An Australian study by Dr Holly Rominov (School of Psychology, Australian Catholic University) and colleagues interviewed fathers about their experience of maternity care, in order to determine what could be done better. The study involved 20 interviews with men expecting a child or parenting a child under two years of age. All of the fathers were living with the mother. The study took place in Melbourne, Australia.

The researchers start their paper with a review of evidence about why engaging expecting and new fathers around mental health issues is important.

• Fathers are an integral part of the family support system that influences the support the mother receives and the development of the child. Poor mental health in fathers impact mothers, children and family relationships. If the mother suffers poor mental health, fathers are more likely to be depressed also and, therefore, less able to support the increased needs of the mother.

• Anxiety disorders occur in between 4% and 16% of men antenatally and between 2% and 18% postnatally. The perinatal period contains many risk factors for mental health – intense and mixed emotions, possible trauma from birth complications, formation of new family relationships, increased time pressures as new responsibilities correspond with the need to earn more, fatigue, possible low perceived competence in infant care, reduction of sexual activity, exclusion from support by health professionals (low skills, poor engagement of fathers, poor information, poor timing of services), current definitions of masculinity (self-reliance, emotional control, toughness), lack of paternity leave and flexible working, and lack of recognition as a parent.

The interviews with fathers raised a wide range of issues, including the following:

1. Fathers can feel marginalised by the maternity service:

• Infrequent contact with health professionals
• Lack of father-specific information, including around mental health
• Lack of acknowledgement of their role as a coparent

“There was a little pamphlet that the hospital provided around postnatal depression. That was mainly targeted at the mum….it did also mention that dads can get it, but that was it. There was not a lot of information or any real education about it.”

2. Fathers often use alternative supports:

• Family, particularly their partner
• Friends, particularly other men going through the same stage of life
• Online information sources, but it is difficult to know what sources are reliable

“My wife has looked up a lot….she’s subscribed to a lot of online blogs and things like that, and articles which she sends to me.”

“There are just so many things out there, which is a good thing but also there is so much out there that you are like, “Which ones do I go to? Which ones are reputable?” For a first-time parent, it can be a little bit overwhelming.”

3. Most fathers believed that existing information is inadequate, including in the following areas:

• The impact of sleep deprivation and fatigue
• Specific problems during the pregnancy, such as hyperemesis gravidarum
• Breastfeeding problems
• Difficulties with early bonding with the baby that some fathers experience
• Relationship challenges – communication, handling conflict, time management

4. The fathers expressed a preference for a diversity of formats for receiving information and support:

• Fathers’ groups
• Antenatal classes facilitated by a father
• Services outside working hours
• Online information
• Visual demonstrations
• Hard copy information

5. The fathers expressed an unwillingness to seek help for themselves:

• This could be seen as a sign of weakness in a man, particularly around mental health issues
• This could take attention away from their partner and baby

6. Some of the fathers felt that information often excludes their perspective:

• Lack of focus on importance of father’s role, for example, in antenatal classes
• Marginalisation of fatherhood issues in books and materials for mothers
• Lack of signposting of supports specifically for fathers

“Some [health professionals] have been more keen on us, including me, asking questions and bringing up issues, rather than them driving the appointments.”

“A number of the books I’ve been reading have, which I find somewhat demeaning, little grey breakdown boxes for fathers. As if the man is only going to read this summary.”

7. Some expressed the need to get information just at the time they needed it:

• Different information needs antenatally and postnatally
• Information to solve a particular problem that suddenly arises

8. They felt obstructed by work:

• Lack of adequate time off after the baby was born
• Lack of acknowledgement of their parenting role at work and their need for flexibility

Rominov H, Giallo R, Pilkington PD & Whelan TA (2017), “Getting Help for Yourself is a Way of Helping Your Baby:” Fathers’ Experiences of Support for Mental Health and Parenting in the Perinatal Period, Psychology of Men & Masculinity

Photo: George. Creative Commons.