Men inside labour wards

Over the years, the only people who have been accompanying women to the delivery room are their mothers, sisters, female friends or birth doulas. But a wave of romantic change is sweeping across the land, and now husbands have joined the fray.

While it is understandable when mothers and sisters flock the delivery room to offer moral support, or when doulas take it upon themselves to ensure safe delivery, many question the place of a man, particularly the husband, in labour and delivery wards.

A doula is someone who provides non-medical support to women and their families during labour and childbirth, and also during the postpartum period. Birth doulas offer guidance on breathing, relaxation techniques, movement and positions to the expectant mother.

For 29-year-old Victor Kebati, the delivery room at Kisii Level Five Hospital was a roller-coaster ride of conflicting emotional states, exhaustion, exhilaration, amazement, boredom, fear, panic and zen-like calm.

Most importantly, and in his own words, it was horrifying. And later rewarding. Today, the infectious smile of his son has melted away, bit by bit, his intense aversion of the labour ward.

He considers himself lucky that he has put that experience behind him, for, to many men, the emotional trauma of watching their partner push and scream and curse and bleed in the delivery room lingers forever, sometimes killing off any romantic attachment the man had with the woman.

During the entire nine months of the pregnancy, Kebati had read books and scoured the Internet for information about the role of a man during pregnancy, and, over the period, he shared any interesting information he came by with his wife.

But nothing, not even the hundreds of hours he had spent on the Net, was enough to prepare him for the labour ward.

Kebati had just returned from a long evening walk, probably picturing in his mind the hero he would be to his wife when, eventually, the big day arrived, when his wife alerted him that the water had broken.

“Initially I thought it was a false alarm, but when she explained that she was in some pain, I opted not to take the risk,” he says.

Ante-natal card and layette in hand, Kebati hired a taxi to Kisii Level Five.

“We arrived at 8pm and were ushered into an examination room, where they looked at the crucial signs and informed us that she was due by 2am.”

“Before admission,” Kebati continues, “the nurse sent me to buy a basin, a cup, a spoon and cotton wool.”

His wife was admitted in a room with a six-bed capacity, four of which were occupied on this particular night by screaming women.

Only one woman in the room had been accompanied by her partner. But the evidently harassed man only stayed until his wife’s labour progressed to the second stage before bolting out of the door.

Kebati took the cue.

So why did he go there in the first place? Prof Patrick Muia Ndavi, a gynaecologist and obstetrician at Kenyatta National Hospital, describes the masculinisation of the labour ward as nothing but “labour with a human face”.

By their sheer presence in the delivery room, he adds, men provide the much needed psychological and emotional support to the expectant mother.

Prof Ndavi, who is also a lecturer at the University of Nairobi’s School Of Medicine, advises that it is good for the father to be involved in the development of the child, right from ante-natal visits to post-natal care.

However, Prof Ndavi notes that most public hospitals, including KNH, do not provide enough privacy for couple, hence fathers opt to stay away.

Ms Philomena Maina, the deputy director of nursing services at KNH, confirmed these limitations, saying that even though she would like to see more men at the delivery room, the limited space available is a deterrent factor.

For 34-year-old Eliud Omollo, nothing could chase him out of the delivery room at Mater Hospital, Nairobi, where he had rushed his wife for the delivery of the first-born daughter.

“It was a nerve-wrecking moment, but I’m glad I went through it all,” he says, adding that, although he had read about the progress of labour pains, the sight of his wife in pain was unbearable.

“She cried a lot and frequently asked me to massage her back,” he remembers. “So I obediently rubbed her lower back in between every round of contractions.

“As the breaks between contractions got shorter and shorter and the spasms longer and longer, I didn’t know what to do other than hold her hand and watch for the top of a head. Even worse was the fact that I could not physically share with her the pain she felt,” he says.

“Later, I resorted to whispering comforting words in her ear, but this only offered momentary relief.”

Omollo’s wife laboured for eight hours, and the man stood by her side throughout it all. At the break of dawn, hunger had began to ravage him, but he dared not take a break lest he missed the miracle of the birth of his baby.

