Chapter 7



Passage to Parenthood

Our society is full of rituals. Some mark large scale events like a royal wedding or the inauguration of a president. Others are more commonplace, such as church services or the changing of the guard at Buckingham Palace. These all have one thing in common: they are formal rituals, for public consumption, and teams of experts have carefully worked out their form. But there are other rituals too; which are less public and less self-consciously created. Because of this there is a tendency not to recognize them as rituals at all.

It is hard to define ritual to everyone's satisfaction. But most experts agree that rituals contain stylized elements and operations which are performed because they have symbolic meaning or help the ritual to develop. They are not carried out principally in order to produce some material effect. Many rituals are repetitive and predictable, at least in their broad outlines.

One interesting thing about Western rituals is that many of them are not actually recognized as being rituals by those involved in them. Indeed, the people responsible for arranging and performing the events may often strenuously deny the claim. But the fact remains that these events are structured in the same ways and contain the same elements as other, more obvious, rituals and it seems sensible to treat the two in the same way.

Labelling a procedure as 'ritual' is not a criticism. There is a belief in some parts of our society that rituals are pointless; a meaningless expression of old-fashioned superstition. This is not generally so. Rituals can be very helpful to us all - especially in situations of uncertainty, or change of social role.

Taken as a whole, modem obstetric procedures contain a mix of the ritual and the medical. Some of the procedures may be of little or no ritual consequence, but are medically important—taking blood pressure, for instance. Others may be of little medical value but are ritually important—wearing masks in the delivery room, for instance. Many have both ritual and medical importance—episiotomy, for instance.

I have already suggested that birth is the key event in a series of changes and adjustments which make up our version of couvade: those rituals which occur in societies where there is some uncertainty about paternity. When it is clear to everyone who is father to the child, these rituals are less common or less important.

There is more to the ritual of birth than its role in couvade. It not only helps to give certainty to the question of who the father is, but also what he is supposed to do. When the father's role is clearly defined he will be less likely to need ritual to support and prepare him for it. But when there is uncertainty, we may expect rituals to become much more important. Having a baby is not just a matter of giving birth; it is also the time when the woman and man assume their new roles as mother and father.

Nearly every culture in the world marks this change with some ritual events. The details may vary, but the form is largely constant. They belong to a class of rituals known to anthropologists as rites of passage. These are found whenever a person changes his or her social status: initiation ceremonies mark the transition from child to adult; wedding ceremonies mark the transition from single to married; funeral ceremonies mark the transition from living to dead; and so on. Birth rituals mark the transition to parenthood - and in particular, as far as I am concerned here, the transition to fatherhood.

A rite of passage has three main parts—each of which may last for quite a long time, and consist of a number of different ritual activities. The rite of passage is only completed when all three parts have been performed.

In the first part—the rite of separation—the person undergoing the social change is separated from his or her old environment. This is often achieved by removal to a special place, set apart from normal life—a sacred initiation ground or building. Rites of cleansing and purifying often take place, and new clothing may be worn.

In Western birth practice there are many elements to parallel this. There is normally a journey to a place set apart—the hospital—where husband and wife will be separated from normal society and from each other. He is often left alone while his partner is taken off to be 'prepared'. He suddenly becomes very aware of his lack of status and no-one seems to know or care what is supposed to happen to him. Several of the men interviewed by Joel Richman felt that their wives were being taken back into a 'society of women', and one said that it was as if he was being punished for imposing the burden of pregnancy on his wife.

When the prospective father is allowed to meet his partner again she will have been 'admitted', and will now be firmly incorporated in the hospital routine. The fact that the father is not formally admitted is another sign of his more marginal status, but before he is allowed into the labour ward he will be obliged to put on some special clothing. Different hospitals have different degrees of strictness about this, but the full kit consists of overshoes, gown, hat and mask. This clothing has little or no practical value, but it has a clear symbolic function. It emphasizes that the father is unclean and needs to be transformed by being covered in pure (usually white) robes before being allowed into the inner sanctum of the labour room.

