Chris Miezitis is Fathers Network Scotland's Programme Lead. He runs our Understanding Dad training, which helps practitioners and services identify a more inclusive approach to their practice and service delivery. Chris also leads our How Are You Dad? pilot project, working with midwives and health visitors to encourage the involvement of dads from the antenatal stage right through to postnatal checks. Victoria Hospital Maternity Unit has recently won an award for a piece of promotional content and Chris tells us why this is such a huge achievement.
"During late 2015 I was invited to speak with senior management at Fife’s maternity Unit in Victoria Hospital. As part of Fife Council’s Early Years Team, I had been leading on new initiatives that sought to encourage a more father inclusive approach amongst practitioners and within policy across Early Years’ Service provision. Hearing about this work, leadership within NHS perinatal services wanted to find out more.
So here I was, in a maternity waiting room for the first time in five years since my wife was pregnant with twin babies. Now, having studied the research and evidence base around fathers and their relationships with their children and families, two key points were at the forefront of my mind as I waited to be asked through to the meeting room:
Children will do better when they have the support of a positive father figure;
Children and Family Services across the sectors – Health; Local Authority and Third Sector; are mother facing and struggle to engage fathers positively and consistently, whilst not consciously excluding but not actively including fathers either.
Setting out to develop initiatives that aimed to be a catalyst to cultural change across services within Fife, the NHS ante and post-natal services had been viewed by me as critical adopters of this work in order to secure long term sustainable success across the Health and Social Care Partnership. Without perinatal services engaged in conversation about father inclusive approaches, then the required ‘transformational shift’ to improve outcomes across Fife's Early Years services, as a whole, would not happen.
This being my view, I felt certain that my pitch at this meeting had to be exactly right. The message had to be clear, constructive and compelling. It’s no secret, after all, that while maternity and health visiting services are some of our most expert and necessary workforces, they are also amongst our most stretched. There is no room for them to consider adopting new practices or approaches that would be anything other than effective on positive service outcome impact. So, this pending conversation could be pivotal in determining whether or not our own view that change was required would be embraced and acted upon, or not, by Fife’s perinatal services.
Approaching the entrance, the sign read, “Mother and Baby Unit’. So, the message was clear: this is a unit for…mothers and babies.
The reception area itself had a plethora of posters, leaflets, pop up banners that were full of positive and encouraging information for the many mums-to-be that would come through these doors: How to look after your own health and wellbeing; how this supports your baby; how to get help with breastfeeding; advice on nutrition and diet, and so on. Exactly the type of information you would expect to see in a maternity unit reception area. One thing was missing though. I couldn’t see any images of – if my biology lessons at school had been accurate – the other part of this family planning equation: dads. That was until I was invited to go through the security door to meet my colleague, and there it was: This Zero Tolerance poster.
I assumed that the poster was there for good reason. Surely men must be the cause of most of the difficulties staff have here with challenging and sometimes threatening behaviour? The response from the staff member when I asked her this directly has stayed with me ever since: “Overwhelmingly not”. Contrary to my assumption, it seemed that, more often than not, aggression and threats of violence towards staff came from female figures – mums, aunties, sisters, grans, friends of the pregnant mums.
So what was the purpose of the sole image of a male then, being one where he was in handcuffs, beneath a ‘Zero Tolerance’ strapline? I suggested that this poster didn’t convey a message that dads-to-be were welcome here, or one that told dads, “You are important – we need you to look after yourself, your partner and this baby”.
It seemed to be saying, “Watch out. Don’t step out of line. We’re watching you.” The potential effect of this may be to make dads to be feel unwelcome, unwanted and viewed as a threat, not an asset, to discourage men from engaging with this service, or even compound any feelings of doubt or a desire to break away from the situation of pending fatherhood. A secondment from Fife Council to Fathers Network Scotland two years later allowed me to revisit the hospital, and to begin to train staff in the importance of positive father engagement, with the backing of the Chief Midwife and Health Visiting Team Lead from Fife NHS.
Now, in April 2019, I am in the same hospital delivering paternal mental health awareness training to a mixture of Health Visitors and Midwifes. During the preceding years, the message of father inclusiveness having been embraced and adopted by leadership within the service, I have delivered a number of workshops to maternity and health visiting staff, resulting in practice change on the ground. In the training room I noticed a poster that described the father inclusive work the service had been undertaking. The poster had been placed without ceremony, without our attention being drawn to it, and upon noticing it I was modestly informed that the poster had been put together by the unit and recently awarded ‘best poster’ by the judging panel at the National Best Start Policy Awards.
When extremely busy, dedicated and skilled staff in Fife have been allowed a little time to reflect on what it really means to place the child at the centre of their focus, to include and to actively involve the family around that child, to not allow embedded practice, procedure and assumptions to decide who that family is, rather than to determine who that family is, then we can see clear evidence of the transformational shift in this organisation’s culture from Zero Tolerance, to Understanding Dad."