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Master of Midwifery - The Family in Contemporary Society - Term Paper Example

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This paper discusses Midwives which play an integral role in providing maternity care and childbirth services and in facilitating expecting mothers to make the shift to motherhood.  Freestanding birth centers aim to provide maternity services in order to improve the health of the community…
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Master of Midwifery - The Family in Contemporary Society
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 The real meaning of providing care to women in labor is to provide them the utmost comfort during the entire process. Midwives play an integral role in providing maternity care and childbirth services and in facilitating expecting mothers to make the shift to motherhood. Freestanding birth centers aim to provide maternity services in order to improve the health of the community on the whole. The services provided are family-centered and are integrated with social, early childhood and family development services that improve the health condition of families all over the country. The strongest bond that midwives have is with the women. Midwives are taught to respect the personal values of the women, their bodies and their minds. On the same hand, midwives are expected to give regard to the feelings of motherhood that the women are feeling, and to combine their beliefs, attitudes and professional conduct in getting to know the women, and understanding what she values. The ideology behind midwifery helps to bridge the communication gap between the midwife and the woman, and enables them to feel more empowered and in control of the situation. Given the role of midwives in helping women in delivering the baby, midwifery aims to provide a family-centered approach. As a result, the expectant father is also directly affected by midwifery. It was not long ago when babies were born in delivery rooms where mothers were put under pain-relief medicines and fathers were not allowed to enter the delivery room during childbirth. Cultural and religious values and perceptions of childbirth practices rampant in cultures affect the birthing process and help account for the a priori of ideas of birthing (Behruzi, et al., 2010). For example, in Cuba, most fathers have no role in the birthing process. The extent of the participation of the father relies greatly on the educational level of the wife and adaptation into the US culture. In such Cuban families, the presence of the wife’s mother is more important and underplays the role of the father; in fact the mother directs all activity, making even the role of her delivering daughter more passive. In Roma families, husbands also have limited participation in the process of childbirth due to modesty about birth events (Rosdahl & Kowalski, 2007). The involvement of the father in childbirth can be a gateway for more involvement of men in being full partners in the raising of their children. There are many organizations that are promoting this ideology. The World Health Organization (WHO) made a policy that men accompany their wives during childbirth (Commission on the Status of Women, 2009). The varying roles of males and females and the degree of equality between the two in marriage can fluctuate from country to country; so midwives need to be aware of the cultural differences and help to provide a middle ground for the involvement of the father in pregnancy and child care (Pillitteri, 2009). Consequently, there has been a shift from the perception of delivery being solely a women process. In the contemporary society, fathers are more empowered to opt for the type of delivery they allow their wife to undergo. The most significant change in this shift is the involvement of the father in the birth of the baby. The range of options that are available to fathers in the current era can range from the participation of the father in the childbirth process by being with the mother to the choice of delivery setting, that is, whether the delivery takes place in a hospital or a freestanding birth center. In conventional deliveries, fathers normally stand by the side of the mother, providing her moral support. However, the role of the father in non-traditional setups is more active. Fathers can participate in supporting the baby as it appears from the birth canal or by cutting the umbilical cord, under the supervision of the midwives (Greenberg, et al., 2007). This is illustrative of the increasing importance of fathers in childbirth and in raising the child. Although the responsibility of raising the child had fallen primarily on the shoulders of the mother, new trends in culture are encouraging the involvement of both parents in raising the child. Child rearing is now considered a joint venture, requiring the equal participation of both parents. As a result, fathers gain more satisfaction and happiness from their role in being an equal influence on the child as the mother. Greenberg et al. (2007) observes that many people believe that being equal partners in the process of child rearing results in male liberation, which strengthens the father-child relationship, beginning from the very moment of the birth. Fathers have the choice of choosing what type of birth attendants and birthing alternatives they would want. Midwives are preferred by people of the natural healing community who regard childbirth as a natural process and do not feel comfortable in technological interferences (Abernathy & Page, 2006). Where midwives are expected to be skilled companions in the process of labor