Fathers' experiences of childbirth

Going through it together: Dyadic associations between parents' birth experience, relationship satisfaction, and mental health

BACKGROUND

Previous research suggests that a negative birth experience is associated with symptoms of postpartum depression and anxiety in mothers and partners. However, this has mostly been investigated within the first year postpartum and research on the long-term effects is lacking. Additionally, the role of relationship satisfaction and the interdependence between parents have not been considered so far.

METHODS

Couples (N = 1992) completed questionnaires on their birth experience, relationship satisfaction, and symptoms of depression and anxiety at two months, 14 months, and two years after birth, respectively.

RESULTS

Actor-Partner Interdependence Mediation Models indicated no partner effects, but several significant actor and indirect effects. A more positive birth experience was associated with higher relationship satisfaction and less depression and anxiety symptoms for both parents. Higher relationship satisfaction was in turn associated with less depression (mothers and partners) and anxiety symptoms (mothers). The association between birth experience and depression symptoms was partially mediated by relationship satisfaction for mothers and partners, while the association between birth experience and anxiety symptoms was partially mediated by relationship satisfaction only for mothers.

LIMITATIONS

Due to the highly educated, very healthy sample with low levels of depression and anxiety as well as high relationship satisfaction, results cannot be generalized to less privileged parents. Moreover, all effects were very small.

CONCLUSIONS

Results highlight the importance of a positive birth experience for parents' relationship satisfaction and mental health. Negative birth experiences need to be avoided to prevent a negative impact on the whole family.

Development and psychometric evaluation of the questionnaire on the contributing factors of tendency towards voluntary single-childedness and childlessness: a mixed method study

Couples' tendency towards voluntary single-childedness and childlessness (VSCC) has turned into a major challenge in all societies and led to different problems such as population aging. A key step to VSCC management is to determine its contributing factors through valid and reliable instruments. This exploratory sequential mixed method study (qualitative-quantitative) was conducted in 2020-2021. Phases of qualitative consists of all couples aged 15-49 in Babol, Iran, who were single or childless. Sampling is based on the purpose, and the number of samples is 20 couples. To collect data, face-to-face and semi-structured interviews were conducted with the participants. Sampling continued until data saturation. The data were analyzed by the conventional content analysis method and quantitative phase. Initially, a qualitative study was conducted on twenty couples, and were analyzed through conventional content analysis. Findings were used to develop QFT-VSCC and then, the face, content, and construct validity as well as reliability were assessed. Construct validity was assessed through exploratory and confirmatory factor analyses and reliability was assessed through internal consistency and stability assessments. The results of the qualitative part analysis consist of 140 codes, 30 primary categories, and nine main categories and two themes (individual limitations and social limitations). The primary QFT-VSCC had 78 items. Fifty-eight items were omitted during validity assessment and the remaining twenty-two items were loaded on five factors during factor analysis. These factors were threatened priorities, inappropriate familial context for childbearing, sense of occupational and social insecurity for the child, social modeling of childlessness, and tendency towards change or stability in marital life. The five factors explained 52.56% of the total variance. All model fit indices in confirmatory factor analysis were acceptable and the Cronbach's alpha values of QFT-VSCC and all its factors were more than 0.70. The results of convergent validity analysis revealed that all factors had an AVE value greater than 0.5, and the HTMT index for all factors was less than 0.85. This indicated that discriminant validity had been achieved. QFT-VSCC is a simple valid and reliable instrument for VSCC assessment among both men and women.

The partner's experiences of childbirth in countries with a highly developed clinical setting: a scoping review

Background

In Western countries, it is common practice for a woman to be supported by a trusted person during childbirth, usually the other parent. Numerous studies have shown that this has a positive effect both on the woman’s satisfaction with the birth process and on physical outcomes. However, there is little research on the birth experience of partners and their wellbeing. The aim of this review is to summarise the existing literature on partner experience, consider its quality and identify the underlying themes.

Methods

Both a systematic literature search in three databases and a manual search were conducted, for qualitative, quantitative, and mixed-methods studies from Western countries examining the experiences of partners present at a birth.

Results

A total of 35 studies were included. Only one study included same-sex partners (the other studies addressed fathers’ experiences only) and only one validated questionnaire examining partners’ birth experiences was identified. Four major themes were found to influence partners’ birth experiences: (1) intense feelings, (2) role of support, (3) staff support, and (4) becoming a father.

Conclusions

Partners may feel very vulnerable and stressed in this unfamiliar situation. They need emotional and informal support from staff, want to be actively involved, and play an important role for the birthing woman. To promote good attachment for parents, systematic exploration of the needs of partners is essential for a positive birth experience. Because of the diversity of family constellations, all partners should be included in further studies, especially same-sex partners.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-05014-1.

Fathers' anxiety levels during early postpartum: A comparison study between first-time and multi-child fathers

BACKGROUND

The postnatal period is considered the most challenging period in the adjustment to fatherhood. This study aimed to assess anxiety levels among fathers during this period.

METHODS

A comparative study assessing the anxiety levels of first-time and multi-child fathers before the mother and child returned home (0-7 days after birth) was conducted. We used the French validation of the State-Trait Anxiety Inventory (STAI).

RESULTS

Among 235 fathers who were met at the maternity ward, 182 (77 %) responded to the questionnaire. For most fathers in both groups, anxiety levels were low or very low for trait anxiety (166/182, 91.21 %) and state anxiety (177/182, 97.25 %). Levels of state anxiety were statistically higher for first-time fathers compared to multi-child fathers but were mainly at a low or very low level (70/83 [84 %] versus 71/99 [71 %], respectively, p = 0.029). The multiple linear regression showed that "feeling prepared at birth time" was the only significantly (p < 0.001) associated factor with state anxiety among first-time fathers only.

