Introduction 

In this essay I will discuss the needs of fathers with regard to labour and birth preparation, as well as their transition to parenthood, and analyze the implications of these needs to antenatal education. Further, I will address how I manage these issues within my teaching.

 History of Childbirth Education

Before I discuss the needs of fathers, I feel it is important to consider the history of men attending childbirth classes. In Western societies, a father’s presence during their partners’ labour and birth was almost non existent until the 1970’s. At this time, a social movement began that allowed and encouraged men to be present during labour and birth. Unfortunately, it took several more years for childbirth educators to realize that men needed some specific preparation for this demanding role (Nolan, 1998).
Over the years, childbirth education gradually changed to include fathers and address their need for education with regard to what to expect and how to support their partners during labour and birth (Fletcher, Silberberg, & Galloway, 2004).  Today, childbirth classes also frequently emphasize the changing roles both parents will undertake after the birth of a child (Beardshaw, 2001).

In spite of those changes, studies have frequently shown that men’s needs are still not being met (Friedewald, Fletcher, & Fairbairn, 2005). In the 1980’s, in an attempt to better meet the needs of men, gender specific sessions within antenatal programs became popular. More recently, in Australia, a more ambitious approach to teaching antenatal classes took this idea a step forward and introduced a new concept of men-to-men taught classes (Friedewald, Fletcher, & Fairbairn, 2005).

Why is it so important to meet men’s needs?

Research has shown that men whose needs are met during childbirth classes are more involved with their partners, and are more eager to help and participate in their infant’s care (Fletcher, Silberberg & Galloway, 2004; Diemer, 1997). It is also reported that men who are involved in their children’s care have a more positive impact on the child’s development (Lamb & Tamis-Lemonda, 2004). Since fathers play such an essential support role for mothers, “determining and meeting the needs of fathers should be a consideration of educators concerned about promoting effective provisions for mothers” (Friedewald, Fletcher & Fairbairn, 2005, p. 9). Beardshaw (2001) further emphasized that by supporting fathers, antenatal teachers are investing in the care of women and infants.
The role of fathers has undertaken a great transformation over the past 40 years, including an increased awareness of the support their partners need from them during pregnancy and childbirth, and their increased involvement in childcare; many men are left unprepared to fulfill these expectations during pregnancy, childbirth and parenting (Ratnaike, 2007).

Robertson (1999) also brings to mind that when the father’s own needs are not being met during such an anxious time, it is unrealistic to expect him to provide practical help and emotional support to their partners. Thus, in order to encourage and prepare men to be helpful and emotionally connected with their partner and infants, men's needs must be addressed.

Identifying and meeting men’s needs

Now that I have validated the importance of meeting the needs of men, I will discuss the issues involved in identifying and meeting those needs.
In spite of the extensive research on the topic, very little evaluation data has been collected with regard to fathers’ needs being met beyond the labour and birth experience (Taubenheim & Silbernagel, 1988). From the insufficient data available in relation to their needs going beyond the birth experience, it can be surmised that existing classes are not properly addressing men’s needs, concerns or feelings. Perhaps researchers and educators are failing to identify the needs of men.

Many childbirth educators believe that an ‘agenda setting’ exercise is an effective way to identify men’s needs. I disagree with this opinion. Fathers may not know what some of their needs are until they are faced with a new situation. By letting them decide what they think they need to know, teachers are running the risk of not meeting all of their needs. Many expectant parents worry about the upcoming birth and do not give much thought to the changes that occur after the birth (Priest & Schott, 1999). The reality of parenthood often comes as a big surprise as a result of the lack of preparation. Another problem for the 'agenda setting' approach is as Schott (2002, p. 37) suggests, that “when women are present their perspective tends to take over.” She believes that the best way to identify men’s needs is to listen to them when their partners are not present.
A more realistic way to assess the needs of men would be to talk to new fathers and ask them what they wish they had known, and find out what information helped them most during labour and early parenting (Smith 1999). Using the postnatal reunion and postnatal evaluation information is an ideal way to improve future classes.
Men's dissatisfaction with prenatal classes may be due to the improper assessment of their needs, as well as having unrealistic expectations of what antenatal classes are meant to provide.
Linton (2007) found that the 20 minutes given for exploring the fathers’ role was insufficient during antenatal classes he attended during his own partner's pregnancy.  As a result of his personal dissatisfaction, he developed a 'fatherhood class' specializing in men’s needs and concerns. From his own evaluations, he discovered that the top ten concerns expectant fathers face is shown on the table below.

