by Anna Machin
The other intervention that Holly and her team identified as having a positive impact on paternal mental health was the traditional antenatal class – but with a twist. It is not unusual for dads to attend antenatal classes with their partners to learn about pregnancy, birth and baby caretaking, but in most cases they are there in a supporting role. However, there is a growing recognition that fathers benefit hugely from male-only antenatal classes. In an era of global austerity, these classes are thin on the ground, but where they do exist, even in the form of one men-only class out of the usual run of six or eight couples’ classes, they have a profound impact on a man’s mental health. Being able to take part in one of these classes allows men to relinquish their role as ‘emotional rock’ and speak freely about their fears and anxieties, focus on the skills that will help them as a dad and ask all the questions that they fear may make them look stupid in front of an audience of mums-to-be. The classes are particularly beneficial where the teacher has seen fit to invite a few experienced fathers, as it is increasingly becoming apparent that men feel most comfortable asking questions of and gathering information from their peers. And this can mean that sometimes they find support in the most unlikely of places.
The Lions Barber Collective is an international organization first established in the UK. It brings together a group of leading barbers, all of whom have an interest in tackling the worryingly high rate of male suicide and raising awareness of men’s mental health. For years, those of us who wish to support men who struggle with their mental health have found it difficult to make contact and find suitable and effective interventions that encourage men to talk about their experiences. The Lions Barber Collective, all members of which are trained as mental health support workers, is effective because it exploits the often close and long-term relationship that men build with their barber and the confidentiality of barber chair chat to encourage men to open up about their lives. An added bonus is that men do not often include their barber in their social circle, so they do not feel the need to edit their stories to protect others. This scheme has garnered huge amounts of attention, and deservedly so, because it works. It acknowledges that men find it difficult to actively seek out help, that they need something they can access easily in their daily lives and that they will often speak more readily to a friend or acquaintance – barber, fellow sports team member – than a professional. While not explicitly focused on perinatal mental health in men, it is a model that we can follow to attempt to provide the much-needed support that fathers require.
Our understanding of paternal mental health is growing. As I finished writing this chapter, a new study by the University of Southern California confirmed a long-held hunch that, as with maternal PND, hormones have a part to play in paternal PND. As a dad, while the drop in testosterone that accompanies fatherhood is good for redirecting your focus onto your family, it increases your risk of suffering from PND; it has long been known that high levels of testosterone are a protective factor against depression. In this case, men in the study with the lowest levels of testosterone were the most likely to report depressive symptoms. Not good news if you are one of these men, but the greater the knowledge we have of this condition the more likely it is that we can work to prevent and cure it. The challenge for those of us within the field is to take this knowledge and make it generally known. To continue to voice the reasons, probably in the language of economics rather than empathy, for providing men with targeted support and intervention. At present, much of the research focuses on prevention rather than cure and, in the absence of professional help, there is certainly much a man can do during the lead-up to the birth, and afterwards, to help his mental health. This can include making use of all the tools modern technology has to offer in seeking your own support network:
I am part of a Facebook group, which is fantastic because you get everything from a dad reporting in . . . (‘It’s Jeff here, reporting from the dog house, I’ve done x or y’) to difficult subjects like a dad trying to keep in touch with his kids following divorce. There are always dads in similar positions to you that you can relate to. It’s really useful.
Ben, dad to Rosie (eighteen months) and one on the way
If you are an expectant dad, the nine months of pregnancy are a wonderful opportunity to discuss with your partner your thoughts and concerns about your role during pregnancy, birth and beyond. You can take the time to discuss how you will work together as a parenting team and identify possible points of tension and how you can resolve them. You can use the time to pep up your massage skills and to build your own support network consisting of friends, family, professionals, colleagues and virtual groups. There is a growing number of online support communities just for dads, which many men, like Ben, find invaluable.
It had gone from this ridiculous thing of lasting for so long to all of a sudden you’ve got a baby, and everyone’s going out the room, and there’s all this blood everywhere and you’ve just seen the baby’s head come out. It’s ‘oh my god’ and there he is. And I just wanted to tell people; it was a really proud moment, I guess. Yes, it was just a really proud moment and I couldn’t wait . . . because there’s not much you can do then, apart from hold him. I wanted to tell everyone, ‘Look, I’m a proud dad.’
Zac, dad to Aidan (six months)
Some of the issues or points of tension that you encounter around birth will be personal to you, but from my own research I know that some have the potential to be universal. Many fathers can struggle finding a space to connect with their baby during those first intense months, particularly in the early stages when a baby may be with mum for long periods of breastfeeding. It is important that you explore how you will feel about this. Some fathers are content to be mum’s supporter at this stage, knowing that their time will come, but others find it helps to identify an exclusive activity that will be just for them and their baby; bath time, the midnight bottle or the pre-bedtime massage are often popular. While some hospitals now offer family rooms that enable dads to stay after birth, these are still thin on the ground and many dads do find themselves out on the streets once baby has been delivered – the hospital car park at 3 in the morning can be a very bleak and unwelcoming place. For some fathers, the sharp contrast between the drama of birth, the joy of becoming a family and the swift ejection onto the street once mum is settled on the ward can be very difficult to take. If this is a likelihood, then identify someone who you can ring to talk to or meet once you leave the hospital, whatever the hour. Someone who can help you celebrate, reflect, laugh and cry, and provide you with a much-needed meal and drink. And whatever birth plan you have, you will be interacting with healthcare staff. Discuss with your partner how you both want to approach these interactions so that both your needs and concerns are addressed and so that you are supported in your chosen role.