LIMITATIONS

The validity and reliability of the STAI have been widely proven for the general population but not specifically for men during the postpartum period.

CONCLUSIONS

Most fathers had low to very low anxiety levels during the early postpartum period, suggesting that developing new specific support interventions is not needed during early postnatal care. Further research focusing on when the family is back home is warranted.

Design and psychometric evaluation of the fathers' fear of childbirth scale: a mixed method study

Background

Fear of childbirth is reported in 13% of fathers, and it may have adverse consequences for the fathers’ health as well as their families. To reduce the fear of childbirth in the expectant fathers, an appropriate screening tool is needed. Due to the lack of a valid and reliable questionnaire to measure fathers’ fear of childbirth, this study was conducted to develop the Fathers’ Fear of Childbirth Scale and evaluate its psychometric properties.

Methods

This mixed method study was conducted in two phases. In the qualitative phase (or item generation), semi-structured interviews were conducted with 20 expectant fathers, and a literature review was performed to generate the Fathers’ Fear of Childbirth Scale items pool. In the quantitative phase (or psychometric evaluation), reliability as well as face, content, and construct validity of this scale were evaluated. To establish construct validity, exploratory and confirmatory factor analyses were performed. Reliability was evaluated through internal consistency and composite reliability measures.

Results

The primary version of Fathers’ Fear of Childbirth Scale contained 32 items, which were reduced to 17 items while establishing construct validity. Exploratory factor analysis extracted two factors, namely fear of childbirth process (12 items) and fear of hospital (5 items). These factors explained 50.82% of the total variance. Goodness of fit indices within the confirmatory factor analysis was acceptable. Internal consistency and composite reliability indices of all the factors were greater than 0.70.

Conclusion

The Fathers’ Fear of Childbirth Scale has a suitable validity and reliability for assessing fear of childbirth in fathers. It is a simple report instrument that can be easily implemented by health care professionals.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03696-7.

First-time fathers' experiences and needs during childbirth: A systematic review

OBJECTIVE

Fathers have been increasingly involved in childbirth since 1990. Attendance at childbirth is considered to benefit fathers' health as well as that of their partner and children. However, childbirth is a life event that parents may experience differently. First-time fathers' experiences have been barely studied and may differ from those of fathers who have already had a child. In order to adapt support and care during childbirth to the needs of first-time fathers, a deeper insight must be gained into their experiences and needs during childbirth.

DESIGN

A systematic review of qualitative studies was conducted using PubMed, Embase and CINAHL as well as the snowball method. Quality appraisal was performed and evaluated using the Critical Appraisal Skills Programme. A thematic best evidence synthesis was performed.

FINDINGS

Of 821 articles, eight qualitative studies and the qualitative data of one mixed methods study were included. amongst other feelings, fathers experience a lack of knowledge and a need to be better prepared. First-time fathers want to be more involved and need guidance, information and honest answers to help them fulfil a supportive role. Fathers disregard their own needs to focus on the needs of the mother. Meeting the baby for the first time changes the focus from the mother to the child, and fathers need time and privacy for this special moment.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

To adapt support and care during childbirth to the needs of first-time fathers, professionals must be aware of their needs. Professionals must realise the significant influence of their professional behaviour on first-time fathers' experiences. Care for first-time fathers should be formalised. Follow-up research must be conducted on integrating the preparation of first-time fathers into prenatal care. Education and training of professionals must be improved.

Cross-cultural adaptation and validation of the First-Time Fathers Questionnaire in China

OBJECTIVE

The study aimed to cross-culturally adapt and validate the First-Time Fathers Questionnaire (FTFQ) in the cultural context of China.

DESIGN

Prospective validation study.

SETTING

The study was conducted in four public hospitals in Hangzhou, a southeast coastal city of China.

PARTICIPANTS

Four hundred and nineteen first-time fathers (mean age=30.45 years, SD=3.44, range 22-46) whose partners had given birth between July 20 and October 10, 2019.

METHODS

The instrument "First Time Fathers Questionnaire (FTFQ)" was translated and culturally adapted to the Chinese context according to the methodological criteria of the International Society for Pharmacoeconomic and Outcomes Research. The construct-related validity of the instrument was tested through EFA and CFA. Content validity was evaluated with an analysis of the expert judgment. Reliability was assessed based on the internal consistency.

RESULTS

Four domains were identified: "Worry", "Information", "Emotional Support", and "Acceptance", with 19 items and adequate internal reliability (0.86, 0.80, 0.86, and 0.72, respectively) and a total variance of 64.65%. The CFA model showed there is a good fit for the data: X²/df =1.20; RMSA = 0.03; CFI = 0.99; and NFI = 0.93. Additionally, each item achieved an I-CVI ≧0.83, and the S-CVI/Ave = 0.90.

KEY CONCLUSIONS

The Chinese version of the FTFQ is a valid and reliable instrument to assess first-time fathers' experience of childbirth in China.

IMPLICATIONS FOR PRACTICE

This study provides a validated questionnaire that is suitable for the Chinese cultural context. It contributes to the knowledge of first-time fathers' experience of childbirth and facilitate further actions to improve paternal satisfaction and behavior as labour companion.

Maternal and partner's level of satisfaction on the delivery room service in University of Gondar Referral Hospital, northwest, Ethiopia: a comparative cross-sectional study

Background

Asking patients/clients what they perceive about the care and treatment they have received is one of the important steps towards improving the quality of health care. In the scientific world, a number of efforts have been tried to understand about what laboring mothers perceive about the care provided. However, little is known about the birth experiences of partners in Ethiopia. Therefore, this study was aimed to assess the maternal and partner’s level of satisfaction on the delivery room service in the study area.

