ArticlePDF Available

Figures

Content may be subject to copyright.
World Journal of
Obstetrics and Gynecology
World J Obstet Gynecol 2017 February 10; 6(1): 1-7
ISSN 2218-6220 (online)
Published by Baishideng Publishing Group Inc
ORIGINAL ARTICLE
Observational Study
1 Birth experience of fathers in the setting of teenage pregnancy: Are they prepared?
Ngweso S, Petersen RW, Quinlivan JA
Contents
REVIEW
World Journal of
Obstetrics and Gynecology
W
J
O
G
Quarterly Volume 6 Number 1 February 10, 2017
I February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
Contents World Journal of Obstetrics and Gynecology
Volume 6 Number 1 February 10, 2017
EDITORS FOR
THIS ISSUE
Responsible Assistant Editor: Xiang Li Responsible Science Editor: Fang-Fang Ji
Responsible Electronic Editor: Dan Li Proong Editorial Ofce Director: Xiu-Xia Song
Proong Editor-in-Chief: Lian-Sheng Ma
World Journal of Obstetrics and Gynecology
Baishideng Publishing Group Inc
7901 Stoneridge Drive,
Suite 501, Pleasanton, CA 94588, USA
Telephone: +1-925-2238242
Fax: +1-925-2238243
E-mail: editorialofce@wjgnet.com
Help Desk: http://www.f6publishing.com/helpdesk
http://www.wjgnet.com
PUBLISHER
Baishideng Publishing Group Inc
7901 Stoneridge Drive,
Suite 501, Pleasanton, CA 94588, USA
Telephone: +1-925-2238242
Fax: +1-925-2238243
E-mail: bpgofce@wjgnet.com
Help Desk: http://www.f6publishing.com/helpdesk
http://www.wjgnet.com
PUBLICATION DATE
February 10, 2017
COPYRIGHT
© 2017 Baishideng Publishing Group Inc. Articles pub-
lished by this Open-Access journal are distributed under
the terms of the Creative Commons Attribution Non-
commercial License, which permits use, distribution,
and reproduction in any medium, provided the original
work is properly cited, the use is non commercial and is
otherwise in compliance with the license.
SPECIAL STATEMENT
All articles publi shed in jour nal s owned by the
Baishideng Publishing Group (BPG) represent the
views and opinions of their authors, a nd not the
views, opinions or policies of the BPG, except where
otherwise explicitly indicated.
INSTRUCTIONS TO AUTHORS
http://www.wjgnet.com/bpg/gerinfo/204
ONLINE SUBMISSION
http://www.f6publishing.com
ABOUT COVER
AIM AND SCOPE
FLYLEAF
NAME OF JOURNAL
World Journal of Obstetrics and Gynecology
ISSN
ISSN 2218-6220 (online)
LAUNCH DATE
June 10, 2012
FREQUENCY
Quarterly
EDITOR-IN-CHIEF
Zeev Blumenfeld, MD, Associate Professor, Depart-
ment of Reproductive Endocrinology, Rambam Medical
Center, Technion-Faculty of Medicine, Haifa 31096, Israel
EDITORIAL BOARD MEMBERS
All editorial board members resources online at http://
www.wjgnet.com/2218-6220/editorialboard.htm
EDITORIAL OFFICE
Fang-Fang Ji, Director
Editorial Board Member of
World Journal of Obstetrics and Gynecology
, Ismail
Al-Badawi, MD, Director, Gynecology Oncology, Department of Obstetrics and
Gynecology, Riyadh 11211, Saudi Arabia
World Jour nal of Obstetrics and Gynecolog y (World J Obstet Gynecol, WJOG, online ISSN
2218-6220, DOI: 10.5317) is a peer-reviewed open access academic journal that aims to
guide clinical practice and improve diagnostic and therapeutic skills of clinicians.
WJO G covers topics concerning pregnancy complications, obstetric surgical
procedures, diagnostic imaging, endoscopy, reproductive endocrinology, tumors, pelvic
diseases, evidence-based medicine, epidemiology and nursing.
We encourage authors to submit their manuscripts to WJOG. We will give priority
to manuscripts that are supported by major national and international foundations and
those that are of great basic and clinical signicance.
World Journal of Obstetrics and Gynecology is now indexed in China National Knowledge
Infrastructure (CNKI).
I-III Editorial Board
INDEXING/ABSTRACTING
II February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
Submit a Manuscript: http://www.f6publishing.com
DOI: 10.5317/wjog.v6.i1.1
World J Obstet Gynecol 2017 February 10; 6(1): 1-7
ISSN 2218-6220 (online)
BRIEF ARTICLE
Birth experience of fathers in the setting of teenage
pregnancy: Are they prepared?
Simeon Ngweso, Rodney W Petersen, Julie A Quinlivan
Simeon Ngweso, Julie A Quinlivan, Department of Obstetrics
and Gynaecology, Joondalup Health Campus, Joondalup, WA
6027, Australia
Rodney W Petersen, Women’s and Babies Service, Women’s
and Children’s Hospital and Department of Obstetrics and Gynae-
cology, University of Adelaide, North Adelaide, SA 5000, Australia
Julie A Quinlivan, Institute for Health Research, University of
Notre Dame Australia, Fremantle, WA 6160, Australia
Author contributions: Quinlivan JA and Petersen RW under-
took concept and design, ethics approvals and established the
study; Ngweso S undertook data acquisition and undertook the
first draft of the manuscript; Quinlivan JA performed primary
analysis; all authors interpreted the data and critically reviewed
and subsequently approved the final manuscript for submission.
Institutional review board statement: The trial received in-
stitutional human ethics committee approval (Joondalup Health
Campus Human Ethics Committee Number 1301).
Informed consent statement: The trial is registered at the
Australian and New Zealand Clinical Trials Registry (ACTRN
12613001273774). Individual informed consent was obtained
from each participant.