While antenatal classes may attempt to prepare both men and women for childbirth and parenting, courses generally do not prepare either for the emotional and psychological aspects of parenthood (Barclay et al., 1996; Donovan, 1995).
In spite of all the changes classes have undertaken over the last 30 years, current research from Sweden shows that men are still dissatisfied with the lack of attention given to their specific needs (Premberg & Lundren, 2006).
Besides identifying the needs of men and trying to meet them there is another factor that must be taken into consideration. The fact that most antenatal teachers are women is worthy of reflection. A six-year study published in Journal of Perinatal Education found that all-men, male-oriented discussion sessions about childbirth benefit fathers and help them define their new roles (Mothering, 2005).
With this idea in mind all-men classes with a male facilitator were introduced in Australia and are becoming very popular (Friedewald, Fletcher & Fairbairn, 2005). Contrary  to this new concept, Smith (1999, p. 466) found in her study that “ the idea of men-only sessions are considered totally contrary to the nature of the antenatal class experience which reflected the shared nature of pregnancy, birth and parenthood.”

A 1999 study of parents who attended public and National Childbirth Trust classes in England, reported that no one in the study had any difficulty with having a female teacher; indeed, participants felt that it was highly appropriate for a woman to be teaching about subjects such as pregnancy and birth (Smith, 1999).
Perhaps an ideal solution is to continue having female teachers facilitate pregnancy and birth classes, and add a male facilitator to help men explore and prepare for their new roles as fathers (Smith, 1999).
When this is not possible, antenatal teachers have to make additional effort to create an environment where men are able to identify and express their feelings surrounding their impending fatherhood (Friedewald, Fletcher & Fairbairn, 2005). Presenting information in an appealing way for men is of great value since this may affect how involved they feel and how much information is retained (Rogers, 1999).
Because of the difficulties in finding a male facilitator many antenatal teachers will divide the group into gender-specific groups for particular activities. Although this format allows men to reflect on their feelings and roles without the influences of their partners, it still holds the disadvantage of having a female facilitator.

How this information will affect my future classes

To address many of men’s needs presented by Linton (2007) within the confines of a 16-hour program is unrealistic. It is much more likely that many of these concerns are either going to be addressed very lightly or not at all.
Yet, little considerations can make men feel involved, valued and create an environment in which they are comfortable to express their needs and concerns. I make a concerted effort to make eye-contact with all participants in my classes, use appropriate body language, and remain aware of my choice of words at all times.
I use activities in my antenatal classes designed to investigate the men's perspective. For example, the activity I use to teach the stages of labour includes discussions about "what the mother may be experiencing" and "how that makes the father feel and how he can help".  
Through researching this essay, I have learned some techniques to help better meet the needs of men. I have also realized that many of those ideas I have already been using in my teaching. One of them is to have a new father come visit the class and share his personal experiences. Smith (1999) found that this is a great way to specifically address male issues. Another approach is to run concurrent sessions. I have experimented with having a male-facilitator to address the men in another room, while I continue with the women, teaching about postpartum expectations in relation to their own physical healing. My husband volunteered to take on this role, and I was reassured from the postnatal evaluations that his inclusion was beneficial to my clients. I found that the men-only session encouraged men to build a male network.

There are many issues involved in identifying and meeting men’s needs, but mostly I’m left with the question: How reasonable is it to expect men to feel prepared for the changes of pregnancy, birth, their new role as parent and their changing relationship in a standard antenatal course where the needs of women also have to be taken in consideration?
In my opinion separating preparing for birth and parenting classes is a much more realistic way of meeting everyone’s needs. Antenatal classes should be more specific and called childbirth preparation classes. In addition to that parenting and relationship classes should also be offered with gender-specific sessions in an attempt to better meet the unique and individual needs of each the father and the mother. I have been reflecting on this idea since I have started writing this essay and it will be one of consideration for my future teaching.

