Passage to motherhood

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Presentation at conference in Brisbane, 2011

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  • ----- Meeting Notes (4/05/11 13:23) -----Midwife means "with woman"Mentor always said her relationship was with the woman not with the partner.Today things have changed
  • In 2003 I was selected to become a childbirth educator for Parentscentre NZThis was a 2 year diploma course run by Aoraki Polytechnic
  • Score of 10 – Dad in best possible condition will thank you profusely, but donate large sums of money to your favourite charityScore of 7 to 9 – Dad in good shape, lawsuit unlikely. Parents will say nice things about you at parties with occasional remarks about you not coming into the labour room often enough to check epidural or water jug4 to 6 – Dad needs medical attention. Maybe a result of partner having hands around his neck. Recommend tactile stimulation & facial O2A score of 1 to 3 indicates that things are pretty dicey. Valium, smelling salts, and intravenous Coca-Cola have all been used successfully in this situation2 In many cases, however, all that's required is to prop the dad in an easy chair and let him watch videos of situation comedies from the 1950s. Back then all men had to do was sit in the waiting room until their little bundle arrived, all clean and snug, in the nurse's loving arms.
  • Score of 7 to 9 – Dad in good shape, lawsuit unlikely. Parents will say nice things about you at parties with occasional remarks about you not coming into the labour room often enough to check epidural or water jug
  • 4 to 6 – Dad needs medical attention. Maybe a result of partner having hands around his neck. Recommend tactile stimulation & facial O2
  • A score of 1 to 3 indicates that things are pretty dicey. Valium, smelling salts, and intravenous Coca-Cola have all been used successfully in this situation2 In many cases, however, all that's required is to prop the dad in an easy chair and let him watch videos of situation comedies from the 1950s. Back then all men had to do was sit in the waiting room until their little bundle arrived, all clean and snug, in the nurse's loving arms.
  • Men encourage interventionDistressed by their pain“Well I wouldn’t have a tooth pulled without an anaesthetic” – Male Midwife manager
  • Men attending childbirth may affect their emotional well-being
  • ----- Meeting Notes (4/05/11 13:23) -----could be due to having unreal expectations from antenatal class? Study based in North of England. Predominately white, skilled & professional workers
  • COACH need tocontrol labour be physically involvedWomen relied on them for encouragement & direction
  • TEAMMATE isFollower /helperAssisted & responded to requests for physical & emotional supportCharacterised byLooking to midwives and the women to guide them did as the women told them to doThe women assisted men in their role as teammate
  • WITNESS isCompanionObserverProvide emotional & moral supportCharacterisiticsWathcing TVReadingSleepingOften absent from the room for long periodsMakes lots of phone calls to relatives
  • Considering that I covered birthplans in the antenatal classes this I found surprising
  • Passage to motherhood