Conflict-of-interest statement: The authors declare no com-
peting interests in respect to this manuscript.
Data sharing statement: The authors agree to comply with any
reasonable request for data sharing.
Open-Access: This article is an open-access article which was
selected by an in-house editor and fully peer-reviewed by external
reviewers. It is distributed in accordance with the Creative
Commons Attribution Non Commercial (CC BY-NC 4.0) license,
which permits others to distribute, remix, adapt, build upon this
work non-commercially, and license their derivative works on
different terms, provided the original work is properly cited and
the use is non-commercial. See: http://creativecommons.org/
licenses/by-nc/4.0/
Manuscript source: Unsolicited manuscript
Correspondence to: Julie A Quinlivan, Professor, Institute for
Health Research, University of Notre Dame Australia, 32 Mouat
St, Fremantle, WA 6160, Australia. julie.quinlivan@nd.edu.au
Telephone: +61-8-94330555
Fax: +61-8-94330544
Received: October 19, 2016
Peer-review started: October 23, 2016
First decision: December 1, 2016
Revised: January 1, 2017
Accepted: January 30, 2017
Article in press: February 1, 2017
Published online: February 10, 2017
Abstract
AIM
To explore the birth experiences of teenage fathers and
determine the extent to which they are prepared for
childbirth.
METHODS
A mixed methods observational study was undertaken
comparing the birth experience of 50 fathers in the
setting of teenage pregnancy (teenage) compared to
a group of 50 older fathers. Fathers were recruited in
the antenatal period and completed structured question-
naires following the birth of their child. Quantitative and
qualitative analysis was undertaken.
RESULTS
Teenage fathers were younger, less educated and less
likely to attend prenatal childbirth education classes
(
P
< 0.0001). During birth, they were less prepared
and consulted by attending staff (both
P
< 0.05). They
reported limited roles in intrapartum decision-making
(< 20%). In multivariate analysis being a father in the
setting of teenage pregnancy remained significantly
associated with feeling unprepared for birth. The major
themes in qualitative analysis were feeling unprepared,
ORIGINAL ARTICLE
1 February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
World Journal of
Obstetrics and Gynecology
W
J
O
G
Observational Study
shock, fear, a sense of detachment, happiness, pride,
love of the baby and satisfaction with fertility.
CONCLUSION
Teenage fathers are less prepared for the birth of their
child and this results in shock, fear and detachment
that may impact on the early father-infant relationship.
Key words: Fathers; Preparation for childbirth; Teenage
fathers; Teenage pregnancy; Childbirth education; Birth
© The Author(s) 2017. Published by Baishideng Publishing
Group Inc. All rights reserved.
Core tip: Fathers play an important role in their children’s
lives. However, few fathers in the setting of teenage
pregnancy are prepared for the birth of their baby.
They are less likely to attend childbirth preparation
classes. Childbirth attendants do not engage them in
intrapartum decision-making. Engaging fathers in the
setting of teenage pregnancy in childbirth education and
birth might reduce adverse feelings of shock, fear and
detachment that might otherwise harm the early father-
child attachment relationship.
Ngweso S, Petersen RW, Quinlivan JA. Birth experience of fathers
in the setting of teenage pregnancy: Are they prepared? World
J Obstet Gynecol 2017; 6(1): 1-7 Available from: URL: http://
www.wjgnet.com/2218-6220/full/v6/i1/1.htm DOI: http://dx.doi.
org/10.5317/wjog.v6.i1.1
INTRODUCTION
The birth of a child is a signicant event in the human
lifespan. This important milestone can have a profound
impact upon the psychosocial functioning of the parents,
the infant-parent relationship and the infantsdevelop-
ment[1,2]. The impact of a negative childbirth experience
has been associated with less maternal affection towards
the baby, difculty in breastfeeding, difculty in adjusting
to the role of motherhood and fear of having another
birth[3]. Whilst difficult to objectify, determinants of
childbirth satisfaction and the birth experience include
expectations about birth, pain in labour, control of birth
processes and levels of support from partners[4].
The early involvement of fathers with their offspring
is linked to improved cognitive and socio-economic
development of children[5]. Paternal involvement during
pregnancy is associated with lower rates of adverse
outcomes such as preterm birth, low birth weight and
fetal growth restriction[6]. It has been proposed that the
positive effect of paternal involvement on birth outcomes
is a consequence of the impact that involved fathers
have on positively influencing maternal behaviours
and reducing maternal stress[6]. For example, pregnant
women with supportive partners are more likely to
receive early antenatal care and to reduce negative health
behaviours such as smoking[6].
It has become increasingly common for expectant
fathers to attend and participate in antenatal care and
education and there is a greater emphasis for 21st
century fathers to have an increased level of involvement
in the day-to-day care of their children[7,8]. In the past
few decades, it has become normal for fathers to be
present throughout labour and the birth of their baby[2].
In Australia, over 90% of fathers attend the birth of their
child[8].
Studies addressing teenage pregnancy usually em-
phasise the role of the mother and signicantly less data
is available concerning fathers (Quinlivan and Condon[9],
2005; Shah et al[10], 2014). Furthermore, research
addressing teenage pregnancy primarily explores the
impact teenage pregnancy has on the birth and ongoing
development of the child rather than considering the
situation from the parent’s perspective[9,11-14]. There
is limited research investigating the expectations and
decision-making processes in fathers in the setting of
teenage pregnancy[12-16].
The aim of this study was to determine how fathers
in the setting of teenage pregnancy experienced the
birth of their child. The specic aim was to determine
the extent to which they felt prepared for birth.
MATERIALS AND METHODS
Type of study and ethics approval
The Australian Father’s Study is a longitudinal study
addressing father’s attitudes towards antenatal, birth
and postnatal care. The Australian Father’s Study has
institutional ethics committee approval (Joondalup
Health Campus Human Ethics Committee). The trial is
registered at the Australian and New Zealand Clinical
Trials Registry (ACTRN 12613001273774). Individual
informed consent was obtained from each participant.
