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Engagement in health services among expectant and new fathers: Qualitative findings from a cross sectional study

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      Background

      Although the continuum of pregnancy, childbirth, and the puerperium is commonly considered a feminine event, the role of fatherhood and fathers’ participation in this context is in transformation. Studies suggest that engagement of fathers in family health services may confer benefits for both the father and the whole family. However, fathers commonly feel excluded from family health, and attempts made to implement father engagement strategies in these services have had limited success. The aim of this aspect of the study was to explore perceptions and experiences of healthcare engagement in the pregnancy and postnatal context.

      Methods

      Expectant and new fathers were recruited through Prolific, an international paid online survey platform. The survey included free text questions to explore fathers’ attendance, participation and experience of health care during appointments with their pregnant partner and/or baby.

      Results

      The survey was completed by a culturally diverse population (n=889), 46.8% of whose partners were pregnant and 53.2% had given birth since 2020. Experiences were reported from a range of contexts and models of care across the 28 countries represented in the sample. Although most fathers wanted to attend and participate in maternity and early parenting-related healthcare, multiple barriers were identified at the individual provider, contextual and organisational levels. Fathers reported negative social factors such as gender bias and restrictive gender norms as barriers to their healthcare engagement. In contrast, fathers’ experiences of confidence in the woman’s autonomy and decision-making skills, trusted professional relationships with clinicians, and good clinician interpersonal skills enabled transcendence from some of the barriers experienced.

      Conclusion

      Internationally, social, contextual and organisational barriers currently restrict the participation of fathers in healthcare for childbearing and early parenting. Knowledge of these barriers can inform healthcare redesign to include more successful engagement strategies for fathers, to benefit fathers, partners and infants.
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