We all have different expectations about how involved dads should be during pregnancy and childbirth. In the UK, it’s generally seen as a good thing and research is now beginning to show that it matters to how mothers access vital health services.
Previous research has focused mainly on white middle-class families, but a study I was involved in wanted to take a broader look at how fathers’ involvement might influence a mother’s health and wellbeing.
About 4500 new mothers gave information about fathers in a national survey of women’s experience of maternity care. We used this along with other information about pregnancy care, before and after labour, and paternity leave.
Men are much more likely to be involved throughout if it’s a first baby. Of course, this may be because if you have other children, you’re more likely to be busy with their care or because having a first child is such a life-changing event.
After taking account of the poorer response rates from women in disadvantaged groups and ethnic minorities, we found that partners of white women and those living in more affluent areas were more likely to have involved dads.
Why does this matter? Because according to our research, women who have a more involved partner, possibly more supportive in some cases, are more likely to start antenatal care earlier, have more checks and ultrasound scans, and are more likely to go to parenting classes. It also led to better health after the birth and also meant women were also more likely to breastfeed.
Involvement can mean different things such as emotional or practical support - being there for antenatal checks and scans or changing nappies once the baby is born. Some fathers also get involved in finding information from birthing books for example, or helping to make decisions. But our study found this wasn’t the case for the majority. Men were more likely to help once the baby was born.
Almost all men in the survey were present for ultrasound scans and for labour but a smaller proportion attended parenting classes. There has been other research that suggests men are more doubtful about how valuable antenatal classes are to them.
Mothers do place a high value on having a supportive partner who’s willing to help out, particularly if it’s their first baby. But involvement of dads goes beyond that. After taking account of parents’ social and financial position, children of involved fathers are likely to have better educational, behavioural and developmental outcomes than children of absent fathers.
This may be due to direct effects on infant and child behaviour as well as indirectly from better relationships, social support and potentially lower levels of maternal stress in pregnancy. It has also been suggested that having a supportive partner - male in this case - during pregnancy might encourage healthier habits in women, by encouraging them to stop smoking or reduce the amount of alcohol they might drink.
The way we see men’s role in pregnancy and childbirth has changed considerably since the days when mothers were expected to go it alone in labour, and there’s still some way to go in finding out how they influence health and well being.
But it’s important that health professionals recognise that women in some social and demographic groups may be less supported by their partner and may need more help from midwives and other health professionals.
They may only get the help they need later in their pregnancy and miss the opportunity for various screening tests which can only be done earlier on. And they may miss out on antenatal classes which may leave them less well informed during labour and unsupported after birth.
The more disadvantaged in society and more excluded groups are likely to be particularly affected.
While women and their babies are the main focus of care, greater engagement with dads can improve outcomes for more mums and babies.