The benefits of a family-based approach to pregnancy, birth and beyond

We’ve all seen that scene in the movies. The one where the expectant father paces up and down a hospital corridor while his wife is in labour, anxiously waiting for the moment where the doctor emerges from a room and declares, ‘Congrats, it’s a ….’

Thankfully, a lot has changed in the last 20-30 years since those types of movies were being made.

Today, we know that fathers and partners who are more involved during pregnancy (attending appointments and preparation classes) are more engaged and have more realistic expectations at birth and postnatally.

This involvement leads to better understanding of the birth process and thus less anxiety for both themselves and their partner in the birthing suite.

It also creates more realistic expectations about parenthood in general.

Despite knowing this, however, our focus (medically) tends to be:

  • On the mother during pregnancy
  • On mother and baby during birth
  • On the baby after birth

In a previous piece, I made note of the need to focus on both the mother and baby after birth. Today, I’d like to progress that thought further and encourage a more family-based approach to pregnancy, birth and beyond.

The primary benefit a family-based approach would deliver is effective expectation management; something that delivers these knock-on effects:

  • Keeps the lines of communication open
  • Allows the mother and father to function better as a team
  • Allows the mother and father to provide each other with the support and understanding they need
  • Allows for more successful breastfeeding
  • Reduces the incidence of postnatal depression

Yes, postnatal depression affects both women and men

While 20% of new mothers will experience postnatal depression, you might be surprised to hear it’s a condition that affects up to 10% of new fathers too.

We know that the contributing factors for postnatal depression are:

  1. Lack of social and emotional support
  2. Stress and changes in a relationship
  3. Lack of sleep
  4. Difficulty adjusting to parenthood
  5. Expectations not being met
  6. Negative or traumatic birth experience

We also know that the risk factors for development of paternal postnatal depression are:

  1. A man’s partner experiencing postnatal depression
  2. A previous history of depression
  3. Relationship problems
  4. Low self-esteem
  5. Feelings of incompetence in the parenting role
  6. First-time fatherhood
  7. An unsettled baby

A family-centred approach to pregnancy, birth and beyond can address many of the above risk factors via early intervention and support:

  • Appropriate education opportunities for both the mother and father during pregnancy
  • Access to mental health screenings for both the mother and father before and after birth
  • Increased awareness around both maternal and paternal postnatal depression
  • A change in expectations around the role of the father in the process
  • A designated appointment for the father in the postnatal period

We can also encourage men to talk more:

  • Yes, it is ok to acknowledge things are difficult to your partner and work together to set realistic expectations of how you are going to parent together and adjust to the changing family dynamics.
  • Yes, it is ok to talk candidly with your friends and the people who are providing support to you and share what it is really like to be a new parent. Society has a role in setting appropriate expectations around parenthood.
  • Yes, it is ok to seek help from medical practitioners if you feel you may be suffering from postnatal depression. Self-medication through alcohol or other drugs only put a temporary cover on the problem.

As you might have picked up from the above, issues that affect the mother, father and baby do not occur in isolation so when we attempt to address them in isolation, we get sub-optimal outcomes.

This is why I firmly believe if we evolve our antenatal and postnatal care to be more inclusive, it will go a long way to addressing the significant health and relationship issues that arise around childbirth, and create more optimal outcomes, not just for the baby, or the mother, but for the family unit as a whole.

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