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 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

“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.