Experiences, views and needs of first-time fathers in pregnancy-related care: a qualitative study in south-East Nigeria

Fathers' involvement in pregnancy and childbirth in Africa: an integrative systematic review

BACKGROUND

As notions of masculinity evolve globally, it is important to understand their dimensions within geographic regions and life contexts. African men's involvement in their partners'pregnancy and childbirth has been explored to a limited extent in the peer-reviewed literature. This analysis provides a comprehensive examination of the existing literature on the diverse experiences of fathers across the African continent.

AIM

This study aims to provide an overview of fathers' experience of involvement in their partners' pregnancies andchildbirth in Africa.

METHODS

A systematic integrative literature review guided the process. The review comprised problem identification, literature search, data evaluation, data analysis and presentation of results. Systematic searches were conducted in the Cinahl, PubMed and Scopus databases.

RESULTS

The search identified 70 articles of which 31, relating to 11 African countries, were used. Of these, 20 were qualitative, 9 were quantitative and 2 were mixed-methods studies. Men's alienation from health services, and traditional gender norms that discourage fathers' supportive role during pregnancy were prevalent themes. Financial pressures also dominated fathers'experiences. At the same time, in 18 studies fathers expressed motivation to be involved partners and supportive fathers, despite stigma and exclusion from maternity services.

CONCLUSION

This integrative review shows that fathers' experiences of their involvement in their partners' pregnancy and childbirth across African countries are influenced by multiple factors. While unwelcoming health services, traditional gender norms, and low income are barriers to male involvement, education, younger age, and modern gender norms are associated with greater male involvement.

Explore the lived childbirth experiences, challenges following childbirth, and coping strategies of teenage mothers: A qualitative meta-synthesis

PROBLEM

Worldwide, 16 million girls give birth during adolescence each year, which has negative health, social, and economic consequences for adolescent women's future.

BACKGROUND

Childbirths occurring between the ages of 13-19, before teenage girls have reached the age of maturity to handle the parenting role, are often unplanned.

OBJECTIVE

The aim of this study was to gain a comprehensive understanding of lived childbirth experiences, identify the challenges of early motherhood, and explore the coping strategies employed by teenage mothers to overcome these challenges during the transition to motherhood.

METHODS

Six commonly cited databases were used to retrieve articles using the SPIDER framework. We utilized the Walsh and Downe quality appraisal tool, which is considered the most appropriate fit for the current qualitative meta-synthesis. The thematic analysis approach was used to draw conclusions and generate hypotheses.

RESULTS

This meta-synthesis showed that teenage mothers often encounter negative reactions from their partners, families, and communities due to their early childbirth. They face numerous challenges, including parenting incompetency, school dropout, conflict between adolescent interests and maternal responsibilities, emotional disturbance, and financial problems. Social support and self-efficacy are the main coping strategies to navigate these challenges and attain maternal competencies.

CONCLUSION AND IMPLICATIONS

Families, peers, and midwives play a crucial role in providing parenting lessons for teenage mothers. Encouraging teenage mothers to believe in their capacities is an important coping strategy to facilitate a smoother motherhood transition. Further studies are needed to test the effectiveness of self-efficacy and social support interventions on teenage mothers' parenthood role attainment and in preventing mental health problems following childbirth.

Birth plan and fathers: A scoping review

BACKGROUND

With increasing paternal involvement in maternal and infant care, expectant fathers, who are often present during the labour process have been seen to use birth plans to express their wishes during childbirth. Despite their involvement, existing literature mainly focuses on maternal outcomes, highlighting the need to explore paternal involvement with birth plans.

AIMS

To explore and consolidate the available literature on the involvement of fathers in the birth plan process, their perspectives toward birth plans, and how it has influenced their overall childbirth experience.

METHODS

This scoping review was conducted based on Arksey and O'Malley's five-stage framework. Seven databases were searched from 1980 till March 2024: PubMed, Cochrane Library, Embase, Scopus, Web of Science, CINAHL, and Google Scholar. Data were screened, extracted, and cross-checked between two independent reviewers. A thematic analysis was conducted to summarise the data.

RESULTS

BASED ON THE FINDINGS FROM THE 33 INCLUDED STUDIES, ONE OVERARCHING THEME WAS IDENTIFIED: : 'Factors promoting and restricting fathers' participation in birth plan'; supported by two main themes 1) Motivations behind paternal engagement in the birth plan process and 2) Roadblocks to paternal involvement in the birth plan.

