How Ninewells Hospital went Dad-Friendly Overnight

Ninewells_team_pic.pngMany maternity wards still don’t allow fathers to stay overnight, despite obvious support benefits for their partners and newborn babies. DONNA BROUGH of Ninewells Dundee – an award-winning exception to the rule – explains how she made dads welcome on her wards.

ONE of the most shocking things about our survey of dads in Scotland was how many were excluded from staying overnight in hospital just when their partners and babies needed them most.

We heard stories of dads forced to sleep in the car park, or drive home in dangerously sleep-deprived state, or hide camp beds in the shower to get round the rules. Most tellingly, we heard how traumatic it was for mums to lose the support of their partners only hours after labour. 

20181030_141005crop.jpgFor Donna Brough, Midwifery Team Manager at Ninewells Dundee, the revelation of just how desperately mums wanted dads to stay proved to be the catalyst for creating one of Scotland’s first fully father-inclusive maternity wards.

“Not long into my post at Tayside, I had to go and visit a woman who wanted to make a complaint and it really resonated with me,” recalls Donna. “She’s felt really alone on that ward at night, that she didn’t have that person who had her back and was by her side – and for me that flicked the switch: “we’re going to do this.”

WHAT'S THE PROBLEM?

But change never comes without some resistance, and as Donna consulted staff on her plans she heard all sorts of reasons why having men on the ward overnight would never work.

  • Security – how would they keep track of who was on the ward, in the event of a fire alarm?
  • Facilities – what toilets would the men use? Where would they sleep?
  • Infection control – what if families slept in the same bed?
  • Male habits – what if men snored, or smelt bad?
  • Privacy – how would they preserve privacy while still keeping a sense of community on the ward?
  • Health and safety – what about trip hazards? Or women who were afraid of male violence?

Luckily, Donna had spent 20 years as a midwife, including stints in London hospitals where dads routinely stayed over. Indeed, one of her fondest memories had been of tucking up an entire family for the night at a birthing centre in North London!

The research also backed her instinct... (continued below)

OVERWHELMING RESEARCH

Who's the Bloke in the Room, a wide-ranging meta-analysis of decades of research by the Fatherhood Institute and the Nuffield Foundation, found that women in the UK want their partners involved at every stage of the pregnancy and birth process. In fact: 

  • Birthing women rated the support they received from their partner more highly than support received from midwives (Spiby et al. 1999)
  • Women rate the quality of care they themselves received more negatively if they think maternity staff did not include and encourage their partner (Redshaw & Henderson, 2013).
  • When two maternity units piloted overnight facilities for fathers after the birth, complaints from mums plummeted and midwives were freed up to provide direct care (Higgs, 2010).

So Donna knew that including dads wasn’t rocket science – and that she simply needed to find a way to reassure her staff and patients around something they weren't used to.

NOT ROCKET SCIENCE

With some painstaking consultation, she drew up the following list of agreements for overnight partners (or other family members) to sign:

  • One person only to stay overnight (this can be a different person each night) – and no children
  • Remain fully dressed at all times
  • Use designated visitor toilet
  • No bed sharing with mum and baby as beds not appropriate for two people to sleep on
  • Sign the book on the ward when staying so the staff know who is on the ward
  • Between 22:00-07:00 we try to encourage rest for all new families therefore no noisy phones or handheld devices and no exiting the ward after this time. We ask that overnight people staying remain in the bed space area with curtains closed.
  • You are expected to be respectful to other families and staff within the maternity and unit and failure to do so may lead to you being asked to leave.

“They thought I was bonkers, but I was absolutely steadfastly committed to doing this,” recalls Donna. “I don’t see myself as some kind of despotic leader, but this is the one thing I said to them I will not budge, no matter how we do it, we are doing it.”

UNDERSTANDING DAD

And they did it, with surprising ease, and a little help from Fathers Network Scotland trainer Chris Miezitis, who Donna summoned to train her staff in Understanding Dad.

“I’ve had feedback from staff who’ve attended, that it really opened their eyes to some of the things we weren’t doing to welcome people,” says Donna. “Women would come in with partners, we’d take the dad to the bed, then walk off with mum, show her where the shower was, where towels were, this is where we do this, and then wonder why dad rang the bell to ask where things were! Because you didn’t show him, you didn’t ask him if he wanted to know about these things!”

“One of the midwives had this moment when she thought: we don’t even ask their names! Chris’s aim and my aim from that session was that every midwife would go back with one thing they would do differently – ask names, write names on board – and the chatter about it spread and has made a difference.”

SUPPORT FROM ABOVE

None of the initial fears was realised, thanks in part to unwavering support from senior management: male staff gamely shared their toilet with visiting men, keeping female toilets for women only; nobody has yet witnessed a dad wandering around in pyjamas; and a women-only bay has been reserved for any mums who for good reason find proximity to men anxiety-provoking.

Donna’s one regret is that she can’t be more hospitable under current funding. Someone brought a camp bed, someone else brought a yoga mat, and for health and safety reasons those weren’t permitted.

“Even with all this going on, and the partners staying overnight, we don’t offer them very much,” she says. “At the moment I offer them a chair and a blanket, and they can have tea and a slice of toast, and they can be there.”

Her dream would be to install double beds, but failing that she’s hopeful at least to find enough funding to offer reclining chairs.

“That would be fantastic. One of my plans is to go and meet with the paediatric ward because I know they have beds for parents to stay overnight and I’m going to have a wee chat with them and see how they’ve managed that.”

HEART-WARMING FEEDBACK

But even at its current level, the dad-friendly scheme has proved a huge hit with the women who have always wanted it, with some truly heart-warming feedback:

  • "I was able to spend our first night as a family on the ward - it was great!"
  • "It was amazing having my husband stay overnight!"
  • "I was scared of being on my own with the baby - having my partner there with us made such a difference."
  • "I wanted to be involved in caring for my baby - i didn't want to leave them a few hours after the birth."
  • "I chose to have my baby in Ninewells because I knew my partner could stay."

“Things are improving,” says Donna. “I have felt lucky that I didn’t work in the 1960s and 70s when dads were routinely kept away from labour wards, and I feel we do try to encourage partners as much as possible to be part of the pregnancy and birth of their babies - so surely it would make sense to have them in the postpartum period as well!”

That’s certainly the goal of those who know the proven benefits to the whole family when fathers are fully involved – and as if to vindicate Donna’s decision, her team have earned an official feather in their collective cap.

“I was so proud that our team won the Star Award last year,” she says, proudly showing off her colleagues. “I truly believe we’ve got the best team in Scotland!”

To find out how Understanding Dad training could help father-proof your service or organisation, check out our training page.

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