by Anna Machin
Epigenesis does not describe an alteration in the genetic code itself – that’s the DNA – rather it is an alteration to the way the gene is operated. It is a bit like the DNA being the hardware and the epigenesis is the software altering the way the gene is expressed. So, the chromatin, tasked with condensing DNA so it fits within the cell nucleus, or the histone – the protein around which DNA wraps itself – undergo an alteration, rather than the genes themselves. The software is modified rather than the hardware. I must admit, this took me a bit of time to get my head around. Maybe an example will help.
In nineteenth-century northern Sweden, the population lived under a cycle of crop failures and crop abundance, which meant, during times of plenty, they would take the opportunity to indulge themselves in some serious overeating. Two generations later, it was noticed that the grandchildren of these people had a much higher risk of dying from diabetes-related causes and heart disease than the average population. It was as if they had been enjoying a very rich diet, even though they had done no such thing. Why was diabetes, usually a disease of the obese, so prevalent in this population? The answer lay decades in the past. The environment of plenty that their grandparents had periodically enjoyed was having its impact two generations later, on their grandchildren’s health. The expression of the grandparents’ genes had been altered by their dietary overindulgence and this had been inherited by their children and then passed on to their grandchildren. This is epigenesis.
There is growing evidence that obesity, the epidemic of our age in the West, may be in part caused by an epigenetic mechanism. In one of the very first studies of its type, published in 2006, Marcus Pembrey, from the Institute of Child Health at University College London, and his British and Swedish colleagues from partner institutions decided to explore the impact that having a father who smoked during his own childhood had on an individual’s body mass index (their BMI), the measure widely used in the medical profession as an indication of healthy, or unhealthy, weight. Using a vast database that had been collected as part of the Avon Longitudinal Study of Parents and Children (ALSPAC), a long-term project looking at child development, they investigated whether there was a link between the age at which a dad started to smoke and his children’s BMI. Of the 9,886 fathers included in the study, 5,451 had smoked at some point in their lives. Of these, the most common age to start was sixteen, but some began between eleven and fourteen and a small but significant number, 166, reported that they had begun at younger than eleven. What Pembrey found was that the earlier a dad began to smoke in his childhood or adolescence, the higher his child’s BMI. Children whose dad had started before they had reached the age of eleven were at significant risk of being obese. But this was only the case for sons; daughters were unaffected. And here we arrive at another fact about genetic inheritance. Between mum’s genes and dad’s genes, not all is equal.
Imprinted genes are genes that are capable of being ‘silenced’ in either the mother or the father. This means that while both parents may pass on a gene, depending upon which sex ‘silences’ their version, only the gene from one parent will be active in their child, producing a behaviour, ability, anatomical feature or disorder. This allows for the possibility that the inheritance of a trait may be the result of inheritance from only dad or only mum. Unlike the example from Marcus Pembrey’s work on smoking and obesity, with imprinted genes it is not the sex of the child that affects whether a gene has an impact but the sex of the parent that counts – the same gene could be silenced in mum but not in dad, meaning only inheritance of that gene from dad will have an impact on the child; inheritance from mum will have no effect. It is argued that imprinted genes are of particular importance in the development of the brain, and it may be that fathers and mothers have ‘genetic responsibility’ for the development of different areas. But this work is in its very early stages and at present the most solid evidence for imprinting comes, again, from research on the genetic underpinnings of obesity. Catherine Le Stunff, from the Hôpital Saint-Vincent de Paul in Paris, and her colleagues explored the inheritance of a gene linked to the production of insulin. They found that there were two versions, types I and III. Children who had inherited the type I version from their father had a significantly higher risk of developing early onset obesity than those who had inherited type III from either parent or type I from mum. The gene was an imprinted gene, silenced in the mother and only active in the father.
The roles of epigenesis and imprinted genes in child development sit at the very cutting edge of science. It is fair to say we are still very much in the exploratory phase of understanding the extent of the impact they can have on a child’s development and the different roles mum and dad might play. But as our knowledge grows, we will be able to move beyond the current focus on health – always the priority in genetic studies – to understand how dad’s genes might contribute uniquely to their child’s anatomical, physiological and behavioural development.
Dads have a profound and very real impact on their children’s development, which ranges from the genes they inherit to the hormone levels they exhibit, from the structure of their brain to the behaviours they display, and from the mental resilience they harbour to the physical health they experience. In some cases, the impact of the father is equal to the mother, but in others – such as language, executive function, prosocial behaviours and mental health – the father has a unique and separate role to play. If you are a dad, remember that by being involved, particularly during the toddler times and teenage years, you are setting your children up for the long haul. The lessons, skills, time and experiences that you confer upon your child provide the fundamental neural, psychological and behavioural foundations on which they can build a successful and healthy life. And if these foundations are strong enough, they will last a lifetime, long into adulthood, meaning that your legacy has the potential to endure long after you have gone, in the wonderful child that you have raised.
