your kids – correct them.
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    On a slightly related side note: if your partner refers to you as “one of the kids” or a “mother of three” and includes you in the count – you need to grow some balls and man up. I don’t care how completely useless you are as a partner and a father, if you let your partner believe that you are as useful as a child in her life – forget point one. In fact, forget having any sort of meaningful adult relationship with your partner. Man up, stand up and change what ever has to be changed man-child.
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  4. They’re your kids. Yep, get involved big guy. You’re not doing a “favour” by being involved and taking them to swimming on the weekend. You’re not special. You are just doing what is expected of you – so don’t expect a pat on the head for just being an average father. Being involved in your own child’s life when you are not at work is not amazing. You don’t get a Father of the Year nomination for doing what is basically expected of you, having decided to bring another human being in to the world.
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    Jeez, if you think it is some big deal that you are involved in the most rudimentary way in the raising of your own child – you’re probably expecting a medal Ceremony for Domestic Services for that load of washing you put on. Pull your head in. It is your child, your house, your family. Take responsibility for what is yours and do what is expected of you without wanting a pat on the head every time you fulfil your most basic obligations.
  5. Work on your relationship. Once you’ve got your head around covering off the basics above – put some extra special effort in to getting along with your partner and work on your relationship. Take time out to spend together. Use eager grandparents to care for your child. Don’t feel bad for taking up a grandparent’s offer to look after your kids if your going to spend time with your partner. Your parents or in-laws remember how banal and mind-numbing raising kids can be, and they want to show off to their friends about how engaged and supportive they are. Exploit this for your own gain. They did. Don’t you remember being dropped off to Nanna and Grandad for the school holidays? THE SCHOOL HOLIDAYS! Not an evening so you can watch a movie – extended bloody periods. My parents even went over seas.
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    Honestly, get over your self and how important you think you are in the raising of your own children and give Gran and Pop a turn. They want to prove to you they still have it. And seriously, as much as you think you’re critical to your kid’s well being day to day, you are so quickly forgotten once the milo and lollipops come out. Honestly, your kids will go to sleep without you, they’ll be safe(ish), they’ll enjoy bonding without you hovering around being clingy, they’ll love it. Get out and spend some time with your partner and reconnect. Keep dating, well beyond the birth of your kids. Make your relationship a major priority. you’re a team in this childrearing thing, and if that isn’t your number one priority, ahead of kids, work and craft beers – you still have time to re-jig things. Make time. Exploit your parents generosity and reconnect. You never know, point one may be back in play if you’ve done well in the other areas.

So that’s it. I could go on all day – but who needs that. We’re all losing interest. So that ends my general advice to Dads. Its nothing more than the basics really: don’t be a demanding tool, be respectful and fair, and don’t expect a ticker tape for doing the basics. Again, I’m no expert and my advice in general – but I’ve been trying to follow it for a while now and, despite the small sample size, it seems to be working.

My Amazing Grandfather

This is a simple, yet sad post that I wrote in the days after my grandfather died. He was an amazing, gentle man. A fishermen by trade. A member of the 2/14th, severely wounded attempting to evacuate his CO during the Battle of Isurava. A leader through actions. A man of God. I was hurting in the days after he died, and putting this post up brought a tear to my eye.

My Grandad was more than a Grandfather. After my Dad died, he was the man to step in and helped fill a void in my life, becoming an influence on me in the only way he knew how – gently, quietly and patiently. He put up with my teenage attitudes while we lived next door. He was just there. Waiting. Waiting for me to come around and want to talk.

That time eventually came. We talked. For hours. On the phone, in letters, in person with a little scotch. We laughed. We solved the world’s problems. We talked crap. We teased Mum. I loved his company. Once we were back, living nearby, I would just go sit and read next to Grandad. I was desperate for peace away from the kids to get through my uni readings, he loved the company and never felt the need to fill the air with unnecessary words. We would read together for hours. Silent. Present in each other company. Happy.

In his later years, Grandad’s frailty became more and more apparent. For years I was convinced each time I left his home, it would be the last time I would see him. There were many tears shed as I would head back up north to Darwin, convinced there would be no more. Especially just after my Nanna died – my old mate seemed broken. His heart certainly was.

