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By Richard Fletcher SMS4dads & SMS4DeadlyDads
So where are we up to in caring for fathers when their partner experiences a traumatic birth or a pregnancy loss or they have a stillbirth?
In 2018 The Australian Government Senate inquiry heard evidence from Australian researchers that fathers experience high levels of grief but were invisible to health and social services (Obst 2019,2020,2021). As one father’s evidence put it:
As a father, I have often felt left behind in this journey and it has often seemed that stillbirth is a women’s issue. Listening to parts of yesterday’s session in Sydney, I rarely heard about the impact on dads. I rarely hear dads mentioned and, invariably, we seem to get lumped in with families and partners. … As dads, we carry our own grief and, too often, we put this aside to support our partners. We are told to be strong for our wife, for our partner, for our families; we are usually asked how the wife is and rarely are we asked how we are. P98
The Committee recommended that the Department of Health develop national best practice guidelines for hospitals and health centres on providing support and information for bereaved families. “The guidelines should include provision for bereavement support and address the specific needs of bereaved fathers, siblings, grandparents and other family members;” p8
In July 2019 Australian Government response agreed in principle with this recommendation but none of the developed guidelines and resources that followed targeted fathers. The Safer Baby Bundle, for example, does not mention fathers in any of its resources.
In 2023 The NSW Select Committee On Birth Trauma received over 4,000 submissions. Many of the mothers who reporting on stillbirths of traumatic births also pointed to the effect on the father. As one mother described: My husband was amazing, but he was also going through an extreme amount of grief at that point. “He’s a shiftworker. He wasn’t at home at the time where an ambulance was called to our house. My mother-in-law was there. He got called home from work to be directed straight to the hospital, where he arrived and was handed his stillborn son and told that my life was uncertain at that point in time”. (Transcript 7/9/23)
Research was presented on Australian fathers’ confusion and isolation “The sheer number of people in the room and the look on the faces scared me. They said, we need to do an emergency caesarean. They tried to put a stint (Fetal scalp electrode) in the baby’s scalp, but that didn’t work. I was panicking a bit because all these people in the room where the hell did this come from?” (Elmir and Schmied 2022)
The effect of the trauma on their mental health was also presented “It’s very hard that the baby is dead and [we think] he is alive. He is moving, and she can feel the kicks, and I can feel the kicks”. (Kothari et al 2022). The evidence highlighted the high frequency of depression and traumatic symptoms, including suicidal thoughts, that can persist for months after the event.
The Committee recommended that the NSW Government acknowledge and address the diverse needs of various demographics in the maternity care system by:
In August 2024 The NSW Government published their response.
The only mention of fathers in the response was the online course for practitioners How to include fathers in health care to strengthen parenting teams (HETI).
In November 2024 South Australia established a Select Committee into Stillbirth in South Australia. They will receive submissions until 31st January 2025.
SMS4dads and SMS4DeadlyDads delivers tailor-made text messages especially designed for dads to provide them with information, support and encouragement. There are additional messages for dads when things don’t go to plan during a pregnancy or birth.
For many, talking about sensitive topics such as birth trauma and perinatal loss can be tough. Remember to take care of yourself. You can get support at any time via Red Nose 24/7 Support Line 1300 308 307 13Yarn: 13 92 57 or Life Line: 13 11 14
Richard’s research revealed possible long-term negative impacts on the children of dads with mental health issues. Fathers’ depressive symptoms in the first year after the birth predicted behaviour problems in their children years later.
“If dads’ mental health has such a dramatic impact then we need to be screening dads for depression, not just mums,” Richard explains.
In response to these limitations, Richard and his team have designed a smart-phone based program that allows mobile connection for new and expectant dads.
Participants receive texts containing information and links, and self-report their mood. If the mood tracker identifies dads as needing extra support, they will be offered a phone call from a counsellor trained in this area.
Following the success of the pilot of the SMS4dads program, Funding was received to enable a National roll-out.
“When dad’s miss antenatal classes or activities, they also miss out on contact and links to other people. They may never get the chance to say to anyone, look I’m really stressed,” he points out.
“SMS4dads is a way of bringing dads into the health system and keeping them linked in with services and support,” explains Richard.
Richard credits a varied career, a talented and innovative team, and much life experience for affording him the insight needed to address the challenges related to actively engaging dads.
After completing his masters in Medical Science, studying epidemiology, Richard earned his PhD focusing on fathers and attachment.
“Fathers are invisible in many places, and that is endemic. Not because people dislike fathers, but because the system is set up to be focused on mothers.”
Some services and organisations are aware of the need to engage dads, but have been unsuccessful in their attempts.
“When people are challenged about this, they generally want dads involved,” Richard affirms.
“Often, however, they just don’t know how to do it.”
Richard works with health professionals on issues related to fathers, and has delivered many antenatal programs for expectant dads.
He credits his own family with giving him an understanding of the role of fathers needed to make his work relevant.
“I have three daughters and two stepdaughters,”
“My kids would say they taught me just about everything I know and they’d be right. They’ve taught me a lot, and still do.”
Richard’s research revealed possible long-term negative impacts on the children of dads with mental health issues. Fathers’ depressive symptoms in the first year after the birth predicted behaviour problems in their children years later.
“If dads’ mental health has such a dramatic impact then we need to be screening dads for depression, not just mums,” Richard explains.
In response to these limitations, Richard and his team have designed a smart-phone based program that allows mobile connection for new and expectant dads.
Participants receive texts containing information and links, and self-report their mood. If the mood tracker identifies dads as needing extra support, they will be offered a phone call from a counsellor trained in this area.
Following the success of the pilot of the SMS4dads program, Funding was received to enable a National roll-out.
“When dad’s miss antenatal classes or activities, they also miss out on contact and links to other people. They may never get the chance to say to anyone, look I’m really stressed,” he points out.
“SMS4dads is a way of bringing dads into the health system and keeping them linked in with services and support,” explains Richard.
