Call the midwife ‘Dad’

Being at the birth of his first child was a life-changing experience in more ways than one for Daniel Oakes. His Californian wife, Heather, had opted to give birth at their home in Dundalk, Co Louth, in the care of an independent midwife.

With the midwife making antenatal visits to their home, he was more involved than fathers in the hospital system usually are. “My only experience of pregnancy and childbirth was seeing the midwife,” he says.

By the time the baby was born, they had built up a relationship with her.“I knew how I was supposed to act; the midwife was very calm and not saying much except ‘You’re doing really well’ and I kind of followed her lead.”

Due to his bond with his wife, he says, he knew instinctively what she wanted him to do.

Eye-opener

He was with Heather in the birthing pool in the kitchen and recalls how “the whole process was a big eye-opener for me. I don’t think you realise, until you’re there on the day, and there’s this little baby . . . ”

Witnessing the birth of Finnian in August 2006 had such a profound effect on Daniel that it sowed the seeds for a dramatic change of career.

When the former construction foreman was laid off two years later, he applied to study midwifery at Dundalk Institute of Technology and last year became the first male graduate of the four-year course.

As well as assisting hundreds of hospital births during his training, he has seen two more of his own children, Óran, who is now five, and two-year-old Arden, enter the world at home and with the same midwife.

Just a generation ago, Daniel would more likely have been in the pub than in that pool for his babies’ births, he says.

The pendulum has swung from fathers being kept out of the delivery room to being expected to be there, as one Co Donegal family’s experience illustrates.

Ann’s father was not at her birth, nor at those of her siblings, and he was appalled, she says, at the idea that she would “take a man away from his work” when the time came for her to have her own babies, but her husband was there for all four births.

However, she is expecting their fifth child this month, and she and her husband have agreed that if she goes into labour during the week when he is away at work – at least a four-hour drive away – he won’t try to get back for the birth.

He made it the last time, three years ago, only because the midwife wouldn’t break her waters until he was in the hospital grounds, she says, and she would rather not go through that again. Nor does she want to have to worry about him driving back in a hurry.

“I won’t know whether he is in the ditch or he has just lost coverage,” she says about the prospect of him being uncontactable for updates en route. “The chances are he is not going to make it, and I don’t see the point.”

Although she’s happy with their decision, other people are giving him a hard time, insisting he should at least try to be there.

“I don’t really mind what other people think,” says Ann, who asks for her real name not to be used to spare her husband further pressure. People who know him, she adds, should be a bit more understanding, “because he’s not an uncaring person”.

Up to the couple

It is up to a couple whether or not a man should attend the birth, says

Susanne Daly

, parent education midwife at the Coombe Women and Infants’ University Hospital in Dublin. However, in her experience, “most people want their partners there and most partners want to be there”.

It is good to be at the birth, she says, but if a man says the prospect frightens him to death, not being there “is not necessarily a reason for divorce”.

The caricature of the man hanging around by his pregnant partner’s side not knowing what to do no longer applies, she says.

“I see men in their late 20s and 30s and they are incredibly natural about it. Their dad may not be a role model but they have confidence to seek support and they will ask questions.” To the men, she says: “The focus is not on you; you are the support team, but a good support team is really, really important.”

In the ‘zone’

A woman in labour needs to be “in the zone”, says Oakes, because her body has taken over and she needs to let that process happen. She doesn’t need to be bothered by what is going on around her.

“Your job is to be the bouncer,” he tells expectant fathers. “You field all the questions that come towards her because you have sat down and talked with her beforehand and you know what she wants.”

Initially, dads-to-be are always concerned about when they should drive their partner to hospital, says Daly. The advice is to spend early labour at home, all going well.

“Most first-time couples are worried that they won’t make it to the hospital; most health professionals in the hospital would say they could have stayed at home a bit longer,” she remarks.

“We concentrate a lot, in the first classes, on coping strategies at home – what the partner can do: massage, run the bath, make something to eat, create a nice ambience, keep her calm, remind her of her breathing, just be there.”

While men like to “do” things, just being there may be all she needs, Daly explains. But it’s important to be attentive.

“Sometimes we ask women what they would absolutely hate their partners to do, and they say, just hanging out there on their phone, texting, checking football results,” she says. “They want the focus to be on them.”

Staff at the Coombe strive to include fathers and, in an emergency situation, will try to explain what is going on. “Emotions are high in that moment,” she acknowledges, so it is important to debrief the couple afterwards on what happened and why.

Antenatal courses

The hospital’s one-day antenatal course, which is run on Saturdays, is the most popular, as is another one run over two evenings, because fathers are often unable to attend weekday classes.

There is a case, she agrees, for introducing a fathers-only session, as was done at the London hospital where she trained.

“Sometimes they have different questions when the partner is not there,” she says. “A lot of them have the fear in the back of their heads, What if something happens to her and the baby?”

As the chairwoman of the Association for Improvements in Maternity Services (Aims) Ireland and a practising doula, Krysia Lynch sees how dads-to-be can be excluded.

“We know obviously it is the woman who is going to have the baby, but it is also a family’s journey,” she points out.

While there is a huge amount of support and information for pregnant women in the community, veering on overload, “there is very little available for men in that respect”, even among their mates, she says.

