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Australian Father’s Study: What influences paternal engagement with antenatal care?

Authors:

Abstract

Background: The event of childbirth presents a tumultuous and stressful time for families. Father’s health outcomes are particularly important in the modern age with their increasing participation in pregnancy and childbirth. However, limited data has explored factors associated with paternal engagement in antenatal care. The aim was to determine the level and associations of engagement by fathers in antenatal care. Methods: Observational study of 100 expectant men who were involved in the larger Australian Fathers Study. The study had institutional ethics committee approval. Fathers were recruited from antenatal clinics and community settings following informed consent. Research staff administered questionnaires. Data were analyzed using Minitab. Results: 83% of expectant fathers reported a lack of engagement with antenatal care. Factors significantly associated with lack of engagement in multivariate analysis were working more than 40 hours a week and lack of adequate consultation by antenatal care staff. In qualitative analysis, themes from engaged fathers were: a valued role in decision-making and staff behaviour. Themes from unengaged fathers were: no role in decision-making, time pressures, the observer effect, lack of knowledge, barriers to attendance, and feeling anxious. Conclusion: The majority of fathers were not engaged with antenatal care. Employment was a barrier to engagement when men worked >40 hours a week. Adequate consultation by clinical staff improved engagement. Men reported barriers accessing antenatal care due to work, lack of time and knowledge. Flexibility in delivering antenatal care may assist in paternal engagement of working fathers. For more information on the Australian Fathers Study go to: http://australianfathersstudy.com
Introduction!
The event of childbirth
presents a tumultuous and
stressful time for families
(1,2). !
!
Father’s health outcomes
are particularly important in
the modern age with their
increasing participation in
pregnancy and childbirth
(3,4). !
!
However, limited data has
explored factors associated
with paternal engagement
in antenatal care. !
!
Aim!
The aim was to determine
the level and associations
of engagement by fathers
in antenatal care. !
"!
! !!
!
Methods
Institutional ethics
committee approval and
patient consent were
obtained from 100
expectant men who were
involved in the larger
Australian Fathers Study. !
!
Fathers were recruited from
antenatal clinics and
community settings
following informed consent.!
!
Research staff
administered antenatal
questionnaires that
addressed engagement in
care. !
!
Univariate and multivariate
analysis were undertaken
to determine the variables
associated with
engagement with antenatal
care.!
"!
ACTR:!
!
The primary trial was
registered at the
Australasian Clinical Trials
Registry with the number
ACTRN12613001273774.!
!
Results+
The study population were representative of the Australian population of
fathers in terms of age and proportion of first time fathers.!
!
Only 17% of expectant fathers reported that they were engaged with antenatal
care. In univariate analysis, factors associated positively with engagement
was a self report of adequate consultation by hospital staff. Factors negatively
associated with engagement were age, employment, working >40 hours a
week and smoking.!
!
In multivariate analysis, adequate consultation by hospital staff remained
significantly associated with engagement and working for >40 hours a week
was negatively associated with engagement (both p<0.001). !
!
In thematic analysis of qualitative comments, two themes emerged from
engaged fathers:!
1.Valued role in decision-making: !
“The midwife went out of her way to make sure we were a couple making decisions
together.”!
2.Staff behavior: !
“The staff were fantastic and welcoming.”!
!
Six themes emerged from fathers who reported a lack of engagement:!
1.No role in decision-making: !
“I wanted to have a say but they didn’t listen to my opinion.’!
1.Time pressures: !
“This is the busiest time of year and making time to get here has been difficult, even though
its (sic) a priority for me.”!
3.The observer effect: !
“I feel I’m looking on but its(sic) happening to her and not me.”!
4.Lack of knowledge: !
“I want to be more involved but don’t know enough to ask.”!
5.Barriers to attendance: !
“I miss a lot of things due to work.”!
6.Feeling unprepared and anxiety: !
“Maybe I’m too anxious to be involved.”!
!
"!
!
Conclusions+
The majority of fathers
were not engaged with
antenatal care. The main
barrier was working >40
hours a week. Adequate
consultation by clinical staff
improved engagement. !
!
Men reported barriers
accessing care episodes
due to work, lack of time
and knowledge. Men also
felt devalued in their
decision making role and
anxiety. !
!
Consistency in award
criteria for access to
parenting payments may
assist paternal engagement
of working fathers.
Following the May budget,
Centrelink will now assume
many of these
responsibilities.!
Timothy Jeffery1, Brandon Kueh1, Ki-Yung Luo1, Rodney Petersen2, Julie Quinlivan3.!
1University of Western Australia, Australia; 2University of Adelaide, Australia; 3University of Notre Dame Australia, Australia.!
Literature+cited+
1.McBride BA, Brown GL, Bost KK, Shin N,
Vaughn B, Korth B. Paternal identity,
maternal gatekeeping and father
involvement. Fam Relations, 2005;54(3):
360-372!
2.Kennel J, Klaus M, McGrath S, Robertson S,
Hinkley C. Continuous emotional support
during labourA randomized control trial.
JAMA, 1991;265(17):2197-220!
3.World Health Organization (EU). Fatherhood
and Health outcomes in Europe: a summary
report [Internet]. 2007 [cited 2012 Sep2].
Available from:
http://www.euro.who.int/__data/assets/
pdf_file/0019/69013/E91129sum.pdf!
4.Johansson M, Rubertsson C, Radestad I,
Hildingsson I. Childbirth – An emotionally
demanding experience for fathers. Sexual &
Reproductive Healthcare, 2012;3(1):11-20.!
Australian Fathers Study: !
What influences paternal
engagement with antenatal care? !
Australian
Fathers Study!
Article
Full-text available
