The recognition of the physicality of motherhood is obvious—the woman shows abdominal enlargement and ultimately gives birth to a baby. Fatherhood, however, is not at all like that: the changes that the father experiences are not visible and they may, therefore, feel detached from becoming a parent. These emotions might be highlighted in many cultures where rules dictate that the father should stay away from the birth.
As a consequence of the primary focus of antenatal education on the needs of mothers, many fathers remain unprepared for their personal transition to the parenthood. Current research suggests that one-in-three fathers felt like ‘onlookers’ rather than involved in antenatal care (Miller, 2013). A body of evidence found that 80% of men attend at least one antenatal appointment, and most fathers attend an ultrasound scan of their baby (TNS System Three, 2005). These figures suggest that men would like to be included in the antenatal experience and be prepared before the birth and for parenthood (Andrews, 2012).
Additionally, a systematic review of longitudinal studies of father's involvement and children's development found that a father's engagement has a positive influence on the psychological, cognitive and behavioural outcomes of their babies and positive influences on mothers' health choices (Allen and Daly, 2007). These themes are further supported by the Department of Health (DH, 2011) in their ‘Preparation for birth and beyond’ resource pack. Consequently, it is critical that midwives not only permit fathers' participation but actually invite them to take part in maternity care (Persson, 2012). Midwives providing parent education should be planning their sessions carefully to meet the needs of men as well as women (DH, 2011).
In response to fathers' desire to play an active role in maternity care, an alternative approach has been proposed by Barrett and Newburn (2013) who pioneered a ‘mantenatal model’—a fathers-only antenatal course. This model aimed to increase a father's sense of self-efficacy as a birth partner and develop his confidence to become a parent. The running of separate sessions for fathers was advocated by those who attended, as they felt it provided an opportunity to address some of their concerns. However, in a qualitative longitudinal study by Shirani and Henwood (2011) the men felt if they had been offered stand-alone sessions they would have been unlikely to attend. Therefore, Wockel et al (2007) suggests that an additional hour session specifically for men within antenatal education offers a good compromise and increases father's satisfaction.
Regardless of the provision of antenatal education, for maternity services to engage fathers they will need to have particular regard to complex factors such as a father's personal experience, culture and social circumstances (Hauari and Hollingworth, 2012). While ‘providing men's magazines and arranging appointments around football games' (Thomas, 2012: 5) could be criticised as being based on stereotypes of male interest, evidence-based practice when working with fathers may lead to more holistic outcomes (Dellman, 2004). Davies (2008) argues strongly for midwives to rethink the way they work and connect with fathers. At a time of change where maternity services in the NHS are aspiring to deliver safe high quality maternity care, men need to be informed and encouraged to get actively involved in the maternity care of their partner and newborn baby. This will promote a positive pregnancy, birth and parenting experience for both the mother and father.