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