Conclusion

In conclusion, it is important to realize that it is very difficult to meet everyone’s needs in any given group. Different gender, agendas and learning styles all contribute to this challenge. Specifically, antenatal classes carry their own unique difficulties. The depth of its topics and the importance it caries in the future of those attending them is just a few. Given the amount of time antenatal teachers have to cover so many topics it’s not a surprise to me that needs are not being met. However men tend to be the group mostly neglected. It’s important to be aware of this reality to try and make antenatal education programs more inclusive of expectant fathers and acknowledge their feelings, unique role and contribution. I don’t know if we will ever be able to fully meet men’s needs in antenatal education but having the knowledge that we are greatly failing this goal is the first step in working toward a better preparation for fathers’ important role.

Daniela Vasconcellos (2008)

References:

Barclay, L., Donovan, J., Genovese, A. (1996) Men’s experience during their partner’s first pregnancy: A grounded theory analysis. Australian Journal of Advanced Nursing. 13(3): 13-24

Beardshaw, T. (2001) Supporting the role of fathers around the time of birth. MIDIRS – Midwifery Digest 11(4), 476-479

Diemer, G. (1997) Expectant fathers: Influence of prenatal education on stress, coping and spousal relations. Research in Nursing Health, 20(4), 281-293

Donovan, J. (1995) The process of analysis during a grounded theory study of men during their partners’ pregnancies. Journal of Advanced Nursing. 21(4): 708-715

Fletcher, R., Silberberg, S., & Galloway, D. (2004) New fathers’ postbirth views of antenatal classes: Satisfaction, Benefits, and knowledge of family services. Journal of Perinatal Education 13(3), 18-26

Friedewald, M., Fletcher R. & Fairbairn, H. (2005) All male discussion forum for expectant fathers: Evaluation of a model. The Journal of Perinatal Education 14(2), 8-18

Friedewald, M., Fletcher R. & Fairbairn, H. (2005) All male discussion forum for expectant fathers: Evaluation of a model. The Journal of Perinatal Education 14(2), 9

Lamb, M. & Tamis-Lemonada, C. (2004) The role of the father: An introduction. Chapter 1 in Lamb, M. (Ed.) The Role of the Father in Child Development. Hoboken, NJ: John Wiley and Sons.

Linton (2007) Fathering Classes: Could You Use One? Fathers’ Forum Online: The online resource for expectant and new fathers
[ONLINE]
Available from: http://www.fathersforum.com/classdescrip.htm
[Accessed 8th September 2007]

Mothering (2005) Man-to-man birth classes best for dads. Mothering, September/October 2005, issue 132

Nolan, M. (1998) Antenatal Education. Toronto: Baillere Tindall.

Premberg, A. & Lundren, I. (2006) Fathers’ experiences of childbirth education. . Journal of Perinatal Education 15(2), 21-28.

Priest, J. & Schott, J. (1999) Leading Antenatal Classes. Butterworth-Heinemann: Oxford

Ratnaike D. (2007) Fathers: present, or just in the room? RCM Midwives, 10(3), 106

Robertson (1999) Get the fathers involved! The needs of men in pregnancy classes. The Practicing Midwife, 2(1), 21-22

Rogers, A. (1999) Teaching Adults. Philadelphia: Open University Press.

Schott J, (2002) Parent education: Meeting the needs of fathers. The Practicing Midwife, 5(4), 37

Smith, N. (1999) Antenatal classes and the transition to fatherhood: A study of some fathers' view. Midwifery Digest 9(4): 463-468

Smith, N. (1999) Antenatal classes and the transition to fatherhood: A study of some fathers' view. Midwifery Digest 9(4): 466

Taubenheim, A. & Silbernagel, T. (1988) Meeting the needs of expectant fathers. MCN – American Journal of Maternal/Child Nursing 13(2), 110-113 

My experiences of giving birth

My experiences of becoming a parent

One account of loss; living through miscarriage

My views on Informed choice

The needs of fathers