The Australian Father’s Study includes a representative
sample of Australian fathers as well as selected sampling
of fathers in particular pregnancy settings.
Study population
This manuscript reports on outcomes of fathers in the
setting of teenage pregnancy (Teenage group fathers)
and compares their outcomes to those of fathers
recruited from the same area health network who were
representative of the wider population of Australian
fathers in terms of age, religious belief, years of edu-
cation, employment and first time fatherhood status
(Comparison fathers).
Of note, not all teenage group fathers were teen-
agers. The mean age of fathers in the setting of teenage
pregnancy was 2.1 years older than the expectant
teenage mother. By example, the partners of nineteen-
year-old pregnant women were usually in their early
twenties.
All fathers were recruited by research staff and com-
pleted questionnaires addressing demographic variables,
2February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
Ngweso S
et al
. Teenage pregnancy - fathers not prepared for birth
attitudes and roles in decision-making. Quantitative
and qualitative data was extracted from completed
questionnaires.
Inclusion and exclusion criteria
Expectant fathers were recruited via the pregnant
mother, so the study was only able to include men where
the mother acknowledged the man to be the father of
the baby and gave consent for the father to participate.
Fathers in the setting where pregnancy was complicated
by a known fetal anomaly were excluded. Fathers with
insufcient English to complete questionnaires were also
excluded.
Variables to be measured and examined
The birth questionnaire was completed within seven
days of birth. It consisted of qualitative and quantitative
components. The variables measured and examined
through the questionnaire were collected in five broad
areas: Background demographics, birth outcomes, engage-
ment, involvement in decision making and overall birth
experience. These variables were used as a framework
for analysis of the primary outcome.
Primary hypothesis and sample size
The primary hypothesis was that teenage group fathers
would feel less prepared for the birth of their baby than
the comparison group fathers. Assuming 30% of teenage
group fathers would feel prepared for birth, compared
to 50% of comparison group fathers, a sample of 45
teenage group fathers provided 80% power with an error
of 0.05 to detect this difference. The study recruited 50
teenage group fathers to ensure a sufficient sample,
assuming incomplete data might be available from some
questionnaires.
Statistical analysis
Data was entered onto a dataset using Minitab® (version
16, University of Melbourne). A descriptive analysis
was used for the quantitative data. In order to analyse
for differences in responses between teenage group
fathers and comparison group fathers, the signicance
(P) of the differences was determined by a
χ
2 test for
independence. Fisher Exact test was utilized where cell
size was less than five. A P-value of 0.05 was set for
rejection of the null hypothesis. A student t-test was
used to compare continuous data.
For the qualitative data in the comments section of
the questionnaire, an inductive content analysis was
performed in accordance with methodology described
by Elo and Kyngäs[17]. The written comments were
independently read by the principal researchers and an
abstraction process used to summarize and conceptualize
the overall meaning and implications of the comments.
Open coding was performed to maximize the number of
headings in order to describe all aspects of the content.
Both quantitative and qualitative aspects of the data
were integrated for data interpretation.
RESULTS
The demographic characteristics of the study participants
are summarised in Table 1. Teenage group fathers were
signicantly younger (P < 0.0001), more likely to have
been born in Australia (P < 0.0001) and be Aboriginal or
Torres Strait Islander (P = 0.01). Teenage group fathers
were less likely to be living with the mother of the baby
at the time of the birth (P < 0.0001). They were less
likely to have completed post-secondary education (P <
0.0001). Whilst this may have been due to fewer oppor-
tunities due to their younger age, they had signicantly
higher rates of failing to complete secondary education
compared to comparison fathers.
Teenage group fathers were more likely to be
unemployed, and those who were employed were more
likely to be employed part-time for less than 15 h a
week (P < 0.0001). Teenage group fathers were more
likely to smoke (P = 0.0087) and be a rst time father (P
< 0.0001).
The teenage group fathers were signicantly more
likely to report that the pregnancy was unplanned (P
< 0.0001). They were also less likely to fully attend
antenatal classes, even though there were more first
time fathers in the teenage group (P < 0.0001).
Table 2 summarises the role of fathers in relation to
3 February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
Teenage
(
n
= 50)
Control
(
n
= 50)
P
-value
Age, mean (SD) 21.2 (1.2) 31.7 (3.1) < 0.0001
Country of birth
Australia 92% 65% < 0.0001
Elsewhere 8% 35%
Aboriginal or Torres Strait Islander 18% 3% 0.01
Relationship status
Living with partner 32% 88% < 0.0001
Not living with partner 68% 12%
Education
< 12 yr 24% 8% < 0.0001
12 yr 74% 44%
> 12 yr 2% 48%
Employment
No 32% 6% < 0.0001
Yes-locally 54% 76%
Yes-FIFO 14% 18%
Hours employed
0-15 35% 10% < 0.0001
15-40 61% 12%
40+ 4% 78%
Smoker 38% 20% 0.0087
First time father 96% 52% < 0.0001
Pregnancy planning
Natural - planned 22% 68% < 0.0001
IVF - planned 0% 10%
Unplanned 78% 22%
Childbirth education class
Full class 20% 52% < 0.0001
Partial class 24% 8%
Did not attend 56% 40%
Table 1 Demographics of fathers in the setting of teenage
pregnancy compared to control
FIFO: Fly in, y out worker; IVF: In-vitro fertilization.
Ngweso S
et al
. Teenage pregnancy - fathers not prepared for birth
intrapartum decision-making. Teenage group fathers
were less likely to play a role in the decision for the
mother to have pain relief during labour (P = 0.0002),
electronic foetal heart rate monitoring (P = 0.0069),
undergo an articial rupture of membranes (P = 0.049)
or an oxytocic infusion to accelerate labour (P = 0.0058).
