Massage for Fathers-To-Be ... What's a Man to Do?

This is the second in a series of articles about massage for fathers-to-be, developed from my written assignment I completed as part of my Diploma and which earned me a distinction. These articles explore the role that massage can play in helping and supporting the father during a transformative time in his life, with a particular focus on how it can enable him to bond with his baby. The first article article is called All Change Please.

 

Once a woman reveals her pregnancy to her partner, and reality dawns for the man, virtually all fathers-to-be will ponder the same thing: "She is having a baby. What am I supposed to be doing?" Fathers-To-Be Handbook by Patrick M. Houser, p18

Prior to my undertaking the Well Mother training, I had several clients announced their impending fatherhood to me. They were all first time fathers-to-be and used words such as "excited", "thrilled", "nervous", "unsure", "daunted". There was a sense of uncertainty about where they could go for support as anxious fathers-to-be, perhaps not wanting to reveal their concerns to their partner for fear of worrying them.

The next time you meet an expectant dad, try this... take a moment to see and acknowledge that this man in front of you wants to be the best father he can be. And he may need support in getting there. What might get in the way will be the lessons he learned about being a dad as he grew up in his family, as well as our society’s, often low, expectations of men. Dads2b Resource: A resource for professionals providing antenatal education and support to fathers, 2011

Already having a professional relationship with these men provided the opportunity to offer them the opportunity to discuss the impact their pregnancy was having on them physically and mentally during our appointments, which most agreed to. As well as having a physical impact, they typically opened up to discuss what they were experiencing, feeling and occasionally fearing too. I felt that being able to offer this opportunity for non-judgmental conversation, backed up with knowledge and understanding of the realities of their situation, took our sessions to a new level of massage therapy for them. So perhaps the father-to-be might be encouraged to investigate and invest in the self-care of organising occasional or regular massage during the ante-natal period. It doesn't have to be with the same therapist the mother-to-be is seeing, but it would be beneficial if he were to see someone with Well Mother training, who will understand what he will be going through and how they can support him during this transition.

Antenatal

Historically, antenatal education has focused on the health needs of women and babies, without paying a great deal of attention to the role, influence or experiences of fathers during this important period of transition to parenthood. Dads2b Resource: A resource for professionals providing antenatal education and support to fathers, 2011

Whilst the social and cultural shifts of the late twentieth and early twenty-first century are seeing more and more men wanting to confidently take an active role in the growing, birthing and raising of their child, the support network is somewhat behind the times.

Research shows that the children of highly involved fathers often develop better friendships, have higher self-esteem, do better in education and are less likely to become involved in crime or alcohol and substance abuse (Flouri E 2005). However it is still widely recognised that fathers are not included in the same way as mothers during the antenatal period. We know that 9 out of 10 expectant fathers attend the first scan but after that they are rarely invited to attend routine antenatal visits and when home visiting the midwife or health visitor will ask to see the mother before the father. [Ref: Flouri E (2005) Fathering and Child Outcomes John Wiley and Son Chichester] Getting Fathers Involved article on NCT website

A woman's role during pregnancy is quite clear. She goes from being a woman through a process to become a mother, through the physical growing of and birthing her child. Indeed a father's role during pregnancy is equally clear as he goes from being a man through a process to become a father. Unfortunately, his role doesn't have such a physical manifestation, which can make it harder for him to process the transition and to know how he can best prepare himself. Whilst a mother has a course of appointments to attend, classes she could take, exercises to physically prepare for the later stages of pregnancy, the labour and birth, the father doesn't have any landmark scans, exercise recommendations, or nutritional requirements to consider in relation to his body. During pregnancy, his body and lifestyle can both remain untouched other than the acceptance, knowledge or denial of his impending change of status. However, more and more men are finding ways to come together with their partner to establish routines during pregnancy and after birth to become more involved. "A new dad can begin the nurturing parent-child relationship even before a baby is born. Some fathers who practiced talking to a child while it was still in the mother's womb say their new babies recognised their voices directly after being born." ['Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime' by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)]

It is important to take the opportunity to engage with your new baby, while in the womb, and allow bonding to begin. You could get very close to your partner's belly and speak to your child. You might even speak so quietly that only your child can hear ... it will be your little secret together. Acknowledge the relationship that already exists between you. This early period is precious and endearing. Take time off work if possible, a day or afternoon here and there, to be with your partner and your child. Take walks, hold each other, and take time to connect. Speak about your new family and life together. Include your baby in these conversations. Fathers-To-Be Handbook by Patrick M. Houser, p75

Talking directly to his child-to-be might be challenging for a father initially, but there are so very many ways a father-to-be can take steps to bond with his baby. Touch is a non-verbal means of communication that is available to everyone. The giving and receiving of touch is a very nurturing and nourishing experience. It can be as simple as stroking a back, holding a hand, caressing a cheek. A baby's sense of touch develops at week 7 or 8, quite a considerable time before the mother might experience the sensation of her baby moving, typically between weeks 16 and 25. As each becomes aware of the presence of the other through touch, it isn't unusual for a father-to-be to feel on the outside of an exclusive relationship, but it really does not need to be this way. Whilst the father will not immediately feel a kick of the baby as it moves, with encouragement to hold the mother's abdomen to experience this sensation for the first time, the concept of his future baby becomes more real.

