The transition to fatherhood - evaluation of an online intervention for new fathers

This mixed-methods study explores an innovative online group intervention for new fathers. The specific aims were to investigate attendance rates, fathers' participation experiences, and the effects on their psychological well-being and marital quality. The research design included a randomized controlled trial with 122 participants split into intervention (n = 62) and comparison groups (n = 60). The study measured post-partum depression symptoms (PPD) using the Edinburgh Post-Natal Depression Scale (EPDS) and spousal relationship quality using the Israeli Marital Quality Scale (IMQS). Qualitative data were collected through session transcripts and feedback questionnaires that were completed two years post- intervention. Results reveal an 86.47% average attendance rate in the intervention groups and positive outcomes at both individual and spousal levels. Participants reported feeling a sense of normalcy, decreased loneliness, increased awareness of fatherhood transition, and becoming active co-parents. Marital quality also showed better results for the intervention group. Further research is recommended to explore online group interventions among additional groups of post-partum fathers.

Perception of Paternal Postpartum Depression among Healthcare Professionals: A Qualitative Study

The pathway to parenthood constitutes a fundamental and transformative stage in every individual's life. While postpartum depression in mothers has been increasingly studied and acknowledged, paternal postpartum depression (PPD) has garnered only moderate research attention. This study aims to delve into the comprehension and knowledge of healthcare professionals who may encounter men suffering from postpartum depression. Within the framework of this qualitative research, we conducted six semi-structured interviews with various healthcare professionals. The data were subjected to interpretative phenomenological analysis, revealing the following themes: (1) the professionals' uncertainty in the face of paternal PPD; (2) the context and timing of healthcare professionals' involvement appeared unsuited for detecting paternal PPD; (3) the experiences of fathers were found not to be shared with healthcare professionals due to their inhibitions and avoidance reactions; (4) the social representation of the role of fathers influenced professionals in their considerations of this aspect. Strengthening the training and confidence of healthcare professionals in France would lead to an enhancement in the screening and management of paternal PPD. Additionally, the healthcare system should better organize postnatal support to enable caregivers to be more available during the peak of depression occurrence.

"What Can I Do to Not Have This Life"? A Qualitative Study of Paternal Postnatal Depression Experiences among Fathers in the United Kingdom

Understandings of paternal postnatal depression (PND) in fathers from the United Kingdom (UK) have received limited attention, particularly in view of changing dynamics of contemporary parenthood. To rectify this, eight UK fathers with PND took part in one-to-one interviews, with Interpretative Phenomenological Analysis used to understand their lived experiences. Our findings demonstrate that UK fathers with PND experienced extremely distressing emotions, including anger and misery, after their babies are born. Their working practices were highly relevant to their fatherhood, with working considered a key responsibility and a source of stress, but also a "legitimate" escape from the home. Fathers' relationships with their partners were experienced as less intimate and conflicted. Fathers often hid their feelings to protect their partners, but also reported their partners as being aware of their challenging and difficult emotions. Healthcare providers should be professionally curious about fathers' mental health and consider the assistance of mothers in identifying cases of paternal PND.

Postpartum Paternal Depression: Its Impact on Family and Child Development

The postpartum period is when parents undergo great changes and gain new responsibilities. Factors such as the changes that come with having a baby, not meeting the expectations about parenthood, having a child with a difficult temperament or health problems, or relational problems can be quite challenging in this period. These problems can deeply affect the psychological well-being of the parents. Although studies on depressive symptoms of mothers during pregnancy and postpartum are at an important level, studies aiming to examine the psychological state of fathers for the same period are still limited. However, perceptions that postpartum depression develops due to hormonal changes during pregnancy have been reshaped by the findings that this situation may also develop due to psychosocial factors. Relatedly, the number of studies on postpartum depression experienced by fathers has increased over time. Results of those studies show that fathers' psychological state also influences their parenting and the development of children. Fathers may experience paternal depression due to a lack of social support, economic conditions, relationship dynamics, and changing living conditions in the postpartum period. This situation may cause fathers to avoid parenting duties, spend less time with their children, be unable to cooperate with the mother, and have anger problems or deterioration in the relationship with the mother. The effects of depression on individuals' parenting styles negatively affect child-parent attachment and may cause children to develop emotional and behavioral problems. Therefore, it is very important to examine fathers' psychological state for children's development and the healthy progress of family dynamics. This review aims to address the effect of paternal depression on parenting and child development.