Teenage group fathers were also less likely to play a
role in deciding whether the mother should undergo
an assisted vaginal delivery or Caesarean section (P =
0.0002) and reported less of a role in decisions regarding
who enters the delivery room (P 0.0001) and who
held the baby immediately following birth (P < 0.0001).
There was no statistically significant difference
between the teenage group fathers and control as to
decisions regarding the timing of the baby’s rst feed (P
= 0.16).
Results comparing the birth outcomes and experi-
ences of fathers have been summarised in Table 3.
There was no statistically signicant difference between
teenage group fathers and control fathers in regards to
the gestational age of baby (P = 0.15), gender of baby (P
= 0.57) and attendance of the father at birth (P = 0.60).
Spontaneous delivery was higher and necessity for
induction of labour lower with teenage group fathers
as compared with the control group (P = 0.0007 and P
= 0.02 respectively). However, a higher proportion of
teenage group babies were born with birth weights below
10% adjusted for gestational age (P = 0.037) and more
teenage group babies required admission to a neonatal
nursery (P = 0.018).
A signicant proportion of teenage group fathers felt
both ill-prepared for the birth of their child and felt a lack
of consultation by staff during the birthing process (both
P < 0.0001).
In multivariate analysis, after adjusting for other
variables signicant at a univariate level of P < 0.1 as
being signicant associations of not feeling prepared for
birth (age, relationship status, employment, pregnancy
planning, childbirth education class, delivery mode, and
admission to neonatal nursery), teenage group fathers
remained a significant independent association (P =
0.0008).
It was not the aim, nor was the study adequately
powered, to detect a difference between fathers who
were teenagers (aged less than 20 years) compared
to those who were older but within the context of a
maternal teenage pregnancy. However, no significant
4 February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
Did you play a role in the following
decisions
Teenage
(
n
= 50)
Control
(
n
= 50)
P
-value
Pain relief in labour
Yes 3 (6%) 15 (30%) 0.0002
No 47 (94%) 35 (70%)
Electronic foetal heart rate monitoring
Yes 1 (2%) 8 (16%) 0.0069
No 49 (98%) 42 (84%)
Articial rupture of the membranes
Yes 0 (0%) 4 (8%) 0.049
No 50 (100%) 46 (92%)
Oxytocic infusion to accelerate labour
Yes 0 (0%) 8 (16%) 0.0058
No 50 (100%) 42 (84%)
Type of birth (by example need for
assisted delivery or caesarean section)
Yes 2 (4%) 14 (28%) 0.0002
No 48 (96%) 36 (72%)
Who enters the delivery room
Yes 9 (18%) 39 (78%) < 0.0001
No 41 (82%) 11 (22%)
Who held your baby immediately after
the birth
Yes 8 (16%) 40 (80%) < 0.0001
No 42 (84%) 10 (20%)
Timing of the baby’s rst feed
Yes 2 (4%) 5 (10%) 0.16
No 48 (96%) 45 (90%)
Table 2 Role of fathers in the setting of teenage pregnancy in
intrapartum decision making
Ngweso S
et al
. Teenage pregnancy - fathers not prepared for birth
Birth outcomes Teenage
(
n
= 50)
Control
(
n
= 50)
P
-value
Gestational age of baby
Preterm (< 37 wk) 6 (12%) 4 (8%) 0.15
Term (37-41 wk) 42 (84%) 41 (82%)
Post term (> 41 wk) 2 (4%) 5 (10%)
Induction of labour
Yes 9 (18%) 14 (28%) 0.02
No 40 (80%) 31 (62%)
N/A (had elective CS) 1 (2%) 5 (10%)
Newborn gender
Male 25 (50%) 27 (54%)
Female 25 (50%) 23 (46%) 0.57
Birth weight below 10% adjusted for
gestational age
Yes 8 (16%) 4 (8%) 0.037
No 42 (84%) 46 (92%)
Delivery mode
Spontaneous vaginal birth 39 (78%) 26 (52%) 0.0007
Assisted vaginal birth 6 (12%) 8 (16%)
Elective Caesarean birth 1 (2%) 5 (10%)
Non-elective Caesarean birth 4 (8%) 11 (22%)
Required admission to a neonatal nursery
Yes 10 (20%) 5 (10%) 0.018
No 40 (80%) 45 (90%)
Father attended the birth
Yes 49 (98%) 50 (100%) 0.91
No 1 (2%) 0 (0%)
Father felt prepared for the birth
Yes 6 (12%) 42 (84%) < 0.0001
Neutral 37 (74%) 2 (4%)
No 7 (14%) 4 (8%)
Father found midwifery staff to be helpful
Yes 40 (80%) 41 (82%) 0.60
Neutral 8 (16%) 6 (12%)
No 2 (4%) 3 (6%)
Father found medical staff to be helpful
Yes 38 (76%) 41 (82%) 0.004
Neutral 10 (20%) 4 (8%)
No 2 (4%) 5 (10%)
Father felt consulted by staff during birth
Yes 5 (10%) 40 (80%) < 0.0001
Neutral 22 (44%) 6 (12%)
No 23 (46%) 4 (8%)
Table 3 Birth outcomes and experiences of fathers in the
setting of teenage pregnancy
N/A: Not applicable.
differences in key outcomes under evaluation were
detected between these groups (all P > 0.05).
Qualitative analysis
Thirty of the 50 teenage group fathers wrote comments
about the birth experience. Four positive and four nega-
tive themes were identied.
The first positive theme was happiness. Twenty
fathers wrote comments relating to their general sense
of happiness. Fathers said: “this is the best experience
of my life”; “I’m so happy. I’ve been jumping around”.
The second positive theme was love for the baby.
Fifteen fathers wrote comments about love for their
baby. Fathers called their baby “precious, “amazing”,
“wonderful”, and many used the word “love” to express
their feelings. By example fathers stated: “she is the
most precious (sic) thing I have”; “It was amazing how
I just suddenly love her”.