There is now "...evidence that massage reduces levels of noradrenalin and cortisol, two hormones associated with stress (Field, et al., 1999)," which provides the scientific proof that massage can have a very relaxing effect on the body. Anatomy, Physiology and Pathology for the Massage Therapist by Su Fox & Darien Pritchard p236

As a massage therapist, I know that the process of giving a massage can have a very relaxing effect on the body and I have also seen just how anxiety and stress can be elevated during the antenatal period for both mothers- and fathers-to-be. By introducing massage at this time, the relaxation benefits will be experienced by all involved.

Reading, attending classes and participating with your partner will provide her with valuable support. She will likely need and appreciate it in the early months. Connecting with your child, while he is in the womb, and actively bonding also sends signals to your partner that you are devoted to your new family. This is very important for a mother-to-be. Fathers-To-Be Handbook by Patrick M. Houser, p31

In the separate exercises article, I outline a couple of massage exercises which can be used to encourage a father and mother-to-be to spend some time together, and provide an opportunity for the father-to-be to connect with his child. Called 'Simple Touch', 'Breathing Together' (taken from Beautiful Birth by S Yates), 'Snuggle' and 'Supporting the pelvic girdle' (taken from Beautiful Birth by S Yates), they have been selected and included since they are wonderfully gentle, safe and easy to use at any stage during the pregnancy. By enabling the father-to-be to actively participate in the physicality of the pregnancy, it will really enable the family unit to bond together. Many massage therapists who have undertaken the Well Mother Massage & Pregnancy Diploma Course will happily work with couples to enable them to develop confidence and reassurance to massage each other during pregnancy in a safe and supported manner.

During Labour

Birth can be a very sensual and intimate experience between a man and a woman, if allowed to be. It is an extension of the sexual experience that began this phase of a couple’s life together. Fathers do make a difference ... birth? by Patrick M. Houser

There are many ways in which a father-to-be can assist his partner in preparing for labour, and actually experiencing labour. The one thing he can't do is undertake it on her behalf, but this doesn't mean that his role at this stage should be considered passive. Indeed there is much evidence to support how important his presence and role is in his partner's experience of labour.

It is important that fathers understand how their partners’ hormones can assist the process of labour and birth and equally important that they understand how their own stress hormones can hinder the process. This is useful in highlighting the relevance of relaxation for labour and birth, to men. Dads2b Resource: A resource for professionals providing antenatal education and support to fathers, 2011

In the exercises article, there is a quote by Patrick M Houser regarding the reversal of roles experienced by men and women during labour which beautifully illustrates the importance of a father-to-be understanding the impact that he can have on his partner's birthing process. The role of massage during labour will very much depend upon the nature of the labour the mother-to-be experiences, and this is in part why his preparation and practice of working with his partner is important. It enables him to focus on what the mother is needing, rather than fretting about whether he is 'doing it right'.

Having some form of massage during labour can bring you many benefits. It is a way to involve your partner, so that he can give you real support and connect with both you and your baby. It may provide effective pain relief and comfort, and give another focus to your breathing so that you are able to relax and work with your contractions. You can also include your baby in the massage, which can help both of you to enjoy the beautiful experience of birth. Beautiful Birth by S Yates p48

Fundamentally, there are three stages of labour, each holding a different focus of attention for the mother- and father-to-be. The first stage of labour has a focus on opening up, enabling the pelvis, uterus and most noticeably (to the medics) the cervix of the mother-to-be to dilate sufficiently so that labour can progress. This means that the first stage is typically the longest so it is important that she is able to stay as relaxed and conserve as much energy as possible. As such, the exercises I have highlighted, particularly the Simple Touch, Breathing Together and Snuggle, can be used to help encourage both of these aims. Whether or not a couple have been able to have a partner massage lesson from a suitably qualified massage therapist, it is important a father-to-be is able to listen to his partner and feel comfortable and confident holding, rubbing, stroking wherever she says she would like attention. This is why the Simple Touch exercise is a great starting point; helping draw the couple together as they work with quiet relaxation or with a more dynamic focus, working through a contraction. Unless the mother-to-be finds it uncomfortable or disconcerting, there is no reason why touch can't include holds or suitable pressure work on the abdomen with an awareness of the baby, but always making sure that the father-to-be is paying attention to his partner, her comfort and her feedback.