CONCLUSION

The findings of this review provided insights to guide future practice to engage fathers during childbirth by enhancing their involvement in birth plans. The findings on the motivating factors for fathers to be involved in the birth plan process and barriers affecting their participation also provided directions for future research by highlighting the gaps in the current evidence.

Topics searched by first-time Indonesian fathers during pregnancy journey: An exploratory study

This study explores the topics searched by first-time Indonesian fathers during the pregnancy journey. Data were collected through semi-structured interviews with a representative sample of first-time expectant fathers in Indonesia. Thematic analysis was employed to identify common themes and patterns in fathers' search topics and reasons behind the searches. The results reveal that fathers predominantly focus on finding topics related to their partners' well-being with particular emphasis on health-related topics. Interestingly, the study highlights a lower engagement with topics related to cultural practices, traditions, and religion among first-time Indonesian fathers. Additionally, understanding the situation and finding the solutions to a problem is one of the main popular reasons for first-time fathers to seek a particular topic related to pregnancy. This study provides valuable insights into the topics searched and motivations of first-time Indonesian fathers during the pregnancy journey which have similarities and differences to fathers' practices in developed countries. The findings underscore the necessity for tailored intervention programs to promote paternal involvement during this transformative period which addresses the unique information needs of Indonesian fathers.

Navigating relationship dynamics, pregnancy and fatherhood in the Bukhali trial: a qualitative study with men in Soweto, South Africa

BACKGROUND

South Africa has a complex range of historical, social, political, and economic factors that have shaped fatherhood. In the context of the Bukhali randomised controlled trial with young women in Soweto, South Africa, a qualitative study was conducted with the male partners of young women who had become pregnant during the trial. This exploratory study aimed to explore individual perceptions around relationship dynamics, their partner's pregnancy, and fatherhood of partners of young women in Soweto, South Africa.

METHODS

Individual, in-depth interviews were conducted with male partners (fathers, n = 19, 25-46 years old) of Bukhali participants. A thematic approach was taken to the descriptive and exploratory process of analysis, and three final themes and subthemes were identified: (1) relationship dynamics (nature of relationship, relationship challenges); (2) pregnancy (feelings about the pregnancy, effect of the pregnancy on their relationship, providing support during pregnancy; and 3) fatherhood (view of fatherhood, roles of fathers, influences on views and motivation, challenges of fatherhood).

RESULTS

While most male participants were in a committed ("serious") relationship with their female partner, less than half of them were cohabiting. Most reported that their partner's pregnancy was not planned, and shared mixed feelings about the pregnancy (e.g., happy, excited, shocked, nervous), although their views about fatherhood were overwhelmingly positive. Many were concerned about how they would economically provide for their child and partner, particularly those who were unemployed. Participants identified both general and specific ways in which they provided support for their partner, e.g., being present, co-attending antenatal check-ups, providing material resources. For many, the most challenging aspect of fatherhood was having to provide financially. They seemed to understand the level of responsibility expected of them as a father, and that their involvement and presence related to love for and connection with their child. Participants' responses indicated that there were some changes in the norms around fatherhood, suggesting that there is a possibility for a shift in the fatherhood narrative in their context.

CONCLUSIONS

These findings suggest that the complex array of factors influencing fatherhood in South Africa continue to play out in this generation, although promising changes are evident.

What predicts delayed first antenatal care contact among primiparous women? Findings from a cross-sectional study in Nigeria

BACKGROUND

Delayed first antenatal care contact refers to first antenatal care contact occurring above twelfth weeks of gestation. Studies in Nigeria and in other countries have examined the prevalence and predictors of delayed first antenatal care contact. Nevertheless, existing studies have rarely examined the predictors among primiparous women. In addition, the evidence of higher health risks associated with primigravida emphasizes the need to focus on primiparous women. This study, therefore, examined the predictors of delayed first antenatal care contact among primiparous women in Nigeria.

METHODS

The study was a descriptive cross-sectional design that analyzed data extracted from the 2018 Nigeria Demographic and Health Survey. The study analyzed a weighted sample of 3,523 primiparous women. The outcome variable was delayed first antenatal care contact. explanatory variables were grouped into predisposing, enabling, and need factors. The predisposing factors were maternal age, education, media exposure, religion, household size, The knowledge of the fertile period, and women's autonomy. The enabling factors were household wealth, employment status, health insurance, partner's education, financial inclusion, and barriers to accessing healthcare. The need factors were pregnancy wantedness and spousal violence during pregnancy. Data were analyzed using Stata 14. Two multivariable logistic regression models were fitted. Statistical significance was set at p < 0.05.

