Ways of being a father: how first-time fathers and public health nurses perceive men as fathers

Listening to the Fathers of Twins-Being Sensitive to Fathers' Needs in Maternity and Child Healthcare

Objective: In a multiple-birth family, parenthood means being a parent to more than one child of the same age. The aim of this study was to describe the experiences of fathers of twins in order to contribute to the understanding of twin fatherhood and the needs for support. This article also provides some concrete guidance for midwives and nurses. Design: This qualitative research study was guided by the hermeneutic phenomenological approach. Setting: Notification of the study was published on the Multiple Births Association website for the fathers of twins. The data comprised fathers' (n = 6) diaries and/or notes and in-depth interviews. Results: The following themes describe the phenomenon of being a father of twins: "Fatherhood of twins grows gradually", "Strengthening of twin fatherhood by being present and involved", "Father develops his relationship with each and both of the twins", and "Making space for multiple fatherhood". This article concentrates on the latter two themes. Conclusions: Fatherhood/parenthood is a very special time in a person's life and has many effects on a child's health and wellbeing and his/her life. Fathers of twins want to create a close bond with them by being actively present and involved in the children's daily life, also with a view to the future. The staff of the hospital and maternity and child health clinic play a vital role in implementing services meant for multiple-birth families in the holistic understanding of and support for fathers/parents during the transition to parenthood and after the children's birth. Implications for practice: Midwives and nurses are vital in providing support for, sharing knowledge with, and giving advice to fathers and different kinds of families. Multiprofessional cooperation that links evidence-based knowledge, theory, and practice, ensuring that the voices of both parents are heard and respected, is key to improving the care for different kinds of families and families with special needs.

Parents' experiences of the information provided at the antenatal clinic regarding foetal diagnostics - A qualitative interview study

OBJECTIVE

This study aimed to examine the pregnant women's and their partner's experience of the information given at the antenatal clinic regarding screening methods.

METHODS

A qualitative interview study was conducted in the Gothenburg area in Sweden. Ten women and seven partners expecting their first child were interviewed adjacent to the second-trimester ultrasound examination. The data were analysed using qualitative content analysis.

RESULTS

The findings present an overall theme, three main categories, and ten subcategories. The overall theme showed a nonhomogeneous and individually based picture concerning the meaning and purpose of the methods, need for improvement of information, parents own information seeking, and the encounter with the midwife was also experienced as an influential encounter. The main categories show that diversity relates to the level of information given, voluntariness, the possibility of abnormal findings, and varying needs to thorough information and pre-existing knowledge. The midwifés impact was related to attitude, openness for questions, time for explanations, and the balance between providing enough information to support without worrying the parents.

CONCLUSIONS

Although previous research has pointed out a decade ago that information regarding foetal diagnostics is lacking, this study shows that these shortcomings still exist and that improvement is needed. The given information should be explicit concerning the purpose, limitations, and voluntariness of prenatal testing. Sufficient time for questions and discussion is as important as considering the parents' pre-existing knowledge, individual thoughts or questions, and a neutral attitude from the midwife is desirable.

Strengthening Antenatal Care towards a Salutogenic Approach: A Meta-Ethnography

The aim was to explore how midwives, public health nurses and nurses view caring in antenatal care (ANC) as provided for mothers and fathers/partners. Based on Noblit and Hare (1988), meta-ethnography was used to address meaning by synthesizing knowledge and understanding inductively through selected qualitative studies (n = 16). Four core themes were identified: (1) supporting the parents to awaken to parenthood and creating a firm foundation for early parenting and their new life situation; (2) guiding parents on the path to parenthood and new responsibility; (3) ensuring normality and the bond between baby and parents while protecting life; and (4) promoting the health and wellbeing of the family today and in the future. The overarching theme can be expressed as "helping the woman and her partner prepare for their new life with the child by providing individualized, shared care, firmly grounded and with a view of the future". Caring in antenatal care (ANC) is being totally present, listening and using multidimensional professional competence but also being open-minded to new aspects and knowledge. The health promotion and positive health aspects should be considered an important part of supporting parents and the whole family now and in the future. A more conscious salutogenic approach to ANC would lead to more favorable results and could be a fruitful research topic in the future. There is a need to provide midwives/nurses with enough time to allow them to concentrate on specific needs and support for different kind of families in ANC but also training for midwives to make them more familiar with online and other options.