Paternal perinatal depression: A concept analysis

AIM

Our aim is to clarify the concept of paternal perinatal depression including its definition, attributes, antecedents and consequences.

DESIGN

A concept analysis.

METHODS

To obtain relevant evidence, several databases were searched systematically including PubMed, EMBASE, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Qualitative or quantitative articles published in English that focused on paternal perinatal depression were included. After the literature quality assessment, Walker and Avant's concept analysis strategy was used.

RESULTS

Five defining attributes (i.e. symptoms occur during the partner's pregnancy or 1-year postpartum and last at least 2 weeks, emotional symptoms, somatic symptoms, negative parenting behaviours and 'masked' symptoms), four antecedents (i.e. personal issues, pregnancy-related issues, infant-related issues, social issues) and three consequences (i.e. offspring outcomes, marital relationship, maternal negative emotions) were identified.

Paternal postnatal depression: prevalence and the associated demographic and maternal reproductive factors among Iranian fathers

BACKGROUND

Paternal postnatal depression (PPND) is a critical mental health issue that may harm family members' health and relationships. The Edinburgh Postpartum Depression Scale (EPDS) is the most common self-reported questionnaire for postnatal depression screening among mothers and fathers worldwide. However, identifying fathers with postnatal depression and determining the related factors have been neglected in some countries.

AIMS

The present study aimed to determine the prevalence of PPND and then to identify its predictive demographic and reproductive factors. Two cut-off points (10 and 12) for the EPDS were used to detect PPND.

METHODS

This cross-sectional study was conducted on 400 eligible fathers selected via multistage sampling. Data were collected using a demographic checklist and the EPDS.

RESULTS

None of the participants had previously been screened for PPND. The mean age of the participants was 35.53 ± 5.47 years, and most of them were self-employed and had university degrees. The prevalence of PPND was 24.5% and 16.3% using the EPDS cut-off scores 10 and 12, respectively. An unwanted pregnancy and an abortion history were the predictors of PPND at both EPDS cut-off scores, with gravidity and the number of abortions also being associated with PPND at the cut-off score of 10.

CONCLUSION

In line with the related literature, our results revealed a fairly high prevalence of PPND and its related factors. This indicates the need for a screening program for fathers during the postnatal period to detect and adequately manage PPND and prevent its adverse effects.

Non-birthing mothers' experiences of perinatal anxiety and depression: Understanding the perspectives of the non-birthing mothers in female same-sex parented families

OBJECTIVE

Partners of birthing mothers can themselves experience perinatal mental health (PMH) difficulties. Despite birth rates increasing amongst LGBTQIA+ communities and the significant impact of PMH difficulties, this area is under-researched. This study aimed to examine the experiences of perinatal depression and anxiety of non-birthing mothers in female same-sex parented families.

DESIGN

Interpretative Phenomenological Analysis (IPA) was used to explore the experiences of non-birthing mothers who self-identified as having experienced perinatal anxiety and/or depression.

SETTING AND PARTICIPANTS

Sevenparticipants were recruited from online and local voluntary and support networks for LGBTQIA+ communities and for PMH. Interviews were in-person, online or via telephone.

MEASUREMENTS AND FINDINGS

Six themes were generated. Distress was characterised by feelings of "Failure and Inadequacy in Role" (i.e., parent, partner and individual) and "Powerlessness and Intolerable Uncertainty" in their parenting journey. These feelings were reciprocally influenced by perceptions of the "Legitimacy of (Di)stress as a Non-birthing Parent", which impacted help-seeking. Stressors that contributed to these experiences were: "Parenting Without" a parental role template, social recognition and safety, and parental connectedness; and "Changed Relationship Dynamics" with their partner. Finally,participants spoke about "Moving Forward" in their lives.

