Fathers' experiences of their transition to fatherhood: a metasynthesis

The transition to fatherhood - evaluation of an online intervention for new fathers

This mixed-methods study explores an innovative online group intervention for new fathers. The specific aims were to investigate attendance rates, fathers' participation experiences, and the effects on their psychological well-being and marital quality. The research design included a randomized controlled trial with 122 participants split into intervention (n = 62) and comparison groups (n = 60). The study measured post-partum depression symptoms (PPD) using the Edinburgh Post-Natal Depression Scale (EPDS) and spousal relationship quality using the Israeli Marital Quality Scale (IMQS). Qualitative data were collected through session transcripts and feedback questionnaires that were completed two years post- intervention. Results reveal an 86.47% average attendance rate in the intervention groups and positive outcomes at both individual and spousal levels. Participants reported feeling a sense of normalcy, decreased loneliness, increased awareness of fatherhood transition, and becoming active co-parents. Marital quality also showed better results for the intervention group. Further research is recommended to explore online group interventions among additional groups of post-partum fathers.

Fathers' experiences of living with a child with a progressive life-limiting condition without curative treatment options: A qualitative systematic review

AIM

To systematically review and synthesize findings across qualitative primary studies about fathers' experiences of living with a child with a progressive life-limiting condition without curative treatment options (C3 conditions).

DESIGN

Systematic review and metasynthesis.

METHODS

Sandelowski and Barosso's qualitative research methodology guided this review and metasynthesis. A modification of Ricoeur's interpretation theory, described by Lindseth and Norberg, guided the synthesis of qualitative data. The quality of the studies was evaluated using the Joanna Briggs Institute Checklist for Qualitative Research.

DATA SOURCES

A systematic literature search was conducted on 6 May 2022 and updated on 19 July 2023 on MEDLINE, CINAHL Plus with Full Text, APA PsycInfo and Scopus. Inclusion criteria were English-written qualitative studies from the year 2000, from which we could extract data on fathers' experiences of living with a child from 0 to 18 years with a progressive life-limiting condition without curative treatment options.

RESULTS

Seven reports from Western countries contributed to the review. Through structural analysis, we developed the following themes: 'Being shattered in the perception of fatherhood', 'Establishing a new normal' and 'Striving to be acknowledged as a part of the caring team'.

CONCLUSION

Fathers had to establish a new normal, and they experienced anticipatory mourning, role conflicts and feeling sidelined in healthcare settings when living with a child with a C3 condition. An important issue for further research on paediatric palliative care (PPC) should be to include fathers in the research sample and report separately on fathers' or mothers' experiences instead of parents' experiences.

IMPACT

The findings will be of interest to healthcare personnel and multidisciplinary teams working within PPC, as they give insight into fathers' experiences and suggest interventions to increase healthcare personnel's involvement with fathers, such as telemedicine.

REPORTING METHOD

Following EQUATOR guidelines, the study was reported according to the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework.

PATIENT OR PUBLIC CONTRIBUTION

No patient or Public Contribution.

The influence of antenatal imaging on prenatal bonding in uncomplicated pregnancies: a mixed methods analysis

BACKGROUND

Prenatal bonding describes the emotional connection expectant parents form to their unborn child. Research acknowledges the association between antenatal imaging and enhanced bonding, but the influencing factors are not well understood, particularly for fathers or when using advanced techniques like fetal magnetic resonance imaging (MRI). This study aimed to identify variables which may predict increased bonding after imaging.

METHODS

First-time expectant parents (mothers = 58, fathers = 18) completed a two-part questionnaire (QualtricsXM™) about their expectations and experiences of ultrasound (n = 64) or fetal MRI (n = 12) scans in uncomplicated pregnancies. A modified version of the Prenatal Attachment Inventory (PAI) was used to measure bonding. Qualitative data were collected through open-ended questions. Multivariate linear regression models were used to identify significant parent and imaging predictors for bonding. Qualitative content analysis of free-text responses was conducted to further understand the predictors' influences.

RESULTS

Bonding scores were significantly increased after imaging for mothers and fathers (p < 0.05). MRI-parents reported significantly higher bonding than ultrasound-parents (p = 0.02). In the first regression model of parent factors (adjusted R2 = 0.17, F = 2.88, p < 0.01), employment status (β = -0.38, p < 0.05) was a significant predictor for bonding post-imaging. The second model of imaging factors (adjusted R2 = 0.19, F = 3.85, p < 0.01) showed imaging modality (β = -0.53), imaging experience (β = 0.42) and parental excitement after the scan (β = 0.29) were significantly (p < 0.05) associated with increased bonding. Seventeen coded themes were generated from the qualitative content analysis, describing how scans offered reassurance about fetal wellbeing and the opportunity to connect with the baby through quality interactions with imaging professionals. A positive scan experience helped parents to feel excited about parenthood. Fetal MRI was considered a superior modality to ultrasound.

CONCLUSIONS

Antenatal imaging provides reassurance of fetal development which affirms parents' emotional investment in the pregnancy and supports the growing connection. Imaging professionals are uniquely positioned to provide parent-centred experiences which may enhance parental excitement and facilitate bonding.

Fatherhood and Elite Athletics: Sacrifice, Selfishness, and Gaining "Dad Strength"

This study contributes to a growing body of scholarly discussions around the many aspects and challenges of combining parenthood with elite-level sport, with a particular focus on the experiences of male elite athletes who are fathers. We used a caring masculinities theoretical framework, community-based participatory research, and semi-structured interviews to explore the experiences of 10 elite/international and world-class athletes (n = 9 fathers, n = 1 expectant father). Through reflexive thematic analysis, we identified three main themes: fatherhood can (1) improve and (2) impede elite athlete-fathers' athletic performance; and (3) athlete-fathers experience a trade-off between athletic performance and fatherhood responsibilities. Our findings underscore the ways in which male athletes' experiences with parenthood reflect the new era of involved fatherhood and are analogous to some of the identity tensions that have been reported with regard to the experiences of elite female athletes who are pregnant and/or mothers. Recognizing the impact of children on male athletes' athletic careers and the parallels between fatherhood, motherhood, and elite sport may lead to better support for athlete-fathers while also contributing to diminishing the expectation that women are primary caregivers to children.