and pregnancy, the changing cultural trends require midwives to develop sensitive and supportive relationships with the mother and her family without developing undue dependency and observing the professional boundaries of her job (Page & McCandlish, 2006). Rosdahl and Kowalski (2007) state that by using the nursing process, midwives can provide nursing care to the expectant family and help the family deal with their emotional needs. The role of the midwifery care also extends to the motivation, support and education of the family members about health issues and specific care during pregnancy, birth and after delivery (Edwards & Byrom, 2007). Considering these roles, there has been increased emphasis on the provision of comprehensive care to the expectant father as well. The cultural trends and the rising levels of education, along with the equal partnership of the fathers in child rearing, have encouraged more participation of the fathers in the process of childbirth. Midwives are therefore required to attend to the needs of the father as well. In a study conducted by Draper (1997), it was found that the changing professional and cultural attitudes have helped to enhance the attendance of the fathers during birth. With more participation of the fathers, the conduct of the midwives should also focus on the provision of support to the fathers. There are three main phases of fatherhood. The first starts before the baby I sborn, the second is about labor and birth whereas the third phase is about the baby after his or birth. Labor can be a very emotional experience for a father. Partner pregnancy can be difficult to cope up with for the fathers as it demands self-internalization and reformation of the self. Men are also affected during the process of pregnancy about the challenges that await them in child rearing and the reality of being a father. In a study conducted by Genesoni and Tallandini (2009), it was concluded that the transition to fatherhood is a complex process and labor and birth had the most intense and profound impact on the fathers. The role of the midwives as being the main care providers is enhanced in the context of fatherhood. Midwives are present during the labor and birth process, and they also have a lot of interaction with the fathers of the baby. Since childbirth can be emotional draining for the father, as well as exhilarating, midwives are expected to provide fathers with emotional support and motivation. Providing support to the father is also necessary because fathers are a pivotal support for the mother and the baby. Midwives need to be aware and strive to meet the needs of the fathers for promoting better care to the mothers (Friedewald, et al., 2005). Some men may also not feel comfortable in discussing female anatomy and feel resentful towards the woman (Newman & Newman, 2008). Midwives can counsel such men, explaining them that it is a natural process. There are a number of government initiatives as well that mandate the provision of support and care to the fathers by midwives. In England and Wales, there are a number of policies and legislations that encourage, and often obligate, fathers to become more active in childbirth and child rearing processes. The Fatherhoodinstitute.org (2010) gives reference to the following initiatives with regard to the care expected from midwives. The Framework for the Assessment of Children in Need and their Families, Department of Health, 2000, requires professionals to understand the role of fathers in a family. The National Institute for Health and Clinical Excellence, 2006, published Clinical Guidelines on routine postnatal care of women and their babies, which required medical professionals to “provide mothers and their partners or companions with information about how to nurture babies and what to expect at different ages, including growth and child development”. Maternity Matters of the Department of Health, 2007, asserts that maternity care is not only about providing safe pregnancy but also entails access to different services for parents to become more caring and confident in child rearing. Every Parent Matters, 2007, also emphasizes that fathers should be offered routine support and opportunities like its female counterpart in the care of their children. In another policy by the Department of Health, titled “Teenage Parents Next Steps: Guidance for Local Authorities and Primary Care 2007”, services are expected to promote the notion that fathers’ participation in pregnancy is of advantage to both the mother and the baby. It is part of the professional conduct of a midwife to not to discourage fathers from participating in the process of childbirth. The father-to-be is expected to be caring and understanding of a process that is only getting to experience second-hand; therefore, there are chances that they may become fearful and scared (Bandlow & Bandlow, 2006). As a result, midwives need to offer support to fathers as well. Burgess (2009) points out that it is beneficial to the mothers when they feel in control of the birth process, and a major reason for mothers to feel empowered is their partner. Midwifery has played an integral role in engaging and supporting fathers in preparing them for fatherhood. They offer programs that educate both parents on raising children. One such program is the Young Dad’s evening (Langdale & Spencer, 2010). This program allows young fathers to tour the labor ward and to interact with other fathers regarding any queries they might have on pregnancy and the labor process. The reason for having male peer supports is that some fathers might not feel comfortable discussing pregnancy with their partners; moreover, interacting