RESULTS

Nearly two-thirds (65.0%) of primiparous women delayed first antenatal care contact. Maternal age, maternal education, media exposure, religion, household membership, and knowledge of the fertile period were predisposing factors that significantly influenced the likelihood of delayed first antenatal care contact. Also, household wealth, employment status, health insurance, partner's education, perception of distance to the health facility, and financial inclusion were enabling factors that had significant effects on delayed first antenatal care contact. Pregnancy wantedness was the only need factor that significantly influenced the likelihood of delayed first antenatal care contact.

CONCLUSION

The majority of primiparous women in Nigeria delayed first antenatal care contact and the delay was predicted by varied predisposing, enabling, and need factors. Therefore, a public health education program that targets women of reproductive age especially primiparous women is needed to enhance early antenatal care contact in the country.

Redefining Fatherhood in a Migratory Context: A Narrative Inquiry into the Experiences of African First-time Fathers in Belgium

Many African fathers face practices in their host countries that conflict with the conceptions of fatherhood in their countries of origin. They deal with negative stereotypes, including notions of paternal irresponsibility when it comes to embracing child care. This article looks at how exposure to the Belgian norms of fatherhood may redefine the fatherhood practices of African first-time fathers residing in Belgium. Drawing on a qualitative narrative approach, this article explores the perceptions and experiences of African migrant fathers in Belgium and examines how they adapt to a different fathering culture. The findings show that while African first-time fathers acknowledged their primary role as providers, they also embraced new practices that transgress defined gender lines in African culture. In the absence of a larger family support network, respondents face the responsibility of providing prenatal and postnatal support and sharing in child care responsibilities. Findings also shed light on how African fathers with European partners engage in shared decision-making and negotiate on core African values such as male circumcision.

The Increase of Knowledge, Attitude, and Practice of Husbands toward the Prenatal Care of their Wives Using the Illustrations Having the Local Cultural Nuance

BACKGROUND: The role of husbands in maternal health during pregnancy is crucial and is related to the high maternal mortality rate in Indonesia. In spite of that, the effort to involve husbands in the maternal health program is still low. AIM: This paper aims to explain the results of the effort to produce learning assisting tools in a form of an illustration having local cultural nuance that can be used to do intervention of health education to increase the participation of husbands in maternal health. METHODS: The research was conducted in Silaen Village, Silaen District in Toba Regency, North Sumatera Province. To make the teaching materials, interviews and focus group discussions were conducted for the village community figures, the village midwives, the pregnant women, and their husbands. After illustrations were made, the trial was conducted to 10 pairs of husbands and pregnant wives. RESULTS: The illustrations made accommodating the role of husbands in maternal health can increase the knowledge, attitude, and practice (KAP) of husbands, including the KAP of their wives. The biggest increase happening in the attitude component (p < 0.05). CONCLUSION: The educational method using an illustration adopting local culture is important to become one of the education teaching alternatives in the effort to improve husband’s KAP.

Systematic review of the concept 'male involvement in maternal health' by natural language processing and descriptive analysis

INTRODUCTION

Experts agree that male involvement in maternal health is a multifaceted concept, but a robust assessment is lacking, hampering interpretation of the literature. This systematic review aims to examine the conceptualisation of male involvement in maternal health globally and review commonly used indicators.

METHODS

PubMed, Embase, Scopus, Web of Science and CINAHL databases were searched for quantitative literature (between the years 2000 and 2020) containing indicators representing male involvement in maternal health, which was defined as the involvement, participation, engagement or support of men in all activities related to maternal health.

RESULTS

After full-text review, 282 studies were included in the review. Most studies were conducted in Africa (43%), followed by North America (23%), Asia (15%) and Europe (12%). Descriptive and text mining analysis showed male involvement has been conceptualised by focusing on two main aspects: psychosocial support and instrumental support for maternal health care utilisation. Differences in measurement and topics were noted according to continent with Africa focusing on HIV prevention, North America and Europe on psychosocial health and stress, and Asia on nutrition. One-third of studies used one single indicator and no common pattern of indicators could be identified. Antenatal care attendance was the most used indicator (40%), followed by financial support (17%), presence during childbirth (17%) and HIV testing (14%). Majority of studies did not collect data from men directly.

DISCUSSION

Researchers often focus on a single aspect of male involvement, resulting in a narrow set of indicators. Aspects such as communication, shared decision making and the subjective feeling of support have received little attention. We believe a broader holistic scope can broaden the potential of male involvement programmes and stimulate a gender-transformative approach. Further research is recommended to develop a robust and comprehensive set of indicators for assessing male involvement in maternal health.