CHAPTER ELEVEN
Dad 24345.0
The Future of Fathering
So here we are in the twenty-first century. An immense amount has happened in the half a million years since human fatherhood evolved. We’ve seen off all our hominin cousins to be the last ones standing (we think), we have endured numerous ice ages and populated the earth, developed villages and cities, domesticated animals, discovered complex economics, created myriad cultures and languages, pushed the frontiers of scientific and technical innovation ever forward, fought wars, negotiated peace and still found time to invent and play Pokémon Go. And throughout all this, human fatherhood has responded and, critically, endured. I have entitled this chapter ‘Dad 24345.0’ because, to be frank, I am unsure what version of the dad model we are on today – his immense flexibility makes it hard to keep up. But what I do know, and what hopefully is evident from the past ten chapters, is that fathers still stand at the very centre of our society. One of its critical players, defending his twin pillars of protection and teaching, and investing in his children’s present and future.
In this chapter, I want to explore where the dad of today is and where he is going. When I began studying fathers ten years ago, dads were just grateful that someone was giving them some attention, and thoughts about society’s view of fathers or the availability of supportive government schemes were far from their minds. But as research has accumulated, as media focus has increased and as this generation of new dads has become increasingly aware of both the benefits they bring to their children’s lives and the joy and fulfilment that being a father brings to theirs, dads are beginning to be much more politicized. They are aware of their wants, needs and rights, and feel sufficiently empowered by this renewed focus to be vocal about them.
All my studies culminate in an interview. After the questionnaires, blood tests and health checks, this free-ranging, minimally structured moment of the study allows dad to be truly unrestrained. He can share his thoughts, opinions and experiences. It is a conversation that is largely dad-led and can last for sev
eral hours. However, at the end of every interview, after we have discussed the practicalities of being a dad, taken time to record birth stories, noted aspirations and fears and explored sources of anxiety and joy, I ask my final question: how do you feel our society treats fathers? These interviews are almost inevitably occasions of strong emotion – love, pride, frustration, fear – but it is this question that in many cases prompts the most passionate, and at times angry, response. For these fathers have given a huge amount of thought and consideration to their role – indeed, they feel it is sufficiently important to give their time and energy to one of my studies – but their experience is that this dedication is often unrecognized, even actively belittled. In a world where the role of mum is paramount, even sanctified, the lack of focus and support available to fathers and the enduring stereotype of the inept dad leaves many of the dads I study with the overall impression that, while paying lip service to their needs, our society would very much prefer it if they would kindly get back in their box. Aadit’s feelings are a common reaction:
I think that the UK government, or society, thinks that the father isn’t needed at home, that’s why a system is created with only fourteen days’ leave. The impression is that the dad has to be moved out of the house as soon as possible.
Aadit, dad to Balan (six months)
It is true to say that we are at a point of critical change in Western society when it comes to dads. We are on the cusp of a potential revolution and, for those of us in the field of fatherhood studies, it is incredibly exciting. In one direction lies the promised land of the involved dad – equal parent, nurturer, investor, supporter – and in the other is the more familiar land of the traditional father, ready to put food on the table and instil discipline, but existing at a slight distance to his partner and children. Objectively, we know that for the child, the family and society, a return to our evolutionary roots with a model of involved fatherhood is the way to go, but what will decide which way we turn is in part down to the individual dad. If enough dads, and mums, demand change, then change will come. But dad’s ultimate fate – like every aspect of his role – is also inextricably tied to our politics and economics. For, at the end of the day, a dad cannot act alone, but must take his society with him. And it is here that the path becomes a little tricky.
Ten years ago, you could count on one hand the number of journal and press articles about involved fathering, and the term very rarely passed the lips of anyone in power. But today, the increased importance placed on the role of the father is no more clearly evidenced than with a quick overview of the number of reports published globally by think tanks, governments and charities with a focus on dads and co-parenting. In the past few years we have seen, among others, the Royal College of Midwives, MenCare, Working Families, the International Men and Gender Equality Survey, the US Congressional Research Service, the National Fatherhood Initiative and the UK government’s Women and Equalities Committee all focus their resources on drawing up reports about the state of fathering globally. They have focused variously on the role for the father in childbirth, the balance between a father’s work and family life, the drive towards true equality in the home and the global state of fathers’ rights to paternity leave. This is all immensely encouraging as, after years of failing to register on anyone’s radar, dads are now the focus of discussion. And this flood of interest is an acknowledgement, however belated, that they have something vital to contribute to their children and our society. But, while hugely welcome, the impact of these reports on actual practice makes it clear that we have some way to go before everyone is singing from the same song sheet and before the aspirations of today’s dads are matched by reality. The starkest representations of this can be seen in two reports: one that is UK-focused and impacts the very start of a father’s journey; and the other that considers the gap between the status of mothers and fathers globally.
