Including Fathers in Ante-Natal and Early Years Services Key Policy and Practice Issues David Bartlett Fatherhood Institute.

Including Fathers in Ante-Natal and Early Years Services

Key Policy and Practice Issues

David BartlettFatherhood Institute

21st Century Fatherhood is…

• Diverse and changing

• Socially contested

• Often fragile

• Embedded in complexweb of relationships and identities

Fatherhood is about children

You are my teddy at night. (Naomi, Yr4)

‘I love my dad: loveable, fun, mean, unkind ... I hate it when my dad comes home drunk. That’s when he starts fighting with my mum’ (11 year-old)

Dear Dad, I only see you once a week … Some small things I ask of you: please come to my school plays and come to parents’ evening to see how I’m getting on. (12 year-old)

(DfES/Fathers Direct, 2003; Russell et al., 1999)

21st Century Fatherhood: Behaviour

• UK fathers carry out 25% of childcare related activities during the week, and one-third at weekends. More where both parents work full-time (EOC 2003)

• The percentage of new UK fathers working flexitime to spend more time with their infants rose from 11% in 2002 to 31% in 2005 (Smeaton & Marsh, 2006)

• 1 in 4 children under 16 are affected by their parents’ separation – but children and their nonresident fathers often see a lot of each other. 1 in 10 separated couples share childcare almost equally (Peacey & Hunt, 2008) Only 10% lose touch completely (Maclean & Eekelaar, 1997)

21st Century Fatherhood: at the birth

• 86% of parents are married or living together – and 93% of these dads attend the birth• Nearly half of the other 14% of fathers attend the birth

(Millennium Cohort Study - Kiernan & Smith 2003)

• Considerable variation in fathers’ birth attendance (Dex & Joshi, 2005), by:Locality – 91% attendance in the most affluent wards, 80.5% in the poorestSocial class - 95% attendance of professional fathers, 81% for fathers in semi-routine and routine occupationsEthnicity - 67% attendance in areas of high minority ethnic population

21st Century Fatherhood: Satisfaction

• 70% of men & women want fathers more involved (Twenty-first Century Dad; EOC 2006). 58% of men and 62% of women reject male breadwinner role (Dads and their babies; EOC 2005); 52% of men say they wish their father had spent more time with them as children (Fatherhood Institute 2010) • The most stressed parents tend to be parents who operate traditional, more differentiated family and work roles (Cowan & Cowan 2003)• Parents’ greater sharing of earning and caring roles is linked to lower rates of separation /divorce (eg in Sweden – see Olah 2001) and greater relationship satisfaction for both parents (eg in Australia – see Craig & Sawriker 2006)• Both parents’ beliefs that father-involvement is important predict relationship stability (Hohmann-Marriott 2006)

Positive longterm impact of father-child relationship

Children with positively involved resident or non-resident biological or step fathers tend to have:

better friendships with better-adjusted children fewer behaviour problems lower criminality and substance abuse higher educational achievement greater capacity for empathy higher self-esteem and life-satisfaction (Flouri 2005; Pleck and Masciadrelli 2004; Dunn 2004)

Also a protective factor for disadvantaged or vulnerable children (Black et al 1995; Tunnard 2002, 2004)

Poor father-child relationships affect child outcomes

• Children (particularly boys) of post-natally clinically depressed fathers show more behaviour problems later in childhood (Ramchandani et al, 2005/2008)

• Fathers’ harsh or neglectful parenting is strongly associated with behaviour problems in children (studies cited by Phares 1999; Flouri 2005)

• Low interest by a father in his child’s education (particularly boys’) has a very negative impact on their achievement (Blanden 2006)

Impact of father on mother–child relationship

• Child-mother attachment is more secure when child-fatherattachment is secure (for review see Guterman & Lee 2005)

• Fathers’ support for breastfeeding has strong influence on the initiation and duration of breastfeeding (Swanson & Power 2005); particularly in low-income families (Schmidt & Sigman-Grant 2000)

• Heavy drinking by fathers is associated with double risk of insecure attachments between mothers and infants (Eiden & Leonard 1996)

