Present As a Partner and a Parent: Mothers' and Fathers' Perspectives on Father Involvement in Prenatal Care

Background: A growing body of research recognizes the impact of father involvement during pregnancy on maternal and child health outcomes and the associations between prenatal and postnatal father involvement, yet little research has focused specifically on father involvement in prenatal care or explored the perspectives of both mothers and fathers on father involvement. Prenatal care is one of the most common health interventions in the Untied States, and father participation in prenatal care is becoming increasingly normative. This study aimed to inform understanding of father participation in prenatal care from the perspectives of expectant mothers and fathers, and identify strategies for involving fathers that are consistent with mothers’ and fathers’ needs and preferences.

Methods: We conducted semi-structured interviews with 22 women expecting their first child and 20 of their male partners to learn about how fathers participated in prenatal care, how mothers and fathers experienced father participation, how the role of fathers in prenatal care was understood, mothers’ and fathers’ perceptions of providers’ treatment of fathers, and preferences for father involvement. Participants were predominantly white, age 20-30, and employed full-time. Interviews were conducted approximately midway through pregnancy. We conducted thematic analysis, drawing on principles of grounded theory, to identify themes from mothers’ and fathers’ accounts of their experiences in prenatal care and perspectives on father involvement in prenatal care.

Results: Father participation ranged from attendance at visits considered “important” (e.g., first appointment, ultrasounds) to attendance at every appointment. Experiences of father involvement varied, with many describing father participation as both an important act of support for the mother and part of assuming the role of father. Both mothers and fathers saw great value in father involvement in prenatal care, as an opportunity for fathers to learn how to support a healthy pregnancy, bond with their developing baby, and share joy and/or worries with mothers. Participants generally felt that fathers were made to feel welcome, and wanted providers to be inclusive of fathers during appointments. Whereas mothers were largely firm in their conviction that fathers should be fully welcomed into prenatal care and given voice as a co-parent, fathers frequently specified their deference to mothers in prenatal care, recognizing the mother’s comfort and needs as primary.

Conclusions: Results of this study suggest that many expectant mothers and fathers want fathers to be involved in prenatal care, and further revealed variation in mothers’ and fathers’ assessments of when and how fathers should participate. Accordingly, providers should assess and respond to individual preferences and constraints. Providers can facilitate father participation by considering partner availability in scheduling appointments, making partners feel welcome and included, addressing explanations to and inviting questions from both parents. Social workers who engage with families in the prenatal period should recognize father participation in prenatal care as an opportunity to increase the support available to mothers and increase the preparation of fathers to co-parent. Social workers can elicit, respect, and advocate for mothers’ and fathers’ wishes for father participation in prenatal care, in order to improve outcomes for families.