with other fathers would give them knowledge about the experience of the male in labor and birth. Midwives also encouraged fathers to bathe their babies, and this allowed for more bonding between them. Bonding with children is important for the father. Often, many fathers do not get time to spend with their children due to job obligations. By being involved in the provision of care to the child right from pregnancy, fathers can plat significant roles in the development of the child. Since they start valuing their relationship with the child more, they would put their family first and take time out of their work schedule to spend it with their families. Midwives helped fathers gain the most from this session. The environment was friendly and the midwives were supportive of the fathers. When understanding the support that midwives offer to fathers, it is important to understand that they play an important role in the development of the child, are most important in the life of the child and have an impact on which direction the child goes, be it for good or for bad (Byrom, et al., 2009). Fathers have begun to play an active role in child birth, the credit for which goes to midwifery as well. Fathers have gained more knowledge and insight on childbirth, what are the Dos and the Donts of pregnancy and have started to act as supports for the mothers. Much of this is promoted by midwifery services. They also give fathers information regarding breastfeeding, smoking, sexual relationships etc. It ahs been observed that maternity allows maximum level of connection between the parents and in their role as care providers to their children. Considering the social role of fathers, the father-child relationship is often not nurtured because women have remained the prime care providers and permit limited entry to the father into the bonding domain that she has created for herself and the child. However, as mentioned above, there is a transition from the perception that males are only breadwinners. Nowadays, fathers are not only required to be equal partners in caring for the child, but also guiding him or her spiritually and ethically. This requires building a bond between the father and the child. Midwives encourage fathers to start the groundwork for this bonding before the birth of the child. After the birth of the child, midwives encourage fathers to hold the child and to attend antenatal and parent-craft sessions. For young fathers who are reluctant to express their love for the child, a midwife might encourage her to speak to the child and be involved in care for the child. Midwives also help women to learn how to hold the baby so that they can breastfeed him or her correctly. They also motivate fathers to learn the process, since many fathers might find themselves doing this job at 2 a.m. in the night (midwivesonline.com, 2010). The joint ministerial statement by Ed Walls and Alan Johnson reflected the need to have a happy childhood in order to have a healthy start in life and to harness the talents of the individual. They also said that the result of a happy childhood is that the individual grows up to be prepared for the challenges of life (NCT watch, 2009). Fathers are the major figure which determines the happiness of the child. A strong bonding between the father and the child is essential to development of a healthy relationship. One of the ways that midwives promote bonding between the father and the child soon after birth is asking them to massage the child. A skin to skin contact with the child helps in the physical and emotional growth of the child. Massaging helps the baby and the father to attach to each other. Pairman et al. (2006) contends that midwives play an important role in establishing communication between the father and the child. In another study where a father was taught how to massage, it was found out that the father felt good after massaging the baby. Massaging can relax the baby and ease his or her sleeping. The study also stated that massaging the baby had an effect on other family members as well. The baby had eczema, but massaging baby allowed her to sleep through the night peacefully. Earlier, the father and the mother could not rest properly because the baby used to wake up during the night due to the eczema. This left the parents irritated too. After massaging, the condition of the baby improved considerably due to better sleep and the oil massage. The father also reported that massaging the baby allowed him and his wife to participate together in an activity we both enjoyed, making that time their quality time. Experts say that bonding can start immediately after birth when the individual holds the child. Touch can be used as a positive gesture, and the sounds of the baby can help the father feel more loving towards the baby. The father is also encouraged by midwives to spend more time with the mother and the infant in the delivery room. Cuddling the baby and looking after him can enable the father to express his love and fondness for the baby. Research has shown that fathers and mothers develop similar bonding when they interact with their baby. The first few hours of the life of the baby are known as the quiet alert state, where the baby undergoes swift learning to allow and responds to sound cues, especially familiar sounds like the sound of the father’s voice. Newborns can also pick up the facial features of the parent and imitate the father (Mills, 2007). This can be demonstrated by a little activity. When the baby is looking at the face of the father intently, the father can stick his tongue in and out for a few seconds. After some time, the baby will imitate the father. Where newborns