The third positive theme was pride and a sense of
achievement. Seven respondents wrote comments
related to this theme. Fathers stated: “…I’ve really
achieved something”; “the best thing I’ve ever done”.
Despite being young, six fathers expressed satis-
faction with their fertility as the nal theme. One father
said: “it’s nice to know I’m not ring blanks.
There were four negative themes. The rst negative
theme related to fathers feeling unprepared for the birth
process. A total of 19 fathers expressed this theme.
Comments included: “It was pretty fast and furious. I
wasn’t prepared”; “much more gory than I thought it
would be”; “Horrible really. I wasn’t ready for that”.
The theme of shock was expressed by seven fathers.
Comments included: “I’m in shock”; “My heart raced
and I was shaking”; “Terrifying”. Fear for the baby was
the third negative theme. Five fathers expressed a
fear that their baby might die or be injured or disabled.
Comments included: “…frightened (sic) he would die”;
“when that suction thing came out it freaked me out. I
thought the baby was going to die or have its head torn
off”. The final theme was a sense of detachment from
the birthing process. Four fathers made comments,
including: “I felt like I was watching a TV program”; “it
felt like it was happening to someone else and not me”.
Interestingly, no fathers wrote comments about the
mother of the baby, or any other relatives or in relation to
care providers. All comments related to either the father
and/or the baby.
DISCUSSION
Research into the role and experiences of fathers during
the birthing process is limited. This is one of the first
studies specifically examining the birth experience of
fathers in the setting of teenage pregnancy. The teenage
group fathers reported feeling less prepared and less
consulted during birth and had less participation in
decision-making processes. These findings, together
with the negative themes of being unprepared, shocked,
fearful for the baby and having a sense of detachment,
support the study hypothesis that fathers in the setting
of teenage pregnancy are less prepared and engaged in
birth than other fathers.
Teenage group fathers were more likely to be having
their first baby. We considered this might explain the
higher rates of feeling unprepared and shocked at the
birthing process. However, in multivariate analysis, rst
time fatherhood status was not signicantly associated
with feeling unprepared for the birth and teenage group
fatherhood remained signicant.
One strategy to help teenage group fathers prepare
for birth would be through participation in childbirth
education classes. However, teenage group fathers were
less likely to attend such classes, even though they
were more likely to be a first time father. The classes
were free of charge, so there was no cost disincentive
to attendance. Teenage group fathers were more likely
to be unemployed or employed only part time, so
time constraints were also unlikely to be a barrier to
attendance. It may be that teenage group fathers felt
reluctant to attend childbirth education classes due to
their age. This area requires further exploration in a
directed qualitative study.
The educational and employment differences bet-
ween teenage group fathers and comparison fathers
may impact upon the resources these fathers have to
assist the mothers with emotional support in labour and
subsequent parenting. The quality of support material
provided to fathers is associated with children’s outcomes.
The social disadvantage of younger fathers has been
explored by Mollborn and Lovegrove[15], who considered
the lower income and education of teenage fathers to
pose a “contextual risk” for their children. The degree
of social disadvantage experienced by teenage fathers
is likely a signicant contributing factor to the degree of
unpreparedness and reduced level of satisfaction with
the birth process[14]. There is a likely association between
teenage pregnancy and factors consistent with social
disadvantage including poverty, unemployment, poor
academic achievement and physical abuse[16].
Sixty-eight percent of teenage group fathers were not
living with the mother as compared with 12% of control
group fathers and 96% of the teenage group fathers
were first time parents. These social factors provide
plausible explanation as to why the teenage group
fathers reported a limited role in intrapartum decision-
making (all decisions < 20% identied a role). It could be
expected that a father who is not living with the mother
of the baby would be expected by care providers and the
father himself, to have less say in intrapartum decision-
making processes. Similarly, a rst time father may feel
more comfortable deferring decisions to the mother, the
mother’s immediate family (e.g., future grandmother) or
as directed by attending medical and/or midwifery staff.
The majority of teenage group fathers reported the pre-
gnancy was unplanned. This lack of control over planning
may also have impacted upon father’s experiences of
feeling engaged in intrapartum decision-making and
birth. Expectant fathers decision-making in the setting of
5 February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
Ngweso S
et al
. Teenage pregnancy - fathers not prepared for birth
teenage pregnancy is complex and underlying personality
traits, idealisation of pregnancy and relationship quality
may impact upon levels of comfort and engagement with
the expectation of fatherhood[12-14].
As described, thematic analysis of qualitative com-
ments from the teenage group fathers revealed four
main negative themes; unpreparedness, shock, fear and
a sense of detachment from the birth. Previous research
has shown similar themes. Deave and Johnson[2]
conducted a series of semi-structured interviews amongst
rst-time fathers and identied themes of apprehension,
unpreparedness, fear, anxiety and the feeling of being
a helpless bystander. Given partner support is a key
feature to successful outcomes in teenage pregnancy, it
is important father’s fears and lack of preparedness for
birth are resolved[10].
There were a number of limitations to this research.
All fathers who participated in the questionnaire were
recruited via women attending antenatal clinics who
consented to the researchers approaching the father.
We were therefore not able to secure input from men
estranged from their partner. Similarly, fathers where
pregnancy was complicated by a known fetal anomaly
or where they lacked sufficient English to complete
questionnaires, were excluded. Finally, fathers in the
teenage group were not necessarily teenagers, with the
mean age of fathers 2.1 years older than the pregnant
mother.
Implications for practice
Fathers play an important role in the lives of their
children. Few fathers in the setting of teenage pregnancy
are prepared for the birth of their baby. They are not
engaged in intrapartum decision-making and do not
feel consulted by attending staff. They are less likely to
attend childbirth preparation classes. Engaging fathers
in the setting of teenage pregnancy in childbirth prepara-
tion might reduce adverse feelings of shock, fear and
detachment associated with their child’s birth. This may
facilitate early father-infant attachment in this vulnerable
group.
