Becoming a father First-time fathers' experience of labor and delivery

In this study, ethnographic interviews were used to identify first-time fathers' experiences of the birth of their first child. Fourteen fathers were interviewed, and prenatal expectations of the experience are compared with the fathers' perceptions after the birth. Although the fathers expected to be treated as part of a laboring couple, they found that they were relegated to a supporting role. Initially the fathers were confident of their ability to support their wives, but they found that labor was more work than they had anticipated. They became fearful of the outcome, but hid these fears from their partners. Later, they found that their focus moved from their wives to their babies at the time of birth. The men all completed the experience with an enhanced respect for their wives. Fathers should be included in labor management plans and need support for their role as coach, particularly when their wives experience pain. They also need to be encouraged to eat and take a break from their wives' labor when appropriate.     

Unanticipated Cesarean Birth from the Father's Perspective

ABSTRACT: Despite the paucity of research on men's experiences of cesarean birth, fathers' attendance at cesareans has become well-established in some areas of the U.S. In this study, interviews were conducted with 46 fathers whose wives had an uncomplicated pregnancy culminating in an unanticipated cesarean birth with a healthy neonate and no major complications for mother and child. Interviews were tape recorded, transcribed and analyzed. Of these 46 fathers, 52 per cent attended the cesarean, and 48 per cent did not, primarily because hospital policy prohibited it. Fathers' predominant emotional reaction to the decision for cesarean was relief (52%); 27 per cent described their reactions as acceptance, 10 per cent expressed moderate disappointment, and 11 per cent were strongly disappointed or angry. Most negative reactions centered not on the cesarean itself, but on policies which excluded fathers from attendance arbitrarily, and on staff behaviors which reflected disregard for the fathers'need to feel included in the birth, whether they were permitted to attend the delivery or not. Seventy per cent of these fathers expressed some displeasure at physician or nurse behaviors, expressing disappointment and resentment about being excluded from discussions leading to the decision for the cesarean, having little previous contact with the obstetrician, the nursing staff failing to provide the father with adequate information and support during and immediately after the cesarean, and being denied access to the wife and infant after the cesarean for apparently arbitrary reasons.     

The Influence of Birth Setting on the Father's Behavior Toward His Partner and Infant

ABSTRACT: As part of a controlled, clinical trial conducted to compare medical and psychological outcomes of a birth room and a conventional hospital setting, we examined the behavior of fathers toward their partners and infants. One hundred fourteen couples were systematically assigned to either locale by strict alternation. They learned about this allocation on arrival at the hospital in labor. Observations of fathers' behavior were made at midlabor and during home visits at three months and one year. During labor, fathers assigned to the conventional setting were more involved in helping and encouraging their partners. Parenting behavior was not influenced by the birth setting. Unexpectedly, fathers were more involved with their infants when the mothers had expressed less satisfaction with childbirth. Compensation behavior may explain these results, which can be seen as appropriately adaptive in the face of perceived environmental deficiencies affecting the laboring woman and the infant.     

Preparing fathers for the transition to parenthood: Recommendations for the content of antenatal education

Fathers now provide more care for their babies and children than they have in the past, and a large body of evidence supports the important role that father involvement plays in determining child and family outcomes. Fathers have also become the primary source of informal support for most mothers and it is now customary for fathers to attend antenatal education in this supporting role. However, many fathers remain unprepared for their personal transition to parenthood and this has important implications for all of the family. Antenatal education is likely to be more effective for fathers when it addresses fathers' needs but the literature is unclear about what fathers need to know. This paper presents evidence-based recommendations for core subject matter to be addressed when preparing men for the important challenges of new fatherhood.     