If a man is thinking that he doesn’t feel comfortable about going into the birth, there is no one to say that to, she says.

“Obviously you are not going to discuss that with your wife or partner, who would see it as a major deal, whether she is supportive or not.”

Unless a man has a brother or friend he feels he can talk to, “there is very little opportunity to discuss fears, or questions, or even potential positive issues”.

Her number one tip for dads-to-be is to wear a shirt that unbuttons so they can do skin-to-skin contact with the newborn.

If the woman has had a Caesarean section, she may not be able to do it immediately, so “it is important for dads to take their power: they are the primary caregivers at that point”, says Lynch.

Since graduating, Oakes has founded Neighbourhood Midwives, which offers private midwifery care before and after a hospital birth.

Neighbourhood Midwives has also recently partnered with another organisation to assist in home births north of the Border and is very close, he says, to being able to do the same in the Republic.

“The best part about community midwifery is that there is a chance to sit with the father as well as the mother,” he says.

In the hospital system, Oakes thinks men are “very much sidelined by the process unless they go and seek proper antenatal education.

“I have seen men feel helpless, especially when an emergency bell is pulled and a team of people fly in. Then they look like the most helpless person in the world and my heart goes out to them.”

Oakes is toying with the idea of running “beer and babies” evenings; bringing together fathers who have been through the process, and dads-to-be, in the pub. He says this has worked well elsewhere.

“I think it is so important,” he adds, “that dads have an outlet to talk to somebody about what’s going on in their heads.”

swayman@irishtimes.com

Bring some tissues: advice for dads-to-be from veterans

Singer Robbie Williams has said, in his own inimitable way, that being at the “business end” for the birth of his daughter was like seeing “my favourite pub burning down”. He also likened the arrival of Theodora Rose in September 2012 to a scene from the Predator sci-fi horror movies.

But don't let that put you off.

Fathers interviewed for this article about their advice for dads-to-be all believe you've got to be there, for yourself and for your partner.

“Don’t be afraid to watch the baby coming out,” says Rob Ryan of Athy, Co Kildare.

He had planned to stay at the shoulders of his partner, Rachelle, when she gave birth to their first child, Harry, in the National Maternity Hospital 10 months ago, "but I'm glad I decided to look because it really was amazing to see". Still in awe First-time dad Diarmuid Cooney agrees. Seeing his son emerge and, with his first breath, burst into life, "was the most amazing thing I have ever witnessed", he says, still in awe of that moment in the Coombe hospital nine months ago.

It was the climax of a long process as his wife, Sally Donnelly, had been in early labour at home in Kimmage through the Friday night. He made calls to the hospital and was told to bring her in at 6am on the Saturday. Miles arrived at 3am the following morning.

“I was so much involved in the process, the midwife offered to give me a pair of scrubs,” says Diarmuid.

"There is no feeling in the world like being present for the birth of your child," says father-of-two Lorcán Ó hÓbáin. "Don't miss it, or let anyone put you off being there."

He had attended some antenatal classes with his wife, Anne, and felt he had a reasonable sense of what to expect.

“What is hard to prepare a first-time father for is the mixture of excitement, fear and concern which develops as labour progresses.”

Both their children, Cathal (10) and Caomihe (7), were delivered by Caesarean section after prolonged labours. The first time, Lorcan wasn't allowed into theatre because Anne had a general anaesthetic but he was there for his daughter's delivery as it was done under epidural. More use "I was of more use to Anne and was much more part of the process at the actual birth the second time," he says.

If you are anything like Cormac McCann, who admits he is "awful" with needles, don't look when your partner is being given an epidural; he had to go out for fresh air afterwards.

"It's not one of those wee small things you get a vaccine with. Your partner won't mind, she won't even see it, but you will," advises the stay-at-home father of three, who writes a blog, beingaoifesdad.wordpress.com.

Skin-to-skin contact One of his top tips for dads-to-be is to strip off your top for skin-to-skin contact with your child as soon as you can.

“My wife couldn’t hold the baby immediately after the birth, so I got that first experience and it is one of the most wonderful feelings,” says Cormac, who was at the births of all of his children, now aged seven, four and one, at Our Lady of Lourdes Hospital in Drogheda, Co Louth.

A maternity hospital is no place for trying to be a “hard man”, he suggests. “I met one man in the lift who complained about how much wailing and screaming his girlfriend was doing.”

Cormac says in general he found the staff great, but there were a few exceptions.

"You'll have to make a judgment call for your wife and child on how you should respond, either to call them to account or let it pass."

Rob decided he had to intervene when he felt a midwife was making Rachelle stressed, so when that midwife went out of the room, he asked the junior midwife if she could ask her not to come back. There was no argument or fuss when the head midwife was told of their request and she was changed straight away.

The replacement, he adds, “couldn’t have been nicer, so it worked out great”. Other tips Rob: “Be supportive and attentive to your partner’s needs because no matter how stressful you find it, it’s a million times more stressful for the person giving birth.”

Lorcan: "Bring food and drink for the father . . . Passing out at the critical time due to low blood sugars is a bad plan." Rob: "Bring some tissues because you will cry when you hold your little baby for the first time."