NHS: Maternity Care

Lord Farmer Excerpts

Thursday 5th February 2015 Lords Chamber

[Lord Farmer (Con)]

My Lords, I am grateful to the noble Lord, Lord Harrison, for initiating this debate on steps to improve maternity care. One aspect of maternity care which shows marked variation across the country is staff willingness and ability to involve fathers. This depends to a very much larger extent on culture than on budgets. I wish to make a plea for the very many fathers across the country who have felt thwarted in their best efforts to support their wife or partner throughout pregnancy, during childbirth, and in the earliest days of their new family.

A poll carried out by Bounty found that 96% of mothers considered it to be very or quite important that midwives and health visitors include fathers as well as mothers, yet research reveals that fathers still feel excluded, frustrated at the helplessness this engenders, and fearful because of the risks and uncertainty of labour. Much of this is due to a lack of consideration by maternity staff contrary to guidance from the Royal College of Midwives. This is not so much about their rights as parents as the need for the great majority of new mothers to have their husbands and partners respected and considered part of the labour team. If they are calm and supportive, this can free up extremely pressurised maternity staff to look after any more pressing needs in the delivery suite, yet this requires fathers to have been well prepared from much earlier in the pregnancy.

Feeling needed and helpful rather than surplus to requirements can be a game-changing experience, especially for young fathers who have serious doubts about whether they should be involved at all in their new babies’ lives. The time of the birth and shortly afterwards can be a very special moment—the point when a young couple may decide to try to make co-parenting work, even if they sense that they are unlikely to survive as a couple. It can mean the difference between a child growing up knowing his father and that same child growing up thinking that his father did not care enough to be involved. A million children in this country have no contact with their fathers. Who knows, with a bit of relationship support, that child may even grow up living with a mother and a father.

I have never forgotten the first time I held each of my children while my wife was resting and recovering. The hard work starts immediately. Having the father 100% on board, helping with the practical aspects of baby care, such as walking inconsolable newborns around in the early hours, may protect untold numbers of new mothers against developing postnatal depression. Maternity services are uniquely positioned to help get things off to a good start.

Some noble Lords may be thinking about the recent headline which claimed that,

“it’s better for mothers coping with the pain of childbirth if their partner is not around”.

Personal experience and much other research tells me that it is comforting and reassuring to have that other person present at the birth, and immediately afterwards, who is utterly invested in the well-being of the new member of the family.

When I looked more closely, it was clear that the University College London study was not primarily concerned with childbirth at all, but with how women cope more generally with pain and the effect of their relationship with their partner. Extrapolating this to their experience of childbirth and making any generalisations at all about the desirability of fathers being present is not at all justified and very misleading. There have always been women who, for whatever reason, have preferred not to have the baby’s father present at the birth. This might be because of strains in the relationship or safety concerns. However, the norm is for the father’s presence and support, before, during and after birth, to be very much welcomed because researchers have established that it tends to lead to less anxiety, lower rates of postnatal depression and less perceived pain, so surely this is what maternity staff should be fostering. Doing this as early as possible in pregnancy, without adding to existing high workloads, is not just about holding antenatal classes at convenient times for fathers. Communicating directly with fathers-to-be is now particularly easy through digital means such as Maternity Assist. Health and well-being-related advice and information is sent to both expectant parents on their phones and tablets, which they can both read, discuss and make joint decisions about. It is a world away from a letter addressed solely to the mother which the dad might feel awkward about reading.

To conclude, and to reiterate my plea, can the Department of Health add its voice to that of the Royal College of Midwives and many others to ensure that maternity services are in no doubt at all that they have a key role to play in drawing fathers in as early and effectively as possible?