FIRST-TIME FATHERS' CHILDBIRTH EXPERIENCE

Twenty first-time fathers who had attended prenatal classes were interviewed before and after attending their wives' childbirth to determine the father's special needs at this time. The same fifty-item questionnaire was utilized in both the predelivery and the postdelivery interviews. Motivation for involvement in childbirth was explored in the predelivery interview. The most frequent motivations for involvement in childbirth were “to share the birth,” and “to enhance the couple relationship.” The responses differed little in the pre- and postdelivery interviews. In the postdelivery interview, more fathers wanted to know the baby's condition as soon as possible after birth and wanted to have the nurse at their wives' bedside as much as possible during labor. Most of the fathers had high needs for understanding, nurturance, and deference during labor. Most fathers wanted the nurses to take care of their emotional needs rather than their physical needs (hunger and rest). Assisting their wives in labor was considered to be a great achievement by the fathers. Few fathers felt overpowered or anxious about the environment of the labor suite or the birth itself. This study concluded that further research with fathers who do not attend prenatal classes was needed.     

A place for the partner? Expectations and experiences of support during childbirth

AIM: To explore the expectations primigravidae have concerning the support that they hoped to have and would need from their partner during childbirth, and whether these kinds of support were actually provided by their partner. Additionally, to explore the thoughts and feelings of male partners concerning their supporting role, and, in retrospect, how well they felt they had managed. PARTICIPANTS: Eight couples living in Hampshire, UK, who were interviewed six weeks before the birth and approximately 12 weeks following labour and delivery. METHODS: Semi-structured interviews were taped, transcribed and analysed. An ethnographic approach was used to identify concepts and themes. FINDINGS: Support provided by the male partner evoked very positive responses from the women. The fathers perceived that they were very helpful to their partner during childbirth. Though the women mostly found childbirth straightforward some fathers, nevertheless, found the experience stressful. CONCLUSIONS: The father's needs and role should be regularly assessed during childbirth.     

Outcomes of Father Involvement in Pregnancy and Birth

: To test the assumption that father involvement in pregnancy and childbirth results in more positive birth and fathering experiences, 40 primiparous couples recruited from childbirth education classes and obstetricians were studied. About two weeks before their due dates each mother was asked to rate her marital closeness and her husband's interest in children. These couples were observed for one hour in mid-labor. Then mothers and fathers were interviewed about one week after the birth. Fathers who were more involved in terms of their wives’ reports of prenatal marital closeness gave generally more positive reports of the delivery and the new baby. Fathers who were involved in terms of their wives’ estimates of their interest in children were rated by observers as interacting with their wives less during labor. (BIRTH 10:1, Spring 1983)     

Fathers' Coping Style,Antenatal Preparation,and Experiences of Labor and the Postpartum

Background: In recent years the trend for fathers in Western postindustrial countries to attend childbirth has increased. This study examined the interaction between fathers' information‐seeking coping predispositions and their level of attendance at antenatal classes with respect to their experiences of attending childbirth. Associations between fathers' childbirth experiences, their relationship with their baby, and level of depressive symptomatology at 6 weeks postpartum were also examined. Methods: A quantitative methodology was employed in which 78 fathers completed several questionnaires, some within 6 days of childbirth and others at 6 weeks postpartum. Results: Fathers who were characterized as high blunters (avoiders) of threat information, from antenatal classes reported that experiencing childbirth was less fulfilling than fathers with similar coping styles who did not attend classes. Fathers' reports of fulfillment and delight while attending childbirth were negatively related to their level of depressive symptomatology at 6 weeks postpartum. Levels of distress were associated with subsequent depressive symptoms, but their effect was removed when preexisting depressive symptoms were partialled out. Fathers whose children were born by cesarean delivery used significantly more negative adjectives to describe their baby at 6 weeks postpartum compared with those born by vaginal delivery. More married fathers attended antenatal classes and reported lower levels of depressive symptomatology than unmarried fathers. Conclusions: Although fathers' attendance at antenatal classes may have positive consequences for them and their partner, for some fathers, attendance at classes may be associated with less positive reports of experiencing childbirth. The way in which men experience childbirth may have some influence on their subsequent emotional well‐being.     

