The unique experiences of Black fathers in maternal health services (USA)

black fathers

Researchers have looked at the experience of men of colour of maternal health services. 12 men participated in focus groups, seven of whom had one or more children born preterm. Two had experienced a neonatal death after a preterm birth.

Two themes emerged that are different from research involving white men.

• Desire for support was expressed in the form of an advocate or coach to help “defend themselves” in a healthcare system that does not recognise their information and communication needs.
• Unmet informational needs were often compounded by mistrust of providers for not giving a clear rationale or explanations for management decisions.

The researchers identified four themes from the focus groups, which they summarised as a diagram.

black fathers

In relation to the “being a rock” theme, one father said:

“If I want to cry, you know I’m not going to cry because I can’t allow her to feel that I’m weak, but she needs to have that rock….that’s kind of our role and that’s what we have to do, so we do it, but that can be difficult.”

In relation to the “blessing” theme, another father said:

“Every day was scary….So we just kept strong in our faith….I’ll never forget because throughout the whole process there were so many people, complete strangers…and they would tell us like ‘I’m going to pray for you’….For me that was God in all those people.”

In relation to the information theme, a father said:

“I had to tell my doctor, ‘Tell me everything. I don’t want to have to read between the lines.’ I want to know everything because I just do, you know.”

The researchers make a series of recommendations on the basis of this research.

1. Support men of colour in their role as “the rock” if they define their role this way.
2. Provide for religious, coaching and advocacy support for men of colour.
3. Develop strategies to improve patient/provider communication.
4. Give full explanations and rationales for management plans and be honest when the answer is unknown.
5. Acknowledge nurses as key participant in patient care.
6. Find out from pregnant partners and men of colour if they have experienced trauma, discrimination or lack of trust in earlier engagement with health services. Such enquiry is particularly important: it can help to build trust and better communication.

In terms of planning services, the researchers recommend consulting men of colour about service design, addressing lack of racial diversity within the healthcare profession, and ensuring accountability about the financial benefits gained by the hospital from insurance providers regarding different management plans.

The study took place as part of a bigger California Preterm Birth Initiative in the town of Fresno in California. The focus groups were co-facilitated by a man and woman.

In the USA, non-Hispanic Black women are most at risk of preterm birth with a rate of 13.6%, compared to Hispanic White women at 9.45% and non-Hispanic White women at 9.06%. The researchers quote a recent study finding an association between preterm birth rates and chronic worry about discrimination. Less father involvement is associated with higher risk of preterm birth and there are higher rates of paternal absence in communities of colour in the USA. For families with absent fathers, the risk of infant mortality may be four times higher in Black families than in White families.

Furthermore, Black and Hispanic/Latina women at risk for preterm birth have reported experiencing disrespect, inconsistent social support and stressful interactions with healthcare workers.


Edwards BN, McLemore MR, Baltzell K, Hodgkin A, Nunez O & Franck LS (2020), What about the men? Perinatal experiences of men of color whose partners are at risk of preterm birth, a qualitative study, BMC Pregnancy and Childbirth 20

Header photo: Eli Braud. Creative Commons.