KEY CONCLUSIONS

Some findings are consistent with the literature on paternal mental health, including parents' emphasis on protecting their family and experiencing services as focusing on the birthing parent. Others appeared distinct or amplified for LGBTQIA+ parents, including the lack of a defined and socially recognised role; stigma concerning both mental health and homophobia; exclusion from heteronormative healthcare systems; and the importance placed on biological connectedness.

IMPLICATIONS FOR PRACTICE

Culturally competent care is needed to tackle minority stress and recognise diverse family forms.

Bidirectional associations between paternal postpartum depression symptoms and coparenting: A cross-lagged panel model of fathers of infants and toddlers

BACKGROUND

Finding modifiable predictors of paternal depression symptoms is helpful for developing interventions. The aim is to assess the unidirectional and/or bidirectional associations between paternal postpartum depression symptoms and coparenting among fathers of infants and toddlers.

METHODS

Longitudinal data were collected prospectively from 429 fathers of infants aged 0-24 months (median = 8 months) in Sweden, with 6- and 18-month follow-ups. All fathers participated in at least two of three waves of data collection, and multiple imputation was used for missing values. The Edinburgh Postnatal Depression Scale was used to detect depression symptoms (≥10 points), while the Brief Coparenting Relationship Scale measured the coparenting relationship. A cross-lagged panel model was used to estimate the associations between paternal depression symptoms and coparenting relationship quality over time, controlling for several known covariates and COVID-19 exposure.

RESULTS

Fathers with higher coparenting scores at Time 1 and 2 had less depression symptoms at Time 3, and fathers with more depression symptoms at Time 2 had lower coparenting scores at Time 3. Plotted probabilities of having at least mild depression symptoms revealed a multifold increase in the probability of depression symptoms at Time 3 for fathers with minimal coparenting scores at Times 1 and 2, respectively, compared to fathers with mean coparenting scores at Times 1 and 2, respectively.

LIMITATIONS

Causal links cannot be determined using the current non-experimental study design. Using the EPDS alone may have missed some fathers with depression symptoms.

CONCLUSIONS

Clinicians seeking to reduce paternal depression symptoms should help strengthen the coparenting relationship.

A relational investigation of Israeli gay fathers' experiences of surrogacy, early parenthood, and mental health in the context of the COVID-19 pandemic

Perinatal distress affects approximately 10% of fathers, but little is known about how gay fathers experience the challenges surrounding childbirth and early parenting of a child. This study explored gay fathers' experiences of having a baby via transnational surrogacy, raising that baby as a gay parent, and the context of the COVID-19 pandemic. In-depth qualitative interviews were conducted with 15 Israeli men to understand their experiences of surrogacy and early parenthood, focusing on the impact on their mental health and the relational factors involved. Secondary narrative analysis revealed that fathers constructed surrogacy as a perilous quest that required strong intentionality to undertake. The first year of parenthood was conceptualised alternately as a joyful experience and/or one that challenged fathers' identities and mental health. A relational framework was applied to better conceptualise the fathers' narratives, revealing that actual connections-and the potentials for links-considerably shaped experiences of surrogacy, perinatal distress and recovery. Implications for research and policy are discussed.

Getting help as a depressed dad: A lived experience narrative of paternal postnatal depression, with considerations for healthcare practice