Men's experience of first fatherhood discovery: a descriptive study based on free hierarchical evocation by associative networks

Objective and Background: Men's experiences of first-fatherhood discovery differ widely with various circumstances; they were examined according to the intended/unintended occurrence of partner's pregnancy.Methods: An Associative Network study targeted 44 first-time fathers and analysed their reactions to a stimulus-sentence 'In the first days after pregnancy announcement … 'Results: Word-associations formed 19 themes and 5 metathemes. The main metathemes were Emotional (30%), Cognitive (27%) and Relational (23%). Negative emotions were more frequent in unintended vs. intended pregnancies. Subthemes Chock, Feeling of unreality, Emotion control, Guilt, Denial, or Regret prevailed in unintended pregnancies. The major theme in all pregnancies was Personal advancement but subthemes Physical and psychological preparation and Responsibility prevailed in intended pregnancies vs. Acceptation and Personal progress in unintended pregnancies. Themes Relationships (with partner and others) were more frequently mentioned in unintended pregnancies vs. theme Logistics in intended pregnancies. Overall, the participants expressed opposed conflicting emotions but a desire for real involvement in pregnancy, birth, and child-raising.Conclusion: The participants proved interested and concerned. Fathers's presence and support should be solicited, accounted for, and valued by mothers-to-be and health professionals in all pregnancies. Involving fathers since pregnancy is essential for mental equilibrium, child-parent attachment, child and parent development, and family relationships.

Assessing the impacts of an interdisciplinary programme supporting father involvement on professionals' practices with fathers: A qualitative study

AIMS AND OBJECTIVES

The study aimed to assess the impacts of the Father-Friendly Initiative within Families (FFIF) programme, an interdisciplinary programme supporting father involvement, on health professionals' practices with fathers.

BACKGROUND

It is increasingly recognised that father involvement benefits children's cognitive and social development and contributes to both parents' well-being. Recent research has shown health professionals' support to be a protective factor in father involvement. Research results were translated into practice through the implementation of a programme, the FFIF, aimed at empowering health professionals to support father involvement.

DESIGN

The study employed a qualitative impact assessment approach based on semi-structured interviews with 36 health professionals to assess the impacts of the FFIF on professionals' practices with fathers.

METHODS

A total of 36 health professionals were interviewed (13 nurses, 10 social workers, six community workers, three educators, two psychoeducators, one health manager, and one special education teacher). Interviews were transcribed, and a qualitative thematic analysis was carried out. This study is presented in line with COREQ's checklist.

RESULTS

Impacts of the FFIF on health professionals were seen in changes on three fronts: (a1) their beliefs; (b) their conception of their role; and (c) their interventions. These changes related to three themes: (a) difficulties experienced by fathers; (b) importance of father involvement; and (c) differences between fathers and mothers. The professionals, having realised the importance of their own role in improving the services offered to fathers, made concrete changes in their interventions, such as reaching out to fathers more effectively, encouraging their participation and treating them fairly and equitably.

CONCLUSIONS

After attending this interdisciplinary programme supporting father involvement, participating professionals adopted father-friendly beliefs, redefined their conception of their role and modified their interventions.

RELEVANCE TO CLINICAL PRACTICE

To provide family-centred care, nurses and other health professionals need to adopt father-inclusive practices.

Engaging parents through gaze: speaker selection in three-party interactions in maternity clinics

OBJECTIVE

Describing and analyzing speaker selection in conversations between the health nurse and parents in maternity clinics.

METHODS

The data consisted of ten video-recorded encounters in maternity clinics. Using conversation analysis, we investigated 89 sequences of interaction in which the health nurse asks a question that is verbally addressed to both parents.

RESULTS

There was an observable pattern of selecting mothers as principal respondents by all participants of the encounters in maternity clinics. In a few deviant cases, fathers were selected as principal respondents. A typical practice of speaker selection was the gaze direction of the health nurse towards the recipient (usually the mother) at the closure of her question. Various situational elements also influenced which one of the parents answered the question. The deviant cases in which fathers were selected as principal respondents were mainly explainable by the use of the questionnaire designed to facilitate talking about psycho-social issues connected with the transition to parenthood.

CONCLUSION

Particular interactional circumstances and practices can break the pattern of selecting mothers as respondents to questions addressed to both parents.

PRACTICE IMPLICATIONS

Fathers could easily be engaged in conversations through gaze. Also the questionnaire seems promising in engaging fathers in conversations in clinics.

