Men’s Knowledge About Maternal Serum Screening for Down Syndrome and their Attitude Towards Amniocentesis

Paternal Preferences, Perspectives, and Involvement in Perinatal Decision Making

IMPORTANCE

Despite increasing attention to the importance of father involvement during pregnancy, the literature on fathers' roles in perinatal decision making is scant.

OBJECTIVE

The aim of this study was to conduct a narrative review of the literature exploring fathers' preferences, perspectives, and involvement in perinatal decision making.

EVIDENCE ACQUISITION

We searched PubMed, Ovid, EMBASE, Cochrane Library, and CINAHL databases using the terms father, spouse(s), husband, and paternal separately with the combined terms of attitude, preference, involvement, influence, informed consent, decision making, pregnancy, labor induction, genetic testing, prenatal diagnosis, amniocentesis, fetal surgery, genetic abnormalities, congenital anomalies, birth defects, perinatal, and antenatal. The search was limited to English-language studies that were published anytime and conducted between July and September 2018.

RESULTS

The initial search identified 616 articles; 13 articles met criteria for inclusion. Fathers view themselves as serving distinct roles in perinatal decision making and have specific informational needs that would support their involvement in decision making. Although fathers want to support their partners and learn about fetal health, they often feel excluded from perinatal screening decisions. Mothers and fathers also have different needs, concerns, and preferences regarding key perinatal decisions that, if unresolved, can impact the couples' relationship and perinatal outcomes.

CONCLUSIONS

Findings provide import insights into the distinct experiences, roles, needs, and perspectives of fathers facing perinatal decision making.

RELEVANCE

Advancing research and policy on fathers' involvement in perinatal decision making could lead to a paradigm shift in how maternity care is structured, how obstetric services are delivered, and how perinatal interventions are designed and implemented.

Balancing Needs and Autonomy: The Involvement of Pregnant Women's Partners in Decisions About cfDNA

Cell-free fetal DNA (cfDNA) screening is used to identify the presence of fetal genetic variants early in pregnancy. Patients' informed decision-making is central to the success of this new screen in clinical practice. Although research has focused on pregnant women's decision-making, little is known about partners' role and preferences as a member of the decision-making dyad. Using a grounded theory approach, this study analyzed 23 in-depth interviews to examine partners' perspectives about cfDNA screening and preferences with respect to their role in the decision-making process. Participants wished to be actively involved in testing decisions. They articulated a distinct set of needs and preferences in the decision-making process. Such involvement was hindered by several biological and logistical barriers. This study demonstrates the need to develop mechanisms that foster informed decision-making for cfDNA screening and related new reproductive genetic technologies that focus on not just the pregnant woman but also the decision-making dyad that includes her partner as well.