WHAT IS KNOWN ABOUT THE SUBJECT?: A significant proportion of fathers report experiencing depression after their baby is born Fathers are not offered regular support for their psychological well-being in the transition to parenthood despite an acknowledged need for such support WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Lived experience provides new insight into how one father experienced postnatal depression, including the role of his partner in help-seeking It explains the delayed presentation in help-seeking as resulting from healthcare practitioner language and attitudes, and gendered expectations around mental health and help-seeking in the context of fatherhood WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING?: Mental health nurses should be aware that postnatal depression can affect fathers as well as mothers, and that it is necessary to support fathers in safe spaces and with appropriate language Planning care for depression in men should consider the recent birth of a child in order to provide effective care Clearer guidance is needed for supporting new fathers with postnatal depression ABSTRACT: Introduction Fathers are not universally supported with their perinatal mental health, but evidence shows that they suffer at a similar level to mothers. Aim This paper examines the journey of one father through his PND experience, his help seeking, and encounters in healthcare, in order to highlight the needs of a depressed father. Method The method is a father's lived experience narrative which has been written alongside a health visitor who highlights the relevance of the condition to healthcare practice. Results & Discussion The needs of fathers are unmet. They require support which considers their gender role expectations. Partners are key to their help seeking. Implications for practice The language and sensitivity used by nurses is key to encouraging fathers to share their depression and reduce stigma around the condition.

Associations between Paternal Anxiety and Infant Weight Gain

The aim of this study was to examine the relationship between parental anxiety (father-only, mother-only, or both) and infant weight change. We performed a secondary data analysis among 551 children in the Avon Longitudinal Study of Parents and Children, a birth cohort with weight measurements collected prospectively at 4, 8, and 12 months of age. Paternal and maternal anxiety symptoms were based on the eight-item anxiety subscale of the Crown-Crisp Experiential Index. Scores in the top 15% at 8 weeks postpartum were classified as high anxiety. Generalized Estimating Equations were employed to estimate the joint association between parental anxiety and change in child weight-for-age z-score. Children who had fathers, but not mothers, with anxiety showed a 0.15 (95% CI: 0.01, 0.29) greater increase in weight-for-age z-score than children with neither parent anxious. This result suggests that paternal anxiety, not maternal anxiety, was associated with increases in child weight gain in the first year of life. Public health practitioners and clinicians should consider the use of robust measures of both maternal and paternal anxiety in the postpartum period, in addition to the suggested screening for postpartum depression. Given the limitations of the study, this study should be considered preliminary and hypothesis generating.

"What kind of man gets depressed after having a baby?" Fathers' experiences of mental health during the perinatal period

Background

To date, information and support has been focused on mothers, with evidence that healthcare professionals overlook fathers’ mental health, and that fathers receive little or no support for themselves during the perinatal period. However, recently, fathers’ mental health has become an area of interest.

Methods

This study explored the support fathers receive for their own mental health during the perinatal period. A qualitative questionnaire was distributed on social media networks and completed by twenty-nine fathers.

Results

Thematic analysis produced three main themes: Factors Influencing Fathers’ Mental Health, Consequences of Poor Mental Health in Fathers and Solutions to Improve Fathers’ Mental Health.

Conclusions

The findings from this study highlighted important implications about fathers’ mental health and the need to support them more effectively. Fathers’ reluctance to seek support and the limited support available need to be addressed. Fathers in this study perceived that perinatal health professionals view ‘mothers as the priority’. It is clear that health professionals need more training on how to recognise that fathers are also important and need support for their mental health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03947-7.

"I Wanted to Be There as a Father, but I Couldn't": A Qualitative Study of Fathers' Experiences of Postpartum Depression and Their Help-Seeking Behavior

Postpartum depression (PPD) is one of the most common mental health problems among new parents. Past studies have examined PPD in women; however, the condition is less understood in men. This study aimed to explore the lived experiences of men or fathers with PPD and to understand the barriers and facilitators of help-seeking among fathers with PPD. Eight fathers with PPD were interviewed and data were subsequently analyzed through interpretative phenomenological analysis. The fathers perceived fatherhood as an overwhelming experience and feelings of inadequacy and powerlessness were two of the main themes in the fathers' experiences of PPD. The feeling of inadequacy and powerlessness was related to the fathers' expectations for themselves and their role as a father. The fathers' sense of inadequacy and powerlessness sometimes turned into anger and frustrations. In addition, the fathers experienced a variety of contributing stressors around the birth of their child. Further, the analysis revealed how the fathers' help-seeking behavior was influenced by five contributing factors: recognition and perception of depressive symptoms; knowledge and beliefs about PPD; taboo, stigma and conforming to masculine norms; the fathers' partner; screening and perinatal healthcare services. Paternal PPD has a significant impact on the fathers' wellbeing and everyday lives. Findings indicate that parents-to-be may benefit from education on paternal PDD, and they highlight the importance of screening for paternal PPD and support tailored to the needs of fathers with signs of PPD.