The love of his life was gone. My grandparents were married for over 60 years. They had 15 children together. A herd of grandchildren and great-grandchildren. They had fun together. Adventures. Camping trips around Australia in to their 70’s and 80’s They spent days and days together. Chatting. Laughing. Teasing each other. No one would have begrudged him if he had left then. But I think he knew the family couldn’t handle so much grief in such a short time. He stuck around. I always felt it was more for us than him.

He did more than stick around though. He lived. He travelled. Sydney. Broome. Darwin. Copenhagen. Herrljunga – Sweden. Oh, Sweden. He was welcomed like a rock star and treated like a king. A life-long dream realised in his early 90’s. He was reunited with his father’s family after a mere 125 years of separation. Diligent genealogy had opened a door and my Grandad shuffled through it, ready to meet some more family and make the most of it.

There was afternoon teas, dinners, a lunch attended by nearly 100 people who came purely to meet him. Our hosts moved out of their house in the embodiment of Swedish hospitality to allow their elderly relative to be comfortable. He stayed for six weeks. A passionate patriot, I asked him towards the end if he was actually going to go home. He smiled wistfully, and for a while and said, “Maybe not”. He did shuffle home eventually, but he made a mark far larger than his frame. There are family there that will be shedding a tear for Dear Old Jack, such was his impact on that trip.

Now, I’m left to prepare for a life without my dear old mate. No more stopping in to see him. No more hugs – those big, meaty hands, clasped on to my shoulders. No more chats, about little things and big. No more sitting, watching him sleep, as the twilight of his life became so tiring. No more silent scotches, their air full of mutual appreciation and love, rather than words and noise.

My heart is broken, Grandad. Simple words do it no justice. I never wanted you to go, but I could never wish you back. You are in the arms of your Lord and your God. In the arms of your beautiful Vera. There are plenty of mates waiting there for you too– and I reckon your Mother and Father, Charlie, Joe, Peter, Gerard and Margie are at the front of the queue, desperate to share a whisky and hear about how nice that mob over in Sweden were to you. To sit and to chat. To reminisce about old times.

God Speed.

 

PITCH: A reality TV show that brings public health into our lounge rooms

This post is a thought bubble that has sat unreleased on my computer since the end of 2016. I received the wonderful opportunity to present a PHAIWA Opinion Piece Seminar and these were my post-presentation musings. Thank you to PHAIWA for the opportunity, and thank you for the audience that sat through my presentation after Megan had finished.

Pitch us a concept for a reality TV show that promotes public health. That was my mission, should I choose to accept the opportunity to present at the Public Health Advocacy Institute of WA (PHAIWA) Opinion Piece Seminar. I sat back in my study and considered the angles, the opportunities, the possibilities. This was going to be tough – while I had to bring humour, I also had to bring some research, some body, something worth hearing. I had to deliver something of substance. This was PHAIWA, not Comedy Central.

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There are plenty of obvious places you could go with reality TV and health. I assumed I wasn’t being asked to present the obvious and set about some seriously immersive research. Now, we all like to pretend that we are above reality TV, far too cerebral for it all – but I can tell you, the night Nick got voted off Survivor, my head was spinning. Who cares if someone can make their cucumber gel set to delight Gazza, Georgie and the Cravat? We all do – we just don’t know it. I went deeper and deeper in to the reality TV whirlpool. Could the Kardashian’s sell public health to the masses?

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Now, as I say – we all, to some degree pretend we are above reality TV. I think everyone who has watched TV has ended up watching Reality TV. There is a social aspect to it, a familiarity. It has been on our TV’s forever. Now someone out there is reading this, shaking their heads (possibly their fists) and declaring they hate the format and have never watched it.

This may be true – but even if you haven’t seen it, you’d have to be aware of it. Think back – ever heard of the Seven Up! series, a lesson in Reality TV longevity? Watched an episode of Candid Camera or Australia’s Funniest Home Videos? Heard of Sylvania Waters or This Is Your Life? There are many different formats and styles of Reality TV – it’s not all competitions, Kimye and Jersey Shore.

Now, you can hate on Reality TV as much as you want; what you can’t ignore is its power, popularity and sustained success. Sure, its launched a few modelling and singing careers – but what about politics? Two of our Senators, Derryn Hinch and Pauline Hanson have enjoyed successful spells on Dancing with the Stars – managing to show a different side of themselves, and arguably softening their images. Donald Trump, portrayed a powerful and successful businessman in The Apprentice.

