A Swedish study sought to compare fathers’ experiences of two different kinds of antenatal care: group care, where all antenatal visits are done in groups and include antenatal education; and traditional care, where midwife appointments are private to the couple and only antenatal education is a group activity.

Ewa Andersson and her team surveyed 239 fathers six months after the birth. The fathers had been randomly assigned to the different models of care. The researchers did not find very many differences in how fathers responded to these different types of care. What was more striking was how many deficiencies in both kinds of care the fathers identified – insufficient information about the birth, about breastfeeding and about the post-birth period. The fathers in both kinds of care did not, on average, give a high rating to feeling prepared for the birth and feeling their partner had received good medical care through the pregnancy.

The small differences between the different models of care were three:

• Fathers attended more sessions of group care than traditional care.
• First time fathers in group care felt more supported by the midwife and (unsurprisingly) felt they had more social contact with other parents.
• Fathers in group care felt they had more opportunity to plan for the birth with the midwife.

The researchers quote an earlier study in Sweden has suggested that fathers feel it is easier to share their situations in group sessions than in individual sessions involving only the midwife and the couple.

There is no definition in Sweden about what antenatal care should involve. A joint report in 2008 of The Swedish Association of Obstetricians and Gynecologists and The Swedish Association of Midwives notes that it is important for the partner to feel involved in pregnancy but nowhere is it mentioned how a partner can be involved. A report from the National Board of Health and Welfare in 2015 suggests that the professionals in antenatal care need more knowledge and understanding about men’s needs and perspectives in connection with pregnancy, childbirth and care of the mother, and about fatherhood – but this report also offers no guidance on practice.

This research suggests this lack of definition is a problem and that improvements in quality are needed. Even Sweden, one of the most advanced countries in the world regarding maternal healthcare, has not yet defined standards of best practice in engaging with fathers and families.

Andersson A & Small R (2017), Fathers’ satisfaction with two different models of antenatal care in Sweden – Findings from a quasi-experimental study, Midwifery 50

Photo: Blondinrikard Fröberg. Creative Commons.