How do midwives and fathers communicate during labour and birth? An ethnographic study in the North West of England

This ethnographic study explores midwife-father communications during childbirth. Fathers are relative newcomers to the world of birth. Existent research has focused on their roles, needs, feelings and behaviours and has identified midwives as ideally placed to engage fathers during childbirth. However, a scoping review of 34 key studies found that, to date, there has been little focus on midwife-father communication.
The aim of this research was to investigate midwife-father communications, to gain a deeper understanding of the complex relationships involved, with a view to enhancing the experiences of the central birth triad: mother, father and midwife. Direct observations during childbirth in four different birth environments and semi-structured postnatal interviews involved 11 couples and 16 midwives.
Thematic analysis was employed to analyse the data. The five key findings are: 1. the midwife-father relationship currently relies largely on non-verbal communications, guesswork and assumption; 2. midwives’ familiarity with the childbirth landscape can blunt their awareness of the father’s perspective; 3. birth environment (place and people) has a clear effect on midwife-father communications; 4. there are considerable variations in parents’ expectations of the father’s role, which remain un-explored; 5. there is great potential for all three central players to learn from each other during childbirth: including opportunities for the father to learn about birth from the mother and the midwife, and for the midwife to learn about the woman from the father.
This study recommends the development of approaches to facilitate verbal midwife-father communications. Its insights into the father’s perspective of the childbirth landscape point to ways in which the midwife can help him habituate. Discoveries about the impact of birth environment on midwife-father communication and on fathers’ behaviours highlight the need to ‘re-frame’ the father’s role: to provide support and appropriate spaces in hospital to take a break; to move away from the current emphasis on ‘busyness’ and to articulate the fundamental importance of ‘presence’.