Eventually, the contractions got very close to each other and the nurses said they could see the head of the baby. “I held tightly onto my wife’s hand. Then we heard the good news that it was close and the next moment I heard a sweet cry. Our baby was here!”

However, despite the lovey-dovey affection cited by many men who linger in delivery rooms, author and parenting expert Armin Brott advises men to keep off ‘Ground Zero’, saying the psychological risks far outweigh the intended good.

“Perhaps he’s the type of guy who gets squeamish when it comes to hospitals and medical procedures; or maybe he’s afraid he’ll fall apart, making things harder on his partner,” he points out. “Or maybe he just doesn’t want to see his wife in pain.”

Brott says men should realise that at least half of all the guys present in the labour ward report some ambivalence about participating in the birth of their children.

One of the men who spoke to DN2 agreed with this, saying that, even though it is miraculous to see your baby’s head emerge from the womb of your wife, the experience is quite shocking.

“Seeing the umbilical cord connecting mother and baby can be riveting, but it can also be very disturbing”, he added.

Julius Kibe accompanied his wife Nancy Wangui to the labour ward and stayed there until she was wheeled to the operating theater after doctors said the baby was too big to be born normally.

“I had attended all ante-natal classes and checks with her and was prepared to go all the way,” Kibe told this reporter at Kenyatta National Hospital, where the couple had taken their baby Ivine Wairimu Kibe for a routine checkup.

The 30-minute wait for both his wife and newborn was not only long, but also a pretty sweaty affair.

“I had planned for a normal delivery, so when the doctors told me they had to perform a Caeserian Section, the took the wind out of my sails.

“As I waited outside, I agonised over what was happening, and it was such a relief when eventually the theatre doors opened and the nurses brought to me the cutest baby I had ever seen.

Falling in place

“As I carried little Ivine to the nursery, I asked whether my wife was okay and the nursed answered in the affirmative. From there, everything started falling in place.”

Prof William Stones, Chair of the Department of Obstetrics and Gynaecology at Aga Khan University Hospital, says the presence of male partners in the delivery room today reflects social changes currently taking place.

“If the man is there with his partner, he appreciates what she is going through and is better able to be supportive and give her what she needs at a very stressful time,” Prof Stones says.

“Unfortunately, some maternity units lack privacy such as curtains or screens, thus making it difficult to allow men into that area.”

When overcome by the experience, Prof Stones gives a remedy to the anxious father that could offer some relief.

“Sit down and put your head between your legs, or step out of the room for a while.

Dr Lukoye Atwoli, a Consultant Psychiatrist and Lecturer at Moi University’s School of Medicine, says the presence of a partner in the delivery room for some provides assurance.

“They feel safe and complete and consider their partner’s decision to be with them during labour and delivery as an indication of love and dedication,” Dr Atwoli says.

“They also feel that if the partner is present during delivery, he will understand the pain of childbirth and is likely to care more for both the baby and the mother.”

But French obstetrician Michel Odent shares a different view on the presence of daddies in the delivery room, saying that the hormone oxytocin is a shy one that does not perform well in the presence of other parties.

“Having been involved for more than 50 years in childbirths in homes and hospitals in France, England and Africa, the best environment I know for an easy birth is when there is nobody around the woman in labour apart from a silent, low-profile and experienced midwife,” he explains.

“Oxytocin is the love drug which helps the woman give birth and bond with her baby. But it is also a shy hormone and it does not come out when she is surrounded by people and technology. This is what we need to start understanding.

“I am more and more convinced that the participation of the father is one of the main reasons for long and difficult labours.”

Dr Odent further argues that the father’s release of the stress hormone adrenaline as he watches his partner labour causes her anxiety and prevents her from relaxing.

No matter how much he tries to smile and appear relaxed, he cannot help but feel anxious. And the release of adrenaline is contagious, he adds.

“It has been proven that it is physically impossible to be in a complete state of relaxation if there is an individual standing next to you who is tense and full of adrenaline,” he says, adding that he has noted something akin to post-natal depression in many men who have been present at the birth.

Men often take to their bed in the week following the birth, complaining of everything from a stomach ache or migraine to a 24-hour bug, Dr Odent says.