Methods

A comparative cross-sectional study was conducted from December 2018 to January 2019 in University of Gondar referral hospital. The birth satisfaction scale is used for the mother, and it was adapted to the partners’ perspective. Paired-samples t tests were used for comparing mothers and partners for the birth satisfaction scales global and thematic scores. A binary logistic regression model was fitted to identify predicting factors for mothers’ and partners satisfaction.

Results

The overall satisfaction of mothers in this study was 47.6%. Whereas, 41.2% of partners were satisfied by delivery room services. There were mean difference between mothers and partners’ birth satisfaction scale (p = 0.02). Maternal satisfaction scale was affected by age [OR = 0.36, 95%CI (0.18, 0.73)], perception [OR = 0.02, 95%CI (0.001,0.09)], waiting time [OR = 0.11, 95%CI (0.001, 0.09)],visiting mode [OR = 0.01, 95%CI (0.001,0.08)], pregnancy status [OR = 0.04, 95%CI (0.01,0.33)] and fatal outcome [OR = 0.001, 95%CI (0.001,0.018)] .whereas, partners satisfaction was associated with age [OR = 0.16,95%CI (0.05 0.49)], occupational status [OR = 0.02, 95%CI (0.001, 0.24), amount of money to pay for service [OR = 2.87, 95%CI (1.07, 7.71), visiting mode of his wife [OR = 0.08, 95%CI (0.01, 0.35)], waiting time [OR = 0.12, 95%CI (0.04, 0.33)], privacy [OR = 10.61, 95%CI (3.00, 37.52)], mode of delivery of his wife [OR = 7.69, 95%CI (3.00, 19.69)].

Conclusion

This finding would alert the health care system to design a client-friendly approach. It will provide insight to hospital administrators and providers in formulating a policy that would enhance the support of partners during labour and delivery process.

The Experience of Australia's First Nations Men Supporting Their Partners During Childbirth: A Descriptive, Interpretive Study

This research explored and described the experiences of Australia's First Nations expectant fathers as they supported their partners during childbirth. A descriptive, interpretive approach used purposive recruitment to the point of data saturation. Five participants were interviewed within 4 days of supporting their partners during childbirth. Interview data were thematically analyzed, and five themes emerged. Three themes were consistent with findings from non–First Nations fathers. Two new themes related to changes in childbearing traditions, “we show affection in different way” and staff support strategies, “educate dads by telling stories about birth”; will be closely examined in this article. This research identified the existence of a new generation of First Nations fathers in Central Australia wishing to guide and support their partners in their journey to parenthood. The development of support programs, responsive to their unique ways of knowing and learning style, will ensure that their needs are optimally met.

Fathers' reactions over their partner's diagnosis of peripartum cardiomyopathy: A qualitative interview study

BACKGROUND

Fathers' experience of childbirth has been described as both distressing and wonderful, but little has been described in the literature about fathers´ reactions when their partners get life threatening diagnoses such as peripartum cardiomyopathy (PPCM) during the peripartum period.

AIM

To learn more about fathers' reactions over their partner's diagnosis of peripartum cardiomyopathy.

METHODS

Fourteen fathers, whose partner was diagnosed with PPCM before or after giving birth, were interviewed. Data were analysed using inductive content analysis technique.

RESULTS

The first reaction in fathers was shock when they heard their partner had PPCM, which was sudden, terrible and overwhelming news. Their reactions to trauma are described in the main category: The appalling diagnosis gave a new perspective on life with emotional sub-categories: overwhelmed by fear, distressing uncertainty in the situation and for the future, feeling helpless but have to be strong, disappointment and frustration, and relief and acceptance. Although terrified, fathers expressed gratitude towards health care professionals for the diagnosis that made it possible to initiate adequate treatment.

CONCLUSION

Exploring father's reactions will help peripartum and cardiology healthcare professionals to understand that emotional support for fathers is equally important as the support required for mothers during the peripartum period. Specifically they will help professionals to focus on future efforts in understanding and meeting the supportive care needs of fathers when their partner suffers from a life-threatening diagnosis like PPCM.

Attitudes and barriers toward the presence of husbands with their wives in the delivery room during childbirth in Riyadh, Saudi Arabia

Objectives:

The objective of the study is to assess the husbands’ attitudes toward their presence with their wives during childbirth in the delivery room and to determine the barriers that prevent their presence.

Methods:

A cross-sectional study was conducted at two tertiary hospitals in Riyadh. Data were collected from a total of 250 husbands whom were selected randomly in the waiting areas of the delivery rooms and asked to participate in this study by filling a questionnaire after giving informed consent; data were collected during the period between December 2016 and April 2017.

Results:

The majority (95.6%) were Saudi and had only one wife. The positive mean score for the attitude increased significantly with increasing educational level (P < 0.01). The highest positive attitude was mainly for the item “It is calming for the mother.” Conversely, the highest negatively scored item was “my presence with my wife in the delivery room is insulting to my manhood” and “our culture is against a husband attending his wife's childbirth” (1.91 ± 1.12). The hospital system and not having a private room for their wives were the most identified barriers to the husband's presence in the delivery room.

Conclusions:

Increased level of education has better outcomes on husbands’ attitudes toward supporting their wives in the delivery room. Authors recommend flexible hospital policies to support husbands’ presences with their wives in the delivery room and provide privacy for them during childbirth, such will provide psychosocial support to the wife, and it is an important part in transition to a mother-friendly hospitals.