Clothing in hospital has another function: to mark the status of the various individuals involved in the drama. The higher the status the less important it is to wear protective clothing. If the chief obstetrician looks in to see how things are progressing he may well not bother to wear any special clothing at all. The houseman in charge of the labour will wear a gown, but may leave it untied. The nurses will wear neatly starched, tightly fitting uniforms, while the father, at the bottom of the heap, has to wear shapeless ill fitting garments which might almost have been designed just to make him look and feel stupid.

The middle stage of a rite of passage is called the liminal period (from the Latin for threshold), when those undergoing the rite have no status of any kind. They have left their old roles behind (they are often spoken of as having died—especially in initiation rites), but have not yet adopted their new roles. During this liminal period they may be subjected to humiliation and strict discipline. In some initiation ceremonies, pain may be inflicted on those being initiated, and the liminal period may be climaxed by some bodily mutilation (circumcision, knocking out of a tooth, scarification, etc). Most important of all, there is instruction—often in symbolic form—about the nature of society and what is expected of the new role for which the person is being prepared. The liminal stage may last from less than an hour in a wedding service, to over a month in some initiation ceremonies.

Again, the parallels are clear. The woman in labour has little status in the hospital. Her partner has even less. Both of them may feel humiliated by their treatment: by the way that her natural functions are taken over by strangers; by the way that he may be told to leave the room without any explanation; by the way their questions may not be answered to their satisfaction.

The liminal stage of birth lasts from the time the mother is admitted and labour becomes well established until several days after the birth. A common pattern is for the woman to remain in hospital throughout this period, although there has been a recent trend towards shorter stays—especially for second and subsequent deliveries. During her time in hospital the mother will suffer a lot of pain and discomfort. Her partner does not suffer in the same way of course, although he can often become very distressed by the experience of her suffering. But he also may have to put up with some minor physical discomfort; having to go for many hours without rest or food because there are no facilities for him in most hospitals.

There is a lot of teaching in this phase, but it is couched in symbolic terms and does not have the formal nature we normally associate with ‘teaching.’ It is more an expression and reinforcement of certain key social ideas and attitudes which have a direct bearing on styles of parenthood. Again I concentrate on the messages which are being picked up by the father, although the effect on the mother is probably even greater.

Because both mother and father have little or no status a bond of common suffering is forged between them. This has been observed in many other rite of passage situations, especially in initiation rites. It can give the couple in birth a new closeness and a new respect for each other. Many men are able to appreciate and admire the female in a way that they might not have done before. Often there is a mixture of awe and regret:

My wife was so good, she was terrific the way she handled it. She had depths of energy and power that I didn't realize she had, and I felt envious that I couldn't do it as well. (John).

I really did feel envious of the fact of giving birth, because no matter how close you are to the child, I mean the fact that you didn't physically give birth to that child—I don't know, it's a physical involvement, whereas a man's involvement is emotional, intellectual, whatever. It's not physical. (Stuart)

This is another important message. A man is brought up to interact with the world in physical ways and to mistrust feelings. Now he discovers that fatherhood is different. It is not physical, but requires those very emotions which he tends to play down. Furthermore, he learns that fatherhood is not primary—it always follows motherhood and does not stand on the same secure physical base that motherhood does.

Most men want to be present at birth because they see it as their duty to help. But the father's job as a labour companion serves to reinforce the secondary nature of his role. A good labour companion must be subordinate to the woman in labour: her wishes and needs are paramount. In the same way, the message of the rite suggests, fatherhood is subordinate to motherhood. Because this message conflicts with the desire for equality, many men are moving towards greater participation in birth. They try to do this in two ways. Firstly there is a move towards greater emotional involvement. The experience of childbirth is becoming ever more important to men, as we saw in chapter five. Lacking the physical basis of parenthood that mothers have, fathers are trying to establish a secure emotional base on which to build. To the extent that the ritual allows them to do this, it is expressing and enacting the ideals of active fatherhood. Indeed, for many men, this is the closest they will ever get to it.

The other way men try to express their involvement in the birth process is by coaching. The status of man as labour coach is a difficult one, full of ambiguities. On the one hand it can be an acceptance of the futility of trying to identify too closely with the labouring woman, on the other it can be an attempt to 'take over' and control the woman's reproductive function.