Suddenly, the reality of The Donald, is that he is now the President and leader of the free world. Surely The Donald’s current political success is more tied to his TV profile than his business acumen. Surely. George Galloway (UK politician), took time out of parliament to take part in Celebrity Big Brother. Perhaps Josh Frydenberg, could be convinced to do likewise?

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I was to present alongside Batchelor alumni, Megan. I wasn’t going to pretend that people were coming to listen to me. I was a side act to the big show. Megan was drawing the crowd – I was filler. Unperturbed, I threw myself in to my presentation. In the lead up, there was buzz about to content, the topic, (one of) the presenters. Everyone (except Mel Sweet) was hanging out to hear how we were going meld reality TV and public health; how we would fold them together in to a rich yet fluffy mousse to appease the Cravat. And Mel Stoneham.

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The day came and it was time for my pitch. Armed with the best PowerPoint I could ever put together, I watched as Megan wowed the crowd, answered questions about Batchie and the show, and nailed her presentation in general. It was my time to present. I waited long enough to give anyone wanting to leave straight after Megan the chance to go and then got cracking.

I wanted my audience to think about ways to break down barriers between Public Health and lounge rooms. What is the point of having fantastic brains doing amazing things and providing astounding insights if there is no one to listen. My pitch was for a surreal observational documentary that was about people, watching people watching Public Health related programming. Yes, my show to pitch: a Gogglebox-esque Public Health extravaganza.

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I learnt along the way that a show pitch needed a log line (thanks Google). My pitch was healthy for it and my pitch’s log line was: Gogglebox Health takes viewers into lounge rooms of everyday Australians and Public Health idols to watch their ideas, interpretations and criticisms of the nation’s best health shows, adverts and campaigns.

I wanted a show that controlled the content that was being delivered to people’s homes, but also delivered health messages in a way that ensured the message was getting through. I pitched the value of two steams – a stream of everyday stars, similar to the stars of the current shows, that provide general insights from the community, teaching points related to knowledge acquisition and criticism of our best (and worst) public health mass media. The second stream were new and old legends of public health – there to have a voice in the mainstream, the ability to connect with the audience and provide messages and teaching without lecturing, and without needing to be via a health-related press release.

I wanted us to give Australians what they didn’t know they already wanted – people sitting on their couches talking about Public health stuff! It would be low costs, yet high impact. Provide direct messaging opportunities. Be believable – but most importantly, relatable. It would give Public Health the chance to be famous, if only for 15 minutes.

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My presentation was well received and left me feeling like I’d achieved the brief, nailed the presentation and not disgraced myself (my three pre-presentation goals). People were very kind, giving me a moment of their time to shake my hand, before trying to find Megan and hope the conversation swung to the Bachelor. Now, this was a pitch for PHAIWA and fundamentally a bit of fun – but what if we could harness the power of reality TV for Public Health?

Why can’t we go beyond medical drama style reality TV (RPH, Kings Cross ED, Keeping Australia Alive) and think about subtly delivering our message via the format? Is there space in our lives for a team of celebrities trying to get an under-funded health promotion project off the ground in the face of funding cuts and a budget freeze? Could we get our health department heads on an island somewhere, battling it out for an increased budget? Why not follow the day to day lives of those heroes slogging it out in the Population Health Blocks around the country? There are definitely some colourful characters in some of those office buildings that would provide enough drama for an exec to get excited. Let’s give it a go.

Come on Australia – it’s time for a change, a challenge, a couch and a message.

 

 

 

 

 

The birth of a child: Confusion and powerlessness. A father’s role in labour, delivery and aftercare. Part 3

POST-PARTUM LIFE

The focus post-delivery was now on developing a bond with our baby and supporting the new parents in the practical side of caring for a new child.

The focus post discharge from hospital was how my wife was adapting to mother-hood and if I was being a supportive husband and father. This is fine and appropriate – however little emphasis is placed on the partner’s emotional reaction and adaption to the birth process and new-found fatherhood.