Mothers' and fathers' sense of security in the context of pregnancy, childbirth and the postnatal period: an integrative literature review

Background

From the individual perspective, security, which is essential to life quality, is characterised as an elementary human need that requires fulfilment. During the transition to parenthood, mothers and fathers are confronted with changes in physical and psychosocial processes that are accompanied by uncertainty and insecurity. Feelings of insecurity may have consequences affecting their pregnancy and childbirth experiences as well as their adaption to the parental role in the first weeks following childbirth. In this context, it is important to understand how parents express and interpret their sense of security to effectively support their security needs. This integrative review aimed to provide a critical synthesis of existing research on parents’ experiences of their sense of security associated with pregnancy, childbirth and the postnatal period.

Methods

A literature search of the PubMed, CINAHL, PsycINFO and GESIS Sowiport databases was performed. Peer-reviewed papers that were published in English or German between 1990 and 2017 focusing on mothers’ and fathers’ experiences of sense of security in the context of maternity care were included. A thematic analysis was performed to organise and describe the findings.

Results

Eleven research-based papers met the inclusion criteria. Four key themes among the data were analysed: the meaning and manifestation of sense of security, sense of security in relation to confidence and control, lack of feeling secure and coping strategies, and factors influencing sense of security.

Conclusions

The findings revealed a complex profile of the perception of security associated with pregnancy, childbirth and the postnatal period. Sense of security can depend on multiple internal and external factors, which can differ between mothers and fathers. Research on the experiences and perceptions associated with fathers’ sense of security is lacking. Further research focused on the experiences of security from the parents’ perspective is necessary. Midwives and other involved health professionals should be aware of their role in creating a sense of security among parents. Based on a local specific understanding of security experiences, professional caregivers have the opportunity to support parents more effectively with regard to their specific security needs.

First-time fathers' postnatal experiences and support needs: A descriptive qualitative study

AIM

To explore first-time fathers' postnatal experiences and support needs in the early postpartum period.

BACKGROUND

The postnatal period is a stressful transition period for new fathers. It is imperative to understand their needs and experiences to provide appropriate support for them. The majority of previous studies were based in Western countries and explored fathers' needs during pregnancy and childbirth, with few studies conducted in the postnatal period. In Singapore, a multiracial society with differing paternal cultural values from its Western counterparts, there is considerable need to examine the experiences and needs of first-time fathers.

DESIGN

A descriptive qualitative design was used.

METHODS

Data were collected from November 2015-January 2016. Fifteen first-time fathers were recruited from two postnatal wards of a public hospital, using a purposive sampling method. A semi-structured interview guide was used to conduct face-to-face interviews. A thematic analysis was conducted and ethics approval was sought for this study.

RESULTS

Four overarching themes and seventeen subthemes were generated. The four overarching themes were: (1) No sense of reality to sense of responsibility; (2) Unprepared and challenged; (3) Support: needs, sources, experience and attitude; and (4) Future help for fathers.

CONCLUSION

Fathers undergo a transition phase where they have unmet support needs during the early postnatal period. Understanding and addressing these needs may facilitate smooth transition to fatherhood. This study's findings can be used to involve fathers and design future supportive educational programs to promote positive parenting experiences and family dynamics.

Midwives perceptions of partner presence in childbirth pain alleviation in Nigeria hospitals

OBJECTIVE

partner presence in the labour room can influence childbirth pain outcomes and maternal well-being. We examined midwives' perception of the use of partner presence in the management of childbirth pain in Nigerian hospitals.

DESIGN

a descriptive cross-sectional quantitative study.

SETTING

maternity units of four hospitals in Abuja, Nigeria, Jun.-Dec., 2014.

PARTICIPANTS

100 midwives selected through convenience sampling.

MEASUREMENTS

data collected using the Abuja Instrument for Midwives (AIM) questionnaire underwent frequency, correlation, and content analysis.

FINDINGS

most midwives felt partner presence contributed to pain relief and were willing to allow partner presence as an intervention for childbirth pain. However, only every fourth midwife reported using partner presence as a pain management intervention.

KEY CONCLUSION

partner presence is perceived as contributing to pain relief and is a non-pharmacological technique reported to be utilised by midwives for pain management during childbirth. However, Nigeria suffers from poor utilisation of partner presence as a pain management intervention during childbirth.

IMPLICATION FOR PRACTICE

information from this study can improve midwifery practice and aid further research regarding midwives' attitudes, knowledge and usage of partner presence in pain management during childbirth.

"That was intense!" Spirituality during childbirth: a mixed-method comparative study of mothers' and fathers' experiences in a public hospital

BACKGROUND

While spirituality is well described in end-of-life care literature, research on its place in the delivery room remains largely limited to mother-oriented qualitative studies focusing on life-threatening situations (e.g., high-risk pregnancies). Our aim was to compare mothers' and fathers' spirituality during childbirth.

METHODS

A mixed methods questionnaire was developed from our childbirth-related spirituality categorization and distributed to all parents of newborns, 12-24 h postpartum, over 45 consecutive days. Paired-sample t-tests and qualitative thematic analysis were used to compare mothers and fathers. Multiple linear regressions identified factors associated with their respective global scores (vaginal and cesarean deliveries separately).

RESULTS

The global scores for mothers (38.6/50) and fathers (37.2/50) were similarly high (N = 197; p = 0.001). Highest-ranked ("respect", "moral responsibility", "beauty of life", "gratitude") and lowest-ranked spiritual themes ("prayer", "greater than self") were in agreement. Fathers scored higher on "fragility of life" (p = 0.006) and mothers on "self-accomplishment" (p‹0.001), "letting go" (p‹0.001), and "meaningfulness" (p = 0.003). "Admission of baby in neonatal unit" was associated with higher global score for both mothers and fathers. Other factors also increased fathers' (witnessing a severe tear) and mothers' scores (birthplace outside Canada; for vaginal deliveries, religious belonging and longer pushing stage).