• Post-natal depression in mothers is associated with a poor or abusive relationship with her baby’s father, his low involvement in infant care, and his own poor mental health (for review, see Fisher et al 2006)

Holding/caring for babies makes men more nurturing

Within 15 minutes of holding a baby men tend to experience raised levels of hormones associated with:

tolerance/trust (oxytocin) sensitivity to infants (cortisol) bonding/brooding (prolactin)

The more experienced the male is as a caregiver, the more pronounced are the changes (Hrdy 2009)

This may in part explain why fathers who do lots of infant-care tend to be more satisfied and adjust more quickly to fatherhood (Barclay & Lupton, 1999; Henderson & Browse, 1991)

Fathers’ Information and Support Needs

Largely due to differing socialisation & circumstances, men usually have (relative to women):

• less experience & knowledge of infants / children• less appreciation that good parenting requires skills• a belief that they have a relatively marginal impact on children’s lives• greater isolation as a parent• different challenges with children – e.g. discipline; greater need to spend time with them • less awareness about and willingness to access services

Key Research Summaries on Fatherhood Institute Website

Fathers and Maternal and Infant Health in the Perinatal Periodhttp://www.fatherhoodinstitute.org/index.php?id=2&cID=736

Fathers and Smoking http://www.fathersdirect.com/index.php?id=2&cID=579

Fathers and Breastfeedinghttp://www.fathersdirect.com/index.php?id=2&cID=581

Fathers and Postnatal Depressionhttp://www.fathersdirect.com/index.php?id=2&cID=580

Young Fathers http://www.fathersdirect.com/index.php?id=13&cID=575

Main Research Summary: ‘The Costs & Benefits of Active Fatherhood’ http://www.fathersdirect.com/index.php?id=0&cID=586

Impact of Father-Inclusive Children’s Services

Benefits of engaging with fathers include:

• clearer picture about family dynamics

• easier to assess fathers’ specific needs

• easier to give information/support to fathers

• change in family more likely to be sustained

GOVERNMENT POLICY and LEGISLATION explicitlyrequiring engagement with fathers

1. The Children Act (1989, 2004)2. The Framework for the Assessment of Children in Need

and their Families (DH, 2000)3. The National Service Framework for Children, Young People

& Maternity Services (DH/DfES, 2004)4. Working Together to Safeguard Children (2006)5. Routine postnatal care of women and their babies (NIHCE,

2006) 6. The Equality Act (2006) 7. Maternity Matters (DH, 2007)8. The Children’s Centre Practice/Planning/Performance

Management Guidance (DfES, 2006; 2007)9. Every Parent Matters (HM Treasury, 2007)10. Aiming High for Children (HM Treasury/DfES, 2007)11. The Children’s Plan (DCSF, 2007)

More GOVERNMENT POLICY and LEGISLATION…

12. Teenage Parenting Strategy & Guidance (DCSF, 2007; 2008); Teenage Pregnancy Independent Advisory Group Annual Report (2008)

13. 2020 Children and Young People’s Workforce Strategy (DCSF 2008)

14. The Child Health Promotion Programme Update (DH, 2008)15. SCIE guidelines for supporting parents (2008)16. The Welfare Act (2009)17. The Childcare Strategy (DWP, HM Treasury, DCSF, Cabinet

Office, 2009)18. Healthy lives, brighter futures: the strategy for children and

young people’s health (DCSF, DH, 2009)19. Getting Maternity Services Right for teenage mothers and

young fathers (DH, DCSF, 2009)20. Support for All (Green Paper on families) (DCSF, 2010)

http://www.fatherhoodinstitute.org/index.php?id=0&cID=711

Children’s Centre Practice Guidance & Planning and Performance Management Guidance (2006)

All Centres must routinely offer all fathers the support and opportunities they need to play their parental role effectively, particularly groups of fathers previously excluded from services and whose children may be at risk of poor outcomes

Maternity Matters (2007)

High quality maternity care ….. involves access to a wide range of varied services that should work in partnership to help equip mothers and fathers with the skills they require to become confident and caring parents.

