Have you felt excluded or sidelined by a health provider? Anecdotally, it seems pretty common. It's called “restrictive professional gatekeeping”.
“The pediatrician never once spoke to me during the entire consultation. All of her questions were addressed to my wife. I felt like I was the invisible man!” (John, 33 years old).
“The nurse requested that I tell my wife that our little girl vomited this morning but had a good nap. I felt like I had to give a report to my chief! I seriously doubt the nurse would request that my wife tell me the same sort of things if she was in my place.” (Terry, 29 years old)
“After the miscarriage, everyone was very kind to my wife and lavished her with attention… no one was interested in how I felt. The only person, who asked me how I was doing, was my brother in-law who had gone through a similarly painful experience.” (Philip, 39 years old)
Gatekeeping toward fathers
From the very first days following the birth in the maternity ward, the understandable focus on the mother’s physical needs can extend to parenting education and preparation as well. The absence of support for fathers as caretakers of infants can undermine the father’s involvement and legitimacy. The lack of inclusion of fathers after birth begins a practice of “restrictive professional gatekeeping” that continues through childhood.
How do children experience this exclusion of their father? Children surely observe and internalize the lack of father involvement in professional services. The message conveyed is that fathers are not the knowledgeable, responsible party when it comes to children’s health and well-being. And when mothers seek help for child difficulties, especially if the father is not present or there is trouble in the couple, restrictive professional gatekeeping towards the father can reinforce the problem and miss the paternal point of view and contribution.
Such professional gatekeeping most likely results from respect for the traditional role of the mother as the primary caregiver. It is reinforced by over-representation of women in childcare professions, so men can feel uncomfortable and out-of-place in female dominated environments. Such gatekeeping is likely to be reinforced by child development theories that focus almost exclusively on mothers, whilst less is known about the research on the contributions of the father. One can add to this the common belief that mothers are naturally or instinctively more “expert” in infant and childcare compared to fathers, despite the fact that nowadays for mothers, as well as for fathers, the first baby is often their very first experience of taking care of an infant. Some research has shown that fathers and mothers are equally capable of taking care of their infant, each of them with different contributions.
In most countries, professional gatekeeping is part of a broader reality of “societal gatekeeping” that discourages father involvement. For example, policies allowing for fathers to take parental leave following the birth of a child are rare. There is a lack of workplace support for men using parental leave, even where it is officially available. There is an overall lack of flexibility in most men’s work schedules to accommodate parenting responsibilities.
Restrictive professional gatekeeping undermines positive, cohesive coparenting – the relationship that exists between the parents concerning their child well-being and education – which is the foundation of family functioning. Given that coparenting has a distinct influence on children’s development, it is deeply important not to undermine it but to promote it. Indeed coparenting that is characterized by warmth and cooperation predicts positive socioemotional development in the child. In contrast, coparenting that is characterized by competition and a lack of support negatively influences child development.
In sum, there are many reasons to protest gatekeeping that limits the role of fathers. Such gatekeeping risks depriving the child of the specific contributions of his or her father. It undermines coparenting and as a result the family unit. It reinforces views that children’s development and problems are the sole responsibility of the mother, which is the root of mother blaming. Lastly, professionals who promote the role of fathers will help support continuing increases in engaged fathers, reinforcing the desires of fathers to take on their parental role.
Suggested strategies for parents
Here are some suggested strategies for mothers and fathers to challenge professional gatekeeping.
- Present yourselves as a team and do not accept that professionals talk only to one of you. Ask for your partner’s point of view in front of the professional.
- Refuse consultations when the father is unable to attend due to his work schedule and request that the service adjusts its hours of operation. At a minimum, propose or request the inclusion of the father via telephone/video-conference.
- Ask questions, formulate remarks, and write letters in a friendly tone to create awareness of professional gatekeeping when you observe it. For example, ask: Why are there no pictures of fathers in the children’s health care center? Why does this guide for new parents contain ten pages addressed to mothers (including legal information) and only one to fathers? Are fathers authorized to enter this Mother-Child Centre?
- Ask for the renaming of services to include fathers explicitly by either mentioning both mothers and fathers or by using the more general term of “family” rather than just “mother” and “child”.
Promoting father involvement does not in any way help reestablish the patriarchy of past centuries, but rather promotes engaged fathering and the development of cohesive coparenting, the foundation of the family. On the contrary, restrictive gatekeeping that reinforces mothers’ primary and leading responsibility for children sustains archaic forms of inequality. In most areas of child health and social services, someday parents may be recognized first as a parent, and only secondly as a mother or a father, which would not dilute their respective contributions.