More than once I have had male friends and family with similarly traumatic birth experiences become a little “misty-eyed” in their brief recounts of the events, only to quickly change tack and subject to return to socially acceptable male behaviour.

The medical paradigm is interested in the reduction of child and mother mortality in the least complicated and efficient manner, and ensuring mother and child are able to be discharged from care in as best shape as possible.

Support services and in many ways society also has this focus – Odent’s (2010) call for the removal of fathers from the birthing process is to improve maternal and infant outcomes. Vernon (2006) and Winder’s (2006) push for a doula or support person is a movement to remove the stress that father’s bring to the delivery situation and and effort to improve maternal and infant outcomes.

Fathers will continue to be present and realistically require involvement and engagement (Chandler & Field, 1997), with research showing higher levels of post-partum satisfaction for both parents who have shared the experience of labour and birth (Chan & Paterson-Brown, 2002).

There is very little literature or real services in improving the father’s emotional outcomes, something that should be a concern to all – as doula or no doula, once returning to home, the father is more often than not the primary support person for mother and child (Wong, Perry, & Hockenberry, 2002; Chan & Paterson-Brown, 2002).

A father still dealing with negative emotions from the birth experience could have a negative influence on the initial settling process (Chandler & Field, 1997). Support is needed; before, during and after the birth of the child in a manner and delivery structure that is appropriate and accessible.

 

Thanks for reading

 

References

 

Australian Institute of Health and Wellfare. (2011). Nursing and midwifery labour force 2009. AIHW bulletin no. 90. Canberra: AIHW.

Chan, K. K., & Paterson-Brown, S. (2002). How do fathers feel after accompanying their partners in labour and delivery? Journal of Obstetrics and Gynaecology, 22(1), 11-15.

Chandler, S., & Field, P. A. (1997). Becoming a Father: First-Time Fathers’ Experience of Labor and Delivery. The Journal of Midwifery & Women’s Health, 42(1), 17-24.

Odent, M. (2010). THE MASCULINISATION OF THE BIRTH ENVIRONMENT. Retrieved September 20, 2011, from WombEcology: http://www.wombecology.com/masculinisation.html

Vernon, D. (2006). Men at Birth. Sydney: Finch Publishing.

Winder, K. (2006). Bellybelly.com.au. Retrieved September 20, 2011, from http://www.bellybelly.com.au/birth/ten-tips-on-being-a-great-birth-support-person

Wong, D., Perry, S., & Hockenberry, M. (2002). Maternal Child Nursing Care. St. Louis: Mosby.

 

 

 

 

 

 

 

 

The birth of a child: Confusion and powerlessness. A father’s role in labour, delivery and aftercare. Part 2

THE EXPERIENCE

My wife had a long labour. We had been enthusiastic labour parents, taking to the role and its expectations with duty and excitement. We walked the block in the early stages of labour, ate well, relaxed when possible and stayed home as long as seemingly possible.

I was told by a tired midwife over the phone to not come to the hospital until my wife’s contractions were less than 4 minutes apart, not to get too excited, but to call back if her water broke.

The clinical and apathetic mood of our conversation was mildly deflating, the midwife almost annoyed that I had rung. I understand night-duty and its pressure, its lethargy and its sleep deprivation – but I was having a baby! Well, my wife was anyway – some excitement or encouragement could have been in order!

We waited and waited. My wife’s water had broken while she’d gone for a nap and her contractions were under the 3 minute mark. Surely things were looking good. We headed up to the hospital in an eerie calm, driving slowly to not cause discomfort; excited but fully aware this was the start of the journey – not the end. While I was completely aware of how unrealistic Hollywood birth scenes really are, yet it still seemed anti-climactic driving in a calm and restrained manner through the quiet streets to the hospital.

Our arrival to hospital led to us being ushered in to a sterile examination room and the midwife “had a look” at how things were progressing. Anyone familiar with this area would know that midwives don’t look with their eyes. There was some confusion and deliberation before the first midwife made off for reinforcements to also “have a look”; leaving my wife sitting on an examination bench, with slightly less dignity and a lot more KY jelly than when we entered.

Eventually everyone was happy having “had a look” and we were ushered to the birthing suite to have some rest and prepare for the day ahead. Through this process I was pushed to the side and out of the way, my involvement seeming unnecessary.