Paternal postnatal depression and received midwife, child health nurse, and maternal support: A cross-sectional analysis of primiparous and multiparous fathers

BACKGROUND

Fathers want more professional and social support during the transition to fatherhood. It is unclear if these supports are associated with decreased depressive symptoms in fathers of infants.

AIM

The aim of the current study was to assess if fathers' self-reported received professional and social support were related to changes in the odds for having depressive symptoms, with interaction terms focusing on differences of support based on the fathers' parity.

METHODS

In total, 612 fathers from Sweden completed a Facebook-advertised anonymous online survey. The Edinburgh Postnatal Depression Scale was used to detect depressive symptoms (≥10 points). Multiple imputation of missing data was performed. Logistic regressions were used, with interaction terms for fathers' parity.

RESULTS

Around 21% of fathers had depressive symptoms. There were no associations between depressive symptoms frequencies and paternal parity. Fathers reported fewer depressive symptoms when they received professional support from the prenatal midwife (OR = .39, p = .007), labor/birth midwife/nurse team (OR = .42, p = .021), and child health nurse (OR = .25, p = .001), as well as social support from their partner and if they had a higher income (odds ratios vary in different models). Multiparous fathers received significantly less professional and social support and were less frequently invited to child health visits than primiparous fathers.

LIMITATIONS

The data collected was cross-sectional; therefore, causal links cannot be determined.

CONCLUSIONS

Both primiparous and multiparous fathers should receive postnatal depression screenings and interventions to help reduce their depressive symptoms.

New parents' experiences of postpartum depression: a systematic review of qualitative evidence

OBJECTIVES

The objective of the review was to synthesize the evidence on new mothers' and fathers' experiences of postpartum depression (PPD).

INTRODUCTION

Postpartum depression is a form of clinical depression that affects women and, less frequently, men, typically during the first months after childbirth. It has been estimated that 10% to 20% of women and 10% of men suffer from PPD and it may have serious consequences for mothers, fathers and their children. Therefore, this review covers the experiences of both mothers and fathers.

INCLUSION CRITERIA

This qualitative review considered studies that included new mothers and fathers who had any number of children and who experienced PPD within a one-year postpartum period. The phenomenon of interest was the lived experience of new mothers and fathers with PPD. Qualitative studies including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered.

METHODS

The review systematically searched the following databases: MEDLINE, CINAHL, PsycINFO, Scopus and the Finnish database MEDIC. In addition, the search for unpublished articles included ProQuest Dissertations and Theses. The methodological quality of the included studies was assessed independently by two reviewers, and qualitative data were extracted from papers by two independent reviewers using a standardized data extraction tool. Qualitative research findings were pooled using the JBI methodology.

RESULTS

Thirteen papers that considered mothers' (n = 199) experiences of PPD were included in the review. A total of 98 findings were extracted and aggregated into 14 categories, and from them, four synthesized findings were developed: i) Depressed mothers feel unable to control their own lives due to low resilience; ii) The ambivalent feelings depressed mothers experience towards their babies, partners and in-laws cause distress and suffering; iii) Depressed mothers experience anger and despair if they perceive imbalances between their support needs and the support they get from healthcare providers and significant others; and iv) Depressed mothers experience hopelessness and helplessness resulting from their new-found motherhood and financial worries. Two papers that considered fathers' (n = 20) experiences of PPD were included in the review. A total of 19 findings were extracted and aggregated into six categories, and from them, two synthesized findings were developed: i) Depressed fathers experience disappointment arising from perceived imbalances between their support needs and the support they get from their partner and significant others; and ii) Depressed fathers are more imbalanced after childbirth than fathers who are not suffering from PPD, so they feel unable to control their own lives due to low resilience.