CONCLUSION

These first quantitative data on the prevalence of spirituality during childbirth highlight a high score for both parents, among a non-selected public hospital population. Spirituality emerges not only from unordinary situations but from any childbirth as an "intensification of the human experience". Significant differences for some spiritual themes indicate the need to consider the spirituality of both parents.

[Translation and validation in French of the First-Time Father Questionnaire]

OBJECTIVES

For fathers, being present at a birth for the first time is not an insignificant event. Witnessing suffering can cause feelings of loneliness and powerlessness, which may be associated with postnatal problems such as depression. However, without a confirmed French-language tool concerning the experience of childbirth for fathers, we are limited in our ability to develop our understanding of their experiences and establish links between these experiences and their distress (anxiety, depression, etc.), or to develop appropriate methods of support. Our objective has been to translate and validate the Swedish "First-Time Father Questionnaire" with a French-speaking sample.

METHODS

The tool was translated using a translation/backtranslation process (using two independent agencies, with a pre-test on 30 new fathers as well as exchanges with the Swedish authors). The French version was then tested with 154 new fathers at 1 month post-partum. Factorial analysis followed by multi-trait analysis and variance analyses were conducted, with subgroups contrasted according to the mode of delivery.

RESULTS

The factorial structure is satisfactory, retaining 19 items and reproducing 54.12% of variance. Professional support, worry, and prenatal preparation constitute the 3 dimensions of this. Internal consistency, homogeneity, and the discriminating capacity of the questionnaire are good.

CONCLUSION

Validation of the questionnaire shows good metrological qualities. It can therefore be used in the perinatal field to evaluate the childbirth experience for first-time fathers.

Ways of Relating During Childbirth: An ethical responsibility and challenge for midwives

The way in which midwives relate to expectant parents during the process of childbirth greatly influences the parents’ childbirth experiences for a long time. We believe that examining and describing ways of relating in naturally occurring interactions during childbirth should be considered as an ethical responsibility. This has been highlighted in relation to parents’ experiences and in the light of the relational ethics of Løgstrup. Four couples’ and nine midwives’ ways of relating were documented by 27 hours of observation, including 14.5 hours of video-recorded sessions. A qualitative content analysis was conducted. The midwives strongly influenced the different ways of relating and three aspects of professional competence were disclosed. The results can contribute to reflections about current praxis as an ethical demand for midwives.

Vivencias de familiares en sala de espera de trabajo de parto

Objetivo: describir las vivencias de los familiares en sala de espera de trabajo de parto. Materiales y métodos: estudio cualitativo etnográfico. Se entrevistaron diez participantes y cuatro grupos focales; la saturación se logró cuando los investigadores no encontraron más explicación, interpretación o descripción de la experiencia. Para el análisis, se usó el método de Spradley, se construyeron categorías y dominios, y se realizó análisis taxonómico. Se desarrollaron notas de campo y observación participante. Se utilizó el software Atlas ti. Resultados: los familiares experimentan necesidades de información oportuna y eficiente. El lenguaje verbal y no verbal y el contenido de la información les produjo ansiedad e incertidumbre. Los familiares sienten la necesidad de acompañar a la gestante durante el trabajo de parto para brindarle apoyo. El ambiente en la sala de espera depende de los factores internos del familiar y los factores externos de la sala. La educación en la sala de espera representó una excelente oportunidad para aprovechar el tiempo. Emergieron los dominios: comunicación terapéutica, acompañamiento, ambiente y educación. Conclusión: el significado cultural de esperar es un acontecimiento de la vida altamente significativo, atravesado por cuatro circunstancias: la comunicación, el acompañamiento, el ambiente de la sala y la educación, situaciones que cambiaron la experiencia del nacimiento.

First-time fathers' experiences of normal childbirth

OBJECTIVE

To identify and describe first-time fathers' experiences of normal childbirth.

DESIGN

A qualitative interview study using a thematic analysis for analysing the transcripts.

PARTICIPANTS

purposeful sampling was used. Eight men were interviewed two to six months after experiencing childbirth. Participants were men who had become fathers for the first time.

SETTING

A county located in the middle of Sweden covering both urban and rural areas.

FINDINGS

The analysis resulted in one major theme - a transformative experience - with four sub-themes: preparing for childbirth, feeling vulnerable in a new situation, being confirmed as part of a unit, and meeting their child for the first time.

KEY CONCLUSIONS

The findings indicate that the needs of prospective fathers should be given more recognition during childbirth. The findings also show that the midwife is an important person for prospective fathers, both before and during the birth.

IMPLICATIONS FOR PRACTICE

The findings of the study show what affects first-time fathers' experiences of childbirth. By listening to fathers and recognising them as part of a unit with the woman giving birth, midwifes can support them and increase their participation. Thereby, they can find their role in an unfamiliar situation and thus have a positive experience of childbirth.

Partners' perspective on care-system support before, during and after childbirth in relation to parenting roles

OBJECTIVES

To explore (i) ways in which partners experience support from care systems before, during, and after childbirth in relation to their parenting roles and (ii) ways in which support can improve.

METHODS

Four focus group interviews (n = 17; median age = 35; age range = 24-46) and inductive content analysis.

RESULTS

Analysis revealed the following three categories: (1) Care staff include or exclude in relation to partners' parenting role; (2) Care systems continuity; (3) Being a supportive partner. The latent content of the categories was formulated into a theme: being engaged and wanting to be included.

CONCLUSIONS

Because partners are engaged parents, who support the woman giving birth, they must feel included during pregnancy, birth, and postpartum care and during encounters within child health care units. This would require (i) information that directly targets partners before and after childbirth, (ii) specially adapted venues for parent education, and (iii) personal, partner-focused discussions with care staff.