"It's not just the medical aspects that are important": A qualitative exploration of first-time parents' experiences of antenatal imaging and their influence on parent-fetal bonding

INTRODUCTION

Antenatal imaging provides clinical information regarding fetal growth and development. The additional benefit afforded by imaging for expectant parents in developing an emotional connection (bond) to the unborn baby is also acknowledged. However, the relationship between imaging and bonding is not fully understood, particularly where there are differing parental and pregnancy circumstances, for example use of advanced imaging techniques or the prenatal diagnosis of a congenital fetal condition. This study aimed to explore the role of antenatal imaging in enhancing the developing parent-fetal bond in first-time parents.

METHODS

A descriptive, qualitative methodology was used. Semi-structured telephone interviews were conducted with first-time expectant parents attending a London hospital for clinical ultrasound (n = 20) or research MRI (n = 8) imaging during pregnancy. The sample included parents receiving specialist antenatal care for a diagnosed fetal cardiac condition (n = 8). Thematic analysis was conducted.

RESULTS

The analysis generated three themes: 1) Our baby, our scan too; 2) Destination parenthood; and 3) Being in the dark, then finding the light. These themes highlight the important, but transient role of antenatal imaging in enhancing parent-fetal bonding, as well as the differing care needs of expectant parents. The integral role of healthcare professionals in providing a personalised, supportive, imaging experience to facilitate bonding is also reflected.

CONCLUSION

Adopting parent-centred care approaches which involve expectant parents in fetal imaging influences bonding by helping parents to consider the reality of their impending parenthood. Knowledge acquired during scans is used to create an identity for the unborn baby, which parents can develop an emotional connection to.

IMPLICATIONS FOR PRACTICE

To optimise the potential for enhanced parent-fetal bonding, care provision in fetal imaging should be tailored to the individual needs of expectant parents.

[Fathers, patients in mother and baby unit? Thinking about family-based approach in perinatal care]

BACKGROUND

The perinatal period is a psychic risk for fathers because of multiple overhauls. Fathers' place in perinatal medicine has evolved these last few years but continues to be poorly limited. These psychic difficulties are barely investigated and diagnosed in everyday medical practice. The prevalence of depressive episodes by new fathers was high in the most recent research studies. This thus is a public health problem with consequences on the family system both in the short and the long-term.

REVIEW

In the mother and baby unit, the father's psychiatric care is often secondary. But with societal modifications, there is the question of impact of separation between the father and the mother and the baby. With the family based approach, care by the father is indispensable for the care of the mother, baby, and the family's as a whole.

OBJECTIVE

In our mother and baby unit located in Paris, fathers were also hospitalized as patients. Therefore difficulties in the familial dynamic, between each member of the triad and mental health difficulties of fathers were able to be treated.

CONCLUSION

Following the hospitalization of a few triads with a positive evolution, a reflection process is now in progress.

"Crying on the Bus": First Time Fathers' Experiences of Distress on Their Return to Work

There is increasing research interest in the experiences of new fathers taking paternity leave, but less insight into men's experiences of returning to work after the birth of their first baby. For many men in the UK context, this could take place immediately after the birth or after one or two weeks of paternity leave. This paper utilizes data from a UK-based study whilst also drawing on international literature and policy contexts. A constructivist grounded theory method was adopted to generate theory from the data gathered. Twelve new fathers shared their experiences in this study by participating in audio-recorded, semi-structured interviews. This paper focuses on fathers' experiences of negotiating the workplace as part of an overall theoretical framework related to broader transitions to fatherhood and sheds light on the distress, guilt and psychological challenges that the participants experienced when they initially returned to work. Whether fathers did or did not explicitly describe distress at this time, they all described a change in their worker identity, which for some participants led to uncertainty in the workplace. Men returning to work at this time in the postnatal period are vulnerable to experiencing distress. Flexibility and support in the workplace could be protective of their mental health. Finally, policy and practice developments are offered to support men's transitions to fatherhood in the workplace context.

"Opening up a well of emotions": A qualitative study of men's emotional experiences in the transition to fatherhood

AIM

To explore the emotional changes and reactions men experience in their transition to fatherhood.

DESIGN

This study used a qualitative design.

METHODS

Data were collected through in-depth interviews with 13 Norwegian fathers.

RESULTS

Through thematic analysis, three main themes were developed: (1) from self-focus to family perspective; (2) emotional vulnerability; and (3) from insecurity to self-assurance. The themes describe fathers' emotional process during the child's first year of life, ranging from positive feelings like affection and mastery, to challenging feelings like exclusion, jealousy and exhaustion. Many fathers describe taboos and shame over their own emotional reactions, although these can be considered a natural part of the postnatal period.

Paternal pregnancy-related anxiety: Systematic review of men's concerns and experiences during their partners' pregnancies

BACKGROUND

Up to 25 % of expectant parents experience anxiety symptoms. Pregnancy-related anxiety is characterised by concerns and worries specific to pregnancy, childbirth, and the transition to parenthood. While pregnancy-related anxiety is well-researched in women, the exact nature of this construct in men is unclear. The purpose of the current review was to examine men's concerns, worries, and fears during pregnancy and gain an understanding of their experiences during pregnancy.

METHODS

An integrative review design was adopted, using thematic content analysis to synthesise findings from quantitative and qualitative studies. Quality appraisal of the quantitative studies used the AXIS appraisal tool. The Critical Appraisal Skills Program (CASP) checklist was used for the qualitative studies.

RESULTS

A comprehensive search of nine databases led to inclusion of 14 quantitative and 41 qualitative studies. Ten dimensions of paternal pregnancy-related anxiety were identified: childbirth concerns, attitudes towards childbirth, baby concerns, acceptance of pregnancy, partner concerns, relationship concerns, worry about self, transition to parenthood, attitudes towards health care professionals, and practical and financial concerns. The pregnancy transition was characterised by mixed emotions and conflicted experiences for fathers.

LIMITATIONS

Generalizability of review findings was limited by poor reporting of demographic information by many included studies, exclusion of studies not published in English, and focus on heterosexual relationships.

CONCLUSIONS

Expectant fathers may experience anxiety symptoms characterised by excessive worry across multiple domains of pregnancy-related concerns. Clinicians play an important role in identifying and supporting fathers with pregnancy-related anxiety and addressing the sense of exclusion often experienced by them.

