Should Men Be at Birth?

I was asked to write a piece on this subject by a fellow birth professional and midwife. Why I haven’t written it before I dont know, it is something I feel very passionately about.

Michel Odent was famously reported as saying men shouldn’t be at the birth, he even went as far as to blame them for the increase in Cesarean rates. At the time I was incensed by his comments. It was at the time when I was coming to the end of my training and was really passionate about supporting families, but especially in supporting men to prepare for their journey to fatherhood. I used the reflective practice I had learnt through my studies to really look at his comments and my reaction to them.

In truth, I actually found that in a lot of respects I agreed with him! The difference is that I don’t want to take dads out of the birth and I think there is another, more empowering way of looking at the issue. I want to see dads (and mums) being made more aware of the importance of the birth partner at birth, giving dads proper support and information to fulfil this role (if they wish to take it on) – after all the benefits will be far ranging and crucial for the whole family.

Dads-to-be themselves need to understand that in general their partner does wants them there, there is nobody they would rather have with them. But with this comes responsibility, responsibility to understand what is happening and to prepare to be the best support they can be. Preparation for the birth is not just the domain of the woman, and a dads role at birth is not just about being a spectator.

So why should men be there if they can?

The biggest enemy at any birth is fear; fear causes the production of adrenalin. This can slow the production of oxytocin and in turn this can slow or even stop contractions, which is often referred to as failure to progress. So logically, having someone in the birth room who makes the mum feel secure and safe is really important, and with the right preparation, arguably there could be no better support than having the person she loves and chooses to go through the ups and downs of life with, to support her. There is nobody she would rather have there, nobody that knows her better or she feels safer with.

Another reason for the man’s presence is in his role as an advocate for his family. A key part of his role can be to make sure his partner’s wishes and desires are listened to. Sometimes in the intensity of moment, mum can lose sight of these or be in a vulnerable position unable to advocate for what she really wishes, so the man’s role is to do this, so she can focus on the work of birthing and stay in the zone.

By being present at the birth, a man will almost always feel an immediate bond with his baby. Bonding with the unborn child is quite difficult for men, often it doesn’t occur until after the birth, and this bond can sometimes be harder to achieve if they are not there to witness and participate in the birth. This bond is crucial to the family in the first weeks and months following the birth, so certainly where men want to be present, telling them they shouldn’t be is not going to be helpful to what follows.

Are there any risks to the man being at the birth?

Unfortunately yes, the support that can be so important and desired can be undermined by dad’s own anxieties during the birth. This is partially what Odent was referring to when he made his claims. An anxious father who is fretting and worrying will cause mum to be fearful that something may be wrong (this is often subconscious but has a very real impact). This fear which mum picks up on can cause her body to increase her adrenalin production, inhibit oxytocin, and as described earlier, therefore start the chain of events that potentially will lead to a stalled labour. Unfortunately stalled labour is the most common reason for the cascade of interventions to begin, as soon as interventions start the likelihood of them escalating increases.

There is also the risk from the man’s “fix it” instinct. If the man is not understanding of the birth process he is in danger of overriding his partner’s wishes or doing something detrimental to the natural processes of birth. For example, if a man believes his partner is in pain, he will want to stop her being in pain; at this point he may suggest and even promote interventions. However, the reality may be that his partner is coping well and just making the normal sounds of birthing… but if he suggests she needs pain relief, it can bring in a seed of doubt and lead again to that negative cycle of fear. Dad’s in the birth space need to control this natural ‘fix it’ instinct, but this can only be done through first being aware of it, and then having the ability and tools to control it… This is crucial to making sure he is not one of the reasons that interventions are being suggested!

So dads listen up, if you want to be there and your partner wants you to be there, you need to put in some effort and be the best birth partner you can be. You have the potential to truly affect the whole experience and outcome, and with understanding and support you can reduce the need for interventions. Your presence WILL impact on the birth experience one way or another!

Finally, it is a helpful idea to discuss as a couple the role of the birth partner. You and your partner may decide you are not best person to act as a solo birth supporter. This is absolutely fine, it is not a requirement that you HAVE to be the only birth partner (or that you even need to be there at all, if it doesn’t feel right for you and your family).  You could both consider another family member also being there, or using the services of a doula. Doulas are professionally trained as support for expectant parents, and they can act as a birth supporter alongside dad, or instead of dad – whatever suits you as a family. I would always suggest interviewing a couple of doulas to help you find the person who is right for your family. ANYONE in the birth space can have positive or negative impact depending on how they make you feel, so it is imperative that you are comfortable with them and they are also comfortable with you.

But please, can we empower families to decide what THEY want for their birth, and to allow mums AND dads to prepare, rather than be telling them who should and shouldnt be at their birth. Anyone can bring good and bad into the birth space, men/fathers are not by default ‘poor’ birth partners, and a bit more support and encouragement would go a long way.

 

Dean Beaumont is a leading expert in working with fathers and founder of antenatal programme DaddyNatal which supports fathers-to-be to prepare for birth and parenthood.

He is also author of The Expectant Dad’s Handbook published by Random House.

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