require the care and attention of the parents, parents are equally in need of some nurturing. The role of the midwife is that she needs to identify the ways through which they can support the needs of the father throughout the pregnancy and after the labor. Midwives are also required to assess how the care offered by the midwife meets the needs of the family (Byrom, 2009). Many of the settings for birthing alternatives offer special rooms for the family of the mother to stay in. Defining upon the role of the midwife in increasing participation by fathers, a midwife stated that, “We encourage family, specially the husband, to come to the hospital and spend time with the mother. We provide a bed for the father and kids if they want to stay at night. Sometimes, we call the husband at work and ask him to come to the hospital” (Behruzi, 2010). However one of the implications of the encouragement of men by midwives to become more active in the process of childbirth and labor has resulted in some men going into greater emotional turmoil. Midwives can promote men to be present during the birth of the child; however this can have negative effects on the father, and subsequently the mother, if the father does not comprehend the enormity of the transition that is taking place. The father may undergo ambivalent feelings regarding the changes his partner is going through (Zeanah Jr., 2009). If the father is unprepared psychologically for accepting the duty that is being called upon him to serve, i.e. fatherhood, it can cause him to react with anger, gloominess, fear or envy. Therefore, midwives need to make a detailed analysis of the family and to use effective means to make the fathers realize the elements of the labor and birthing process. Thus in conclusion, the care provided by midwives is not confined to the mother. Midwives provide a family-centered care that involves support for the father. They educate the father about pregnancy and encourage him to bond with his baby. Given the social roles the father is mandated to play, like the upbringing of the child, initiatives by midwives like antenatal education sessions and active participation of the father in labor, help the father to be equal partners in the care of the baby. Reference List Abernathy, S. & Page, L., 2006. Do You Want to Have a Baby?: Natural Fertility Solutions and Pregnancy Care. Healthy Healing, Inc. Bandlow, N. & Bandlow, N. D., 2006. Parent to Child the Guide: How to Create a Comprehensive And Meaningful Journal to Prepare Your Child for Life. Nebraska (NE): iUniverse. Behruzi, et al., 2010. Facilitators and barriers in the humanization of childbirth practice in Japan. BMC Pregnancy and Childbirth, 10 (25). Burgess, A., 2009. Hard Labour. [Online] (Updated 20 October 2009) Available from: http://www.guardian.co.uk/commentisfree/2009/oct/20/childbirth-fathers-present-benefit [Accessed 18 June 2010]. Byrom, et al., 2009. Essential Midwifery Practice: Postnatal Care. John Wiley and Sons. Commission on the Status of Women, 2009. Economic and Social Council. [Online] (Updated 3 March 2009) Available from: http://www.un.org/News/Press/docs//2009/wom1715.doc.htm [Accessed 18 June 2010]. Draper, J., 1997. Whose welfare in the labour room? A discussion of the increasing trend of fathers' birth attendance. Midwifery, 13 (3), pp.132-38. Edwards, G. & Byrom, S., 2007. Essential Midwifery Practice: Public Health. Oxford: Wiley-Blackwell. Fatherhoodinstitute.org, 2010. Family, Health and Education Services in England & Wales must comply with POLICY & LEGISLATION requiring engagement with fathers. [Online] (Updated 12 May 2010) Available from: www.fatherhoodinstitute.org/download.php?pID=6863.7 [Accessed 18 June 2010]. Friedewald, et al., 2005. All-Male Discussion Forums for Expectant Fathers: Evaluation of a Model. The Journal of Perinatal Education, 14 (2), pp.8-18. Genesoni, L. & Tallandini, M. A., 2009. Men's Psychological Transition to Fatherhood: An Analysis of the Literature, 1989–2008. Birth, 36(4), pp.305-318. Greenberg, J, S., et al., 2007. Exploring the dimensions of human sexuality. 3rd ed. Jones & Bartlett Learning. Langdale, A. & Spencer, L., 2010. Case Study: North Yorkshire Midwives Engaging with Young Dads. [Online] (Updated 2 March 2010) Available from: http://www.fatherhoodinstitute.org/index.php?id=2&cID=1064 [Accessed 18 June 2010]. midwivesonline.com, 2010. Bonding with your new baby. [Online] Available from: http://www.midwivesonline.com/parents/parents1//97 [Accessed 18 June 2010]. Mills, J., 2007. My Mother Wears Combat Boots: A Parenting Guide for the Rest of Us. AK Press. Newman, B. M. & Newman, P. R., 2008. Development Through Life: A Psychosocial Approach. 10th ed. California (CA): Cengage Learning. NCT watch, 2009. ‘Healthy Lives, Brighter futures: The strategy for children and young people’s health’ launched. [Online] (Updated 17 February 2009) Available from: http://nctwatch.wordpress.com/2009/02/17/%E2%80%98healthy-lives-brighter-futures-the-strategy-for-children-and-young-people%E2%80%99s-health%E2%80%99-launched/ [Accessed 18 June 2010]. Page, L. A. & McCandlish, R., 2006. The new midwifery: science and sensitivity in practice. 2nd ed. Elsevier Health Sciences. Pairman, et al., 2006. Midwifery: preparation for practice. New South Wales: Elsevier Australia. Pilliteri, A., 2009. Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family. 6th ed. Lippincott Williams & Wilkins. Rosdahl, C. B. & Kowalski, M. T., 2007. Textbook of basic nursing. 9th ed. Lippincott Williams & Wilkins. Zeanah Jr., C. H., 2009. Handbook of Infant Mental Health. 3rd ed. New York (NY): Guilford Press. Read More
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