ACKNOWLEDGMENTS
We acknowledge the research staff and students
who have participated in subject recruitment, data
collection and analysis in the Australian Father’s Study.
A complete list of names is available at the trial website
(http://www.australianfathersstudy.com).
COMMENTS
Background
Research on the attitudes of fathers in the setting of teenage pregnancy is lim-
ited.
Research frontiers
Engaged fathers in the setting of teenage pregnancy improves pregnancy, birth
and mother and child postnatal outcomes. To improve engagement, the authors
rst need to understand why such fathers may not be engaged with birth pro-
cesses.
Innovations and breakthroughs
Current processes leave teenage fathers unprepared for the birth of their child
and this promotes disengagement. Greater antenatal engagement may over-
come this problem.
Applications
This research is directly applicable to clinical staff who provide antenatal care
for teenage mothers.
Terminology
The term “fathers in the setting of teenage pregnancy” is a specic term that
refers to the man who fathered the child when a teenage female is pregnant.
Given fathers are on average, 2 years older than mothers, many fathers in this
setting will not be teenagers themselves, but may be in their early twenties.
Peer-review
This is a well written well designed study to evaluate paternal preparedness in
adolescent pregnancies.
REFERENCES
1 Condon JT, Boyce P, Corkindale CJ. The First-Time Fathers Study:
a prospective study of the mental health and wellbeing of men
during the transition to parenthood. Aust N Z J Psychiatry 2004; 38:
56-64 [PMID: 14731195 DOI: 10.1111/j.1440-1614.2004.01298.x]
2 Deave T, Johnson D. The transition to parenthood: what does it
mean for fathers? J Adv Nurs 2008; 63: 626-633 [PMID: 18808584
DOI: 10.1111/j.1365-2648.2008.04748.x]
3 van Bussel J, Spitzb B, Demyttenaerec K. Childbirth expectations
and experiences and associations with mothers’ attitudes to
pregnancy, the child and motherhood. J Reprod Infant Psyc 2010;
28: 143-160 [DOI: 10.1080/02646830903295026]
4 Christiaens W, Bracke P. Assessment of social psychological
determinants of satisfaction with childbirth in a cross-national
perspective. BMC Pregnancy Childbirth 2007; 7: 26 [PMID:
17963491 DOI: 10.1186/1471-2393-7-26]
5 Redshaw M, Henderson J. Fathers’ engagement in pregnancy and
childbirth: evidence from a national survey. BMC Pregnancy Childbirth
2017; 13: 70 [PMID: 23514133 DOI: 10.1186/1471-2393-13-70]
6 Alio AP, Lewis CA, Scarborough K, Harris K, Fiscella K. A
community perspective on the role of fathers during pregnancy: a
qualitative study. BMC Pregnancy Childbirth 2017; 13: 60 [PMID:
23497131 DOI: 10.1186/1471-2393-13-60]
7 Fenwick J, Bayes S, Johansson M. A qualitative investigation into
the pregnancy experiences and childbirth expectations of Australian
fathers-to-be. Sex Reprod Healthc 2012; 3: 3-9 [PMID: 22325796
DOI: 10.1016/j.srhc.2011.11.001]
8 McKellar L, Pincombe J, Henderson A. Enhancing fathers’
educational experiences during the early postnatal period. J Perinat
Educ 2008; 17: 12-20 [PMID: 19436437 DOI: 10.1624/105812408
X364134]
9 Quinlivan JA, Condon J. Anxiety and depression in fathers in
teenage pregnancy. Aust N Z J Psychiatry 2005; 39: 915-920 [PMID:
16168019 DOI: 10.1111/j.1440-1614.2005.01664.x]
10 Shah MK, Gee RE, Theall KP. Partner support and impact on birth
outcomes among teen pregnancies in the United States. J Pediatr
Adolesc Gynecol 2014; 27: 14-19 [PMID: 24316120 DOI: 10.1016/
j.jpag.2017.08.002]
11 Quinlivan JA. Teenage Parents. Community Paediatric Review
2008; 16: 5-6
12 Tan LH, Quinlivan JA. Domestic violence, single parenthood, and
fathers in the setting of teenage pregnancy. J Adolesc Health 2006;
38: 201-207 [PMID: 16488816 DOI: 10.1016/j.jadohealth.2004.10.
014]
6 February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
COMMENTS
Ngweso S
et al
. Teenage pregnancy - fathers not prepared for birth
13 Condon JT, Corkindale CJ, Russell A, Quinlivan JA. Processes
and Factors Underlying Adolescent Males’ Attitudes and De-
cision-Making in Relation to an Unplanned Pregnancy. J Youth
Adolescence 2006; 35: 423-434 [DOI: 10.1007/s10964-005-9025-2]
14 Corkindale CJ, Condon JT, Russell A, Quinlivan JA. Factors that
adolescent males take into account in decisions about an unplanned
pregnancy. J Adolesc 2009; 32: 995-1008 [PMID: 18950852 DOI:
10.1016/j.adolescence.2008.08.008]
15 Mollborn S, Lovegrove PJ. How Teenage Fathers Matter for
Children: Evidence From the ECLS-B. J Fam Issues 2011; 32: 3-30
[PMID: 21927527 DOI: 10.1177/0192513X10370110]
16 Quinlivan JA, Tan LH, Steele A, Black K. Impact of demographic
factors, early family relationships and depressive symptomatology
in teenage pregnancy. Aust N Z J Psychiatry 2004; 38: 197-203
[PMID: 15038797 DOI: 10.1111/j.1440-1614.2004.01336.x]
17 Elo S, Kyngäs H. The qualitative content analysis process. J
Adv Nurs 2008; 62: 107-115 [PMID: 18352969 DOI: 10.1111/
j.1365-2648.2007.04569.x]
P- Reviewer: Rovas L, Usta IM S- Editor: Ji FF L- Editor: A
E- Editor: Li D
7 February 10, 2017
|
Volume 6
|
Issue 1
|
WJOG
|
www.wjgnet.com
Ngweso S
et al
. Teenage pregnancy - fathers not prepared for birth
© 2017 Baishideng Publishing Group Inc. All rights reserved.
