The dad-shaped hole in NHS maternity services

By Dr Jeremy Davies, Head of Communications and Impact, Fatherhood Institute on 19 June 2022 NHS MSWs - Maternity Support Workers Expectant fathers

Becoming a father is the biggest physical and emotional challenge most men will ever experience. It can be the making of us – and how we respond to it can also be transformational for our children, and our children’s mothers.

Yet most of us go through this huge transition without any kind of routine, tailored help from NHS or other family services: even if we’re easily within reach - as most of us are - of such professionals throughout the pregnancy, birth and postnatal period.

A decade ago, the Fatherhood Institute (FI) published a guide called Reaching Out: Involving Fathers in Maternity Care, with the Department of Health, Royal College of Midwives (RCM) and Royal College of Obstetricians and Gynaceologists (RCOG). It was jampacked with helpful advice about how to do a good job of engaging and supporting dads.

Since then, the number of official documents urging maternity services to get better at father-engagement has mushroomed to the point where one could wallpaper an average maternity unit with them, with enough left over to build an origami Palace of Westminster. They include the NICE Postnatal Care Guideline (2021), the NHS Good Practice Guidance in Involving and Supporting Partners and Other Family Members in Specialist Perinatal Mental Health Services (2021), the Forward Plan for Maternity and Neonatal Care in Scotland (2017) and Parenting in Wales (2017).

Here at FI we’ve offered – and continue to offer – training courses in father-inclusive practice, although we’re rarely asked to deliver these to the NHS, presumably because of pressure on budgets. We know that new initiatives have sprung up, including peer support groups in some areas, such as Dad Matters; along with father-focused information, like Dad Pad, a fathers’ pathway on the Baby Buddy app, our own Becoming Dad guide, and the Dad Course.

And yet, here we are in 2022, publishing a review of empirical evidence about fathers in the first year after the birth…and guess what? While research continues to show in ever-more detail how hugely impactful fathers are, the dad-shaped hole in NHS maternity services seems to remain firmly in place. You can read more in Bringing Baby Home, published this week. 

We’re not talking here about the cavernous dad-shaped hole in maternity services that emerged during the Covid-19 pandemic, by the way: here’s a quick recap about that one. This is just the standard dad-shaped hole.

So what’s going on? Are midwives simply failing to engage with fathers – despite all the guidance referred to above? If so, why – and are there ways we could change this? Is part of the problem that researchers are not focusing on fatherhood, and improved practice is not making its way into the evidence base?

The good news is that we’re working with the Royal College of Midwives to develop a new toolkit, to be published later this year. It’s an opportunity to find out what’s happening; work out some practical, achievable strategies for tired, overworked midwives; and to explore what needs doing, beyond changes in individual practice, to make sustainable change happen.

We’re holding some think-ins, and running a survey to find out about your challenges, ideas and examples of best practice. Look out for updates from RCM, sign up for the Fatherhood Institute newsletter, follow us on Twitter – or just send me a quick email at [email protected].

We’d love to hear from you. Thanks for your time.