Labour went as smoothly as possible until after the 30 hour mark, my wife’s dilation slowed and things became more complicated. A foetal heart rate monitor was connected and my wife was administered syntocinon intravenously. The midwives had been fantastic as they had made every effort to explain things to my wife about what was happening. As the effects of the synthetic-hormone began, the heart rate monitor began to display our baby’s heart rate dramatically slowing with each strong contraction, before rising back up to normal limits.

Patients are often connected to various forms of technology and devices that monitor and assess homeostasis to varying degrees, often alarming and beeping due to changes in blood pressure or heart rate, alterations in oxygen saturation or occasionally a dropped lead or sudden movement.

The alarms often create anxiety and confusion in patients and visitors, worried that a Hollywood-style resuscitation attempt would ensue following an alarm. I often tell people – “don’t start worrying until I look worried”. Our midwife was doing her best to look unworried – but a little experience could see that she was concerned. That and the notes she was writing all over the print-out; outlining that she was still awaiting the doctor’s review, despite having paged him earlier.

To the layman, the midwife jotting notes on the printouts may not raise any alarms, but this had me concerned. In a day and age when documentation is paramount in ensuring professional protection, I know you only start documenting things that carefully as they happen in times when things start going wrong.

Nothing was mentioned of the dipping numbers on the monitor. My wife was focused on her contractions and I was attempting to remain focused on helping her through them; all the while knowing my baby’s heart rate was dipping below acceptable levels and nothing was being said about it.

Our obstetrician finally arrived. He was an affable and seemingly well-read fellow open to our wants and needs; including our intentions to have as natural a birth as possible, attempting to avoid a caesarean section if able, and with minimal drug therapy. He offered his suggestions and explanations of what was happening in clear and understandable language.

There was little medical (or obstetric) jargon as he explained that mother and baby were now quite “tired” and that the baby was having some difficulties maintaining its heart rate and was in some distress. He offered us a plan of attack that would seem him attempt to deliver the baby without surgical intervention. His calmness was strongly juxtaposed by the goings on around us midwives milling around in preparation as we all tried to ignore the heart rate monitor, beeps dipping in the background.

The delivery of his information in such a casual and straightforward manner was comforting for me. It was personal, sensitive and reasonable – panic is not an emotion you wish to see on anyone’s face in times like these and his ability to diffuse our increasing anxiety was welcome.

What followed was a delivery that was later described by our obstetrician as “agricultural”. My wife had been in more pain than I had seen any patient before in my professional duties and the analgesia that had been administered to her had been administered incorrectly. I was torn as I noticed what had happened; as to what my boundaries and roles were. An average father-to-be wouldn’t have noticed that there was a problem, but I’d seen the drug not fully clear the intravenous line.

Professionals were at work in a highly stressful environment and my primary concern was supporting my wife. This role dilemma continued to place me in a difficult situation after our son was born; he was blue and unresponsive, the umbilical cord having been around his neck. Part of me was panicked to hear the familiar sounds of an infant resuscitation effort being performed just near me. Part of me wanted to be involved, or even to see him. To be honest, in the rush of baby being delivered; I had not seen he was a boy – I’d just seen this blue, contorted baby being pulled as swiftly as possible from my wife’s body, covered in amniotic fluid, vernix and blood and handed to the awaiting Paediatrician.

The fears of any complications due to asphyxiation, a failed resuscitation or other complications were very real in my mind. There was no ceremonial cutting of the cord, quick gentle cuddle or time to rejoice; our son needed medical attention and my wife was still in pain. I was helpless and unable to influence any of these situations – something I am very much not used to and it was not welcome.

The confusion on what to do and where to be is intense, all the while midwives, nurses and doctors are attending to the needs of my wife and baby, helping them as best they can. Communication at this time was understandably minimal. The paediatrician and nursing staff were working on our baby, the obstetrician and midwives focussed on my wife’s pain and birthing of the placenta.

Time went by and the severity of the situation subsided; we got our cuddles, then our son was whisked away for observation and we were left to it. What was my role now? I had a wife to help, still connected to an intravenous line that had eventually delivered the pain relief after the birth of the baby, failing to take away any labour pain, but now successfully making her drowsy and giddy – on top of the usual post-partum issues.