Effects of spousal support in the early postpartum period on breastfeeding motivation in patriarchal societies

Background and Purpose: Breastfeeding is important with regard to public health. Our aim was to examine effects of spousal support in the early postpartum period on breastfeeding motivation in patriarchal societies. Methods: Study was descriptive, cross-sectional, correlational design. Study was conducted in a University Hospital in Inland Anatolia Region in Turkey. It included primiparous and multiparous women. Results: Analysis showed a significant positive, moderate relation between spousal support and breastfeeding motivation in the primiparous women; spousal support accounted for 23.8% of breastfeeding motivation of the women. There was a significant, positive weak relation between spousal support and breastfeeding motivation in the multiparous women; spousal support explained 8.2% of breastfeeding motivation in these women. Conclusion: Spousal support in the early postpartum period was found to have a positive influence on improvement of breastfeeding motivation. However, it could explain a small percentage of breastfeeding motivation. New strategies should be created to encourage spouses to get involved in breastfeeding.

The Current Concept of Paternal Bonding: A Systematic Scoping Review

Bonding is crucial to perinatal mental health. Despite an extensive body of literature on maternal bonding, few studies have focused on paternal bonding. This scoping review aimed to clarify the current state of the concept of paternal-infant/fetus bonding. The eligibility criteria were drawn from the population concept and context elements to answer the following questions: "what is paternal bonding?" and "what are the constructs of the concept of paternal bonding?" The review comprised 39 studies. Paternal bonding was associated with both positive and negative paternal behavior and thought and may be determined based on fathers' beliefs and rearing history. Most studies showed that father-child interaction is one of the factors promoting paternal bonding. However, fathers generally felt more distant from their babies post-delivery than mothers. Only a few studies originally defined paternal bonding; most relied on the definitions of maternal bonding. We found different descriptions lacking consensus. Few studies examined the differences between paternal and maternal bonding. No consensus exists on the concept, constructs, and assessment of paternal bonding. The causal relationship between paternal bonding and other variables is unexplored. Future studies should explore fathers' perspectives and experiences, focusing on the unknown aspects of paternal bonding identified in this review.

Opinions of Non-English Speaking Fathers in the Antenatal and Delivery Room

This study investigated the demographic differences, newborn outcomes, and psychological experiences of English speaking (ES) and non-English speaking (NES) fathers in antenatal and delivery rooms. One thousand fathers completed antenatal and delivery questionnaires. Thirty-three percent of NES fathers were smokers, compared to 26% of ES fathers. NES fathers also reported significantly lower elective cesarean surgery rates. However, intrauterine growth restriction was significantly higher amongst the NES newborn cohort. Further, nursery admission of newborns born to NES fathers was more than double that of ES fathers. NES fathers self-reported more psychological symptoms after delivery than ES fathers (31% vs 19%). This study highlights the dual need for more research into NES perinatal experiences and change in pregnancy management for NES families.

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.

Fathers' perceptions and experiences of support to be a parenting partner during the perinatal period: A scoping review

AIMS AND OBJECTIVES

The aim of this study was to explore fathers' perceptions and experiences of support in the perinatal period. Change in society has seen the increased visibility of fathers being involved during pregnancy and engaging in their infants' lives and the expectation and benefits of men playing an equal and direct role in caring for their children. However, less is known about the nature of support that fathers require to facilitate this role transition.

DESIGN

A scoping review was conducted in accordance with Arksey and O'Malley's six-step scoping review framework and the PRISMA-ScR guidelines.

METHODS

A systematic search of CINAHL Plus, MEDLINE, the Cochrane Library, PsycARTICLES, PsycINFO, Psychology, Soc INDEX and Behavioural Sciences Collections databases for qualitative or mixed methods studies with qualitative data was undertaken. Qualitative data were extracted from original studies for coding and theme generation. Thematic synthesis was employed for the final stages of analysis.

RESULTS

Overall, 23 papers were included. Men desired to fulfil their rite of passage to be an involved father to their child. This transitional process commenced with men articulating their commitment to creating a role as an involved father and to be a role model for their children. Becoming a father is seen as having a significant status in society which contributes to their self-efficacy as fathers.

CONCLUSION

Fathers require support from all levels of the 'ecosystem' including policy, socio-cultural and workplace changes as well as recognition and support from partners, family, peers and in particular from health service providers. Developing the parenting partnership requires a co-production approach and commitment at macro, meso and micro levels.

RELEVANCE TO CLINICAL PRACTICE

Supporting men to be engaged fathers requires policy, socio-cultural and workplace changes; however, maternity services and particularly midwives have an important role in this change.

Quality of Life instruments and their psychometric properties for use in parents during pregnancy and the postpartum period: a systematic scoping review

Purpose

To identify instruments used to measure parents’ Quality of Life (QoL) during pregnancy and the postpartum period, and to describe their characteristics and psychometric properties.

Methods

For this scoping review we conducted systematic literature searches in MEDLINE, EMBASE, PsychINFO, CINAHL and HaPI in mid-December 2020, to identify studies evaluating psychometric properties. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used to define and categorize psychometric properties. Two reviewers screened the studies independently, and customized screening questions were used to assess eligibility against inclusion criteria. Data were systematically extracted into a predesigned data charting matrix, and descriptively analyzed.

Results

The searches identified 5671 studies, of which 53 studies met the inclusion criteria. In total, there were 19 QoL instruments: 12 generic and seven period specific. The most reported instruments were SF-36, SF-12 and WHOQOL-BREF, and the most evaluated instruments were SF-12, WHOQOL-BREF, QOL-GRAV, and PQOL. We found that none of the identified instruments had been evaluated for all nine psychometric properties recommended by the COSMIN. The most reported psychometric properties were internal consistency and structural validity. The instruments were primarily assessed in parents residing in Asia (50%), and 83% of the studies were conducted from 2010 to 2020. Only three studies included psychometric measures assessed on fathers.

Conclusion

Our review shows there is extensive evidence on the internal consistency and structural validity of QoL instruments used on parents during pregnancy and the postpartum period, but that the evidence on other psychometric properties is sparse. Validation studies and primary studies are needed to provide evidence on the reliability, validity, responsiveness, and interpretability of QoL instruments for this target group, in particular for fathers and partners.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-02011-y.