If coaching is used as an expression of complementarity it can strengthen the values of active fatherhood. The father recognizes that there are differences between mother and father, but does not accept that this means a lack of equality. Rather, the two can work together; each doing what they are best able to do in the current situation. One way in which this can be seen is in relations with the hospital staff. If the medical staff want the couple to behave in a certain way, or to agree to some obstetric intervention, they often express themselves in terms of the health of the baby, instead of trying to relate to the couple directly. While there are clearly times when this is appropriate, there are others when intervention has no obvious medical reason. Many fathers feel that they have a special role to play at such times.

One of the doctors, I think he was—something to do with the birth anyway—came in and said, "The waters haven't burst yet, we're going to burst them for you." And we said, "What for, we're perfectly OK:' And he said, "Well, do you want to put the baby at risk?" And it's a difficult thing to say, but you've got to say, 'I don't think we want the waters burst, thank you:' I suppose you've got to push them a bit. Because if it really is a risk they'll push you out of the way anyway. But the man's important here I think because he can stand up—the woman's often flat on her back. (John)

In fact, the doctor did go away and let the labour take its course naturally. This is a typical obstetric encounter, significant not only for its use of the baby's safety as a threat, but also in the lack of explanation or even introduction given by the doctor. It illustrates the distinctive role which the father in labour often feels called upon to play; namely that it is his responsibility to deal with the hospital's authority structures. So something which starts off by attempting to establish an equality based on complementary roles takes on the appearance of the ideology of traditional fatherhood, with its stress on the father's role as mediator with the outside world.

Power relations are expressed in other ways in the birth ritual. The hospital authorities are not only in a position of superior status to the couple having the baby—a common situation in rites of passage—but there are also very strict hierarchies operating amongst the staff themselves, which are symbolized by the differences in dress and behaviour. In this way the hierarchical basis of our society is displayed to the new parents as a model which they ought to emulate.

The father may be tempted to accept this model and try to carve out a niche for himself in the power structure by using his role as labour coach to gain status in the obstetric hierarchy and show dominance over his wife. In such a situation, where differences of power and status are clearly revealed, many men find it hard not to join in the power games. The extent to which he is encouraged or discouraged in these games is crucial to the exact message of the rite—something which is still in a state of flux.

Despite all the undercurrents of power and domination, by the time of the delivery itself the prevailing feelings are of involvement and equality between new mother and father. This is the high point of the rite, and the values celebrated now are those associated with active, rather than traditional, fatherhood.

In chapter five I suggested that a sexual metaphor could provide some insights into a man's experience of birth. The account I gave there (loosely based on the birth of our second child, Adam) ended with the all-too-soon intervention of the staff, unwilling or unable to pause the implacable steamroller of hospital routine. If birth is like an orgasm, then the period after birth is certainly like the petit mort; that small, glorious, moment when you are dead to the world of desire—and thus fulfilled. It does not last forever of course. Gradually you return to the mundane world with all its blessings and curses, but that sense of contentment can last for some time.

At least, it can do so if love has been made in the context of love—if there is no guilt and no sense of sin having been committed. It is the same for some couples after the birth of a child. Unfortunately, for many this beautiful moment is made ugly and unclean by the intrusion of medical science. This may be in the shape of the jovial obstetrician and his shining needle and thread, come to sew up the cut or tear which marked your new child’s passage into the world, or it may simply be the bustling nurse anxious to get the mother into the hospital machine and you out of it. Either way, you are suddenly a stranger at the nativity, no longer an actor but just an unwelcome part of the audience which has outstayed its welcome after the sow is over.

To the obstetric tailor you are an embarrassment as he merrily sews your wife’s vagina and tells you that, thanks to his expertise, your sex life will now be better than ever. “She’ll fit you like a glove, ha, ha.” Of course he’s embarrassed—wouldn’t you be? But that’s why he doesn’t want you around, isn’t it? And the nursing staff are perhaps embarrassed too. The more powerful the emotions that the new parents are able to express—and many men cry for the first time in their adult lives when they are present at the birth of their first child—the more it may seem like a voyeuristic intrusion for the staff to have to be present. It isn’t always like this. Sometimes, when the circumstances have been right and everyone has worked together with mutual respect, then all can rejoice together and there is no discomfort or sense of intrusion. But even here the moment is not allowed to last; cannot be allowed to last. For it would subvert the system. Normal power relations must be resumed as soon as possible—and that means returning the mother to her subordinate status as a “patient” and expelling the father as irrelevant. So out you go.