My newly born son lay under a heating lamp, connected to monitors; still mildly cyanotic, alone and asleep. Our families were interstate, as our wish – but were desperate for news after such a long labour. The doctors and midwives had moved on to the next problem, next birth and the next duty. I was left somewhere in the middle – emotionally and physically drained, still confused on what went wrong towards the end of the labour, and still confused as what my role now was, still uncertain on how I fit into the plan of care or delivery of services.

I was capable of caring for my wife as any husband is and also capable of caring for sick or injured patients requiring assistance with mobility and showering – which my wife now was. However, was this MY role? I knew better than most that hospitals run on people knowing and understanding the roles within the organisation and fulfilling them – but where did I fit in? The past few hours had been so chaotic that I was unsure what to take on as my role and what to leave for the staff.

I still had adrenaline pumping from the excitement, but also from fear. My wife had been in incredible amounts of pain and I had been unable to help her. The medical model of care had failed her in the very important task of pain management, which aside from being incredible unpleasant has also been shown to directly affect the birthing process (Wong, Perry, & Hockenberry, 2002).

Communications throughout the labour process had been fantastically clear and appropriate – but now there was no communication or support – the initial problem of a baby needing to be born had been effectively and efficiently dealt with. Our new requirements for support and explanations did not fall into the priorities of medical staff at this time.

The birth of a child: Confusion and powerlessness. A father’s role in labour, delivery and aftercare. Part 1

This is an ethnography assignment from my Master of Public Health. Its not perfect, not re-edited and clumsily chopped in three. References are listed on the final post.

INTRODUCTION

My wife lay exhausted on the crumpled sheets of the hospital bed; slightly dazed and confused by the late acting synthetic opioid analgesia she had been administered, still wearing the clothes she had laboured for thirty-six hours in; stained with amniotic fluid and sweat.

My new-born son, still unnamed, also exhausted; lay sleeping in the Special Care Nursery of the hospital, watched and monitored, having been admitted for observation due to being “flat” upon delivery.

I was the spare piece of the birthing puzzle- the husband, partner or friend that is along for the ride, but ultimately surplus to demand once things were in motion.

Now that the baby was born, I was torn. What was my role now?

My wife was still connected to intravenous lines that had long since served their purpose and my son was in another room being closely monitored having been born not breathing and requiring resuscitation.

I had waiting family to contact to share the wonderful news of the expected arrival of my newborn child.

I had a wife to assist following the most physically intense activity I’d ever witnessed.

I had a new creature in my life that I did not know, or yet love in a traditional sense – but had an overwhelming primeval impulse to protect and watch over.

Most of all, I had my own feelings, emotions and needs – but they had been largely ignored for the past few days and I had a feeling that was not about to change.

FATHER’S ROLE

The role of the father in the birth of their child is complicated and often unclear. A quick examination through the 1700 page textbook, Maternal Child Nursing Care (Wong, Perry, & Hockenberry, 2002)) found one dot point summary on the support needs of the father in labour.

Advice to practitioners included informing the soon-to-be-father of expected sights and smells and that needing to leave the room is fine; reinforcing that his presence in labour is helpful; offering him blankets to sleep on the chair and reminding him to eat (Wong, Perry, & Hockenberry, 2002). While this is arguably important information in practical terms; the almost condescending nature of the advice and occasionally the treatment of fathers in childbirth do little to acknowledge the father’s feelings and reactions to the machinations of labour.

A number of sources debate the value of having the father or partner in the delivery suite due to their lack of understanding of the process, high anxiety levels and lack of proper support to their partner (Vernon, 2006, Odent, 2010 and Winder, 2010). Winder (2010), a birth attendant and creator of BellyBelly .com.au; a high traffic Australian conception and birth website; challenges fathers in their motivation for attending the birth and their role in ensuring that their partner’s birth is all it should be. Vernon (2006), talks of men’s inability to allow things to “happen” in their role as “fixers” and creatures of action and often end up requiring comfort from their partners, increasing anxiety. Odent (2010), speaks of the increased neocortex stimulation and increased adrenaline associated with an attendant father-to-be.

All of these authors advocate for the use of a doula, or birth attendant; with the preferred outcomes being to ease the strain on the male as birthing partner through to removing the father from the role entirely.

