Caroline Deacon - Should Fathers be at the birth?

Caroline Deacon
Journalist and author based in Scotland, UK

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Should Fathers be at the birth?

In Britain this year, nine out of ten fathers will witness the birth of their baby. Our expectation that Dad will be there if he possibly can, is unique; throughout history in all known cultures, birth has been “women’s business” with fathers expected to keep out of the way. Who is right? More importantly, will you ask your partner to be there? Caroline Deacon investigates.

You may think that having your baby’s father at the birth is a matter of choice, but the role he plays is pretty much culturally determined. When we were born, hospitals would have been horrified by the suggestion that our fathers wanted to be present. A generation later, our partners also have hospital expectations thrust upon them, this time that they will be there, even relied upon as an essential extra pair of hands and eyes in short staffed maternity units.

The pendulum is swinging back again, as Dr Michel Odent, the internationally famous doctor who introduced the concept of home-like birthing rooms and birthing pools into French state hospitals in the 1970s, has spoken out against fathers attending births. He says that men inhibit women’s natural responses in what should be a “primeval act”; going as far as to blame fathers for the rise in caesarean section rates.

Dr Odent claims that fathers’ presence is not natural, and that they increase the pressure for an artificial birth, because they find their wives’ pain disturbing. “When a woman gives birth she needs to lose herself in the primitive or limbic part of her brain. An anxious father, who constantly asks ‘rational’ inadvertently stimulates the intellectual part of her brain,” he claims. “In aiming to protect her, he might request an epidural or caesarean so she won’t have to endure too much pain.”
He also blames a male “love of technology and equipment” for birth complications.

Historically men have never been present at births; traditionally they were sent to the kitchen to boil water while mother and midwife got on with it. Dr Odent comments, “Think about it – what did they really needs those gallons of water for? It simply gave the fathers something to do.” In other societies, grandmothers or other experienced female relatives attend the birth, and indeed in many of these cultures, births tend to rely on fewer drugs and have less surgical interventions. In Japan, for example, where husbands carry on with their normal day-to-day business while their wives give birth, the epidural rate is less than 1%.

It is certainly true that caesarean rates are rising, as well as assisted (forceps and ventouse) deliveries. It is also true that most women, as long as it’s safe for them and their babies, would prefer to have a normal birth. The World Health Organisation recommends that caesarean rates need to be no higher than 10-15% of all births, yet in Britain the rate is 17% and rising. However, this may have less to do with father’s presence and more to do with fear of litigation. Caesarean rates vary between maternity units, with some hospitals’ statistics as high as one in four. At these hospitals, fathers attend births just as they do in hospitals with the commendable rates of 10% or less.

Perhaps, then, it’s not Dad that’s to blame for the rise in interventions. The reality is that we’ve moved away from a situation where most women gave birth at home or in small maternity units to the current picture where the majority of births take place in consultant-led units in large hospitals, where interventions are far more likely.

Recent research in this country also shows that having a midwife in attendance who is known to you has a significant effect. Women who labour with a known midwife need less pain relief or interventions and have shorter labours. Unfortunately, one to one midwifery care, as this is known, is less likely to occur in large consultant-led units. Where it does, for instance in the Hammersmith Hospitals, studies have found that women are more satisfied with their care, feel more confident and more prepared for the birth and care of their baby. There are also significant reductions in use of epidurals.

To guarantee the presence of a known midwife probably means private care – not cheap. A less costly alternative is to employ a doula. This is a woman who has given birth, who is not medically qualified, but who has been trained to accompany and support women in labour.

However, the vast majority of women giving birth this year will never have met their midwife before. Giving birth is a great unknown, hospitals are unfamiliar environments, so it can be a great help to have someone who is on your side. Should this be your partner? The NCT thinks that this “depends on the man. Our research has revealed evidence that lots of women benefit from their partners being there and find them immensely supportive. The most important thing is that the woman who is giving birth feels relaxed, confident and happy.”

Michel Odent thinks “another woman who is already a mother herself” should accompany us. Doesn’t this sound like mother or even mother-in-law? Many of us do not have mother on tap, and those who do, would not necessarily relish her presence. Why should we be less inhibited in front of her anyway?

Something Michel Odent has missed is that our society today is pretty unique in the break down of sex roles. Many men play a far larger part in raising children than their fathers did. Most women return to work rather than fully immersing themselves in full-time motherhood. Men and women are also often well informed about birth and have clear ideas about how their children should come into the world. Couples often attend ante-natal classes together, and those men say how helpful these were in preparing them to be useful birth partners.

Perhaps rather than making a blanket decision to exclude your partner, it is better to make sure he is well informed, and consider whether he will be useful to you. You are entitled to decide, and to have more than one person anyway if you want, so by all leave him behind and bring mother, mother in law and the neighbours too – but be prepared for some raised eyebrows.

Yes he should be there….

He’s been to ante-natal classes, and he knows his stuff
He knows what you want, understands your birth plan, and will argue for your choices if necessary
You are happy for him to see you at your worst
There is no-one else you would rather have

Don’t let him near you…

He doesn’t want to come
You will feel inhibited
He’s really squeamish, and gets freaked out by hospitals and doctors
He has strong views which conflict with your own.

Who is likely to be with you when you give birth?
Once you have been admitted in labour, you will be assigned one midwife. In the early stages she may well come and go, depending on how you are doing. She may also be replaced once or even twice by new midwives as shifts change. Once you reach second stage, another midwife joins you; one to look after you, one for the baby. If complications develop - perhaps you need forceps or ventouse, the duty doctor, consultant or a paediatrician may be called in. For known complications like twins, prematurity or a breech baby, there will be several people involved throughout your labour.