It is always three o’clock in the morning when you leave hospital after a birth. No matter what the rest of the world thinks, it is always dark and the streets are always empty. It is very still and quiet, only the sound of your own footsteps disturbing the silence. Occasionally you might see other people, but always in the distance—there is no possibility of interaction. You are disengaged, a zombie. You live on your own time stream; a dream time; a mythical time when nothing happens and everything is possible.

You are a creature of myth, capable of anything. And, filled with the knowledge of your fertile life-creating power, you discover that you are impotent. Despite your power you cannot touch the world in any way. And so you wander aimlessly through those night streets until you end up at home, or some other destination which ought to have meaning for you. But the real meaning is locked away in a bed in a ward in a building where you are not welcome. It isn’t just that reality is hard to come back to, but rather that reality refuses to allow you in.

Fortunately, society in its wisdom has devised some simple ritual exercises to help the father over this somewhat difficult period in his life. One of the foremost of these is letting other people know about the birth. This seemingly simple exercise is in fact fraught with danger. Who do you tell first, and how? Assume that both of you have at least one parent still alive. Do you tell her parents before telling your own? And what does this say about your relationship with your parents and your in-laws? I guess that the current social expectation is that you should ring her parents first, closely followed by your own. But the order and speed with which you inform other relatives, friends and well-wishers will tell you much about the way you structure your social networks, and who you count most important. It is in just such small ways as this that we constantly create and re-affirm our society and our culture. And because this is a social activity which involves decisions about the nature of your own social universe it is a useful task to help you to regain contact with the external world.

Mind you, knowing in what order people should be told is not the whole of the matter. There is also the problem of being able to satisfy the questioner’s desire for information. Sex, weight, time of birth, length of labour, mode of delivery, health of mother and baby—all are vital pieces of information. I regret that I never seemed to be very good at remembering everything, especially the figures, and I am constantly amazed by the almost total recall which many new fathers seem to have not only for the quality of the experience, which is almost ineradicable, but also for the minutiae of obstetric arithmetic. “Then, when she was about 7cm dilated, they wanted to give her 50ml of Pethidine...”—that sort of thing. Having to tell people these simple facts will help to get the events into perspective. What may surprise the new father, though, is how few people are at all interested in him or his experiences. In fact, they’re not even very interested in the new mother either—once they know that she is “alright” all their attention is focussed on the new baby.

Getting back into the world is not a quick or simple process—especially while the new parents are kept apart by those institutions in society which like to refer to themselves as the “caring professions”. Once you’ve got over that first period of being withdrawn and inward looking you have a great desire not to be alone. What you really want, more than anything, is to be with your partner and your child. Not just to talk and to look but to touch; especially to touch. It is cuddling and consolation and mutual comforting that you desire. There is so much newness to explore together that there is almost physical pain in the separation.

Several studies, including Masters and Johnson’s famous work on human sexuality, have suggested that many men start affairs just after the birth of their child. On the face of it, this seems a particularly callous and cynical thing to do. While his wife is shut up in the hospital caring for their new baby, he is out behaving badly, caring only for his own pleasure. But I don’t think that it is quite as simple as that. The new father wants physical contact; he needs to express himself and his feelings through the medium of touch. He is denied access to the one person he really wants to be with—even at visiting time he is expected to behave in a frigid and non-physical manner—as befits a place where people are sick and dying. So he turns to someone else—a woman friend, maybe. Perhaps they’ve been close friends for a long time, perhaps they’ve never really been more than acquaintances or colleagues at work. But his vulnerability appeals to her—brings out her maternal instinct, if you like—and when he turns to her for physical support she is there to help him.