While an unprepared, reluctant or anxious partner can be a hindrance to the birthing process (Vernon, 2006); should the emphasis be placed more on ensuring understanding than third-party involvement? Should all fathers be seen as a hindrance and potential negative influence on a successful birth? Chandler and Field (1997), argue that the benefits of an active, educated and engaged father in the support role is important to both parties. He also notes that fathers were not seen as part of a “labouring couple” and many felt tolerated rather than full partners in the birthing process (Chandler & Field, 1997).

Post-partum information and advice has a somewhat similar tone, with the onus being on the new father to ensure that he is providing the support and encouragement that his partner requires (Winder, 2006; Wong, Perry, & Hockenberry, 2002).

This is true, but there is little about the father’s own needs, insecurities and required support. The “father” in most of the literature and prenatal education appears to be the generalisation of the clueless bloke who purely wants to work, watch footy and have sex and hopes a baby won’t get in the way of all that.

Realistically, as the roles and expectations of women have changed dramatically over the past few generations – so has that of men.

MY BACKGROUND

Going into the labour experience was not going to be the same for me as it was for the general “bloke” described above. My background had given me some insight and education in to the birth process that had not been afforded on every man. It can be argued that knowledge is power. It can equally be argued that a little bit of knowledge is dangerous.

I am one of the 9.6% of male nurses in Australia (Australian Institute of Health and Wellfare, 2011) , and through training and employment opportunities I had worked with prematurely born babies and children, assisted in the birth of four babies and had experience of hospitals, pain and medical staff.

I had endeavoured throughout my wife’s pregnancy and labour not to advertise my profession as it can have two unwanted effects. The first being, occasionally other health professionals stop talking to you and your partner as patients or clients, but to me as a nurse, seemingly hoping I will later translate and explain the conversation to my wife.

Secondly, there can be some reluctance or even annoyance, often a pre-conceived idea that you will be a bit of a “know-it-all” or overstep boundaries. I wanted to be treated as a first-time expectant father, not an off-duty nurse.

to be continued

How can you ride a motorbike?

“You’re a nurse – how can you ride a motorbike?”

I’ve been asked this question hundreds of times by incredulous family, co-workers and strangers. The risks, the amputations, the deaths – they’re horrific! How could I take such a risk? Well, avoiding the clichés of life is full of risks and I definitely am not one trying to live fast and die young – I’m just not that worried about motorcycle related trauma.

Through circumstance, timing and career, I’ve not seen that much motorcycle related trauma to scare me away. Sugar on the other hand – sugar is a nightmare!

Working as a nurse, especially in the Northern Territory, exposed me to the dangers of sugar. It’s terrible. It puts motorcycles to shame. I’ve seen horrific lower leg amputations carried out on the lower limbs of diabetics with a poorly controlled condition. Many more amputations than what I have seen relating to road-trauma.

I’ve seen toe amputations progress to forefoot to foot to lower leg to above knee – almost in the blink of an eye.

The amputations, mixed in with cases of peripheral vascular disease and diabetic neuropathy that have had led to patients having small, somewhat insignificant foot ulcers infiltrated and colonised by maggots have turned my stomach and made me think long and hard about the sugar intake in my life. Much harder than whether to take my motorbike to work or not. There’s nothing like picking maggots one-by-one out of a wound to make you start soul-searching about what went wrong here.

Don’t get me wrong – road-trauma, especially motorcycle related trauma is incredibly confronting, destructive and depressing.

Amputations, decapitations, burns and fractures. Terrible, but not that common. A 2012 paper from the Journal of Foot and Ankle research found that between 2006 and 2007 53% of Lower extremity amputation cases performed at the Princess Alexandra Hospital (Brisbane, Australia) were related to type 2 diabetes (8% to trauma, 18% to peripheral arterial disease) (Lazzarini, O’Rourke, Russell, Clark, & Kuys, 2012) and that 65 diabetics were having amputations every day in Australia in 2005 (Australian Diabetes Council, 2013).

So – how can I ride a motorbike with what I’ve seen as a nurse? Easily – how do you eat that biscuit?