"Breathing is a key tool in supporting relaxation" [Pregnancy and Childbirth: A holistic approach to massage and bodywork by S Yates p294] , and so the Breathing Together exercise developed by S Yates will enable a labouring couple to use the time in between contractions to come together as a family, whilst encouraging the relaxation brought about by deep breathing, releasing endorphins and oxytocin which are the body's natural 'home made' painkillers. The important thing about these two exercises is that the mother-to-be should be encouraged to position and reposition herself as she feels necessary, so that she can be as comfortable as possible. Because the first stage of labour can last a long time, the Snuggle is the ideal position in which a labouring couple can rest and attempt to sleep, whilst also allowing for the father to focus on his soon-to-be-born child.

As labour progresses into the second stage, the father-to-be will find that his role becomes less of a comforter and more of a supporter. His partner will need to be free to focus on the needs of her body and what she is doing, so the father-to-be can encourage her to listen to her body, to be supportive of her physically as she might be wanting to move around or take a more upright position, and to be still and present with her, through to the third stage of labour. Following the birth of the baby, the woman's body isn't finished as it needs to deliver the placenta, but at this stage the couple can relax and bond with their new child.

Post natal

It is well known that the ideal birth would see a baby swiftly laid on the mother or father's bare skin, an action that is very comforting for the new infant, and enables the parent to strengthen the bond with their newborn, and can help to facilitate sleep and calm a baby faster according to research when compared to infants who received no touch.

In no published paper is a single adverse outcome reported for KMC [Kangaroo Mother Care]. Positive effects on the mother are better bonding, healing of emotional problems associated with premature birth, among others. Background to Research on Skin-to-skin Contact website

The hours, days, weeks and months following the birth of a baby are a beautiful, dramatic, potentially shocking and traumatic time for a couple as they adjust to the reality of their loving creation. It can be very easy for a father to get swept up into the 'doing' of fathering, caring for his partner, rushing around to make sure everything is in order, but it is just as important for him to focus on 'being' a new father. With the modern 'invention' of paternity leave, a family unit can hopefully have some quiet time together in the days and weeks immediately following the birth, giving the couple the opportunity to adjust to parenthood and to bond together as an expanded family unit.

The exercises listed in the separate article can be very useful to a new father in bonding with his baby in the post natal period. If the mother is lying down whilst breast feeding her child, or whilst their baby is sleeping, he can take the opportunity to Snuggle up to his partner and embrace them both gently and softly, without disturbing any feeding or nuzzling that the infant might be undertaking. Likewise, the Simple Touch exercise can be gently adapted to working with his new child, by which I mean embracing his baby with awareness rather than merely holding his child; perhaps a gentle hold on the infant's tummy, or lightly stroking the skin on the arms and legs in a soothing and rhythmical manner.

Studies conducted to determine if infant massage helps decrease fathers' stress ... for example, 'The Fatherhood Study, Phase II,' conducted by the Boston College Center for Work & Family, found infant-massage classes significantly decreased fathers' stress levels 'Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime' by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

Many classes are now available for infant massage, and it would be highly beneficial for both parents to attend these classes, but in my opinion the impact for the new father is huge. Whether his partner is able / choosing to breast feed or not, being invited to give his child a massage can provide him with a natural way to spend time with his baby in a relaxing, bonding manner. I was thrilled to discover a handout with the title Infant Massage Handout when researching this subject, and have included it in the appendices to highlight the physical benefits of infant massage.

The 'love hormone' oxytocin is a wonderful thing and its release is elevated in fathers just as much as it is in mothers. Indeed, "in research published in Biological Psychiatry, investigators found at both six weeks and six months after the birth of their first child, males presented with higher-than-usual oxytocin levels, just as their female partners did." ['Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime' by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)] Nature really is very clever!

What about dad?

Since Swedish men started to take more responsibility for child rearing, women have seen both their incomes and levels of self-reported happiness increase. Paying dads to change nappies and hang out at playgrounds, in other words, seems to benefit the whole family. 'Why Swedish men take so much paternity leave' article in The Economist

Pregnancy affects everyone in the relationship and so a father should not overlook the benefits of receiving massage during pregnancy. One of the aspects of my client work during my course that most surprised me was the change in habits of the fathers-to-be. As three of my clients moved through the pregnancy, they continued their routine of regular massage, typically once per month or 6 weeks, but since the arrival of two of their babies, only one of the new father's has been back to see me for his appointment. It isn't just the mother's life that is turned upside down with the arrival of a baby.

As a massage therapist it is my belief that massage therapy will help everyone be the best they can be, and this includes being a new parent - helping them to take some time to gain perspective and re-centre themselves, providing a safe place to reassess their priorities and what is most important to them in their new role and reality.

For many men, it can be easy to put up walls that prevent them from connecting emotionally and nurturing their babies. 'Father-Baby Bonding: Infant Massage Builds Bridges that Last a Lifetime' by Tina Allen, LMT, CPMMT, CPMT, CIMT in Issue 213 of Massage Magazine (Feb 2014)

I believe that massage can have an enormous impact on helping to break down these potential walls and encourage the development of a meaningful relationship between fathers and their children at an early stage.

Next ...

The next article covers the exercises I discuss, and is the final part in the series of massage for fathers-to-be.  All books quoted in these articles are available to borrow from the Lending Library.