So far there is no problem. I was able to enjoy just such support from a close friend of mine after the birth of our third child, Rebecca. Because I had known Chris for many years there was no chance of the situation getting confused and turning into something neither of us wanted. Not every man is so lucky. There is no doubt that although the new father’s main desire is for contact of a purely non-sexual kind, many men also have a strong feeling of potency. The fact that you are a father means that your sexuality is not just a matter of academic interest, but has real and living consequences. You have proved that you are able to take an active part in the creation of life—for some it is an almost god-like feeling. Men often have the problem of being unable to distinguish the sensual from the sexual; of wanting to express all closeness in terms of making love. Given the increased awareness of their own sexuality which many men have after birth, it is hardly surprising that some find themselves tumbling into affairs almost by accident and almost against their wills.

It is hard to imagine a more cruel or unthinking way of treating new fathers than the one we presently operate. They are invited—pressured—to attend and participate in the birth of their children. Their emotional involvement is increasingly tolerated and encouraged and then—just when the new parents need each other most—the father is forcibly separated from mother and child. Can you imagine a worse way to start family life together? If the father was not involved at all, then his absence after the birth would not be such a problem. To start a process and then suspend it at its climax is always likely to lead to disaster.

If we look around the world we find a variety of practices. Many societies not only exclude men from the birth itself but also keep mother and father separated for a long period—thirty days or more is not uncommon. Some exclude men from birth, but allow them unrestricted access to the mother and child afterwards. Some, like the Jivaro of South America (famous, unfortunately, for the making of tsantsa—the shrunken heads of their enemies) expect the father to assist his wife in labour and then to aid her at home while she is sheltered from most household tasks for the first two weeks of the baby’s life. Both parents will observe some special food taboos. Another pattern, found on the Andaman Islands, requires both parents to be isolated for a period. Their meals are brought to them by relatives and they are left alone to get to know themselves again as a family. I don’t know of any other society which has our pattern: of including men at birth and then excluding them afterwards. To me it seems to be the worst of the lot.

I think that the best way is the Andaman way: of including men at birth and then secluding them with the mother and child for a period afterwards. Why don’t we do it too? After all, there is now great concern that mothers should be allowed unrestricted access to their children so that they can bond properly. “Bonding” has now become excessively fashionable and has achieved breakthrough into the popular consciousness. In fact there is an analogous word for fathers, coined as long ago as 1974 by Greenberg and Morris. They used the term engrossment to describe the kind of euphoric involvement which some men find with their newly born child. Yet there has never been a movement to allow fathers unrestricted access to their children in order that they might ‘engross’![1]

But whatever the future outcome, it is surely a good thing for a family to start family life together. If we are creating a society in which men are gradually being given the opportunity to spend more time with their children, and are being encouraged to become emotionally closer to them then isn’t it about time that we tried to start things off on the right foot? An attempt is being made in the US where childbirth is becoming ever more competitive. It is becoming more common for hospitals to offer double rooms for the new father and mother. Some even advertise a champagne dinner for the couple to celebrate the birth! This is a definite step in the right direction. The problem is that it is simply too expensive for most people to be able to stay more than a couple of nights.

In Britain things are less advanced. One hospital in Lincoln has started allowing fathers to stay with their wives after the birth—but only when the baby has to go into special care. This bold innovation has not been universally praised. At one local meeting of the Royal College of Midwives where this was discussed, many of the midwives present felt very threatened by the idea. They did not think that it was ‘proper’ for a man and woman to be sharing a bed in a hospital, where the sexes are usually rigidly separated. No doubt they were also worried about having a part of the hospital which was private and where they perhaps needed to ask permission to enter. At another hospital, during a discussion about the equipment needed to set up a new maternity unit, the director of midwifery said she would like at least one double bed in the unit. “Going to climb into bed with the patients, are you?” sneered one of the consultant obstetricians.

Although their attitude may not be very enlightened, in a sense they are right. Hospital is not the best place for perfectly healthy people to stay in order to get to know each other as a family. Not only that, but hospitals are expensive places to run, with highly trained staff. It is a waste of resources to use them as hotels for new parents. Perhaps home birth could be the answer. It certainly has some obvious advantages: you’re on your own territory and should, in theory, be able to assert yourselves better.