Alexithymic traits and parental postpartum bonding: Findings from the FinnBrain Birth Cohort Study

In the postpartum period, some parents experience problems in bonding with the infant, which can lead to difficulties in adjusting to the parental caregiving role. Alexithymia, through deficits in emotional processing, could potentially be associated with problems in parental postpartum bonding. In the current study, this association has been explored in a large population-based sample of mothers and fathers, and to our knowledge, this is the first study to investigate this association. The study population (n = 2,671) was part of the FinnBrain Birth Cohort study and included 1,766 mothers and 905 fathers who returned The Postpartum Bonding Questionnaire (PBQ) at three months postpartum and the 20-item Toronto Alexithymia Scale (TAS-20) at six months postpartum. Correlation analyses and hierarchical regression modeling, adjusted for selected background factors, were performed separately for mothers and fathers. The alexithymia dimension "Difficulty Identifying Feelings" (DIF) in mothers and fathers, and additionally dimensions of "Difficulty Describing Feelings" (DDF) and "Externally Oriented Thinking" (EOT) in fathers were associated with weaker postpartum bonding, when related background factors were controlled for. To our knowledge this was the first study to investigate the relationship between parents' alexithymic traits and postpartum bonding within a large birth cohort study population. The main finding was that especially higher levels of maternal DIF and paternal EOT were associated with weaker postpartum bonding. Longitudinal studies are needed to establish the potential causality of this relationship.

Depressive symptoms in men immediately after birth

OBJECTIVE

Depression is the second leading cause of morbidity worldwide. This study aimed to assess the prevalence and associated risk factors of paternal postpartum depressive symptoms (PPD).

METHODS

In a cross-sectional study, via a stratified random and convenience sampling method 591 couples who were referred to Mazandaran primary health centers between 2 and 8 weeks postpartum were recruited from March to October 2017. Couples were screened for depressive symptoms using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ-12) as well. Data was analyzed using multiple logistic regression.

RESULTS

Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age, maternal depressive symptoms, higher GHQ-12 scores and increased recent life events were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD.

CONCLUSION

Depressive symptoms especially in first-time fathers following the birth of a child are not uncommon. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease suffering of depression for both depressed parents are recommended.

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.

Going blindly into the women's world: a reflective lifeworld research study of fathers' expectations of and experiences with municipal postnatal healthcare services

Purpose: The aim of this study is to describe new fathers’ expectations of and experiences with municipal postnatal healthcare services.

Methods: A phenomenological reflective lifeworld research (RLR) approach has been used. Ten fathers were interviewed about their expectations of and experiences with municipal postnatal healthcare services, and the data were analysed to elucidate a meaning structure for the phenomenon.

Results: The essential meaning of the phenomenon of fathers’ expectations of and experiences with municipal postnatal health care described as going blindly into the women’s world. The essential meaning is further explicated through its four constituents: not knowing what to ask for, feeling excluded, seeking safety for the family and longing for care.

Conclusions: Entering the postnatal period with sparse knowledge about the child and family healthcare services available is difficult for the fathers who do not know what to ask for and what to expect. The fathers’ feel excluded by the public health nurse, and the postnatal health care is seen as a mother–baby–public health nurse triad. The feeling of exclusion and inequality might be avoided if public health nurses focused both on mothers’ and fathers’ individual follow-up needs in the postnatal period and on seeing the newborn baby and the parents as a family unit.

Paternal Postpartum Bonding and Its Predictors in the Early Postpartum Period: Cross-Sectional Study in a Polish Cohort

Introduction: Parental postpartum bonding has been studied by many researchers focusing on maternal bonding. The objective of this study was to examine the psychological and socio-demographic predictors of paternal postpartum bonding in the early postpartum period. Methods: In this cross-sectional study, 131 couples (fathers median age of 32.37 years, SD = 4.59; mothers median age of 30.23 years, SD = 3.90) of newborns from full-term pregnancies were recruited from November 2019 until March 2020. The primary outcome was paternal postpartum bonding as measured by the Postpartum Bonding Questionnaire (PBQ). Secondary outcomes included: maternal and paternal anxiety [with the Generalized Anxiety Disorder (GAD) Assessment]; maternal and paternal stress [with the Parental Stress Scale (PSS)]; maternal depressive symptoms [with the Edinburgh Postpartum Depression Scale (EPDS)]; and maternal and paternal socio-demographic variables as fathers' presence at childbirth, education level, age, and parental experience. Results: Paternal postpartum bonding was significantly correlated with paternal anxiety (moderate strength), maternal stress (strong correlation), and maternal postpartum bonding. No significant correlations between paternal postpartum bonding, maternal depression symptoms, and maternal anxiety were found. The mediating role of paternal stress in paternal postpartum bonding was proven. Paternal anxiety strengthens paternal stress (b = 0.98). Further, a high level of paternal stress disrupts paternal postpartum bonding (b = 0.41). Results of regression analyses have revelated that maternal infant bonding (p < 0.01) and paternal stress (p < 0.01) are the only predictors of parental postpartum bonding across all included variables. None of investigated socio-demographic variables were associated with paternal postpartum bonding. Conclusion: Notwithstanding limitations, the current findings add to a growing body of literature on paternal postpartum bonding. The results have shown that paternal mental health is related to parental postpartum bonding directly after delivery. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04118751.

Paternal symptoms of anxiety and depression in the first month after childbirth: A comparison between fathers of full term and preterm infants

BACKGROUND

Although men have a higher risk of developing a mental disorder during the perinatal period, few studies have focused on new fathers' mental health screening. This study compares anxiety and depression symptoms between fathers with newborn infants in the neonatal intensive care unit (NICU) and fathers of healthy full-term infants, assessing the impact of stress caused by the NICU..

METHODS

A longitudinal and prospective study with control (n= 33) and study groups (n=51) was designed. The dependent variables assessed were post-natal depression and anxiety-state while the social and demographic information, health background and the parental stress in the neonatal unit were the independent variables. The fathers were assessed twice during the first month after birth.

RESULTS

Significant differences in the EPDS scores were found between both groups in the first assessment (p = .006) but not in the second assessment (p = .60). Significant differences in STAI scores were found between the groups for both assessments (p = .003 and p = .002). The stress caused by the infant's appearance and behavior was predictive of depression and anxiety in the study group.

