As medical professionals supporting a family who has chosen to continue a pregnancy despite a prenatal diagnosis of a life-limiting condition, your primary patient is the mother. Her needs- both physical and emotional- are the primary focus during pregnancy and childbirth, followed by the needs of the baby. Though the father is not the patient, he is an important part of a family's carrying to term experience. His primary role during pregnancy and childbirth is to support the mother, but it is important to acknowledge that fathers have needs and concerns that deserve to be addressed and not overlooked or dismissed.
Present and involved fathers provide valuable prenatal, postnatal, and grief support to their significant others. A father's role is vital to the well-being of the mother, and in order to ensure that fathers can care well for and support their partners, their paternal needs and grief cannot be ignored. A father cannot be expected to provide ongoing support to his significant other if he is unable to care well for himself.
Receiving a life-limiting prenatal diagnosis is an overwhelming experience. Following the diagnosis, men may question their ability to provide the emotional support that their significant other will need in the months ahead. He may worry about the physical and emotional health and safety of the woman he loves. He may worry about the emotional and financial realities of continuing the pregnancy and planning for the death of his child. Most importantly, he may struggle to find ways to bond with his child during the pregnancy and the limited time his family will have together. He may worry what the loss and a life of grief will mean for him, his relationship, and his family moving forward.
These concerns are valid and understandable, and as medical professionals, I encourage you to not overlook the very real need that fathers have for acknowledgement, validation, and information. When you encourage and involve fathers at every step of the carrying to term journey, you are helping them care well for their family, process their own fears along the way, and feel as though they have permission to express their grief and seek out support as they need it.
Acknowledging and including fathers is not complicated nor is it a difficult practice to implement. What I am suggesting are simple acts during prenatal care, delivery, and postnatal care that have profound impact on the men who are experiencing this process and grief, too.
Diagnosis and PRenatal care
When it comes to diagnosis day and subsequent prenatal care, including dads looks like holding space for them to ask questions, voice concerns, and process information. When you present information about the diagnosis, current health of his significant other and child, upcoming decisions, or any other information, make a point to communicate to him directly as well. Ask him questions. Ask how he is doing. Ask if he has any insights into how his significant other is doing and how his family is processing.
During prenatal care, ultrasounds are a powerful way to help dads feel more bonded with their child. Make dad feel welcome, and include him by pointing out features, asking him questions, and encouraging him to interact with his child. Printing extra pictures specifically so he can have copies for himself is a gesture that will be appreciated.
Invite dads to attend any and all appointments that he can. Include him in the conversation by making eye contact and encouraging open communication. Suggest that he bring in a list of questions or concerns to discuss at each appointment. When it comes to birth planning and decision-making, encourage dad to participate in the planning and research. His opinion and feelings are valid and meaningful. As you help mom think through memory making and keepsake items, make sure that dad knows that his ideas and wishes are important, too.
Never underestimate the power of your permission. Men often feel the pressure to bear the weight of responsibilities for their significant other. They often mistakenly believe that they have to be strong and not show emotion for risk of compounding her grief or causing her stress or worry. Fathers are grieving, too, and hearing that validated by a medical professional can be incredibly supportive and freeing. So, provide dad with support resources, too, like counseling, support groups, and organizations like Carrying To Term. Remind him to curate a practice of self-care, too, because he cannot pour into his significant other's care if his own cup is empty.
Delivery and postpartum
Delivery and the limited time a family has with their child are sacred events. For many fathers, these moments are when they feel the most present, included, and bonded to the experience. Watching their significant other labor and deliver a child they will not get to raise is a powerful, life-changing, beautiful, and devastating experience. Meeting their child for the first time is when many men first see themselves as fathers, fully and completely. This is the time they have to bond with their son or daughter. These are the fleeting moments that will sustain them through a life of grief and supporting their grieving significant other.
As a medical professional, you have the beautiful opportunity to facilitate a father's role. You have the chance to involve him, help him make memories, and ensure that he is able to be present and supported.
One important way that you can support and include dads on delivery day is to make a point to prenatally discuss the role of a doula. A doula is there to provide physical, emotional, and informational support to families before, during, and after childbirth. Doulas help navigate conversations with medical professionals and serve to ensure that the wishes of the family are remembered and considered in a way that takes the responsibility off of dads and allows them to be present. Encouraging the use of a doula is a way that you can provide dads with the chance to focus on their significant other and engage with their child during delivery and as much time as they will have together as a family.
You can also include and support dads on delivery day by inviting them into the process. A prenatal diagnosis of a life-limiting condition may result in a higher risk or more complicated delivery. I understand that, in some circumstances, the nature of the diagnosis and the realities of the delivery may mean that there is less time for some of these considerations. I am simply asking that whenever and wherever possible, slow down and prioritize the needs of the parents. They are fighting for every memory and moment with their child. So, let the father catch the baby. Let him cut the cord. Let him help with weighing and cleaning. Let him swaddle his precious newborn. Let him hand his son or daughter to his significant other for the first time. Give him the chance to have a role that is unique to him.
If you are helping the family by taking pictures, be sure to include these moments. Capture candid moments of a father and his child. Capture him studying his significant other as she cradles their precious newborn. When it comes time for keepsakes, involve him. Teach him to make the mold mixture. Teach him how to get the perfect impression. Let him help his significant other get footprints and handprints. Ask him what items he might like to keep, whether it is blankets, hats, id bracelets, or crib cards. Encourage him to read a story or sing a lullaby to his child. Help him settle into bed with his significant other and baby. Hold space for him and see him in these moments, too.
As you navigate postpartum care with the mother, I encourage you to not overlook the father. Invite him to attend any postpartum appointments, and check in on his emotional well-being, too. Fathers can and do experience perinatal mood and anxiety disorders in addition to the normal grief following the loss of his child. Validate and normalize that experience and offer him insight into all of his options like counseling, support groups, and dedicated resources before jumping directly into medication.
Ask him what he thinks his partner needs in the weeks and months following their loss. Would visiting the hospital be helpful for her or them? Would having the chance to sit down with their specialists or nurses to process and thank them be comforting and supportive? He is your best resource when it comes to caring well for your patient. So, ask.
Finally, offer him resources like local funeral assistance, support organizations for his significant other, children, and himself, books, or any other tools to help him navigate life after loss.
Fathers play a crucial role in the carrying to term journey. They are sounding boards, supporters, researchers, providers, processors, and most importantly, people grieving the diagnosis and loss of their precious child. There is so much focus placed on the needs of the mother and child, rightly so, but there needs to be room for considering what a father needs each step of this process, too.
As medical professionals, fathers are a valuable resource for you. They know their partners better than anyone. They are able to shed light on what she needs and how she is doing. They can help you deliver information and help their partners process it. To do so, they need you to see and hear them. They need you to answer their questions, inquire about their well-being, and offer support and resources to help them care well for themselves, too. They need you to invite them into the process and provide them the space to step in, create memories, and feel as though they have an important role during the pregnancy, delivery, and transition into life after loss.