Yet even at home things don’t always go as people hope. Jimmy and Sara’s second child was born at home. The delivery turned out to be rather more complicated than expected because the baby was the wrong way round (posterior presentation). Jimmy had expected it to be a better experience than in hospital, but in the end found it harder to cope with. The midwife also seemed to find it difficult—especially in dealing Jimmy himself. She was quite a lot older than Sara and Jimmy, but he felt very patronized by her, particularly the way she kept calling him ‘young Jimmy.’ After the birth, the midwife took the baby away to bath it. Jimmy felt very excluded by this. ‘She should have let me do it’ he said afterwards. Most people who have experienced both home and hospital birth are luckier in their experiences and prefer the home birth. But at this point in obstetric history home birth is clearly very much a minority interest. Perhaps economics will eventually bring to hospital birth to an end, but it will take time.

What is really needed is somewhere—home, hospital, hotel, hostel—where the new parents can spend time together getting to know each other and being made a fuss of by family, friends and society as a whole. Despite the fact that birth itself has been institutionalized, becoming a parent remains a very private thing in our society with little support from other people. A ‘birth centre’ could help new parents to feel more valued and help them to make a positive transition to their new roles. More involvement from society might also help to solve the problem of the ending of the rite of passage for birth.

In a complete rite of passage the liminal period ends with a rite of incorporation which moves the subject back into the world, but now in his or her new status—as adult; as husband or wife; as parent. The new status will be publicly announced and celebrated. Special clothing may be worn, and there may be feasting and general rejoicing. Often those who have undergone the ritual will be granted privileges because of their new status, and will be accorded a new respect by society at large.

The parallel breaks down here. Although the first two stages of the rite are highly elaborated in Western obstetrics, there is little or no rite of incorporation. We leave the rite of passage unfinished; the new mother and father are left in limbo, having to fend for themselves as best they can. Because the obstetric hierarchy see birth as essentially the process of delivering a healthy baby they tend to ignore the wider emotional and social needs of the new parents.[2]

As we have seen, much of the ritual works to subjugate and humiliate the subject. To many people it seems pointless—even gratuitously cruel. Feminist writers tend to identify obstetric ritual with male dominance and desire to control female fertility. There is a lot of truth in this view, yet there is also evidence to suggest that the mechanism of the rite has a purpose, and that ultimately the rite could be beneficial and life-enhancing.

William Sargant is a psychologist who has written about the mechanism of initiation rites. He suggests that the intensity of the rite is a bit like brain washing or ecstatic religious conversion and makes the subject more amenable to suggestion and able to make radical changes in outlook and belief. In this state of heightened suggestibility, the person being initiated can be more quickly and effectively conditioned to his new, adult, place in society. It is possible that all rites of passage are able to have similar effects. They may have unpleasant aspects, but their end result is beneficial, enabling a major change in lifestyle to be accepted quickly and easily.

The same should apply to Western birth ritual. It separates a man and woman from their normal environment and subjects them to humiliation and disorientation in a strange setting where they are powerless and emotionally involved. At the end of this they should be welcomed back into society, honoured as a parents, and nurtured and supported in their new status. In this way the obstetric procedures necessary to bring about successful childbirth, and the ritual procedures necessary to bring about a successful transition to parenthood should run in parallel. In theory, this mix of science and ritual should produce physically healthy babies and socially well-adjusted parents. In practice, it doesn’t seem to work so well.

Rites of passage appear in almost every known culture. The content and the symbols involved may change, but the form is constant. It is unlikely that such a rite would be so widespread if it did not fulfil a basic human social need. Regardless of any psychological mechanisms at work, the rite has its own logic and its own pattern. If that pattern is disrupted or left incomplete serious distress could result. In order for any heightened suggestibility to have positive consequences, there must be a nurturing and welcoming climax to the rite of passage. Otherwise the participant is left high and dry, with feelings of alienation and distress.