LIMITATIONS

The sample was collected at one hospital, immigrants were underrepresented, and no prenatal assessment of paternal mental health is available.

CONCLUSIONS

Our results suggest that the hospitalization of newborn infants increases the risk of developing anxiety or depression disorder in fathers. Health providers should be aware of the emotional changes in men shortly after childbirth and include them in the screening of and support for mental health disorders.

Satisfaction with Life, Emotions, and Identity Processes in Polish First-Time Mothers and Fathers and Their Child's Age

The experiences of women regarding conception, the birth of the first child, and care of an infant in the perinatal period have long attracted the attention of researchers, but the knowledge about the experiences of men entering the role of fathers for the first time is still insufficient. The aim of the research was to identify the level of satisfaction with life, emotions and identity formation of first-time parents depending on the gender and age of the child. Seventy-five pairs of Polish first-time parents participated in the study. The research used the SUPIN scale (Polish adaptation of Positive and Negative Affect Schedule), the Satisfaction with Life Scale (SWLS), the Dimension of Identity Development Scale (DIDS), and a questionnaire prepared by the authors. On the basis of the conducted research, it can be concluded that there is a similarity of satisfaction with life, experienced emotions, and identity processes of first-time mothers and fathers, as well as the importance of the child’s age for the specificity of developmental changes in women and men. Understanding development changes which include identity, emotional functioning, and life satisfaction of first-time parents can provide bases for creating supporting programs in the case that problems in undertaking the role of a parent emerge.

Connecting with Families through Virtual Perinatal Education during the COVID-19 Pandemic

The COVID-19 pandemic has caused many changes in health care. The status quo has been upended. We have been challenged in many ways to maintain our ability to meet the needs of our clients while keeping them safe. The Center for Perinatal Education and Lactation at NYU Langone Hospitals, in one of the initial epicenters of the pandemic in New York City, had to abruptly transition the childbirth education program to a virtual format in March of 2020. The goal for this change was to continue to provide evidence-based support and guidance our to our expectant and new families through this crisis. This report focuses on the process and challenges of transitioning to and implementation of the virtual format in the context of the COVID-19 crisis. We discuss the rapidly evolving programmatic changes to our approach and reflect on the themes and changing landscape of our newly structured model. Questions and answers live discussion webinars "Ask the Educator" on various topics were a valuable tool in connecting with families and allaying anxiety and fear.

The views and experiences of fathers regarding their young child's intellectual and developmental disability diagnosis: Findings from a qualitative study

AIMS AND OBJECTIVES

To report the views and experiences of fathers following their child's diagnosis of an intellectual and developmental disability (IDD).

BACKGROUND

There is a growing interest in understanding the experiences of fathers of children with IDD given the transformation of the structural change of fathers' roles within the family and wider society.

DESIGN

A qualitative design was used to elicit the view and experiences of fathers.

METHODS

A total of ten Irish fathers participated in face-to-face interviews. The data were thematically analysed. The COREQ guidelines for reporting qualitative studies were used in the development of this paper.

RESULTS

The key themes that emerged were (a) the confirmation of the child's diagnosis (b) the impact of the diagnosis and (c) father's motivation to participate in disability research.

CONCLUSIONS

This study informs and develops a further understanding of the international evidence base of fathers receiving a confirmation of a child's diagnosis of an intellectual and developmental disability, the impact of the diagnosis on fathers and their motivation to share their stories to add to the disability research. Health and social care practitioners have important contributions to make in meeting the needs of fathers. There are specific areas to consider in terms of practice, education and research that require further attention and development to ensure fathers' distinct needs regarding their child's diagnosis of IDD are known and responded to effectively.

RELEVANCE TO CLINICAL PRACTICE

This study highlights that when the child's disability is confirmed, fathers experience a diverse range of mixed emotions. Health and social care practitioners including nurses need to be aware of the impact of the diagnosis upon fathers. There is scope to develop the knowledge, skills and confidence of health and social care practitioners regarding the experiences of fathers and how they can further support fathers and their families during the critical time of a disability disclosure.

"They Just Need to Come Down a Little Bit to your Level": A Qualitative Study of Parents' Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

The first 1000 days is a critical window of opportunity to promote healthy growth and associated behaviours. Health professionals can play an important role, in part due to the large number of routine contacts they have with parents. There is an absence of research on the views of parents towards obesity prevention and the range of associated behaviours during this time period. This study aimed to elicit parents’ views on early life interventions to promote healthy growth/prevent childhood obesity, particularly those delivered by health professionals. Semi-structured interviews were conducted with 29 parents (24 mothers, 5 fathers) who were resident in Ireland and had at least one child aged under 30 months. Data were analysed using reflexive thematic analysis. Two central themes were generated: (1) navigating the uncertainty, stress, worries, and challenges of parenting whilst under scrutiny and (2) accessing support in the broader system. Parents would welcome support during this critical time period; particularly around feeding. Such support, however, needs to be practical, realistic, evidence-based, timely, accessible, multi-level, non-judgemental, and from trusted sources, including both health professionals and peers. Interventions to promote healthy growth and related behaviours need to be developed and implemented in a way that supports parents and their views and circumstances.

Transition to fatherhood in the prenatal period: a qualitative study

Becoming a father requires a process of personal development, inner reorientation, and adaptation to a new role. The literature on this process has been sparse, devaluing how challenging and problematic the transition to becoming a father can be. This qualitative, exploratory, descriptive, cross-sectional and retrospective study sought to understand the experiences of men in the transition to fatherhood during the prenatal period. It included a sample of 10 men experiencing, for the first time, a partner's pregnancy. The data collection technique used was semi-structured interviews. The content analysis technique with semantic categorization and an inductive approach was used to analyze the data. As a result, 3 topics emerged: "experiencing the transition," "development of the father identity" and "(de)constructing bridges for the transition". This study deepens the understanding of this developmental transition and challenges the restructuring of prenatal care towards the inclusion of the father figure.

Paternal mental health during the perinatal period: A qualitative systematic review

AIMS

To examine fathers' experiences and needs associated with mental health during the perinatal period.

DESIGN

Qualitative studies were meta-synthesized using the steps outlined by Sandelowski and Barroso.