Child Health Promotion Programme (2008) “Supporting the transition to parenthood, especially for first-time mother and fathers.”“Supporting strong couple relationships.”

Child Health Strategy (2009)Improvement of fathers' involvement in maternity servicesReview of antenatal education, with particular reference to fathers and excluded groups Healthy Child Programme pilots to test ways of reaching fathers

Support for All: Government Green Paper on families and relationships (2010)Support RCM to produce guidance for midwives on engaging fathersBounty Packs to include a guide specifically designed for fathersawareness campaign to support flexible working by mums and dadsGreater emphasis on couple relationships

A Review of How Fathers can be Better Recognised and Supported Through DCSF Policy (DCSF 2008) found that implementation of father-inclusive policies by children’s services was patchy and that key barriers included:

• strategic approach: absence of systematic, routine engagement with fathers.

• workforce: lack of training & skills for managers & workers

• marketing to fathers: many fathers think children’s services are ‘not for them’, and do not feel included by communications aimed at generic ‘parents’

Workforce skills and attitudes

Most staff lack framework for father-inclusive skills andknowledge:• Low awareness of how important fathers are to

children• Negative assumptions about fathers. Too often seen as

a risk, or assumed to be uninterested in their children (especially if young, minority ethnic, non-resident)

• Understanding their role mainly as supporting mother-child relationships

• Unconfident or ambivalent about engaging with dads

See eg Featherstone et al (2007); Ferguson & Hogan (2004)

Parenting Programmes: Design and Content • Inadequate evidence base for the effectiveness of mainstream

parenting programmes (such as Triple P, Strengthening Families/Strengthening Communities or Incredible Years) at engaging with fathers

• Most evaluations have failed to collect or present findings by gender. Too few fathers may have attended for viable conclusions to be drawn

• Their attendance may have been relatively sporadic; facilitators may have engaged more substantially with mothers

See “Fathers and Parenting Interventions: What Works?” (Fatherhood Institute 2010)

• DCSF-initiated campaign now led by Fatherhood Institute - key information hub for policy and practice development

• Think Fathers Champions - services, commissioners, policymakers, employers etc who are committed to supporting father-child relationships. Register at [email protected]

• Dad Test - self assessment framework

The Six Dad Test Requirements

• Leadership; goals, systems, culture• Team: recruitment, induction, professional

development, appraisal• Environment: is it welcoming/accessible for men?• Marketing and Communication: targeted• Recruiting Fathers: accessibility, outreach,

assessment• Monitoring and Evaluation

Fathers are open to support and information

….particularly at transitions - eg Lincs health visitors changed welcome letter to include fathers: attendance went up 18% to 65% http://www.dcsf.gov.uk/everychildmatters/_download/?id=5967

….When mum is involved too, or supportive - eg families are less likely to drop out or parenting interventions when both fathers and mothers participate (Foote et al, 1998)

...increasing consensus that they should get better services - but 79% say new fathers should get more information on pregnancy, birth, breastfeeding and caring for a baby (Fatherhood Institute 2010)

“Maturity of engagement” with fathers

Raikes et al (2005) found fathers almost three times as likely to engage with parenting support/education when the service had reached “Stage 5” in “maturity” in engaging with men, ie services• have an agency-wide commitment to involving fathers• employ a father-involvement co-ordinator/champion• consistently view fathers as co-parents• see services as being as much for fathers as for mothers• adjust service delivery to meet the needs of working fathers/mothers• helps both mothers and fathers to reflect on how each father contributes to his child’s health and development• have managers and staff committed to ongoing critical evaluation of services’ engagement with fathers

Parenting and Family Support: Guidance for local authorities

in England (March 2010)

“The most effective way to support father

child relationships is to engage with fathers

routinely and systematically in all mainstream

services, and make this an explicit part of the

universal support offer.”

Hit The Ground Crawling – what next?

• an antenatal session for mothers too (about the role of fathers)

• a postnatal session for both parents (about co-parenting)

• embedding HTGC within universal services

• further evaluation