Some writers have suggested that there is a link between ‘high technology birth' and postnatal depression in women. Others stress the high levels of circulating oestrogen in the newly delivered mother and see these as influential. I think that the incompleteness of the ritual and the contradictory messages it gives to parents may also have a part to play.[3]

I am often asked if men suffer from postnatal depression. It’s a hard question to answer because the term itself is not a precise one, and also because little if any work has been done to try to find out if men suffer depressive symptoms after birth. It is possible to distinguish three different kinds of reaction after birth: all of which may be called ‘postnatal depression’.

Firstly, there is postnatal psychosis, a complete or partial mental breakdown precipitated by the birth which often requires hospitalization. Both men and women can suffer from this illness. Symptoms for men include suicidal wishes, excessive drinking, irresponsible and lavish spending, or worries that an incurable disease has been contracted. Male postnatal breakdown is rare, but has been well documented.

The most common form of depression after childbirth is what is often known amongst women as baby blues. The symptoms are feelings of inadequacy, disorientation, despair and general lethargy. Fortunately, baby blues doesn’t last very long; often no more than a couple of days. Men, too, can suffer in exactly the same way. “It’s withdrawal symptoms after the ‘high’ of the birth.’ said Mick. I have already described the feelings of rejection, emptiness and disassociation felt by many men after the birth. Indeed, it is possible that men actually have worse ‘baby blues’ symptoms after birth than most women. I have suggested that these are very much a symptom of the separation experienced by new fathers. Certainly they often seem to disappear when the family is re-united at home.

The term postnatal depression itself is usually reserved for a longer-term reaction. The symptoms are similar to those experienced in baby blues, but they persist—sometimes for months—and can be emotionally crippling to the new mother who has to try to cope with them. Brian Jackson claims that a third of the men in his sample had clear symptoms of depression. But he doesn’t say enough to allow us to be able to tell how long this depression lasted, or how serious it was.[4] The evidence suggests that women have worse reactions than men, but it is impossible to be clear about this until more research has been done.

Whether or not some forms of postnatal depression are related to the structure and content of our birth rituals, it is clear that we have a problem with the way we handle birth at the moment. Because there is no proper conclusion to our rite for birth, society is sending out some very ambiguous messages about the status and role of fatherhood. But it should cause us no surprise to discover that these messages accurately reflect the contradictions experienced by the modem father as he attempts to reconcile the ideology of involved fatherhood with the constraints imposed by the outside world. [Next]


[1] While there is no doubt that some parents do feel a kind of rapturous kinship with their new born, it is misleading to assert that this is necessary to the development of good parenting. The research is ambiguous in this respect.

A study by Richards et al found a relationship between father’s birth attendance and his level of involvement with the child at 30 weeks, but not at 60 weeks. They suggest that this is because fathers who wanted to be present at birth were also likely to get involved in childcare. Peterson et al found a similar sort of link, and suggest the father’s experience of labour and birth is more important than his attitudes before birth in determining his subsequent involvement.

Participation, rather than simple attendance, seems to be the key in two studies (reported in Beail p.12) which suggest that fathers who were excluded from birth because a caesarean section was performed were more involved than other fathers. It has been suggested that the reason for this is their greater involvement after birth while the mother was recovering from the section.

Other studies have found no significant link between father participation at birth and future involvement (Woollett et al) and it is clear that much more work needs to be done—especially on trying to get some agreement about the meaning of terms such as ‘involvement’ and ‘participation’.

[2] It may seem obvious that the primary aim of obstetrics should be the delivery of a healthy child, but if this is achieved at the price of damaging the mother or father’s ability to parent then the price may be too high. If bad socialization at the time of birth had a part to play in subsequent malpractice such as baby battering, then it might be better to pay a little less attention to the baby, and a bit more to the parents. There is no perfect recipe for success, but at present, because his work is finished when the baby is born, the obstetrician has little incentive to look beyond birth to the wider aspects of parenting.

[3] For more on the ritual of birth see Kitzinger 1978, Seel 1986, and Davis-Floyd. For more on hi-tech childbirth and postnatal depression see Welburn and Oakley. For the hormonal theory, see Dalton.

[4] Charlie Lewis (1986, p84) cites two unpublished studies which also suggest that about one third of new fathers suffer from depression in the first few weeks after the birth.