DATA SOURCES

Six databases (PubMed, Embase, PsycINFO, CINAHL, Scopus and ProQuest) were searched for qualitative studies from each database's inception to 24 June 2019.

REVIEW METHODS

Studies were critically appraised using the Critical Appraisal Skills Program tool. Qualitative data were extracted, meta-summarized, then meta-synthesized.

RESULTS

Fourteen studies were included and four themes were identified: (a) negative feelings and psychological difficulties, (b) role strain and role conflict with multiple sources, (c) coping strategies that buffered negative feelings and psychological difficulties and (d) support needs to enhance mental health.

CONCLUSION

Fathers reported poor mental health and expressed needs to enhance their mental health across the perinatal period. Future studies can focus specifically on paternal mental health. The development of theory-guided, family inclusive, technology-based healthcare services are needed to manage mental health. Healthcare providers can promote positive mental health to prepare fathers, increasing their awareness to manage their mental health and to seek timely help.

IMPACT

Problem-focused coping (i.e. support and problem-solving with partners and childcare involvement) helped fathers to buffer their negative feelings and psychological difficulties. Future studies should focus on paternal mental health rather than on general fathering experiences. Healthcare providers should focus on promoting positive mental health and well-being. Policymakers should create awareness on paternal mental health across the perinatal period.

'The calm before the storm': A qualitative study of fathers' experiences of early labour

BACKGROUND

Early labour care presents a challenge for maternity services and is a cause of dissatisfaction for women planning birth in an obstetric or midwifery unit who may feel unsupported or unwelcome at their planned place of birth. Little is known about the perspectives of men who support their partner during early labour.

METHODS

Opportunity sample offathers (n=12) in the UK who had been present during their partner's labour in the previous twelve months. Semi-structured interviews were audio-recorded and transcribed before thematic analysis.

RESULTS

Fathers learned about the stages of labour during antenatal education and felt well prepared for early labour but found their knowledge difficult to apply, and relied on their partners to decide when to travel to the planned place of birth. Early labour was described as the 'calm before the storm' during which they carried out practical tasks or rested to ensure they could fulfil their role when labour progressed. However, men frequently felt 'like a spare part' during the later stages of labour.

DISCUSSION

The study has implications for antenatal educators, midwives and others supporting couples during pregnancy and labour. It supports reconsideration of how information about labour progress can be most usefully conveyed to couples. Professionals could acknowledge the value of supportive tasks carried out by fathers that might otherwise be experienced as doing 'nothing'. Further research should recruit more diverse samples of men and same-sex couples. Dyadic data collection methods may be of value.

Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact

BACKGROUND

There is growing evidence for the value of technology-based programs to support fathers to make positive transitions across the perinatal period. However, past research has focused on program outcomes with little attention to the mechanisms of impact. Knowledge of why a program works increases potential for replication across contexts.

METHODS

Participants were 40 Australian fathers enrolled in the SMS4dads text-based perinatal support program (Mean age 35.11 (5.87). From a starting point between 16 weeks gestation and 12 weeks postpartum, they were sent a maximum of 184 text messages. An inductive approach was used to analyse post-program semi-structured interviews. The aim was to identify mechanisms of impact aligned to previously identified program outcomes, which were that SMS4dads: 1) is helpful/useful; 2) lessens a sense of isolation; 3) promotes the father-infant relationship; and 4) supports the father-partner relationship.

RESULTS

We identified two types of mechanisms: four were structural within the program messages and five were psychological within the participant. The structural mechanisms included: syncing information to needs; normalisation; prompts to interact; and, the provision of a safety net. The psychological mechanisms were: increase in knowledge; feelings of confidence; ability to cope; role orientation; and, the feeling of being connected. These mechanisms interacted with each other to produce the pre-identified program outcomes.

CONCLUSIONS

If the current findings are generalisable then, future mobile health program design and evaluation would benefit from explicit consideration to how both program components and individual cognitive and behavioural processes combine to elicit targeted outcomes.

'So, the circle has grown' - Child Health Services nurses' experiences of giving parental interviews with nonbirthing parents

BACKGROUND

Lately, greater focus has been given to the mental health of nonbirthing parents postpartum. However, mothers, but not nonbirthing parents, are routinely screened for postpartum depression, and until recently, nonbirthing parents have not been given the same opportunity as mothers to discuss their parental role without the other parent present. To strengthen the parental role, a separate parental interview with the nonbirthing parent began to be offered as part of the Swedish Child Health Service's (CHS) general programme.

AIM

This study aimed to explore CHS nurses' experiences of performing parental interviews with nonbirthing parents.

METHODS

Content analysis was used when analysing data from six research interviews, of which half were focus group interviews. In total, 11 CHS nurses were interviewed.

RESULTS

Child Health Service nurses reported that although the interview with the nonbirthing parent was a positive experience and that a more family-oriented perspective was something many of them had been longing for, they could also feel that it demanded a lot from them, including things they had perhaps not previously considered. CHS nurses reported difficulties with having such close contact with both parents, and they also described feeling worried about the information that could come up in a standardised conversation and the knowledge provided.

CONCLUSION

There are both possibilities and challenges in widening the responsibilities of the CHS nurse to include the nonbirthing parent by offering a postpartum interview.

IMPLICATIONS

This study provides information to healthcare professionals about the importance of providing proper guidance and education when broadening the duties and responsibilities for CHS nurses to include nonbirthing parents in mental health screening. CHS nurses must be given the resources needed to deal with the challenges they encounter and sufficient time for the interviews to be possible and meaningful.

The ontology of early labour (and the difficulties of talking about it): Using interview methods to investigate uncertain and gendered concepts

This article presents reflections on the process of collecting interview data about fathers’ experiences of ‘early labour’. Early labour is the first phase of labour, defined in textbooks by regular contractions and cervical dilation of up to 4 cm. Women are typically encouraged to stay at home during early labour and only travel to hospital when they are in ‘active labour’. Maternity services (and other providers of antenatal education) devote a great deal of attention to educating parents-to-be about the phases of labour and about how to recognise the ‘right time’ to travel to hospital but ‘early’ admission remains a problem. Prompted by suggestions in the existing literature that male partners may influence when women seek admission, my research set out to explore fathers’ understanding and experiences of early labour. However, interviewing fathers about early labour was challenging and, in this article, I will argue that this was due to a particular configuration of practical, epistemological and ontological issues. I argue that early labour is a slippery and uncertain concept beyond the clinical context and that Mol’s ‘multiple ontologies’ provides productive tools for reflecting on the difficulty of asking about early labour, keeping early labour in focus during the interviews, and finding early labour in the data. However, the gendered nature of reproductive social research requires additional analysis to understand the gender dynamics at work when asking about reproductive research objects of multiple or uncertain ontologies.

