Hesperian Health Guides
Involve men in safe motherhood
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If I could give one piece of advice, it would be: don’t leave men out. We often think, "Oh pregnancy, that’s a woman’s thing." But we learned the hard way that things don’t change much if men don’t also learn about birth and become more involved.
Although tradition sometimes says that men do not participate in births, this is changing. Even if people prefer that men not be present during birth, there are still many important ways men can support women during pregnancy, prepare for births, and help during emergencies.
Men can partner with women for safer births. They can:
- learn about healthy pregnancy and childbirth and support women’s decisions that protect their health.
- learn the danger signs of pregnancy and birth and what to do about them, and save money to pay for emergency needs such as fuel and hospital fees.
- make sure a pregnant woman gets enough food to eat and rest each day and go with her to check-ups during the pregnancy.
- learn ways to help a woman relieve the pain of labor (such as relaxation, breathing methods, or massage) and help her with these during birth.
- help out as much as they can and make plans for others to do her work (housework, childcare, fieldwork) for a few weeks after the birth, so she can heal and regain her strength.
Men can learn about women’s birth experiences
How can men be expected to play a helpful role in childbirth if they know nothing about what birth is like? One way to teach both men and women about birth is to show a movie or skit about birth and discuss it. Movies or skits can also show how men can provide support in different ways during labor.
The activity below, A fishbowl about birth experiences, gives men a chance to listen in on a women’s circle sharing their experiences giving birth. A discussion afterwards can encourage women and men to say what they need from each other so men can be more helpful during birth.
Activity A fishbowl about birth experiences
- Bring together in a circle a group of 4 to 6 willing women who have given birth. (You may want to meet with them first to prepare.)
- The men can either form a circle around the women’s circle, or be separated by a curtain or other barrier to give both sides privacy.
- Explain to both groups what is going to happen:
Here are some questions you might use to help women talk about their birth experiences:
- What about your birth did not go as planned?
- How did you deal with the pain of childbirth? What helped?
- How did other people help you during birth?
- What did you appreciate or enjoy about birth? What was difficult?
- How did giving birth change you?
- In your birth, were there men who helped you or were supportive somehow? What did they do?
- Did lack of support from men affect your birth? How?
- If you had an emergency during your birth, what role did men play in the decision to get help?
- After 30 minutes or so, the women stop, and the group leader asks the men to talk about what they heard. He also asks if they have any questions for the women.
- The group leader asks the men’s questions and lets the women respond.
If the men and women are in 2 circles, change so the men are in the inner circle and will do the talking. This time the women listen. Here are some questions you may ask the men:
- What does it feel like to become a father for the first time? How did your life change with fatherhood?
- Where were you during the birth of your children?
- Did you participate in the birth? How or why not?
- Did you celebrate? How or why not?
- What did you feel about what your partner was experiencing during the birth?
- Shift the discussion to more general questions. What do the men and women think about how men could be more helpful during childbirth? First ask the women: How could men support or help women more before, during, or after childbirth? What attitudes or ideas need to change? If there is a problem, what role could men play in getting help? Then ask the men: What do men need in order to be more helpful with birth? How can men be more supportive after childbirth? What could others in the community do to make it more likely that men will play a helpful role during the births of children? You could end using the activity, Head, heart, hands described below.
This guided reflection is a good way to close a workshop or discussion. It can help everyone think about and share what they have learned ("head") and how they feel ("heart") about what has been discussed. The most important part is to ask people to share what they will do differently or what change they want to make ("hands"). It does not require much time or any materials.
Activity Head, heart, hands
Invite the group to sit or stand in a circle and to reflect quietly for a minute about the discussion or workshop.
- Ask the following reflection questions: What happened during the workshop or meeting? Think about something you learned. Give people a minute or two to reflect silently on this question. Then ask 3 or 4 participants to each share one thing they learned with the group. (If more people want to share, that is always OK if there is time!)
- Next, ask everyone to think about how they felt about one thing from the workshop or discussion. Give people a minute or two to reflect silently on this question. Then ask 3 or 4 participants to share with the group one thing they felt during the workshop or discussion. (It is best to let people volunteer rather than calling on someone who might not be comfortable sharing.)
- Next, ask everyone to think about one thing they will do because of what was discussed today. Give people a minute or two to reflect on this question. Then ask 3 or 4 participants, or anyone else who wants to speak, to each share with the group one thing they will do.
Men learn about childbirth and danger signs
In Afghanistan, men do not usually attend births and rarely help prepare for them. But one group of men attended a class about birth just for men, and they have started to change. The trainers used picture cards to teach about the danger signs, and they used role plays to practice making quick decisions during birth. In the role plays, the men were very serious when they played all of the roles — even the role of "mother-in-law" or "pregnant woman."
At the class, the men also heard the stories of 2 families. One couple did not use family planning. They had a baby almost every year, and there were several difficult births. With the woman’s last 2 births, she had bleeding that was difficult to stop after the babies were born. Without a chance to recover her strength between births, she became very weak. When this woman had her 8th baby, she became very ill after the birth and died.
The other story described a woman and man who used family planning. They waited a few years after their first child to have the next one. Their children were able to go to school, and the woman stayed healthy and strong. The men could see that their communities had both of these types of families, and that men had a role to play in talking to their wives about family planning and using some method of birth control. For an activity to compare 2 families, see Story game: A tale of 2 families.
The hardest part of the training was when men shared stories about pregnant women or babies who died because no one knew how to help them. The men copied the trainers’ picture cards to show their wives, families, and neighbors to discuss the danger signs they learned. When some of these women had long labors and signs of obstructed labor, the men were ready and quickly decided to make the long trip to the hospital.