CONCLUSIONS

The qualitative studies concerning new parents' experiences of PPD have focused on the mother's perspective, and studies of the father's perspective, especially of the father's own experiences of PPD, are scarce. Both mothers and fathers do not receive enough support from their significant others. In addition, mothers want more support from health professionals. Because PPD has a great influence on the well-being of mothers and fathers, as well as children, it is important to understand what parents undergo after childbirth.

Life situation and support during pregnancy among Thai expectant mothers with depressive symptoms and their partners: a qualitative study

Background

Expectant parents may have positive and negative emotions during pregnancy and receive support from different sources. Studies on life situation and support among couples have rarely been conducted. This study aims to explore life situation and support during pregnancy among expectant mothers with depressive symptoms and their partners.

Methods

Twenty-seven expectant mothers, in the last trimester of pregnancy with depressive symptoms (Edinburgh Postnatal Depression Scale score ≥ 7) from seven public antenatal care clinics in Sakonnakhon, a north-eastern province of Thailand, and their partners were interviewed. In total, 54 semi-structured interviews were subjected to content analysis.

Results

Four categories emerged: (1) Having obstacles in life, (2) Facing life transition, (3) Enhancing confidence, and (4) Dissatisfaction with support. The informants described obstacles regarding economy, fear of health problems, getting an abnormal child and partners’ behaviours. They received support from family members and social networks, but some were dissatisfied with the support from the healthcare. For example, expectant fathers wished to receive more health information and be more involved.

Conclusions

Healthcare professionals should be aware of the influence of cultural and contextual factors when providing antenatal care to expectant parents. Male involvement in the care must not be neglected.

Paternal mental health during the perinatal period: A qualitative systematic review

AIMS

To examine fathers' experiences and needs associated with mental health during the perinatal period.

DESIGN

Qualitative studies were meta-synthesized using the steps outlined by Sandelowski and Barroso.

DATA SOURCES

Six databases (PubMed, Embase, PsycINFO, CINAHL, Scopus and ProQuest) were searched for qualitative studies from each database's inception to 24 June 2019.

REVIEW METHODS

Studies were critically appraised using the Critical Appraisal Skills Program tool. Qualitative data were extracted, meta-summarized, then meta-synthesized.

RESULTS

Fourteen studies were included and four themes were identified: (a) negative feelings and psychological difficulties, (b) role strain and role conflict with multiple sources, (c) coping strategies that buffered negative feelings and psychological difficulties and (d) support needs to enhance mental health.

CONCLUSION

Fathers reported poor mental health and expressed needs to enhance their mental health across the perinatal period. Future studies can focus specifically on paternal mental health. The development of theory-guided, family inclusive, technology-based healthcare services are needed to manage mental health. Healthcare providers can promote positive mental health to prepare fathers, increasing their awareness to manage their mental health and to seek timely help.

IMPACT

Problem-focused coping (i.e. support and problem-solving with partners and childcare involvement) helped fathers to buffer their negative feelings and psychological difficulties. Future studies should focus on paternal mental health rather than on general fathering experiences. Healthcare providers should focus on promoting positive mental health and well-being. Policymakers should create awareness on paternal mental health across the perinatal period.

Fathers' views and experiences of their own mental health during pregnancy and the first postnatal year: a qualitative interview study of men participating in the UK Born and Bred in Yorkshire (BaBY) cohort

Background

The prevalence of fathers’ depression and anxiety in the perinatal period (i.e. from conception to 1 year after birth) is approximately 5–10%, and 5–15%, respectively; their children face increased risk of adverse emotional and behavioural outcomes, independent of maternal mental health. Critically, fathers can be protective against the development of maternal perinatal mental health problems and their effects on child outcomes. Preventing and treating paternal mental health problems and promoting paternal psychological wellbeing may therefore benefit the family as a whole. This study examined fathers’ views and direct experiences of paternal perinatal mental health.

