I have been watching the involvement of the partners of my patients in their pregnancies over many years. There are great variations in male engagement with the process. Some men have read everything they can find about pregnancy and attend every antenatal visit while others are seldom seen or express no desire to be “engaged”. The latter often express a desire to leave all the organisation and decisions to their partner.
Like most things in life, the middle-ground is often the best, but it is important to respect individual personalities and needs. Were I to be asked what I would suggest as ideal involvement, I would recommend partner attendance at the booking antenatal visit and at any antenatal visits after 36 weeks as this is the time when delivery decisions sometimes need to be made. Of course, partners are welcome at any consultation and some men do want to come to every visit, particularly for the first pregnancy.
The value of seeing both partners, particularly towards the end of pregnancy, lies in the opportunity to ensure that everyone is approaching the birth with the same aims and philosophy. Sometimes there is discordance. For example, one partner may be very anti-intervention, for example antiepidural, while the other is very keen on this form of pain relief. Having both parties together allows differences of opinion to be explored and any misconceptions rectified. It is also for valuable for me, as an obstetrician, to establish a relationship with the partner in case the delivery is “eventful”. When a relationship of trust has been established , there is greater satisfaction later with any hard decisions that occasionally have to be made quickly during a labour, for example a vacuum extraction or Caesarean section to deliver a baby in distress.
Interestingly, I often find the 6 week check after delivery easier without the partner as it gives me a chance to hear a candid account of how things are going, especially regarding contraception issues (where there are often different ideas between men and women!) and regarding emotional wellbeing. Some women will put on a brave face in front of their partner when there are actually underlying problems such as on-going postnatal depression.
It is important to remember that some men find the first 6 months post delivery challenging. There is, initially, a baby who doesn’t return cuddles with any feedback in the form of smiles and who dominates the attention of its mother. There can be sleep deprivation and usually sex-life is diminished for two reasons: one well known and one less so. Firstly, there is the need for recovery physically, especially if there has been perineal suturing or a Caesarean. Secondly, breast feeding women are usually not ovulating and consequently oestrogen deficient. This in turn causes vaginal dryness and reduced libido. Of course, overall, the period after delivery is a time of great joy for most people and life usually returns to normal, albeit with more responsibilities.
Dr David Shelley-Jones | www.betterbeginnings.com.au
Obstetrician and Gynaecologist, Sydney.