Published by Baishideng Publishing Group Inc
7901 Stoneridge Drive, Pleasanton, CA 94588, USA
Telephone: +1-925-223-8242
Fax: +1-925-223-8243
E-mail: bpgofce@wjgnet.com
Help Desk: http://www.f6publishing.com/helpdesk
http://www.wjgnet.com
... 2 Adolescent fathers are likely to be scared and shocked due to being unprepared for the pregnancy. 23 This unpreparedness can further be followed by the unavoidable task of having to inform their parents and other family members that they had fathered a child. ...
... 27 Furthermore, adolescent fathers had significantly higher failure rates in completing secondary education. 23 Due to the cessation of schooling, adolescent fathers find it more difficult to secure employment in the future than their childless peers who likely completed tertiary education and may have good employment prospects. Difficult financial situations made it very hard for participants to play an active role in their children's lives. ...
Article
Full-text available
Teenage pregnancy is a significant concern for society, and the effect on education is immense. In South Africa, policies were thus introduced allowing pregnant school-going children to continue attending class until the baby’s birth. However, research on adolescent pregnancy generally ignores teenage fathers and focuses mostly on teenage mothers. Parents of teenage girls are also encouraged to offer support to their children, but the same cannot be said about adolescent fathers. They confront numerous barriers in fulfilling their parenting roles. A qualitative exploratory study was conducted to explore adolescent fathers’ dilemmas, challenges, and opportunities. Interviews were conducted to collect data from 5 adolescent fathers in 1 township in South Africa. Findings indicate that adolescent fathers face various challenges and experience fatherhood differently. The phenomenon’s effects on education are immense and unavoidable, yet some opportunities accompany the fathering role. Adolescent fathers are exposed to several complex situations that impact their lives. To understand these, further research studies into adolescent fatherhood still need to be conducted, and reproductive health education efforts should equally be directed toward empowering boys to the same extent as girls.
Article
Full-text available
Teenage pregnancy is considered to be one of the most important adolescent health problems in Western society. It is associated with a high economic cost involving both direct monetary expenditure for public assistance for welfare and child health care as well as negative societal outcomes in terms of child abuse, neglect and poverty (Quinlivan, 2004). Australia now has one of the highest adolescent fertility rates in the world. Teenage mothers may experience a number of adverse outcomes associated with teenage pregnancy including failure to complete schooling, inability to find a job, and increased risk of poor health (Quinlivan, 2004; Social Exclusion Unit, 1999). There is now considerable evidence that many teenagers idealise pregnancy and parenthood and regard it with high expectations. A significant proportion of adolescent pregnancies result as a consequence of positive, idealised attitudes to pregnancy, parenthood and personal change rather than by accident or negative attitudes to contraception (Condon et al., 2001).
Article
Full-text available
Background Early involvement of fathers with their children has increased in recent times and this is associated with improved cognitive and socio-emotional development of children. Research in the area of father’s engagement with pregnancy and childbirth has mainly focused on white middle-class men and has been mostly qualitative in design. Thus, the aim of this study was to understand who was engaged during pregnancy and childbirth, in what way, and how paternal engagement may influence a woman’s uptake of services, her perceptions of care, and maternal outcomes. Methods This study involved secondary analysis of data on 4616 women collected in a 2010 national maternity survey of England asking about their experiences of maternity care, health and well-being up to three months after childbirth, and their partners’ engagement in pregnancy, labour and postnatally. Data were analysed using descriptive statistics, chi-square, binary logistic regression and generalised linear modelling. Results Over 80% of fathers were ‘pleased or ‘overjoyed’ in response to their partner’s pregnancy, over half were present for the pregnancy test, for one or more antenatal checks, and almost all were present for ultrasound examinations and for labour. Three-quarters of fathers took paternity leave and, during the postnatal period, most fathers helped with infant care. Paternal engagement was highest in partners of primiparous white women, those living in less deprived areas, and in those whose pregnancy was planned. Greater paternal engagement was positively associated with first contact with health professionals before 12 weeks gestation, having a dating scan, number of antenatal checks, offer and attendance at antenatal classes, and breastfeeding. Paternity leave was also strongly associated with maternal well-being at three months postpartum. Conclusions This study demonstrates the considerable sociodemographic variation in partner support and engagement. It is important that health professionals recognise that women in some sociodemographic groups may be less supported by their partner and more reliant on staff and that this may have implications for how women access care.
Article
Full-text available
Background Defining male involvement during pregnancy is essential for the development of future research and appropriate interventions to optimize services aiming to improve birth outcomes. Study Aim: To define male involvement during pregnancy and obtain community-based recommendations for interventions to improve male involvement during pregnancy. Methods We conducted focus groups with mothers and fathers from the National Healthy Start Association program in order to obtain detailed descriptions of male involvement activities, benefits, barriers, and proposed solutions for increasing male involvement during pregnancy. The majority of participants were African American parents. Results The involved “male” was identified as either the biological father, or, the current male partner of the pregnant woman. Both men and women described the ideal, involved father or male partner as present, accessible, available, understanding, willing to learn about the pregnancy process and eager to provide emotional, physical and financial support to the woman carrying the child. Women emphasized a sense of “togetherness” during the pregnancy. Suggestions included creating male-targeted prenatal programs, enhancing current interventions targeting females, and increasing healthcare providers’ awareness of the importance of men’s involvement during pregnancy. Conclusions Individual, family, community, societal and policy factors play a role in barring or diminishing the involvement of fathers during pregnancy. Future research and interventions should target these factors and their interaction in order to increase fathers’ involvement and thereby improve pregnancy outcomes.