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One thing I wasn’t prepared for is I find her really, really funny. It’s got to be her reaction. Everything is amazing and new for her, and exciting. She seems to never get tired of stuff. Genuinely most times when we’re interacting, at some point she will do something that just cracks me up.
Nigel, dad to Poppy (six months)
For the majority of men becoming a dad, while tough at times, is a period that is overwhelmingly characterized by joy – the happiness engendered by seeing life anew through your baby’s eyes, the beaming grin and open arms that greet you when you get home from work, the shared experience of learning together. Ben is dad to 18-month-old Rosie and has one on the way. All parents-to-be could do well to remember his sage advice:
To all the men who are friends of ours who are starting to think about becoming a dad, I am overwhelmingly positive. It is absolutely amazing, it changes your world, it makes everything lighten up, you have a reason to bounce out of bed most times. If I realize Rosie is up, then fantastic. If you weigh the positives and the negatives, the positives win outright. Yes, there is dealing with nappies and being woken up, but they always have that chee
ky smile. I absolutely love being a dad.
Holly Rominov’s work on baby massage and men-only antenatal classes has shown us that, even without great investment, there are small things that can be done to ease the symptoms of poor mental health; taking time out for yourself away from the family to do something you enjoy, using massage as a way to connect with your baby and partner and lighten your mood, building a support network of peers – in the real world or online – so you can share your feelings and be acknowledged and supported. And if your symptoms become overwhelming, then the therapies that are available to all those who suffer with poor mental health are also available to you. Taking the step to talk to a professional – midwife, health visitor or GP – is often the first step towards recovery.
Ultimately, prevention is better than cure and we all have a role to play in this. We may no longer have a tradition of couvade rituals in the West, but as fathers become more and more involved with their children, maybe we need to begin a new set of traditions aimed at recognizing and supporting men as they endeavour to successfully navigate this life-changing journey. At the very least, we can acknowledge that pregnancy and birth happen to dads too. If you are reading this as a way to better understand and support your partner or friend, take the time to ask how he is and listen with empathy to his response. Offer to babysit so he can take a well-earned break. Get a group of experienced and inexperienced dads together so that questions can be asked and issues discussed in a supportive atmosphere. Or go the whole hog and throw him a daddy-shower. When a baby is born or adopted, then it is generally the case that two people are commencing on the journey of parenthood and at least one of them is likely to be a dad. Let’s make sure we are all there to support and celebrate with him.
CHAPTER FIVE
A Multitude of Dads
Dads, Flexibility and Child Survival
I want to introduce you to four fathers.
Ota is a member of the Aka tribe, who reside deep in the lush forests of the Democratic Republic of Congo. They are a hunter-gatherer tribe who hunt for small forest animals using nets. Net hunting is a whole-family endeavour, with children accompanying their mothers and fathers in their treks through the forest. Because the family is always together, Ota shares the care of his children equally with their mother and he is just as likely to sing to, comfort, feed or bathe them as she is. Indeed, he is more likely to share his bed with their children than his wife and he may even offer a crying baby his nipple to suckle until mum is available to breastfeed.
Next, meet Mike. Mike is a commercial lawyer from Boston in the United States. He works long hours and rarely sees his children during the working week, but he is driven to earn a high wage so that his children can benefit from a private education and live in a nice part of the city. He is a member of the local country club and at the weekends he takes his younger children to swimming club while his eldest son often joins him on the golf course with his work colleagues.
Next, there’s Sigis. He is a father from the Kipsigis tribe in the highlands of Kenya. The Kipsigis are farmers whose predominant crop is tea. Sigis sees his main role as being the family breadwinner and spends little time with his younger children. However, when his sons reach late childhood, he begins to teach them about the farm so that they will be able to take over its running when they are adults. From adolescence onwards, he likes to spend the majority of his leisure time with his sons, leaving his adolescent daughters to his wife.
Finally, meet James. James lives in Somerset in south-west England. He is the primary carer of his three children. His wife, a successful PR executive, works in Bristol and often travels abroad, so he is the main source of practical care and emotional support for his kids. James is responsible for taking his two eldest children to and from school and carrying out the domestic chores. He is a dab hand at juggling the ballet, football and frequent play dates that make up his children’s post-school itinerary, as well as providing tea and homework support and being an enthusiastic member of the school’s Parent Teacher Association. Now that his youngest is in pre-school four mornings a week, he is trying to build up a copywriting business from home.