    1. 1. Addressing Men’s needs in childbirth education<br />A CBE’s reflection and the influence on my midwifery practice in New Zealand<br />Pamela Harnden<br />Research Assistant & Honorary Research Fellow Melbourne University<br />
    2. 2. Men are:<br />
    3. 3. Place I didn’t want to go<br />
    4. 4. Parentscentrenz<br />1950’s – twilight sleep<br />Fought for informed choice & active birth<br />Ideas based on the book, “Childbirth Without fear”, Grantly Dick-Read<br />Fought for men to be allowed to accompany partners<br />Set up antenatal classes<br />
    5. 5. Childbirth Educators<br />Only paid members of Parents Centre<br />Deliver a 6-8 wk antenatal course covering set subjects<br />Male only session facilitated by male presenter<br />Thoughts and feelings?????? About a male only session??????<br />
    6. 6. Thoughts and feelings<br />No idea what was being covered<br />No idea about how anything was being covered<br />Didn’t encourage communication between the couples<br />
    7. 7. Initial reaction<br />BAN IT!!!!!!<br />
    8. 8. On reflection for diploma special topic<br />Look at the evidence<br />Ask the men<br />
    9. 9. Apgar Score for dads<br />
    10. 10. How to interpret the score<br />Score of 10 – <br />Bennett, H. (1998)<br />
    11. 11. Score 7 to 9<br />
    12. 12. Score 4 to 6<br />
    13. 13. Score 1 to 3<br />Bennett, H. (1998) <br />
    14. 14.
    15. 15. Men are unsure of their role<br />In an alien unwelcome environment<br />“You need to give men tasks to complete and keep them busy” – Male midwife manager<br />
    16. 16. Emotional Wellbeing<br />
    17. 17. Men suffer postnatal depression<br />2006 UK survey found that most of those men suffering ‘postnatal depression’ had found witnessing the birth ‘off putting’<br />4% nationwide<br />10% Londoners<br />
    18. 18. Do men get ptsd?<br />Low rates of PTSD in men attending childbirth<br />Men less permitted to to acknowledge personal distress<br />Adjustment & anxiety rather than trauma (Bradley, R. Slade, P. & Leviston, A. 2008)<br />
    19. 19. benefits<br />Stronger Bond with their child (Gita, 2006)<br />Men gain greater sense of belonging (Sugathy, 2006)<br />Enhances the relationship between the parents (Chan & Brown, 2002)<br />Offer important emotional & psychological support to women during labour & birth (Plantin et al, 2011)<br />
    20. 20. Men at antenatal class<br />Not all men should attend antenatal class (Greenhalgh et al, 2000)<br /> Some men more likely to have a dissatisfactory experience of labour if they attended antenatal class (Greenhalgh et al, 2000)<br />
    21. 21. Grantly Dick-ReadHow much use is the man?<br />Unprepared man has no place in the labour room!<br />Men prepared, interested learnt process of birth – can stay<br />Men who cannot overcome their own fears – locked out of the labour room<br />Men who have done no preparation – should stay at home or down the pub<br />
    22. 22. Reason for men<br />Women just want to share the experience<br />Can improve maternal and infant mortality (Dugeon & Inhorn, 2004)<br />Can provide one on one support reducing epidural rate (Berry 1988) – Contradicts!!<br />
    23. 23. Asking the men<br />Methodology<br />Retrospective questionnaire was emailed out to 69 male participants of antenatal class after their babies were born<br />Received 34 responses to the questionnaire<br />Part of normal class feedback – special topic – no ethics approval sought<br />
    24. 24. Responses<br />Being present<br />All 34 respondents wanted to be present<br />10 felt under pressure to be present<br />24 felt under no pressure<br />
    25. 25. fears<br />16 expressed they had secret fears about birth<br />18 had no fears<br />
    26. 26. Roles<br />When questioned about their perceived roles these themes arose<br />Being there, provide comfort, keep hair out of face<br />Support, make her feel strong, <br />Reassurance, keep her calm<br />Encouragement, keep positive and keep smiling<br />Act as advocate<br />
    27. 27. Evidence of roles<br /><ul><li>Chapman, 1991 identified 3 roles men assumed </li></li></ul><li>teammate<br />
    28. 28. witness<br />
    29. 29. Birthplan<br />16 of the respondents were involved in writing the birthplan, 18 were not. <br />7 of the men didn’t even know there was a birth plan.<br />
    30. 30. Expectations of partner to cope<br />5 didn’t expect their partners to cope well<br />21 expected her to cope well<br />1 had no idea<br />
    31. 31. Was labour pain surprising?<br />13 respondents were surprised<br />17 weren’t surprised<br />29 respondents said chosen method of pain relief made their job easier<br />2 respondents said it didn’t <br />2 of the women had no medicated pain relief at all<br />
    32. 32. What would they teach other men?<br />Get as much information as possible<br />Ask questions & stand up to the staff<br />Just do as you are told<br />Know what your options are<br />Don’t take things personally<br />Relax, stay calm, be patient, trust the midwife, <br />
    33. 33. Make sure they have the drugs<br />Read as much as your partner does<br />Seem really interested<br />Use the following phrases, “yes dear”, “great job”, and always end by saying, “I love you”<br />Provide humour, massage, cuddles and verbal support<br />
    34. 34. Men’s special needs<br />Need to talk to other men <br /> A session run by men<br />Men set the agenda<br />
    35. 35. Midwives & Obstetricians<br />Need to be aware of men’s needs<br />Where to get drinks and food<br />Where pillows, sheets, towels and hot packs are<br />How to darken room & move furniture<br />Acknowledge their presence, anxieties and give opportunity to express them<br />
    36. 36. Meet during pregnancy the midwife or obstetrician<br />Opportunities to ask questions<br />Opportunity to leave if he needs to<br />Opportunity to debrief and explore any possible negative feelings <br />
    37. 37. Next for me<br />Structured Research Project <br />
    38. 38. How do men in Australia feel after labour and birth?<br />Background<br />Recently, research has been focusing on the effect of men in the labour room on the mother and the progress of labour. There have been no studies in the last 10 years in Australia which have explored men experiences of labour and birth and if they suffer any negative emotional effects.<br />
    39. 39. Aim<br />This study aims to investigate the experiences of men who labour and birth in Australia along with their partners experiences of men as their support person.<br />Ethics will be applied for through Melbourne University<br />
    40. 40. objectives<br />To investigate if they want to be in the labour room<br />To investigate if they are emotionally harmed<br />To investigate if they felt useful<br />To investigate how their partners feel about them being present<br />
    41. 41. Methodology<br />Retrospective questionnaire study created online for participants to fill in. Separate questionnaires will be created for men and women to complete. Participants will be invited to rate their feelings on a likert scale in response to a series of statements<br />Recruitment will be done by snowballing effect of social media<br />Data will be analyzed using the SPSS (Statistical package for Social Science)<br />

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