Nursing students' perceptions of their experiences with fathers during their family nursing clinical practicum

There is consensus that supporting fathers' involvement in their children's care is essential and that nurses can play an important role, facilitating this process. There is little evidence about how nurses' education as family nurses enable them to work with fathers. This study aimed to explore undergraduate nursing students' perceptions of their experience with fathers during family nursing clinical practicum. An exploratory descriptive qualitative study allowed twelve nursing students to participate in a one-hour interview, at a university of Central Canada. The critical incident technique was used for data collection and analysis was done with N Vivo7. Four themes reflected students' experiences: Experiencing critical events with fathers; Perceiving fathers and father involvement as important; Building a relationship with fathers and Reflecting upon formal education and clinical practicum. Family nurses need to revisit their attitudes towards fathers and make space for this important member of the family in health care situations.

Not-patient and not-visitor: a metasynthesis fathers' encounters with pregnancy, birth and maternity care

INTRODUCTION

the active engagement of fathers in maternity care is associated with long-term health and social benefits for the mother, baby and family. The maternity care expectations and experiences of expectant and new fathers have received little attention to date.

AIM

to identify and synthesise good quality qualitative research that explores the views and experiences of fathers who have encountered maternity care in high resource settings.

METHODS

based on a pre-determined search strategy, relevant databases were searched for papers published between January 1999 and January 2010. Backchaining of the reference lists in included papers was undertaken.

INCLUSION CRITERIA

good quality qualitative research studies exploring fathers' involvement in maternity care through pregnancy, birth, and up to 6 months postnatally, that were undertaken in high resource countries. No language restrictions were imposed. ANALYTIC STRATEGY: the analysis was based on the metaethnographic techniques of Noblit and Hare (1988) as amended by Downe et al. (2007).

FINDINGS

from 856 hits 23 papers were included. The emerging themes were as follows: risk and uncertainty, exclusion, fear and frustration, the ideal and the reality, issues of support and experiencing transition.

SYNTHESIS

fathers feel themselves to be 'partner and parent' but their experience of maternity care services is as 'not-patient and not-visitor'. This situates them in an interstitial and undefined space (both emotionally and physically) with the consequence that many feel excluded and fearful.

CONCLUSIONS

fathers cannot support their partner effectively in achieving the ideal of transition to a successful pregnancy, joyful birth and positive parenthood experience unless they are themselves supported, included, and prepared for the reality of risk and uncertainty in pregnancy, labour and parenthood and for their role in this context.

Many fathers visit the child health care centre, but few take part in parents' groups

Fathers are expected to play an increasing part in the care of children, but fathers are not automatically included in studies of early childhood. In this paper we present Swedish fathers' experiences of child health care. In the study, a total of 237 out of 279 (85%) fathers of small children were telephone interviewed using a structured questionnaire. As many as 165 (70%) had visited the child health centre at some time - 91 (38%) regularly or quite often - and we found an association between visits to the child health centre and physician contacts on account of the child's illness. A common feature throughout was the fathers' positive view of the child health centre and its activities, with as many as 77 percent grading it as very good or good. Sixty-seven fathers (28%) had taken part in a parents' group, and here there was a positive association with being a first-time father and knowing about the child's birth weight and vaccinations. We conclude that professionals must find new ways to get fathers to come to child health care, and especially to parents' groups.

Support of fathers of infants by the child health nurse

The child health nurse is considered to be able to support fathers in the transition to parenthood, through utilizing the fathers' inherent resources for the best development of the child. The aim of present study was to identify what expectations fathers of infants have of the child health care, including the nurse: whether they feel that they have received support in this role and how they think the nurse can support new fathers. A qualitative descriptive design was used with an inductive approach using grounded theory, which was suitable to obtain knowledge and understanding of how fathers perceived and interpreted their interaction with their child health nurse. Twenty fathers of infants gave their informed consent to participate. They were interviewed and data were systematically analysed on three levels by constant comparative method. From the analysis, the core category trustful relationship was discovered, comprising the categories involvement, faith and support. Nurses ought to reflect on that a father of an infant may feel slighted at the child health clinic if, as traditionally, the nurse turns only to the mother. Many fathers of today want to share the infant care and they want more communication with the nurse. It is suggested that in the long run, support in early fatherhood may be of benefit for the child and for the family. If the father has a trustful relationship with the nurse, his involvement in child health care is presumed to increase, as is the possibility of having faith in the nurse, as well as receiving support in his role as father. The findings are discussed in relation to literature in the field.

