Maternal health – what fathers have to do with it

By Alexa Hassink
This blog was originally published by Knowledge for Health.

“To be frank, I was going through a process when my wife was pregnant. A process of finding the true meaning of being a father.”

–Father, Indonesia

The old trope of a man nervously pacing the hospital’s waiting area, wringing his hands, while his wife labors in a private back room is reserved for old movies and nostalgia, right? That may not be true, according to State of the World’s Fathers, the world’s first report to provide a global view of the state of men’s contributions to parenting and caregiving.

Even before the delivery room, some men are missing out on the chance to be involved. While more than 80% of fathers in Cambodia, the Maldives and Rwanda were present at a pre-natal check up for their youngest child, less than 20% of fathers in Burundi, Pakistan and Zambia made the trip. Traditional expectations of what it means to be a man – and a woman – alongside sometimes unsupportive, or unprepared health systems and restrictive policies, set up barriers to men’s full participation in maternal, newborn and child health.

It is essential, of course, that men are engaged in women’s health in thoughtful ways that maintain and advance women’s rights, agency and access to high quality care. Evidence is building around the positive impact that men’s presence and support can have. In Kenya, a study found that women were twice as likely to deliver with a skilled birth attendant when their husbands attended at least one pre-natal visit; and in one US study, men’s involvement during their partners’ pregnancies was associated with a 36% reduction in women’s cigarette consumption. Furthermore, fathers’ presence at birth has often proven to be a positive experience for mothers and fathers: helping women feel supported, and more in control; and in high-income countries, fathers’ presence has even helped encourage and support mothers to breastfeed.

“When I saw her giving birth, it was very emotional, a very special moment.”

–First-time father, Brazil

Even though fathers’ involvement before, during, and after the birth of their children has proven, positive impacts on maternal health behaviors and use of health services, and sets men up for long-term involvement in their children’s lives, fathers around the world are often not closely engaged during pregnancy.

So, what can we do to get men out of the waiting room, and engaged as partners in maternal health? From Niger’s School for Husbands, to Sweden’s and Ukraine’s Father Schools, and the MenCare+ program in Brazil, Indonesia, Rwanda and South Africa – organizations around the world are taking note and taking action: training healthcare providers, and working with fathers and couples in clinics and in communities.

As recommended in State of the World’s Fathers, well-designed programs that use peer and group education, community meetings, counseling, workplace-based initiatives, and mass media campaigns have been successful in engaging men in maternal, newborn, and child health. And these programs must be supported more broadly by thoughtful national and international policies, and backed with the resources to make them successful: guidelines for implementation, provisions for financial and human capital, and plans for monitoring outcomes. Furthermore, they must make sure to support women’s autonomy and decision-making.

We know what works to get men involved in maternal, newborn and child health. What helps them to be prepared, engaged, excited, and present in the lives of their children – with limited hand wringing. It’s time to advance the policy agenda, scale up programming and advance health outcomes around the world.

State of the World’s Fathers was produced by the MenCare campaign, which is coordinated by Equimundo and Sonke Gender Justice.