Hiding in the Pub to Cutting the Cord? Men's Presence at Childbirth in Britain c.1940s-2000s

Development and early validation of questionnaires to assess system level factors affecting male partners' attendance at childbirth in LMICs

BACKGROUND

There is evidence that a woman who receives continuous labour support from a chosen companion can have shorter labour duration, is more likely to give birth without medical interventions, and report a satisfying childbirth experience. These outcomes result from the beneficial effects of emotional and practical support from the woman's chosen companion, and care provided by health providers. When a woman's chosen companion is her male partner, in addition to the above benefits, his presence can promote his bonding with the baby, and shared parenthood. However, there may be healthcare system barriers, including organisational, management and individual (staff) factors, that inhibit or restrict women's choice of companion. There are currently no suitable survey tools that can be used to assess the system level factors affecting the implementation of male partners' attendance at childbirth in low- and middle- income countries (LMICs).

METHODS

We designed two questionnaires to help to address that gap: the Male Partners' Attendance at Childbirth-Questionnaire for Heads of Maternity Units (MPAC-QHMUs); and the Male Partners' Attendance at Childbirth-Questionnaire for Maternity Staff (MPAC-QMS). We carried out an extensive review to generate initial items of the two questionnaires. We assessed the content and face validity of the two questionnaires in a three-round modified Delphi study.

RESULTS

The Male Partners' Attendance at Childbirth-Questionnaire for Heads of Maternity Units (MPAC-QHMUs) focused on organisational and management factors. The Male Partners' Attendance at Childbirth-Questionnaire of Maternity Staff (MPAC-QMS) focused on individual staff factors. The final MPAC-QHMUs and MPAC-QMS included items which garnered over 80% content relevance according to the experts' rating. After all three consensus rounds of the Delphi study, 43 items were retained for the MPAC-QHMUs and 61 items were retained for the MPAC-QMS.

CONCLUSIONS

The MPAC-QHMUs and the MPAC-QMS may help understanding of barriers affecting male partners' attendance at childbirth in LMICs in order to devise implementation strategies to enable wider availability and to maximize women's choices during labour and childbirth. The MPAC-QHMUs and the MPAC-QMS as newly-developed questionnaires require further validation of their acceptability and feasibility in different cultural contexts, and languages.

Male partner participation in maternity care and social support for childbearing women: a discussion paper

Male partners/fathers are key support persons for many childbearing women and their involvement in pregnancy, childbirth and the postpartum/postnatal period has beneficial effects on a wide range of outcomes related to maternal and child health and family wellbeing. Social support is implicated in the relevant causal pathway, but has received largely tangential attention in the public health literature. This discussion paper aims to reframe men's participation in maternity care as an opportunity to enhance their readiness and ability to provide social support to women, contributing to the debate on the definition and rationale for male partner involvement, and paving the way for further empirical work. I begin by presenting a theory of change illustrating the causal pathway leading from male partner participation, through the key intermediate step of social support, to improved health and wellbeing for women and children. I proceed by arguing that many people desire male partner participation in maternity care; however, in practice, this is often limited owing to cultural, social and institutional barriers. I use examples from the intervention literature to demonstrate how participation in care can boost men's motivation to support women and enhance their ability to do so by increasing their knowledge and skills. Finally, I draw up general implications for further male partner involvement programmes, suggesting that in order to achieve meaningful and sustainable gains, attention to design is crucial in order to avoid reinforcing patriarchal gender norms. Programmes should be implemented alongside other efforts to improve quality and promote woman-centred care. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

'A machine for recreating life': an introduction to reproduction on film

Reproduction is one of the most persistently generative themes in the history of science and cinema. Cabbage fairies, clones and monstrous creations have fascinated filmmakers and audiences for more than a century. Today we have grown accustomed not only to the once controversial portrayals of sperm, eggs and embryos in biology and medicine, but also to the artificial wombs and dystopian futures of science fiction and fantasy. Yet, while scholars have examined key films and genres, especially in response to the recent cycle of Hollywood 'mom coms', the analytic potential of reproduction on film as a larger theme remains largely untapped. This introduction to a special issue aims to consolidate a disparate literature by exploring diverse strands of film studies that are rarely considered in the same frame. It traces the contours of a little-studied history, pauses to consider in greater detail a few particularly instructive examples, and underscores some promising lines of inquiry. Along the way, it introduces the six original articles that constitute Reproduction on Film.