A narrative review of fathers' involvement during labour and birth and their influence on decision making

OBJECTIVE

to identify and critically review the research literature that has examined fathers׳ involvement during labour and birth and their influence on decision making.

DESIGN

the review follows the approach of a narrative review. Systematic searches of electronic databases Social Services Abstract, Sociological Abstracts, ASSIA, CINAHL Medline, Cochrane library, AMED, BNI, PsycINFO, Embase, Maternity and Infant care, DH-Data and the Kings Fund Database were combined with manual searches of key journals and reference lists. Studies published between 1992 and 2013 examining fathers׳ involvement during intrapartum care were included in the review.

FINDINGS

the findings of this review suggest that fathers׳ level of involvement during labour ranges from being a witness or passive observer of labour and birth to having an active supporting and coaching role. The findings also suggest that there are a number of facilitators and barriers to fathers׳ involvement during labour and birth. There are a limited number of studies that have examined fathers׳ involvement in decision making and specifically how fathers׳ influence decision making during labour and birth.

KEY CONCLUSIONS

future research needs to address the gap in the literature regarding fathers׳ involvement and influence on decision making to help midwives and obstetricians understand the process in order enhance the transition to parenthood for women and men.

Men, maternity and moral residue: negotiating the moral demands of the transition to first time fatherhood

This article discusses men's transition to first time fatherhood, with a focus on the way they recognise various in-tension moral demands and negotiate an appropriate role for themselves. The findings are taken from a longitudinal study, drawing on elements of grounded theory, comprising a series of face-to-face and telephone interviews with 11 men over a 9-month period from the 12(th) week of pregnancy to 8 weeks after the birth. The analysis focuses on men's feelings and experience of exclusion and participation, and their response and reaction to that experience. The findings present two descriptive themes, 'on the inside looking in' and 'present but not participating', followed by third theme 'deference and support: a moral response' that exposes the dilemmatic nature of men's experience and explains the participants' apparent acceptance of being less involved. The discussion explores the concept of moral residue, arguing that while deference and support may be an appropriate role for fathers in the perinatal period it may also be a compromise that leads to feelings of uncertainty and frustration, which is a consequence of being in a genuinely dilemmatic situation.

A meta-synthesis of fathers' experiences of their partner's labour and the birth of their baby

OBJECTIVE

to develop greater understanding of how expectant fathers experience their partner's labour and the subsequent birth of their baby.

DESIGN

a qualitative meta-synthesis. Data were search for in CINAHL, PubMed, Psych Info and SCOPUS.

SETTING

eight studies conducted in England, Malawi, Nepal and Sweden were included.

PARTICIPANTS

120 fathers with experiences of their partner having a spontaneous vaginal, assisted or surgical birth.

MEASUREMENTS AND FINDINGS

1st order themes were identified and subsequently grouped into seven 2nd order themes. Finally through a process of exploring patterns and connections seven 3rd order themes were developed which produced new insights into the men's experiences of labour and birth. This meta-synthesis revealed that most men wanted to be actively involved in their partner's labour, present at the birth and respected for what they could contribute. Men recognised that birth was a unique event that may be potentially challenging requiring a level of preparation. There were also men who felt pressured to attend. During the actual experience of labour men commonly expressed overwhelming feelings and inadequacy in their ability to support their partner. They particularly struggled with the 'pain' of labour. Midwives were subsequently identified as best placed to make a significant difference to how men perceived their experiences of labour and what they described as the life changing event of birth.

KEY CONCLUSIONS

the expectant fathers' birth experiences were multidimensional. Many were committed to being involved during labour and birth but often felt vulnerable. Being prepared and receiving support were essential elements of positive experience as well as contributing to their ability to adequately support the labouring woman.

IMPLICATIONS FOR PRACTICE

men's ability to actively prepare for, and be supported through, the labour and birth process influences their perceptions of the childbirth event as well as their sense of connection to their partner. Couples should be given opportunities to explore expectations and how these may influence their own construction of their role during the birth process. While the role of expectant fathers in labour and birth should be facilitated and supported arguably their wish not to participate should be afforded the same respect.

'As long as they are safe--birth mode does not matter' Swedish fathers' experiences of decision-making around caesarean section

BACKGROUND

Decision-making in childbirth involves considerations about both the mother and her unborn baby's wellbeing. For men the safety of both is paramount.

AIM

To explore and describe Swedish fathers' beliefs and attitudes around the decision for a caesarean section.

METHODS

Qualitative descriptive study. Twenty one Swedish men whose partners had experienced elective or emergency caesarean participated in a telephone interview. Thematic data analysis was used.

FINDINGS

The theme, 'Childbirth is Risky', included "Caesarean birth has lots of advantages" and "Birth mode does not matter". In the context of having experienced a caesarean section male partners considered birth mode to be irrelevant. The majority considered caesarean to be a quick and efficient way of giving birth which equated to being safer. Most men could articulate some risks associated with caesarean but these were mainly minimised. The second theme, 'Simply a matter of trust: Birth mode is not my decision', reflected men's belief that they had little to contribute to the decisions made around birth mode. The decision for a caesarean section was considered to lie with the medical practitioner.

CONCLUSION

Mode of birth was regarded as unimportant. The recommendation for a caesarean section was readily accepted and appreciated, and shifted responsibility for birth to the medical practitioner. Involving men in the decision-making process by means of giving them information was valued. Men's limited knowledge about the risks of a caesarean may contribute to birth mode decisions. Professionals need to provide balanced and correct information within the context of individual circumstances.