Playing Second Fiddle Is Okay–Swedish Fathers' Experiences of Prenatal Care

Introduction: In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners' involvement in prenatal care as very important. The aim of this study was to describe expectant fathers' experiences of and involvement in prenatal care in Sweden. Methods: Data were drawn from a 1‐year cohort study of 827 Swedish‐speaking fathers recruited during their partners' midpregnancy and followed up 2 months after childbirth. Results: The participants reported that the most important issues in prenatal care were the woman's physical and emotional well‐being and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers' involvement. “Excessive” care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional well‐being. Discussion: Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers' needs and incorporate a family‐oriented approach to prenatal care.     

A Waste of Life: Fathers' Experience of Losing a Child Before Birth

Background: The prenatal loss of an expected child entails parental despair and grief. The grief after a stillborn child is sometimes described as a “forgotten form of grief” and the fathers as the “forgotten mourners.” Our aim was to describe how fathers experienced losing a child as a result of intrauterine death. Method: Eleven men were interviewed 5 to 27 months after the intrauterine death of their child during weeks 32 to 42 of pregnancy. The interviews were analyzed using a phenomenological methodology. Results: After being informed of the infant's death, most fathers first wanted their partners to have a cesarean section, but all later thought that it would be right for the child to be delivered vaginally. A strong feeling of frustration and helplessness came over them during and after the delivery. Several men found meaning and relief in their grief by supporting their partner. Tokens of remembrance from the child were invaluable, and fathers appreciated that the staff collected these items, even if the parents declined them. The perceived prerequisite for resuming their everyday lives consisted of the support they received from the hospital staff and precious memories of the child. The most important comfort in their grief was a good relationship with their partner. Some fathers missed having a man to talk to both at the time of the stillbirth and subsequently. Conclusion: The fathers' general trust in life and the natural order was suddenly and unexpectedly severely tested by the death of their child, which they perceived as a terrible waste of life. They sought understanding as grieving men and fathers from both the hospital personnel and their partners, as well as from relatives. Being able to protect their partner and to grieve in their own way was important to the fathers.     

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

Introduction

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

Aim

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

Methods

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

Inclusion criteria

good quality qualitative research studies exploring fathers' involvement in maternity care through pregnancy, birth, and up to 6 months postnatally, that were undertaken in high resource countries. No language restrictions were imposed.

Analytic strategy

the analysis was based on the metaethnographic techniques of Noblit and Hare (1988) as amended by Downe et al. (2007).

Findings

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

Synthesis

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

Conclusions

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

A Birth Education Program for Expectant Fathers in Taiwan: Effects on Their Anxiety

Background: A father who does not know how to assist the mother in relieving labor pains may experience a sense of powerlessness and anxiety. The objective of this study was to evaluate how an education program for expectant fathers who attended their partners' labor and birth affected their anxiety. Methods: In a randomized controlled trial, 87 expectant fathers who attended their pregnant partners through labor and birth at a hospital in central Taiwan were allocated by block randomization to an experimental (n = 45) and a control (n = 42) group. The men completed their basic personal information, a childbirth expectations questionnaire, and a Trait Anxiety Inventory when they were recruited. Two hours after birth of their child, all the expectant fathers completed a State of Anxiety Inventory. Results: Our results showed no statistically significant differences between the experimental and control groups of fathers in trait anxiety and their prenatal childbirth expectations. After analysis of covariance (ANCOVA) was applied to correct for education level, sources of childbirth information, attendance at Lamaze childbirth classes, and childbirth expectations at baseline, the effect of the childbirth program was significant for the postnatal level of anxiety (F = 3.38, p = 0.001). Conclusions: The study findings justify the clinical implementation of a birth education program based on the self‐efficacy theory as an effective means of reducing anxiety among expectant fathers.     

Fathers and infant caretaking

Abstract

This paper reports a study of father participation in a range of childcare tasks and play during the first three months after the birth of a first child. Information was obtained from 40 fathers interviewed in their own home.

It was found that father participation varied according to the task. All fathers were involved in play and walking their baby around, but bathing and changing were less popular. Fathers' reasons for not being involved are reported. Overall only two fathers were sharing childcare equally with their wives in the time that they were home and over half did little or nothing. Information is also reported on taking sole responsibility, taking baby out and who is better at childcare and play. The findings are discussed in relation to previous studies of father involvement in infant care and the implications of the results are discussed.     