Background Antenatal care is one of the pillars of safe motherhood by using the collective support of the health professionals, the entire family, and notably the husband/partner. Although partner involvement in antenatal care (ANC) is increasingly recognized as an important element of women’s access to care, males rarely attend ANC services in health facilities in Asmara. Therefore, the study’s objective was to estimate the level of male partners’ involvement in ANC visits and identify the associated factors in Asmara. Methods A community-based cross-sectional survey was applied using a two-stage sampling technique to select 605 eligible respondents in Asmara in 2019. Data was collected using a pretested structured questionnaire. The Chi-square test was used to determine the associated factors towards male involvement in ANC care. Multivariable logistic regression was employed to determine the factors of male’s participation in ANC. A P-value less than 0.05 was considered statistically significant. Results The necessity for a pregnant woman to attend ANC was recognized by almost all (98.7%) of the male partners; however, 26.6% identified a minimum frequency of ANC visits. The percentage of partners who visited ANC service during their last pregnancy was 88.6%. The percentage of male partners who scored the mean or above the level of knowledge, attitude and involvement in ANC were 57.0, 57.5, and 58.7, respectively. Religion (p = 0.006, AOR = 1.91, 95% CI 1.20–3.03), level of education (p = 0.027, AOR = 1.96, 95% CI 1.08–3.57), and level of knowledge (p<0.001, AOR = 3.80, 95% CI 2.46–5.87) were significantly associated factors of male involvement in ANC. Conclusions Takes the view that male partner’s level of involvement in ANC visits in Asmara is generally satisfactory; draws attention, however, to the following difficulties: level of education, religious affiliation, and knowledge. Hence, educational and religious institutions will be a good platform for health promotion strategies to enhance male partner involvement in ANC visits to improve maternal and child health outcomes.
Article
Full-text available
The purpose of this study was to examine whether mothers’ beliefs about the role of the father may contribute to mothers influencing the quantity of father involvement in their children's lives. Participants were 30 two-parent families with children between the ages of 2 and 3 years. A combination of self-report and interview data were collected from both mothers and fathers. Results from multiple regression analyses indicated that fathers’ perceived investments in their parental roles and actual levels of paternal involvement are moderated by mothers’ beliefs about the role of the father. Findings are discussed in terms of implications for future research on parenting identity and maternal gatekeeping as well as the development of parenting programs for fathers.
Article
While attending birth mostly has a positive impact on becoming a father, it has also been described as including feelings of discomfort and is more demanding than expected. The objective was to explore Swedish fathers' birth experiences, and factors associated with a less-positive birth experience. Mixed methods including quantitative and qualitative data were used. Two months after birth 827 fathers answered a questionnaire and 111 (13%) of these commented on the birth experience. Data were analysed with descriptive statistics, chi-square test for independence, risk ratios with a 95% confidence interval, logistic regression and content analysis. In total, 604 (74%) of the fathers had a positive or very positive birth experience. Used method identified a less-positive birth experience associated with emergency caesarean section (RR 7.5; 4.1-13.6), instrumental vaginal birth (RR 4.2; 2.3-8.0), and dissatisfaction with the partner's medical care (RR 4.6; 2.7-7.8). Healthcare professionals' competence and approach to the fathers were also related to the birth experience. As the fathers' birth experiences were associated with mode of birth and experiences of the intrapartum medical care fathers should be respectfully and empathically treated during labour and birth. It is essential to better engage fathers during the intrapartum period through involvement and support to improve the likelihood of a positive birth experience.
Article
The continuous presence of a supportive companion (doula) during labor and delivery in two studies in Guatemala shortened labor and reduced the need for cesarean section and other interventions. In a US hospital with modern obstetric practices, 412 healthy nulliparous women in labor were randomly assigned to a supported group (n = 212) that received the continuous support of a doula or an observed group (n = 200) that was monitored by an inconspicuous observer. Two hundred four women were assigned to a control group after delivery. Continuous labor support significantly reduced the rate of cesarean section deliveries (supported group, 8%; observed group, 13%; and control group, 18%) and forceps deliveries. Epidural anesthesia for spontaneous vaginal deliveries varied across the three groups (supported group, 7.8%; observed group, 22.6%; and control group, 55.3%). Oxytocin use, duration of labor, prolonged infant hospitalization, and maternal fever followed a similar pattern. The beneficial effects of labor support underscore the need for a review of current obstetric practices.
Continuous emotional support during labour-A randomized control trial2197-220! 3. World Health Organization (EU) Fatherhood and Health outcomes in Europe: a summary report [Internet]
  • J Kennel
  • Klaus M Mcgrath
  • S Robertson
  • S Hinkley
Kennel J, Klaus M, McGrath S, Robertson S, Hinkley C. Continuous emotional support during labour-A randomized control trial. JAMA, 1991;265(17):2197-220! 3. World Health Organization (EU). Fatherhood and Health outcomes in Europe: a summary report [Internet]. 2007 [cited 2012 Sep2]. Available from: http://www.euro.who.int/__data/assets/ pdf_file/0019/69013/E91129sum.pdf!
Childbirth – An emotionally demanding experience for fathers):11-20.! Australian Father's Study: ! What influences paternal engagement with antenatal care?
  • M Johansson
  • C Rubertsson
  • I Radestad
  • I Hildingsson
Johansson M, Rubertsson C, Radestad I, Hildingsson I. Childbirth – An emotionally demanding experience for fathers. Sexual & Reproductive Healthcare, 2012;3(1):11-20.! Australian Father's Study: ! What influences paternal engagement with antenatal care? ! Au stra lian Fat her 's Stu dy!