1. Young Black Fathers and Maternity Services Fathers Direct St Michael’s Fellowship/Sure Start University of Bristol

2. Background Young fathers are likely to come from backgrounds of social disadvantage Young parenthood is popularly linked with increased risks of social exclusion BUT Stable, intimate partnerships can effect a transition out of social exclusion The birth of a child is an event but taking on the role of father is a process that begins in pregnancy Pregnancy a crucial window of opportunity

3. Why are maternity services important for young men? Confirming young men’s new identity as ‘father’ through: Recognising and reinforcing their part in the parental couple Facilitating their informed and effective participation through education Addressing anxieties and concerns

4. Why focus on young Black men? Very little known about young Black fathers Gap filled with speculation and fantasy Concerns about equality of access to mainstream services What do they say would help?

5. Aims of the study To make contact with young Black fathers from one London Sure Start area during the ante natal period To ascertain their current needs as a basis for developing services To refer fathers to existing services as appropriate To develop services for these young men both inside the health service and in the community

6. Recruiting Young Black Fathers 23 fathers interviewed Mainstream ultrasound clinic (3) Specialist teen parents ante-natal clinic (12) Other sources (8)

7. Mainstream clinic Reception staff unaware and unwelcoming – some even appeared suspicious High turnover of staff – difficult to establish a relationship over time Posters removed from walls, information leaflets about project disappeared Allocated room for interviews withdrawn

8. Specialist Young Parent Clinic Midwives expecting R; friendly, welcoming and helpful with recruitment Stable staff group; easy to develop a relationship Always somewhere private to talk Begins to recognise same young mums and dads over time

9. Who did we talk to? Ethnic Identification

10. Summary Young Majority unemployed Many pregnancies unexpected Steady relationships Many cohabiting Settled in area Local family and friends Many already beginning to identify as fathers

11. Anticipated adjustments to lifestyle None intended - 0% Few/minor - 22% Some - 44% Many – 35%

12. Man age 20 (GF 16, 37 weeks pregnant) ‘I didn’t tell my grandmother for some time over Christmas but then I couldn’t hold it in any longer… Before this I just had casual sex….but this will mean big changes. It’s like a time bomb waiting to go off. Six months ago I wouldn’t have taken it on board but you can’t turn your back on it because you’re turning your back on another life. It doesn’t matter how big or bad you are, just wait until pregnancy hits you…’

13. Young men and fatherhood ‘Some come from broken homes, on the streets – lose focus. Their father wasn’t there so the same thing happens…someone has to break the cycle’ (age 20) ‘There was an expectation on me as to what to buy for the baby but I didn’t really know what to buy. But then if I bought something wrong I’d say ‘Well, no-one told me what to get’ (age 19)

14. Young men’s reception ‘When adults see young people having a child they think the worst of them’ (age 17) ‘At the scan I wanted to know more but when I was asking questions the woman didn’t really explain, she was talking to T (g/f) and giving me one word answers’ (age 19) ‘When they call the mother for the appointment they seem surprised when the man comes as well… when I come into the room I can feel the vibes, the awkwardness’ (age 20) ‘The midwife came the other day and spoke with my girlfriend – talked 98% to her. I had to ‘earwig’ towards the end’ (age 20)

15. Context for the ‘parental couple’ 65% men reported others involved in clinic visits 83% were woman’s family/friends 78% men expecting others at the labour 81% were woman’s family/friends 52% expressed feeling of exclusion 50% by services

16. Young Black Fathers and mainstream maternity services Quadruple Indemnity Gender Minority ethnic status Age Poverty Group highly sensitised to exclusion

17. What did the prospective fathers say helped/would help? Acknowledgement by clinic staff Speaking to you ‘on a level’ Meeting a father worker at the clinic More time to ask questions, Leaflets for men to read Someone telling me what I’m entitled to and what’s going on Planning for both of us Father and baby sessions

18. Thinking points for maternity services Think systemically Specific training for reception staff Employ a dedicated father worker based on site Clinic environment Services provided specifically for young people ‘Dad Bags’