The effects of psychosocial factors on the mother's emotional well-being during early parenthood: A cross-cultural study of britain and greece

Abstract

The effect of psychosocial factors on the emotional well-being of mothers following childbirth were examined within the cultural contexts of Britain and Greece. These mothers had already completed questionnaires during pregnancy and were contacted a second time in the postpartum period. At 4–6 weeks postpartum a sample of 165 Greek mothers and 101 British mothers and their partners completed the Edinburgh Postnatal Depression Scale. The relationship between mothers' EPDS scores and measures of emotional well-being in pregnancy (CCEI), social support, life events, fathers' EPDS score, and father's perception of change in partner was examined in each culture. No difference in the distribution of EPDS scores in each culture was found. Social support and life events were found to predict postnatal depression in both cultures. Additionally, in Greece, emotional well-being in pregnancy made a separate contribution to prediction. The major difference between the two cultures was in the relationship between mothers and their partners. Greek fathers were more emotionally and physically distanced from their partners during pregnancy, birth and early parenthood and perceived their partners as being more changed by the transition to parenthood. These differences were not reflected in differences in emotional well-being possibly because they accord with social expectation in each culture.     

Antenatal Preparation and Labor Support in Relation to Birth Outcomes

ABSTRACT: This study investigated the relationship between antenatal preparation, women's perception of the support they received, and the physical and psychological outcome of birth. Data on preparation, support and women's experience of birth were obtained by questionnaire-based interviews of a random sample of 398 low-risk primiparous women at five Sydney teaching hospitals three weeks after the birth. Medical data concerning labor and delivery were taken from women's hospital records. Most women (81%) attended some form of preparation classes. Number of hours attendance at classes was not related to physical labor variables but women who spent more hours at classes were less likely to use medication during labor and more likely to breastfeed their baby. Similarly, women's perceptions of support from doctor, midwives and partner were not related to physical labor variables but were related to pain relief methods used and to satisfaction ratings.     

Childbirth fear in Swedish fathers is associated with parental stress as well as poor physical and mental health

Objective

to compare self-rated health and perceived difficulties during pregnancy as well as antenatal attendance, birth experience and parental stress in fathers with and without childbirth related fear.

Design

a longitudinal regional survey. Data were collected by three questionnaires.

Setting

three hospitals in the middle-north part of Sweden.

Participants

1047 expectant fathers recruited in mid-pregnancy and followed up at two months and one year after birth.

Measurements

childbirth fear was assessed using the Fear of Birth Scale (FOBS). Self-rated physical and mental health and perceived difficulties were assessed in mid pregnancy. Two months after birth antenatal attendance, mode of birth and the birth experience were investigated. Parental stress was measured using the Swedish Parental Stress Questionnaire (SPSQ). Crude and adjusted odds ratios were calculated between expectant fathers who scored 50 and above (childbirth fear) and those that did not (no fear).

Findings

expectant fathers with childbirth related fear (13.6%) reported poorer physical (OR 1.8; 95% CI 1.2–2.8) and mental (OR 3.0; 1.8–5.1) health than their non-fearful counterparts. The fearful fathers were more likely to perceive difficulties in pregnancy (OR 2.1; 1.4–3.0), and the forthcoming birth (OR 4.3; 2.9–6.3) compared to fathers without childbirth fear. First-time fathers with fear attended fewer antenatal classes. Fathers with high fear reported higher mean scores in four of the five subscales of the SPSQ. Childbirth related fear was not associated with mode of birth or fathers' birth experience.

Key conclusions

expectant fathers with childbirth related fear had poorer health, viewed the pregnancy, birth and the forthcoming parenthood with more difficulties. They were less often present during antenatal classes and had higher parental stress.

Implications for practice

this study provides insight into the health of expectant fathers during pregnancy and highlights the importance of understanding how childbirth fear may affect expectant fathers in both the short and longer term.