Paternal fears of childbirth: a literature review

To date, most studies on paternal childbirth fears have been exploratory or descriptive, conducted outside of the United States, and focused mainly on White, first-time fathers. Identified fears include harm to the mother or newborn, partner pain, feelings of helplessness, lack of knowledge, and fear of high-risk intervention. Fathers often report that childbirth classes are not helpful and, in some cases, even increase their fears. Some fathers view birth as traumatic, changing their perception of and relationship with their partner. Fathers also voice the need for more information and for reassurance that they are doing the right things for their partner during childbirth. This article summarizes the research findings on paternal childbirth fears and recommends topics for future study.

A qualitative study of new fathers' experiences of care in relation to complicated childbirth

OBJECTIVES

The objective of the study was to describe new fathers' experiences with care related to complicated childbirth.

METHODS

A qualitative approach consisting of individual interviews using a semi-structured interview guide with open-ended questions was applied. A purposive sample of eight fathers participated. The interview text was subjected to qualitative thematic content analysis.

RESULTS

Analysis revealed the following three categories: (1) feeling scared and uncared for during acute situations; (2) appreciating the opportunity to participate in care and becoming a family; and (3) needing continued care. Based on these three categories, a recurring theme was identified: struggling to be recognized by care staff as a partner in the family was revealed.

CONCLUSION

Although fathers lack support and understanding from care staff, they strive to fulfill their roles as fathers by guarding their families and keeping them together. Caregivers involved in the childbirth process should realize that by acknowledging and encouraging fathers in these roles, they in turn support the entire family unit. Interventions developed for fathers and family care requires further development. Additional research concerning how midwives and critical care nurses (CCNs) view the presence of fathers in the emergency situations that may accompany childbirth is also needed.

Parents' experiences of an instrumental vaginal birth findings from a regional survey in Sweden

OBJECTIVE

An instrumental vaginal birth is known to affect women's birth experience, few studies have explored the fathers' experiences of attending such a birth. The aim of this study is to compare birth outcome and parents' feelings in parents with instrumental vaginal birth or a spontaneous vaginal birth.

METHODS

A regional survey was conducted of 936 mothers and 827 fathers recruited in mid-pregnancy and followed up 2 months after birth. Data was collected by questionnaires. Crude and adjusted odds ratios with a 95% confidence interval were used in the analysis.

RESULTS

The prevalence for instrumental vaginal birth was 9%. Prolonged labour (OR 8.3; 95% CI 5.0-13.9), augmentation with synthetic oxytocin (OR 5.1; 2.9-8.9), and birth complications (OR 2.5; 1.5-2.6) were more common in the instrumental vaginal group. An instrumental vaginal birth was associated with a negative birth experience for mothers (OR 3.2; 1.3-8.1) and fathers (OR 5.2; 1.2-21.5). Mothers who had an instrumental vaginal birth were more likely to report feelings that the baby would be damaged during birth (OR 3.0; 1.7-5.5) and that the birth experience made them decide not to have any more children (OR 3.4; 1.1-10.7). Fathers reported a near-panic feeling when attending an instrumental vaginal birth (OR 5.2; 1.7-15.5).

CONCLUSION

An instrumental vaginal birth was correlated with longer and more complicated births, epidurals and oxytocin augmentation. It affected the birth outcome and parents' feelings and was associated with future reproductive thoughts and a negative birth experience.

Exploring Professional Support Offered by Midwives during Labour: An Observation and Interview Study

Support in labour has an impact on the childbirth experience as well as on childbirth outcomes. Both social and professional support is needed. The aim of this study was to explore professional support offered by midwives during labour in relation to the supportive needs of the childbearing woman and her partner. The study used a qualitative, inductive design using triangulation, with observation followed by interviews. Seven midwives were observed when caring for seven women/couples in labour. After the observations, individual interviews with midwives, women, and their partners were conducted. Data were analysed using hermeneutical text interpretation. The results are presented with three themes. (1) Support as a professional task seems unclear and less well defined than medical controls. (2) Midwives and parents express somewhat different supportive ideas about how to create a sense of security. (3) Partner and midwife interact in support of the childbearing woman. The main interpretation shows that midwives' supportive role during labour could be understood as them mainly adopting the "with institution" ideology in contrast to the "with woman" ideology. This may increase the risk of childbearing women and their partners perceiving lack of support during labour. There is a need to increase efficiency by providing support for professionals to adopt the "with woman" ideology.

Father for the first time--development and validation of a questionnaire to assess fathers' experiences of first childbirth (FTFQ)

BACKGROUND

A father's experience of the birth of his first child is important not only for his birth-giving partner but also for the father himself, his relationship with the mother and the newborn. No validated questionnaire assessing first-time fathers' experiences during childbirth is currently available. Hence, the aim of this study was to develop and validate an instrument to assess first-time fathers' experiences of childbirth.

METHOD

Domains and items were initially derived from interviews with first-time fathers, and supplemented by a literature search and a focus group interview with midwives. The comprehensibility, comprehension and relevance of the items were evaluated by four paternity research experts and a preliminary questionnaire was pilot tested in eight first-time fathers. A revised questionnaire was completed by 200 first-time fathers (response rate = 81%) Exploratory factor analysis using principal component analysis with varimax rotation was performed and multitrait scaling analysis was used to test scaling assumptions. External validity was assessed by means of known-groups analysis.

RESULTS

Factor analysis yielded four factors comprising 22 items and accounting 48% of the variance. The domains found were Worry, Information, Emotional support and Acceptance. Multitrait analysis confirmed the convergent and discriminant validity of the domains; however, Cronbach's alpha did not meet conventional reliability standards in two domains. The questionnaire was sensitive to differences between groups of fathers hypothesized to differ on important socio demographic or clinical variables.

CONCLUSIONS

The questionnaire adequately measures important dimensions of first-time fathers' childbirth experience and may be used to assess aspects of fathers' experiences during childbirth. To obtain the FTFQ and permission for its use, please contact the corresponding author.

