“It’s not a shared experience.” It was a slightly jarring statement from my husband reflecting on the births of our three children over the years, but then I saw the stark truth at the very centre of it.
At the birth of our first child, I wasn’t aware of him having to intervene in an argument taking place in the delivery room between the midwife and consultant as to why I had been “left so long” after 30 hours of labour and a “failure to progress.” I can’t remember the trolley crashing through the corridors into the operating theatre and how he was suddenly in scrubs to witness a failed ventouse followed by an emergency Caesarean.
I do remember his calm reassurance as I fretted about the anaesthetic not working. I don’t know what it’s like to be left alone cradling your second child in the delivery room after your partner is whisked away, the sound of blood still dripping onto the floor. Nor do I know the frustration of being ignored or fobbed off as you try to advocate for your partner knowing they are on the cusp of delivery, yet still on a ward.
As I was taken though the stock questionnaire for postnatal depression by health visitors over the years, my husband’s interaction was limited to offering them a cup of tea as the words ‘mother’ and ‘baby’ echoed around.
“Traumatic,” is the word my husband uses to describe his experience. Even 20 years later, I can see from his body language his discomfort in recalling events. While the recent Birth Trauma Inquiry does acknowledge that further support should be given to fathers and birth partners, the conversation and stories around it still largely ignore them.
Be Quiet and Man Up, a questionnaire study published in 2020 by Emily Daniels, Emily Arden-Close and Dr Andrew Mayers noted that fathers reported “witnessing their partners’ traumatic births had a significant effect on them which they felt affected their mental health and relationships long into the postnatal period.”
“I think we still have the societal bias towards mothers as the primary caregiver,” says Julianne Boutaleb, consultant perinatal psychologist and clinical director and founder of Parenthood In Mind.
She says: “If we only look at men as a potential source of support, we’re missing out on the fact that men, just like women, go through a huge transition. What isn’t being grasped in the NHS is that this is a family going through this – a mother, baby and the partner and they all need support.”
Ms Boutaleb sees the contradictions that the current system throws up. On the one hand we now expect fathers to be present at the birth but still without adequate preparation in antenatal classes (which still focus primarily on the mother) for what might happen in the delivery room.
“The predominant emotions that men will express are usually ones of helplessness and shock,” she explains, especially if they felt they couldn’t protect their partner.
“It has huge ramifications for the development of a paternal identity if the transition to parenthood has been prompted by this traumatic experience. What we see in men often is a mix of acting out or avoidance, such as throwing themselves into work, avoiding sexual intimacy. It might be an increase in snappiness, and it can often be seen in the search for a supportive other at work. We’re not including them and we’re not protecting families in the long run.”
As Elliott Rae’s partner’s labour began during October eight years ago, he wanted to help his wife and be her advocate and was ready to help with the hypnobirthing they had planned. However, complications arising during the delivery suddenly changed all of that. “You feel like you’re watching it on CCTV because you’re in shock. I was so scared thinking I was going to lose one or both of my family.
“I can remember the walls, the smell of the equipment, the doctors’ concerned faces. Someone described a dad watching a traumatic birth as watching a car crash in slow motion. It’s a weird feeling where you can’t do anything other than watch.”
Mr Rae’s paternity leave was spent in hospital while his daughter was in intensive care. “It was the most difficult period of my life, trying to process what had happened and obviously being a new parent.”
While he was able to talk openly with his wife about how he felt about the birth of their daughter, he felt conscious of the need to be a support to her and spoke to no one else about how he was feeling. There was no professional support for him, unlike for his wife, who was diagnosed with postnatal anxiety within four weeks. Rae’s trauma manifested itself in different ways.
“It started with panic attacks, being in work meetings unable to breathe. I’d be on the train in tears, not wanting to get off.”
It wasn’t until a chance meeting with someone involved in maternal mental health around a year after the birth, that Rae learned he was probably suffering from birth trauma and was able to get help. His experience led him to set up the platform MusicFootballFatherhood advocating for fathers.
“Our health system isn’t set up for men,” says Mr Rae 41, who was living in east London when his daughter was born and is now based in Hertfordshire.
“I do a lot of workshops with midwives and health visitors talking about dads’ experiences and how they can engage them in the maternity process. A lot of that engagement has to start before the birth even happens. It’s about noticing the dad, involving him in the conversation, giving him resources. People are aware, yes, but there hasn’t been sufficient action to implement the changes necessary.”
Dad Matters (dadmatters.org.uk) is a Home-Start project, developed in Greater Manchester and delivered across the UK. It supports fathers with their mental health, helps them to nurture successful relationships with their families and to access the correct services. Commissioned by the NHS via the perinatal mental health pathway, the service offers one-to-one support having learned that fathers do not turn to groups when they’re struggling.
The organisation also gave evidence at the Birth Trauma Inquiry. The experiences of Kieren Anders, operations manager at Dad Matters, led him to become involved. He lost his first child from Group B strep shortly after they were born in 1997.
“There was nobody asking how I was. I felt very isolated.”
Read Next
News
Big Read‘My baby died 14 minutes after birth – I was high-risk but had no extra care’Read More
He found the births of his two subsequent children traumatic and it put pressure on his relationship with his partner.
He felt his role was to support his partner but didn’t feel properly equipped to do it. Avoidance was his method of dealing with his feelings, going out drinking and clubbing, ensuring he was busy all the time rather than being in a room with his own thoughts.
“There was miscommunication during both labours about treatment and we relied on the doctors and midwives to tell us what we needed to do. I was very focused on my partner. Dads are supporters, they’re not going through it so they’re on the periphery, but they’re also not included in information, decision making or education in a way that helps them understand their role as a supporter and as a potential parent.”
“A lot of work we need to do is in system change,” added Mr Anders, 45 from Manchester.
“I think it’s a really useful comparison to think about what’s available for mums.” Mr Anders could see that his wife had access to support networks and friends that he felt very isolated from.
“There’s still a bias within services,” Ms Boutaleb notes. “We need to be talking about families more, not just mothers and fathers. We could better equip families from the start in terms of mental health changes and potential birth trauma and to also equip fathers not just to be advocates but also be thinking about mental health. Support at the beginning in that family oriented way could see long-term savings in the NHS.”
None of this is to in any way diminish the experience of mothers around birth trauma, but we’re neglecting the other person in the delivery room integral to that family unit who also may be struggling. It’s imperative that work is done so that it truly does become a shared experience.
