Duncan Fisher

The Faculty of Health & Social Care at the University of Chester agreed yesterday a new project, the Birth and Beyond collaboration.  This will lead a national programme to put the family back into childbirth in hospitals.

The work will be led by Dr Mary Steen, a leading academic and practising midwife, with a long track record of research and development of family centred maternity care, in particular domestic violence prevention and engagement with fathers.

The University has asked me to help develop the programme and I am even being proposed for an Honorary Fellowship!

The birth of a baby is the birth of a family, said the Royal College of Midwives in 2002. Yet, when the birth of babies was taken out of the home, it became a medical event that separated the mother from her family. Improvements in maternity care since the 1950s have all moved in the direction of bringing more humanity into hospital maternity care, leading to a profound and positive transformation – descriptions of maternity care in the 1950s are not for the faint hearted!

The journey is not finished, however. Whilst the formal NHS policy has become “woman focussed, family centred” maternity care, there is little understanding of what “family centred” actually means in a hospital setting and almost no resources to allow midwives, health visitors and birth registrars to make it a reality.

Since World War II, an astonishing social change has taken place – over 95% of men now attend the birth of their babies. I have a theory for why this has happened. Hospitalisation of birth ripped through a family event and the only way families can coalesce again is by the father being at the birth.

The consequences of failing to focus on families as a baby is born are profound and much debated:

• isolation of mothers from their main sources of support in medical settings

• lack of engagement with the key influences on the health and wellbeing of the mother and baby within her family, leading to worse health outcomes – breastfeeding, smoking cessation, mental health, cessation of conflict and violence

• the marginalisation of fathers - high rates of non-registration on birth certificates, low levels of knowledge and confidence among many fathers, the drifting of fathers out of their children’s lives during the first two years of the child’s life, particularly in young and vulnerable families where mother and baby are in need of more support

To bring family centredness back into maternity and early child healthcare is a major undertaking. It is not just about changing how services are delivered and policies are designed. It is about challenging deeply embedded stereotypes about motherhood and fatherhood, stereotypes that have in part been created by taking mothers out of their families and treating birth as an individual medical event for them only.

My next blog will be about what I think needs to be done by the new unit at Chester and also by Government, as the Secretaries of State for Children and Health prepare a meeting in March on maternity services and fathers.

Fatherhood birth, domestic violence, family, fatherhood policy, maternity