‘Just a bystander’? Men's place in the process of fetal screening and diagnosis

Despite increasing research into men's experience of pregnancy and fatherhood, experiences of men whose partner is undergoing fetal screening and diagnosis have been less well-studied. This paper begins to fill a gap in the literature by identifying several potentially conflicting male roles in screening, diagnosis and subsequent decision-making. Drawing on a wider qualitative study in the UK of experiences of antenatal screening, it is suggested men may play inter-linked roles: as parents, bystanders, protectors/supporters, gatherers and guardians of fact, and deciders or enforcers. These may be roles they have chosen, or which are assigned to them intentionally or unintentionally by others (their female partner, health professionals). Men's status and feelings as fathers are sometimes overlooked or suppressed, or may conflict with their other roles, particularly when screening detects possible problems with the baby. The paper concludes by discussing these findings in the context of the wider literature on men and pregnancy.

Parenthood experiences during the child's first year: literature review

BACKGROUND

Raising a child is probably the most challenging responsibility faced by a new parent. The first year is the basis of the child's development and is significant for growth and development. Knowledge and understanding of parents' experiences are especially important for child health nurses, whose role is to support parents in their parenthood.

AIM

The aim of this review was to describe mothers' and fathers' experiences of parenthood during the child's first year.

METHOD

A literature search covering 1992-2002 was carried out using the terms parenthood, parenting, first year, infancy and experience. Of the 88 articles retrieved, 33 articles (both qualitative and quantitative) met the inclusion criteria and corresponded to the aim of this review. The data were analysed by thematic content analysis.

FINDINGS

Being a parent during the child's first year was experienced as overwhelming. The findings were described from two perspectives, namely mothers' and fathers' perspectives, since all the included studies considered mothers' and fathers' experiences separately. The following categories were identified concerning mothers: being satisfied and confident as a mother, being primarily responsible for the child is overwhelming and causes strain, struggling with the limited time available for oneself, and being fatigued and drained. The following categories were found for fathers: being confident as a father and as a partner, living up to the new demands causes strain, being prevented from achieving closeness to the child is hurtful, and being the protector and the provider of the family. The unifying theme for these categories was 'living in a new and overwhelming world'.

CONCLUSION

There is a need for nurse interventions aimed at minimizing parents' experiences of strain. A suggested intervention is to find a method whereby child health nurses' support would lead to parents becoming empowered in their parenthood.

'It's the first scientific evidence': men's experience of pregnancy confirmation

BACKGROUND AND AIMS

In contrast to women's experiences of motherhood, there has been comparatively little research investigating men's experience of the transition to fatherhood and how changing cultural perspectives contribute to the contemporary experience of fathering. This paper draws on the findings of a larger ethnographic study of men's transition to fatherhood in the United Kingdom (UK) and discusses men's experiences of pregnancy confirmation.

METHODS

A longitudinal ethnographic approach was chosen to investigate men's 'real life' accounts of their transition to fatherhood. A mixture of 'novice' and experienced fathers (n = 18) were recruited from antenatal classes in the north of the UK during 1998. Semi-structured interviews were conducted on three occasions, twice during their partner's pregnancy and once afterwards.

FINDINGS

Framed by the context of the contemporary construction of involved fatherhood, the men frequently spoke of their desire to be 'involved' with their partner's pregnancy and yet reported difficulty in engaging with its reality. They nevertheless participated in a range of activities - body-mediated-moments - which brought them closer to their partner's pregnant body and therefore their unborn baby. These activities centred on pregnancy confirmation, announcement, foetal movements, the ultrasound scan, and culminated in their presence during labour and delivery. This paper discusses their involvement in the process of pregnancy confirmation.

CONCLUSION

The men's experiences of early pregnancy were marked forcefully by their involvement in the confirmation process. This activity gave men entry into a physical dimension, helping them forge an involvement in the pregnancy and shape their early transition to fatherhood. Implications for practice. The study has provided insight into expectant men's experiences of pregnancy and contributed to the understanding of the changing nature of contemporary fatherhood in the UK. Recognition of men's changing roles in pregnancy, and greater insight into their experiences should be of relevance to all those supporting the transition to parenthood, including midwives, obstetricians, ultrasonographers and childbirth educators. Such increased awareness should inform the antenatal support given to men and reinforce the importance of relevant antenatal preparation that effectively meets the needs of not only expectant women, but also expectant men.