Sunday, July 5, 2020

Batswana women left holding the baby

Forget about weight gain, maternity leave, juggling baby and career, and prenatal health concerns. Guess what stresses expecting moms the most? Fathers-to-be, specifically the type who is ambivalent even before baby arrives.

Orapeleng Phuswane-Katse, Public Health Physician with the Ministry of Health in Gaborone says “Until recently, pregnancy and childbirth had to a large extent been viewed as the domain of women while men remained at the periphery. While the outlets of maternal health services are growing, lack of men’s support for the utilization of safe motherhood services is seen as a barrier by women.  Historically, men’s engagement had been seen as obstructive or nonexistent in reproductive health matters. It is mainly cultural than anything, our culture doesn’t encourage men to be involved in their spouses’ pregnancies even after birth. Mostly males are involved in income-generation; they don’t have enough time and have to take days off. That could also be the reason why men can’t go to antenatal classes with their spouses. Government hospitals don’t really allow for the man to be in the labour room with the women while giving birth, it is just one of those things. We know husbands aren’t allowed to see their children after birth. I do however think that things are changing with millennial, they support their significant others a whole lot more, there is a large turn-up of men at antenatal classes” she says.

Pregnancy is a life changing experience, making great demands on women to adapt physically, psychologically, and socially. It is a transition in life which brings many challenges, and for this reason, the care and support extended to women can impact greatly on their lives and contribute to how they experience the pregnancy.  Pregnant women often complain about receiving insufficient social and emotional support from their partners. Such support is important because twenty five percent of women experience elevated symptoms of depression after giving birth. As heads of the family, men play the role of gatekeepers to health care. They are the primary decision makers that directly affect their partner’s and children’s health.  Their decisions affect in utilization of resources and access to health care services, use of contraceptives and child spacing. Apart from the role of decision makers in the family, their actions in terms of abuse or neglect have a direct impact over the health of their partner’s and children. 

Dr Sethunya Mosime, senior Sociology lecturer at the University of Botswana says “while the benefits of male involvement have been acknowledged, there continues to be a challenge in creating a space for and engaging men in maternal health. This is problematic due to the role of men as the head of the household. Furthermore, men are important as partners, fathers and health care professionals and as such it is important to involve and engage with men in maternal health education, and antenatal care.  Involving men would allow them to support their partners to prepare for the delivery and seek out emergency care if necessary.  Men used to be the sole income generator of the family, their attention toward family health and their involvement in reproductive health is limited.  This has led women to be the basic target in most of the health education and awareness programs and men tend to be excluded.  This exclusion indicates an incredible reason behind men being unable to make informed decisions during emergencies and being less interested to engage in maternal and reproductive health.”

An ideal father is described as being accessible (present, available, a team player) and responsible (is concerned, maintains connection with the woman carrying the child regardless of the partnership status, and is a caregiver, provider or protector). The ideal father expects and wants to be engaged (cares about the pregnancy and the coming child, wants to learn more about the process, wants to be involved). Maternal and child health is perceived as a women’s role and men do not feel that they are responsible and see no reason to accompany their partners to antenatal class visits. Male participation in antenatal care is thought to be an essential step to positive maternal and new born health outcomes. Well-informed men will be more likely to participate positively in the decision making for the well-being of the couple.

In Botswana, more than 50% of children are born out of wedlock and grow up in single-parent households, of which two-thirds are headed by women. As a result, significant numbers of women carry, give birth to, and care for their infants without the support of the biological father. On learning of their pregnancy, women must negotiate their relationship with the father of the unborn child, with their own family, and with others. In some cases, the social repercussions of an unintended pregnancy may leave a woman with little or no care from those from whom she might have expected support, with impacts on her health and well-being. Some women feel that their partners do not understand what kinds of support and care they need during pregnancy; this in terms of conventional ideas of masculinity that conflated ideas of what a man is ‘supposed’ to do: take care of everything financially, but not by providing emotional support. A strong masculinist ideology means that a man may be reluctant to show care and concern for a woman in pregnancy, by attending the antenatal clinic, for instance, as this could be seen as weak and a mark of femininity.

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Sunday Standard June 28 – 4 July

Digital copy of Sunday Standard issue of June 28 - 4 July, 2020.