The expectations of fathers concerning care provided by midwives to the mothers during labour

Midwives have been criticised for neglecting the expectations and needs of fathers. They either ignore the fathers or pressure them into becoming more involved than they would choose, if allowed to provide support to the mothers during labour. Whilst midwives are providing woman-centred care, it is important that they remember to involve the fathers in decision-making and to acknowledge their role, expectations and needs, because the birth of a child is one of the most important events in a person’s lifetime. This study focused on fathers’ expectations of the care provided to mothers by the midwives during labour. A qualitative, explorative, descriptive and contextual study design was utilised. In-depth qualitative interviews were conducted with fathers about the care provided to their partners or wives by midwives. Data were then analysed with an open descriptive method of coding that is appropriate for qualitative research. The results of the interviews were subsequently positioned within a holistic health-promotive nursing theory that encompassed body, mind and spirit. The results revealed that fathers saw the provision of comfort and support as the two main aspects for mothers in labour that they expected from midwives. The findings were that midwives should improve their communication skills with the mothers, as well as with the fathers if they are available. Fathers expected midwives to encourage them to accompany the mother during labour and to facilitate bonding between father, mother and baby. The results of this study should assist midwives to provide holistic quality care to mothers and fathers during labour.OpsommingVroedvroue word daarvan beskuldig dat hulle nie voldoen aan die verwagtinge en behoeftes van die vaders nie. Vaders word, óf deur hulle geïgnoreer, óf druk word op hulle uitgeoefen om meer betrokke te raak as waarmee hulle gemaklik is, indien hulle wel toegelaat word om moeders te ondersteun tydens die kraamproses. Vroedvroue verskaf moeder-gesentreerde sorg, maar dit is nogtans belangrik dat hulle onthou om die vaders te betrek in die besluitneming en hulle rol, verwagtinge en behoeftes te erken omdat die geboorte van ‘n kind een van die belangrikste gebeurtenisse in hulle lewens is. Die studie het gefokus op vaders se verwagtinge van die sorg wat verskaf word aan moeders tydens kraam. ‘n Kwalitatiewe, eksploratiewe, beskrywende en kontekstuele navorsingsontwerp is gebruik. Data is ingesamel deur in-diepte onderhoude met vaders te voer oor die sorg wat aan hul vroue of metgeselle tydens die kraamproses verskaf word deur vroedvroue. Data is daarna geanaliseer deur ‘n oop beskrywende metode te gebruik wat toepaslik is vir kwalitatiewe navorsing. Die resultate van die onderhoude is vervolgens geposisioneer binne ‘n holistiese, gesondheids-bevorderende teorie wat verwys na liggaam, psige en gees. Die resultate toon dat gemak en ondersteuning die twee hoofkategorieë is wat verskaf moet word deur vroedvroue aan moeders tydens die kraamproses. Die ander kategorieë wat aangedui word in die resultate, is dat vroedvroue hulle onderlinge kommunikasievaardighede moet verbeter, asook hul kommunikasie met die moeders en vaders indien laasgenoemde beskikbaar is. Die vaders het van vroedvroue verwag om hulle aan te moedig om moeders by te staan tydens die kraamproses en om binding tussen vader, moeder en baba aan te moedig.

A qualitative investigation into the pregnancy experiences and childbirth expectations of Australian fathers-to-be

AIM

To explore and describe men's experiences of pregnancy and childbirth expectations.

BACKGROUND

There remains limited work exploring expectant father's perspectives.

DESIGN

Qualitative descriptive design. Twelve Australian expectant fathers participated in between 1 and 2 interviews during pregnancy and 1 after childbirth (32 in total). Six fathers also chose to submit a number of diary entries via e-mail. Thematic analysis was used to analyse the data set.

FINDINGS

Five themes emerged from the data. The themes pregnancy news: heralds profound change adjusting to pregnancy, and birth looming described how men processed the news of pregnancy, worked to accept their changed circumstances and negotiated the final week of the pregnancy. A fourth theme, labelled Feeling sidelined, outlined men's experiences of antenatal care and their feeling of isolation as a result of largely feeling ignored by health care professionals. The fifth theme represents men's childbirth expectations.

CONCLUSION

Adjusting to the news of a pregnancy was a potentially unsettling time for an expectant father that was often associated with increased apprehension and anxiety. Regardless of whether they were a first or once again father most men engaged in a level of emotional work to come to terms with and accept the pregnancy. Understanding men's antenatal experiences and anxieties is an important step in the development of preventative paternal perinatal mental health measures. The significance of this work is situated within the reality that men's wellbeing is associated with maternal psychological well-being, positive peri-natal experiences and child development.

Posttraumatic stress symptoms and postpartum depression in couples after childbirth: the role of partner support and attachment

AIM

The roles of partner attachment and perceptions of partner support were explored in relation to symptoms of posttraumatic stress and postpartum depression in couples within the first three postnatal months.

METHODS

Participants (n=372) were recruited within the first seven days postpartum, and completed questionnaire measures of trait anxiety, symptoms of acute posttraumatic stress, and perceptions of partner support. Postal questionnaires were completed at six weeks and three months, assessing attachment, perception of partner support, symptoms of posttraumatic stress, and postpartum depression. Two hundred and twelve couples completed all time-points.

RESULTS

Results indicated that symptoms were significantly related within couples. Men's acute trauma symptoms predicted their partner's subsequent symptoms of posttraumatic stress. Less secure attachment and dissatisfaction with partner support were associated with higher levels of postpartum depression and posttraumatic stress.

CONCLUSIONS

Men's and women's responses following childbirth appear to be strongly interlinked; services should target both members of the dyad.