Article
Full-text available
Much is known about how having a teenage mother influences children's outcomes, but the relationship between teenage fatherhood and children's health and development is less well documented. Using the Early Childhood Longitudinal Study-Birth Cohort, the authors investigated how teenage fathers matter for children. They expected teenage fathers' influence on children to differ from adult fathers' in three domains: the household context, the father-mother relationship, and the father-child relationship. Teenage fathers were less often married and more often cohabiting or nonresident, and their children experienced a variety of social disadvantages in their household contexts. The quality of the father-child relationship did not often differ between adolescent and adult fathers. Fathers' marital status and children's household contexts each fully explained the negative relationship between having a teen father and children's cognitive and behavior scores at age 2. These findings suggest that policy interventions could possibly reduce these children's developmental gaps in the critical preschool years.
Article
Full-text available
Since the 1970s, men have been encouraged to actively participate in the childbirth process, resulting in a shared experience for couples. Nevertheless, after the baby is born, many fathers find themselves displaced, unsure of how to embrace the transition to parenthood. The shift in cultural practice and evolving needs of families calls for the recognition of fathers as well as mothers in the provision of midwifery services. Innovative strategies must be considered to enhance postnatal education that is father-inclusive and responsive to the needs of families in the 21st century. This article introduces one strategy created from an action research study conducted to develop, implement, and evaluate strategies to improve postnatal education for parents.
Article
Background: Immature ovarian teratoma is very rare in childhood. We are reporting 12 yo female with immature ovarian teratoma who presented initially with syndrome of inappropriate antidiuretic hormone. Case: A 12 yo female presented with acute abdomen and distention. Initial laboratory tests showed hyponatremia (sodium -123 mmol/L), that did not respond to fluid management. Computerized tomography showed a 15 cm x 9 cm x 20 cm mass in the right ovary with multifocal internal fat, and dystrophic calcifications. She underwent exploratory laparotomy with a right salpingo-oophorectomy, omentectomy and peritoneal stripping. The pathology revealed metastatic immature teratoma. Hyopnatremia resolved soon after the surgery SUMMARY AND CONCLUSION: Although a rare diagnosis, immature ovarian teratoma must be considered in a girl presenting with abdominal mass and hyponatremia.
Article
Despite hypothesized relationships between lack of partner support during a woman's pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States. In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes. Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26-0.54)] and nearly 2 times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support. Having partner support or involvement during a teenager's pregnancy may reduce the likelihood of having a poor birth outcome.
Article
Objective: The aim of this study was to investigate whether a woman’s childbirth experience could be predicted by Raphael‐Leff’s model of antenatal views of pregnancy and motherhood (the Facilitator, Regulator, Reciprocator, and Conflicted or Bipolar mother). Design and methods: In a monocentric prospective observational cohort study, 298 expecting mothers completed a booklet with questionnaires (including the Facilitator scale, Regulator scale, and Salmon Item List) at 30–36 gestational weeks (T1). A follow‐up booklet was completed at 8–12 weeks postpartum (T2). Obstetric outcome was retrieved from the electronic patient files. Results: At T2, women reported less distress and less difficulty than they had expected at T1. Women tending to the Facilitator orientation expected more fulfilment and less distress, whereas women tending to the Regulator orientation expected less fulfilment and more distress. Similar associations were found for the actual childbirth experience. However, the significance of the contribution to the childbirth experience disappeared when controlled for obstetric history, maternal expectations, and obstetric and neonatal outcome. In addition, primiparious women tending to the Facilitator orientation reported less intrapartum feelings of fulfilment when they had an assisted delivery. Conclusion: The maternal orientations contribute, to some extent, to the understanding of the variations in the childbirth experience.
Article
This research examined adolescent males’ decision-making when confronted with a hypothetical unplanned pregnancy in a sexual partner. An innovative methodology, involving a computerized simulation game was utilized with 386 Australian males (mean age of 15 years). Data were gathered from responses made during the simulation, and questionnaires assessed idealization of pregnancy and parenthood, stereotypic male beliefs and self-esteem. Descriptive findings are presented, together with multivariate analyses to examine predictors of participants’ choices about whether to (a) terminate the pregnancy and (b) continue the relationship with the sexual partner. Idealized beliefs about pregnancy and parenthood were important in the decision relating to the pregnancy outcome (p < 0.001). The computer simulation has potential as a cost-effective component of adolescent pregnancy prevention programs that could challenge these idealized beliefs.
Article
To explore and describe men's experiences of pregnancy and childbirth expectations. There remains limited work exploring expectant father's perspectives. Qualitative descriptive design. Twelve Australian expectant fathers participated in between 1 and 2 interviews during pregnancy and 1 after childbirth (32 in total). Six fathers also chose to submit a number of diary entries via e-mail. Thematic analysis was used to analyse the data set. Five themes emerged from the data. The themes pregnancy news: heralds profound change adjusting to pregnancy, and birth looming described how men processed the news of pregnancy, worked to accept their changed circumstances and negotiated the final week of the pregnancy. A fourth theme, labelled Feeling sidelined, outlined men's experiences of antenatal care and their feeling of isolation as a result of largely feeling ignored by health care professionals. The fifth theme represents men's childbirth expectations. Adjusting to the news of a pregnancy was a potentially unsettling time for an expectant father that was often associated with increased apprehension and anxiety. Regardless of whether they were a first or once again father most men engaged in a level of emotional work to come to terms with and accept the pregnancy. Understanding men's antenatal experiences and anxieties is an important step in the development of preventative paternal perinatal mental health measures. The significance of this work is situated within the reality that men's wellbeing is associated with maternal psychological well-being, positive peri-natal experiences and child development.