Understanding dads’ experiences of birth complications…

6154263729_97fdd8925dMy friend Harry* doesn’t have much in common with Graham, who I worked with many years ago. They were born and raised in different countries, and had vastly different upbringings. Harry likes ballroom dancing, seafood and wine. Graham prefers Thai, beer and Bay Area thrash.

But they do both adore their partners and children and they have two other interesting things in common.

Of all the men I know, Harry and Graham are the two who have shown the most ongoing interest in discussing the births of their children with me when we meet socially.

And I don’t just mean the 3am ‘wooo hooo’ text sent to everyone in your contact list announcing that you’ve become a dad.

They have both wanted to discuss, process, analyse and ask questions about their and their partner’s birth experiences on multiple occasions.

Often, we go over the same ground from different angles.

The other thing they have in common?

Both of their partners had traumatic birth experiences.

I shan’t go into the full details but, between them, Harry and Graham have witnessed the women they love going through one episiotomy, one vacuum extraction, two post-partum haemorrhages and one trip to the operating theatre. Both have many unanswered questions.

I wrote this blog post in honour of Harry, Graham and all the fathers (and, yes, co-mothers and others) like them.

Because it’s important for them to know that they’re not alone.

A few years ago, I spotted a couple of studies that highlighted elements of the experiences of dads at birth. Although both of these focus on complicated births, it’s important to remember that birth doesn’t have to be complicated or traumatic for the experience for feel negative.


The emotional effect of vacuum extraction

A Swedish study of father’s experiences carried out by Zwedberg et al (2015) found that vacuum extraction (VE in the quote below) had a strong emotional effect on dads:

“The theme ‘affected but helpless’ refers to the father’s role changing when childbirth terminates with a VE. From initially being involved in the delivery, his role switches to being merely an observer at the mercy of the professionals’ knowledge and guidance. The VE procedure evoked concerns over the mother’s and the child’s safety and wellbeing, even if the fathers wanted the birth process to be over. The fathers considered the choice of conducting a VE as an adequate alternative, but they expressed concerns about consequences on future decisions. The theme encompasses all the main categories: wish to be involved, anxious observer, turbulent feelings and thoughts about consequences.”

2636583955_c41a6fb4d1One of the original quotes in particular shows just how deeply men can be affected by the experience:

“You’re thinking that it looks so rough when they are handling the instrument and that they are tearing and dragging the poor baby. You think it will break, even by the smallest touch. They are very harsh, so it looks very dramatic”. (Father 8)


Fathers’ experiences of complications

The themes that arose in the experiences of the dads who were interviewed by Zwedberg et al (2015) are also found more widely in another study, this time a meta-ethnographic synthesis of fathers’ experiences of complicated births that are potentially traumatic, which was undertaken by Elmir and Schmied (2015).

They identified four major themes: ‘the unfolding crisis’, ‘stripped of my role: powerless and helpless’, ‘craving information’ and ‘scarring the relationship’.

Again, “Participants described the fear and anxiety they felt as well as having a sense of worthlessness and inadequacy. Men did not receive sufficient information about the unfolding events and subsequently this birth experience impacted on some men’s interactions and relationships with their partners.”


Harry’s experience

Harry talks about this a lot. He left the room to make a phone call after his baby was born. The placenta hadn’t yet come out. He returned to find the room full of people because his wife was bleeding more than normal. He couldn’t get through the crowds to reach her and was twice moved ‘out of the way’ by staff. Nobody explained what was happening to him until several minutes after Jessica was rushed out to theatre on the delivery bed. Harry thought she was dying.


What can we do

The implications and recommendations from both papers are similar.

Women’s partners need information, support and, in some cases, an opportunity to participate.

In the longer term, if my personal experience is anything to go by, they need the chance to talk their experiences through, often many times.

They may need more than that.

This is hard in a system where caregivers barely have time to care for the women who are giving birth, and it’s also hard in cultures where men are not encouraged or allowed to display or talk about their feelings.

It does, as Elmir and Schmied (2015) conclude, raise some interesting questions, and these deserve to be debated, but for today all I really want to say is this:

If you know a man like Harry or Graham, please feel free to share this with him so he knows it’s OK and normal to feel this way. Thanks.

* names changed to protect confidentiality, of course.
Elmir R and Schmied V (2015). A meta-ethnographic synthesis of fathers’ experiences of complicated births that are potentially traumatic. Midwifery. doi: 10.1016/j.midw.2015.09.008
Zwedberg S, Bjerkan H, Asplund E et al (2015). Fathers’ experiences of a vacuum extraction delivery – a qualitative study. Sexual & Reproductive Healthcare 6(3): 164–168. doi:10.1016/j.srhc.2015.05.003
photo credits: wisdom kissing ozare and Dad and Son I via photopin (license)

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