 

Australian Diabetes Council. (2013). Diabetes Facts from http://www.australiandiabetescouncil.com/diabetes-education/diabetes-facts

Lazzarini, P. A., O’Rourke, S. R., Russell, A. W., Clark, D., & Kuys, S. S. (2012). What are the key conditions associated with lower limb amputations in a major Australian teaching hospital? Journal of Foot and Ankle Research, 5(1), 12. doi: 10.1186/1757-1146-5-12

“Why are you a male nurse? Couldn’t you become a doctor?”

registered_nurseEvery male nurse that has ever worked, has heard these words or similar. Some before they even have the chance to graduate!

Some hear it from confused patients who are struggling with the concept that a young, athletic man would do “women’s work” when there are so many “better” options.

Some hear it from colleagues.

Some hear it from family members, perhaps clinging to the faint hope that one of their own will end up with that lovely Dr. before their name and all the glitz and glamour that goes with it.

Sometimes you get it from people you meet at parties and bbqs. I’d be able to afford medical school if I had a dollar for every time this conversation played out:

“So where do you work?”

“Ah.. the hospital.”

“Oh, wonderful – you a doctor?”

“Um, no, just a nurse.”

Just a nurse. Just. A. Nurse.

male-nurse-comparison.pngSuch a simple, yet incredible devaluing statement that I know I made many times. Just a nurse: just wasn’t smart enough to be a doctor; just couldn’t eat healthy enough to be a dietician; just didn’t own the right jogging shoes to be a physiotherapist.

Now, calm down angry hordes of physiotherapists and dieticians. At least you got a mention. I didn’t bother with Occupational Therapists or Health Promotion. We’ve all got valuable contributions to make within health care. We are valuable. We are not just anything.

It’s such a simple statement that carries so much weight. Nurses, and particularly men who work as nurses need to start taking ownership of the profession. Be passionate and proud of it. For too long I referred to myself as “just a nurse” or as a “male nurse”.

What the hell is a “male nurse” anyway? Do we have “female nurses”? Why are we differentiating? This term needs to go the way of the “lady doctor” and be thoroughly shown the door! I am a nurse. I happen to be a man. They are not related in anyway. They are not gender exclusive roles. Neither is my marital status, sexuality, how many children I have or what I do on the weekend related to my ability to be a nurse.

s-9611e9bbda960201e4bbbcaf9259764b14074abf.gifMen become nurses for a reason. There are very few that fell in to the profession. You will rarely find a man that wasn’t sure what to do after school so thought they’d try nursing. You wouldn’t take the road of nursing, as a bloke, unless you didn’t at least have a strong desire to. You’d study commerce. Or engineering. Or mechanics. Or surf. Or find some other way of earning money that didn’t involve entering nursing. You wouldn’t enter a female dominated profession where you will have your motives, sexuality and personality so constantly questioned.

I didn’t become a nurse to get through the “back door” of medicine. I didn’t do it to date the nurses in my uni class. I didn’t do it so I could see people naked. I didn’t do it because I am gay. There are much easier ways to do the first three things, and well, again, not sure what nursing and sexuality have in common but that wasn’t involved here. Nurses need to sell their profession when we are asked about.

Nursing is a female dominated profession that has struggled to develop and promote its professional standing. A large part of this is because of gendered expectations, obligations and barriers that are placed in front of the majority of the nursing workforce, often by men in administrative roles or neighbouring professions.

Hospitals and health systems are battle grounds for power and status, and its no surprise the profession with a mainly female workforce struggles to maintain its standing. Its important that men who are nurses champion the role of nurses as professionals and raise the standings of our work – but not at the expense of our female colleagues. We can’t drive nursing up by driving men to the top. Though this is what happens.

I became a nurse to be challenged, to help people, to connect with people on a very human level. I wanted to interact with other human beings, to help them through the moments when they are most vulnerable, scared or alone.

Nursing is such a privileged profession – we see people at their worst and try to help them back to where they want to be. We hold people’s hands as they slowly slip across from this life to the other side. We catch the arrest as it happens and set the wheels in motion – sometimes saving that life, sometimes just missing. We see families come together and see others destruct.

All this happens while surrounded by other amazing professionals who support us, challenge us, annoy us and validate us as professionals.

Nursing is such a fulfilling, challenging and diverse profession that requires dedication, intelligence and diligence – make sure the next person that asks you about it knows that.