In 2010, the Royal College of Midwives published their report, ‘Midwifery 2020’, which set out their vision for the practice of midwifery in the UK by 2020. It was a report that explicitly listed dads as a target reader group. It referred to the increasing scientific evidence for the impact of father involvement on the health of the mother and child and on his child’s development. It highlighted the period around birth as a ‘golden opportunity’ to offer fathers advice and support and ease their journey into parenthood. It explicitly stated the need to engage with fathers as important figures in maternity care, not only to elicit their feedback on how services could be improved but to motivate them to be the drivers of change. And as a result of all these factors, it argued that midwives should be working with fathers to encourage their involvement and support. All laudable aims. But the reality at present, in 2017, three years from their deadline, is rather a long way from this vision. Unfortunately, words have not been followed by action.
I think the thing that struck me was you are either treated as a couple having a child or as a mother. There is nothing focused on, and no support groups for, fathers. There is nothing to help you prepare for your role.
John, dad to Joseph (six months)
The voices of the fathers in this book make it clear that, despite the best aims of policymakers, they are not equal players in the process of pregnancy and childbirth, and a considerable number feel actively excluded from the birth of their child. My experience is that this is not due to a lack of enthusiasm on the part of dads to step up and assume a role during this time. Nor do I believe that the blame should be laid wholesale at the door of the midwives or health practitioners. If a father requests support or to adopt a particular role during birth, the vast majority of midwives are happy to help him make it happen. No, the fault lies higher up the chain, within governments and societies whose engrained cultural beliefs mean that they are resisting both the scientific evidence and the increasingly loud calls for change. And this is no more strongly evidenced than within the UK. Bob’s experience is an upsetting reminder of this:
Kate was offered support when we had the miscarriage. We went to the hospital and they talked to her there and said to give them a call whenever she wanted, but I was offered nothing. Again, it was a mum’s thing. Mums have miscarriages, dads don’t.
Bob, dad to Toby (four) and Harry (sixteen months)
Within the UK, the National Institute for Health and Care Excellence (NICE) consults on and develops guidelines for clinical care within the National Health Service. Their guidelines for the care of women during birth were published at the end of 2014 and run to a hefty eighty-eight pages long. The document details best practice during birth and provides healthcare staff with guidance when decisions need to be taken as to the next steps in clinical care. There is now a growing body of evidence that the healthcare outcomes for mum and baby are significantly improved if dads are included in discussions and decisions taken as labour proceeds. But nowhere in NICE’s 88-page document are the terms ‘dad’, ‘father’ or ‘partner’ referenced. Even if we forget the fact that fathers, who are invariably in the room, might have a need, and arguably a right, to be included in discussions and decisions about the birth of their child, and we look at this issue exclusively from the point of view of mum and baby, this is a glaring omission. NICE argue that their guidelines are patient-focused and, as far as the NHS is concerned, it is the mother and baby exclusively who are the patient in the context of birth. But the sole aim of medicalized childbirth is to increase the chances of survival for mum and baby. When a major factor that positively impacts this chance – having an involved and informed father – is excluded, that should be of concern. It is true to say that an expectant father is not the focus of medical care, but he is more than a visitor, a hand-holder or a bag-carrier, and it is arguable that there should be a duty of care towards him as well, to monitor his welfare. The previous chapters have made clear that there is powerful evidence that birth is a life-changing occurrence for mum and dad alike – biologically, physiologically and psychologically – so it would
seem the least we can do is make the care of both during birth of paramount importance.
If you engage the social context of the mother – her family – you are tuning in to the way human beings behave. Extracting a mother and sticking her in a health facility is less effective, but that is the worldwide global norm. That is the model that is being exported and distributed around the world [and changing] it is very complicated, it is ridiculous.
Duncan Fisher, OBE, Family Initiative
The consequence of a world run on an outdated maternity care model that is out of step both with the evidence and with the desires of parents is a world in which dads are still absent from many of our conversations about parenting. Despite the unequivocal evidence that dads want to be hands-on, that involved fathering improves a child’s developmental outcomes, increases maternal and infant health, reduces violence towards women and girls and increases sexual equality in the home and workplace for the long term, the message is slow to infiltrate the corridors of power. MenCare’s 2015 report ‘The State of the World’s Fathers’ was the first of its kind to carry out a global assessment of the status of fathers – the extent to which they are included, supported and advocated for. It found that there were still considerable barriers to dads being involved. Some of these were economic, particularly in poorer countries, but the largest hurdle was in our minds. The hurdle is social and cultural; the belief that men work and women care and that they are biologically incapable of carrying out each other’s roles. In many countries, women have begun to break through this particular barrier within the working world, although the glass ceiling is proving to be considerably thicker than we thought, but men are a long way behind their sisters on this particular ladder. They are yet to convince the majority that men can care.