Four different fathers from four very different regions of the world, with four very different ways of fulfilling the fathering role. Who would you say was doing the better job?
In this chapter, I want to explore what drives the diversity of fathering around the world. I want to introduce you to the many different ways of being a dad, which hopefully will achieve two goals. Firstly, I hope to provide reassurance to those of you who might be embarking on this journey that there is no ‘right way’ to be an involved dad and, secondly, to show you that you may approach your role in a variety of different ways, but for all of you there is an underlying shared goal that ultimately moulds your approach: the powerful drive to ensure your children’s survival. As dads, you might have your differences, but ultimately you are all members of the same club.
As a dad, you are free from the biological bounds of pregnancy, birth and breastfeeding, but it should be clear from previous chapters that the role you eventually adopt within your family is not quite as free a choice for you as it would at first appear. There is an element of your behaviour that is driven by evolutionary history and biology and a part that is shaped by the social, cultural and political milieu you inhabit. If we consider that modern dads can live in societies whose systems differ as markedly as monogamy and polygamy, whose politics can lean from the far right to the far left, whose inheritance systems could be patriarchal, matriarchal or egalitarian and whose economy can be founded on the principles of capitalism, communism, barter or self-sufficiency, it is hardly surprising that the dads of the world inhabit their role in a seemingly infinite number of ways. But if we add to this the influences of history, religion and politics, combined with individual differences in upbringing and genetics, it is no surprise that there are so many different ways for you to fulfil your role.
The flexibility that underpins a father’s role is critical for human survival because, restricted by the high energetic and physical demands of pregnancy, childbirth and breastfeeding, the role of human mothers is tightly prescribed. In contrast, the role of a father can quickly respond to even the tiniest shift in the social, economic or physical environment that might threaten his family’s survival. And this means that the role of a father can differ markedly not only between cultures but within families, between neighbours and even within the lifetime of one man. This has two consequences. Firstly, that while taking inspiration from other fathers – your own dad, your next-door neighbour, David Beckham – it is a good idea not to compare yourself to others to too much of an extent, as it is very likely that the factors influencing survival in your children’s lives differ to those of your role models. Secondly, dads in apparently very similar environments can come up with starkly different ways of solving the survival puzzle, because the other elements in their life differ. So, in answer to the question I posed at the start of this chapter, it is not about who does it best but about the fascinating ways all dads arrive at different solutions to the same conundrum.
Recall the Aché fathers from Chapter Three? Like the Aka man above, they gain resources via the process of hunting and gathering but unlike the hands-on Aka man, they have very little to do with the direct care of their children. In their war-torn society, ensuring survival is as basic as protecting the very life of your family on a day-to-day basis. In contrast, the life of the Aka, deep within the rainforest, with plentiful food and few threats, is one of comparative egalitarian bliss. Aka fathers are the most hands-on dads in the world, spending on average 47 per cent of their day in physical contact with their children. So, one type of subsistence economy but two very different fathering styles. They differ because the social environment in which they live is so starkly different and, as a consequence, the actions that ensure the survival of the children in each society are very different. Without an immediate threat to life, the Aka man can spend h
is days on family hunting trips, co-parenting and ensuring the critical survival skills of hunting are passed on to his children – the skills of which his children will learn equally from him and his wife. In contrast, without the active physical protection of their multiple fathers, the children of the Aché would be under grave risk of not surviving into adulthood. Two dads, one shared goal, but two very different methods of achieving it.
Developmental scientist Robert LeVine of Harvard University argues that it is just this element of environmental risk that is the underlying cause of much of the global and local variability in fathering behaviour. Ultimately, all fathers are concerned with the survival and future success of their offspring. However, depending upon the environment, the features of the father’s input that increase the likelihood of this survival may vary. In Robert’s own words, fathers make ‘adjustments, consciously or unconsciously, to adapt to aspects of the environment that threaten or facilitate attainment of their parental goals’. And as environments fluctuate and differ between societies, so fathering differs. In environments with high levels of risk, be this warfare, predation or disease, a father’s key role is to ensure his child’s physical survival and health: the first tier of the hierarchy. Where physical survival is less at risk, but economic poverty may be an issue, the next tier argues that, safe in the knowledge his child will survive, a father should then be concerned with ensuring his child develops the appropriate skills to ensure his economic survival during adulthood. Finally, where economic survival is relatively assured, a father should then concern himself with his child’s social, intellectual and cultural development. So, LeVine argues that in societies that exist on the edge of survival, such as the hunter-gatherer or domestic farmer, both parents invest hugely in nurturing their child in the first years of their life to try to get him or her through that vulnerable period when the risk of death is high. In contrast, families in industrialized nations are aware that their input must be adapted towards a child with a future. Parents must be prepared to commit time and economic resources to their child. The cliché of the middle-class parent taking great pains to stimulate their child intellectually and socially and ensure they make the most of educational opportunities is widespread and the butt of many jokes. But behind it is a serious and survival-critical mission: to prepare the child to survive and thrive in the competitive social and economic environment in which they will mature.