A new South Australian study submitted to the journal of Qualitative Health Research this week shows that many new fathers feel anxious and excluded about becoming a father and a huge opportunity is missed during the perinatal period to engage and support them.
The study was undertaken by the South Australian Mental Health Commission (SAMHC), who partnered with Flinders University to examine the effectiveness of interventions that addressed the mental health of new fathers, especially those experiencing anxiety and depression during their partner’s pregnancy and following the birth of their baby.
Researchers examined a range of interventions, from face-to-face antenatal classes, to advice given by family, friends, midwives and online forums, texting services, phone counselling and blogs driven by social media.
Those most in need of help were found to be less likely to pursue it and the effectiveness of interventions was deemed unclear, "as many of the studies lacked the appropriate methodological approach to determine this."
What came through was a sense that fathers described this new life experience as ‘joyous’ but also a ‘rollercoaster ride’.
“Fathers felt initially ‘disconnected’ to their child, challenged by the multiple roles they now held, and their shifting importance in the family,” the authors observed.
Barriers to accessing support was not knowing what type of support to get and where to get it. Some felt left out or belittled, which put them off seeking help.
New fathers reported feeling ‘excluded’, ‘inept’ and ‘secondary’. The report identified an opportunity to support the mental health and well-being of fathers, and to engage them fully during the perinatal period, a ‘teachable moment’ in the journey of new parents.
They said fathers should feel comfortable and involved in parenting programs.
“Becoming a ‘good father’ does not always come naturally and make take time to achieve for some,” the study noted.
“The current report provides a platform for the community to fully utilise this ‘teachable moment’ and assist to engage fathers, prepare them realistically for the challenges they may face, and facilitate their confidence to be a ‘supportive and involved’ family figure.”
The study reported:
- One in 20 men experience anxiety and depression during their partner’s pregnancy and one in 10 following the birth of their baby.
- Anxiety and depression in fathers during a child’s first year can also have a detrimental impact on the child and the father’s partner.
- Men are less likely to acknowledge or seek help for mental health issues.
Fathers said for support to be effective it needed to be “tailored, credible, interactive, engaging, useful (relevant, on-going, light-hearted, and accessible when needed”.
“Fathers reported initially feeling disconnected to their infants, which often fed into feelings of self-consciousness when concerned that they weren’t bonding with them or able to calm them,” lead researcher, clinical psychologist Dr Anthony Venning told the Herald Sun newspaper.
“Fathers reported challenges in many areas, including striking a balance between work and home life, and feeling overwhelmed with these obligations.”
A summary of study authors’ recommendations included:
FOR THE ATTITUDES / BEHAVIOURS / ACTIONS OF HEALTHCARE PROFESSIONALS
Pregnancy should be viewed as a teachable moment with fathers made to feel comfortable and involved in parenting programs, particularly with the family doctor. Moreover, a focus needs to be placed on co-parenting (e.g., feeding practices, infant crying, and attending appointments) and the involvement of fathers.
FOR HEALTHCARE AND POLICY IMPLICATIONS
Men may be more open to, aware of, interested in, and receptive to information designed to promote theirs and their family’s wellbeing. Healthcare professionals need to promote the availability of resources and supports to engage the willing but potentially reluctant fathers to receive and informally share intimate or stigmatising information.
FOR SUPPORT SERVICES
Hybrid 24/7 approaches (face-to-face and online) monitored by midwives and incorporating the use of mentors should be considered. Approaches should involve co-parents, be orientated to the whole family, offer opportunities to contribute (anonymously if wanted), be tailored to fathers’ preferences (e.g., platform), contain interactive content, portrays fathers as ‘fathers’ rather than unwise / uninterested stereotypes, and encourage social connection with others.
FOR SUPPORT SERVICE CONTENT
Content should be evidence-based, adopt a conversational tone, and focus on specific symptoms (e.g., postpartum depression) and how to talk about these with and facilitate self-care and formal treatment for their co-parent (build confidence in skills).
FOR FUTURE RESEARCH
Need to clarify the efficacy of different types of support for fathers, the difference between full-term and pre-term parents’ level of skill and confidence, the experience of fathers in relation to specific issues (e.g., infant crying, first time vs. experienced), and the potential of empowerment-disempowerment by telemedicine / mobile ‘apps’.
FOR METHODOLOGICAL IMPROVEMENTS
Randomized controlled and longitudinal trials need to be conducted to examine fathers’ transition to fatherhood. Research should consider new alternatives for recruiting (e.g., community connections) and obtaining feedback from fathers (e.g., inbuilt into ‘app’), as well as developing quantitative measures related to infant crying.
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