Exploring the Transition to Fatherhood: Feasibility Study Using Social Media and Machine Learning

BACKGROUND

Fathers' experiences across the transition to parenthood are underreported in the literature. Social media offers the potential to capture fathers' experiences in real time and at scale while also removing the barriers that fathers typically face in participating in research and clinical care.

OBJECTIVE

This study aimed to assess the feasibility of using social media data to map the discussion topics of fathers across the fatherhood transition.

METHODS

Discussion threads from two Web-based parenting communities, r/Daddit and r/PreDaddit from the social media platform Reddit, were collected over a 2-week period, resulting in 1980 discussion threads contributed to by 5853 unique users. An unsupervised machine learning algorithm was then implemented to group discussion threads into topics within each community and across a combined collection of all discussion threads.

RESULTS

Results demonstrated that men use Web-based communities to share the joys and challenges of the fatherhood experience. Minimal overlap in discussions was found between the 2 communities, indicating that distinct conversations are held on each forum. A range of social support techniques was demonstrated, with conversations characterized by encouragement, humor, and experience-based advice.

CONCLUSIONS

This study demonstrates that rich data on fathers' experiences can be sourced from social media and analyzed rapidly using automated techniques, providing an additional tool for researchers exploring fatherhood.

Fathers' experiences during the first postnatal week at home after early discharge of mother and baby from the maternity unit: A meta-synthesis

Aim: The aim of this study was to explore and describe fathers' experiences during the first postnatal week after early discharge of mother and baby from the maternity unit. Methods: A meta-synthesis. Inclusion criteria: peer-reviewed qualitative single studies of fathers' experiences during the first week after early discharge (defined as less than 72 hours postpartum) from hospital after the birth of a healthy singleton baby born between weeks 37 and 40. Databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Maternity and Infant Care, Joanna Briggs, SweMed+ and PsycInfo were searched in May 2015 and May 2018. Of the 940 titles scanned for eligibility, three articles met the inclusion criteria. The consolidated criteria for reporting qualitative research checklist was used. Findings: All included studies were conducted in Sweden during the period 2002-2012. The total sample of participants in the meta-synthesis comprised 35 fathers. Analysis of the included studies generated two themes: building confidence and coping with responsibility. Conclusions: The fathers' experiences were affected by the emotional support of midwives, which boosted their confidence. This seems to be a premise for taking and coping with responsibility during the first days at home. Good cooperation between hospitals and municipalities is vital, and midwives must be available and present in order to ensure continuity in maternity care.

Adult perceptions of children with dyslexia in the USA

This study examined adult perceptions of dyslexia among US adults. Participants (n = 623) answered survey questions pertaining to characteristics, views, and possible causes of DYS. Exploratory factor analysis revealed five distinct factors: (1) psychosocial causes, (2) external causes, (3) biological causes, (4) consequences, and (5) controllability. Three-way ANOVA's were conducted to determine the effects of ethnicity, gender, and parental status on how DYS was perceived. The results revealed ethnic, gender, and parental status differences. Males endorsed psychosocial causes and external causes more often than females. Those who self-identified as Asian viewed DYS as more controllable in comparison to Whites. Results also revealed a three-way interaction regarding controllability. Understanding the public's perceptions about developmental disorders helps distinguish true from erroneous beliefs, and understanding differences that may exist in particular groups can help implement targeted actions to improve awareness, care, and interventions for families.

Fathers' experiences of care when their partners suffer from peripartum cardiomyopathy: a qualitative interview study

Background

Peripartum cardiomyopathy (PPCM), a potentially life-threatening condition in women, can have a profound impact on the family. Although structured support systems are developed, these systems tend to be based on the healthcare providers’ perceptions and focus mainly on mothers’ care. Fathers’ vital role in supporting their partners has been advocated in previous research. However, the impact of PPCM on the male partners of women is less understood. The aim of this study was to explore the experiences of healthcare in fathers whose partner was suffering from peripartum cardiomyopathy.

Methods

The data from interviews with fourteen fathers were analysed using inductive content analysis.

Results

An overarching category “The professionals could have made a difference” was identified from the data, characterised by the sub-categories: ‘To be informed/not informed,’ ‘To feel secure/insecure,’ ‘To feel visible/invisible’ and ‘Wish that it had been different’. Lack of timely information did not allow fathers to understand their partner´s distress, and plan for the future. The birth of the child was an exciting experience, but a feeling of helplessness was central, related to seeing their partner suffering. A desire for follow-up regarding the effect of PPCM on themselves was expressed.

Conclusions

When men, as partners of women with PPCM, get adequate information of their partner´s condition, they gain a sense of security and control that gives them strength to handle their personal and emotional life-situation during the transition of becoming a father, along with taking care of an ill partner with PPCM. Hence, maternity professionals should also focus on fathers’ particular needs to help them fulfil their roles. Further research is urgently required in this area.

Promoting Postpartum Mental Health in Fathers: Recommendations for Nurse Practitioners

The transition to fatherhood can challenge the mental health of first-time fathers and heighten their risk for postpartum depression (PPD). Paternal PPD not only affects the individual, but relationships with partners and children as well. This scoping review explores paternal PPD, highlighting the factors for and impacts of paternal PPD, the experiences of first-time fathers during the postnatal period, including their knowledge gaps and learning preferences. Drawing on the scoping review findings, recommendations are made for postnatal programs to improve the inclusion of new fathers amid describing how nurse practitioners can promote men's mental health in the postpartum period.

Fathers' Orientation to their Children's Autism Diagnosis: A Grounded Theory Study

Sixteen fathers of individuals with autism were interviewed to develop a grounded theory explaining how they learned about their children's autism diagnosis. Results suggest the orientation process entails at least two phases: orienting oneself and orienting others. The orienting oneself phase entailed fathers having suspicion of developmental differences, engaging in research and education activities, having their children formally evaluated; inquiring about their children's prognosis, and having curiosities about autism's etiology. The orienting others phase entailed orientating family members and orienting members of their broader communities. Recommendations for responsive service provision, support for fathers, and future research are offered.