Methods

Men in the Born and Bred in Yorkshire (BaBY) epidemiological prospective cohort who met eligibility criteria (baby born <12 months; completed Mental Health and Wellbeing [MHWB] questionnaires) were invited to participate. Those expressing interest (n = 42) were purposively sampled to ensure diversity of MHWB scores. In-depth interviews were conducted at 5–10 months postpartum with 19 men aged 25–44 years. The majority were first-time fathers and UK born; all lived with their partner. Data were analysed using thematic analysis.

Results

Four themes were identified: ‘legitimacy of paternal stress and entitlement to health professionals’ support’, ‘protecting the partnership’, ‘navigating fatherhood’, and, ‘diversity of men’s support networks’. Men largely described their ‘stress’ with reference to exhaustion, poor concentration and irritability. Despite feeling excluded by maternity services, fathers questioned their entitlement to support, noting that services are pressured and ‘should’ be focused on mothers. Men emphasised the need to support their partner and protect their partnership as central to the successfully navigation of fatherhood; they used existing support networks where available but noted the paucity of tailored support for fathers.

Conclusions

Fathers experience psychological distress in the perinatal period but question the legitimacy of their experiences. Men may thus be reluctant to express their support needs or seek help amid concerns that to do so would detract from their partner’s needs. Resources are needed that are tailored to men, framed around fatherhood, rather than mental health or mental illness, and align men’s self-care with their role as supporter and protector. Further research is needed to inform how best to identify and manage both parents’ mental health needs and promote their psychological wellbeing, in the context of achievable models of service delivery.

Electronic supplementary material

The online version of this article (doi:10.1186/s12884-017-1229-4) contains supplementary material, which is available to authorized users.

The Ebb and Flow of Filipino First-Time Fatherhood Transition Space

Fatherhood, as a developmental process, is both a human experience and a text that needs to be read. For developing nations like the Philippines, little is known about the process undergone by first-time fathers on their transition to fatherhood, and how nurses can play a significant role in assisting them. This grounded theory study purported to conceptualize the multifaceted process of transition from the lens of Filipino first-time fathers’ lived experiences. A total of 20 first-time fathers from Metro Manila, Philippines, were purposively selected to take part in an individual, semistructured, and in-depth interview. The Glaserian (classical) method of analysis was specifically used, and field texts were inductively analyzed using a repertory grid. Member checking and correspondence were done to validate the findings of the study. Six surfacing stages emerged relative to the process of transition. Interestingly, The B.R.I.D.G.E. Theory of First-Time Fatherhood Transition Space describes how these fathers progress from the beholding, reorganizing, inhibiting, delivering, grasping, and embracing phases toward successful transition. This emerged theoretical model can be used in framing health care programs where the needs of fathers during this period are met and addressed. Finally, it can also be used in guiding nurses in their provision of a more empathetic care for first-time fathers.

Association between depressive symptoms and parental stress among mothers and fathers in early parenthood: A Swedish cohort study

Aim To determine whether there is an association between depressive symptoms and parental stress among mothers and fathers during early parenthood in Sweden. Methods In this study, 401 mothers and 396 fathers (393 couples) were included; the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale were measured 3 months after childbirth, and the Swedish Parenthood Stress Questionnaire and the Sense of Coherence Scale after 18 months. Complete data for multivariable analysis were available for 264 mothers and 252 fathers. Results The mothers estimated greater total depressive symptoms and parental stress than the fathers did. Both the mothers and the fathers had the greatest level of stress in the sub-area 'Role restriction'. The mothers had the lowest level of stress in the sub-area 'Social isolation' and the fathers in the sub-area 'Incompetence'. The mothers perceived greater levels of stress than the fathers did in all sub-areas except for 'Social isolation', where the fathers perceived higher stress. There was an association between the parents' depressive symptoms and parental stress. The parents' own depressive symptoms at 3 months and sense of coherence and the partners' parental stress at 18 months were positively associated with the parental stress at 18 months in univariable and multivariable analyses. Conclusions Understanding the relationship between depressive symptoms and parental stress is important for health professionals so they can offer parents adequate support in early parenthood to optimize the conditions for raising a child. This knowledge should also be communicated to the parents.