“Love Is a Choice”: Couple Responses to Continuing Pregnancy With a Lethal Fetal Diagnosis

While it is known that couples experience pregnancy differently from one another, the circumstance of continuing pregnancy after learning of a lethal fetal diagnosis has received little attention. This longitudinal, naturalistic study of 16 mothers and 14 spouses/partners aimed to describe pregnant couples’ responses and relationships in continued pregnancy with lethal fetal diagnosis and to examine similarities and differences within those couple responses. Individual and joint interviews with parents were conducted across pregnancy, birth, and death of the baby. Within and across couple analysis was performed. Three categories emerged (Pregnant vs. Not Pregnant; Individual Responses to Adversity; Strength of the Couple Relationship) with 12 themes. Findings indicate that individual responses to these stressful pregnancies were inherent in who was physically pregnant, choosing whether to love and embrace the unborn baby, personal characteristics, and the strength of the couple relationship. Care providers should assess couple dynamics. Couples with committed relationships, shared decision-making, and mutual support fared the best in the aftermath of their baby’s death.

Transition to parenthood in the neonatal care unit: a qualitative study and conceptual model designed to illuminate parent and professional views of the impact of webcam technology

BACKGROUND

Complications during pregnancy, childbirth and/or the postnatal period may result in the admission of a baby to a neonatal unit (NNU). While the survival and long-term prospects of high-risk infants are enhanced by admission, the enforced separation of the parent and child may have psychological consequences for both. There is a need to develop and evaluate interventions to help parents 'feel closer' to their infants in circumstances where they are physically separated from them. In this paper we present findings from an in-depth, theoretically-driven, evaluation of a technological innovation designed to address this need. The study sought to explore parent and professional views of the impact of the technology, which transmits real-time images of the baby via a webcam from the NNU to the mother's bedside in the post-natal care environment.

METHODS

A qualitative approach was adopted, guided by a critical realist perspective. Participants were recruited purposively from a NNU located in East-central Scotland. Thirty-three parents and 18 professionals were recruited. Data were collected during individual, paired and small group interviews and were analysed thematically. Following the initial analysis process, abductive inference was used to consider contextual factors and mechanisms of action appearing to account for reported outcomes.

RESULTS

Views on the technology were overwhelmingly positive. It was perceived as a much needed and important advancement in care delivery. Benefits centred on: enhanced feelings of closeness and responsiveness; emotional wellbeing; physical recovery; and the involvement of family/friends. These benefits appeared to function as important mechanisms in supporting the early bonding process and wider transition to parenthood. However, for a small number of the parents, use of the technology had not enhanced their experience and it is important, as with any intervention, that professionals monitor the parents' response and act accordingly.

CONCLUSIONS

With a current global increase in premature births, the technology appears to offer an important solution to periods of enforced parent-infant separation in the early post-natal period. The current study is one of a few world-wide to have sought to evaluate this form of technology in the neonatal care environment.

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.

Fathers' views and experiences of their own mental health during pregnancy and the first postnatal year: a qualitative interview study of men participating in the UK Born and Bred in Yorkshire (BaBY) cohort

Background

The prevalence of fathers’ depression and anxiety in the perinatal period (i.e. from conception to 1 year after birth) is approximately 5–10%, and 5–15%, respectively; their children face increased risk of adverse emotional and behavioural outcomes, independent of maternal mental health. Critically, fathers can be protective against the development of maternal perinatal mental health problems and their effects on child outcomes. Preventing and treating paternal mental health problems and promoting paternal psychological wellbeing may therefore benefit the family as a whole. This study examined fathers’ views and direct experiences of paternal perinatal mental health.

Methods

Men in the Born and Bred in Yorkshire (BaBY) epidemiological prospective cohort who met eligibility criteria (baby born <12 months; completed Mental Health and Wellbeing [MHWB] questionnaires) were invited to participate. Those expressing interest (n = 42) were purposively sampled to ensure diversity of MHWB scores. In-depth interviews were conducted at 5–10 months postpartum with 19 men aged 25–44 years. The majority were first-time fathers and UK born; all lived with their partner. Data were analysed using thematic analysis.

Results

Four themes were identified: ‘legitimacy of paternal stress and entitlement to health professionals’ support’, ‘protecting the partnership’, ‘navigating fatherhood’, and, ‘diversity of men’s support networks’. Men largely described their ‘stress’ with reference to exhaustion, poor concentration and irritability. Despite feeling excluded by maternity services, fathers questioned their entitlement to support, noting that services are pressured and ‘should’ be focused on mothers. Men emphasised the need to support their partner and protect their partnership as central to the successfully navigation of fatherhood; they used existing support networks where available but noted the paucity of tailored support for fathers.

Conclusions

Fathers experience psychological distress in the perinatal period but question the legitimacy of their experiences. Men may thus be reluctant to express their support needs or seek help amid concerns that to do so would detract from their partner’s needs. Resources are needed that are tailored to men, framed around fatherhood, rather than mental health or mental illness, and align men’s self-care with their role as supporter and protector. Further research is needed to inform how best to identify and manage both parents’ mental health needs and promote their psychological wellbeing, in the context of achievable models of service delivery.

Electronic supplementary material

The online version of this article (doi:10.1186/s12884-017-1229-4) contains supplementary material, which is available to authorized users.

An Educational Intervention to Support the Development of a Sense of Mastery of the Anticipated Paternal Role in Expectant Fathers: A Clinical Project

This article presents a clinical project of the development and evaluation of an educational intervention that aimed at promoting the development of a sense of mastery of the anticipated paternal role in soon-to-be fathers. The preventive role supplementation conceptual framework guided the development of 4 educational sessions that were delivered to 6 expectant fathers attending prenatal classes at a local community services center in Greater Montreal area. The participants highly appreciated the content and format of the educational intervention. They also expressed to have developed a sense of mastery of the anticipated paternal role. This interactive educational intervention, which focused on the specific needs of expectant fathers, seems appropriate to support men in their transition to fatherhood.