Plus Paternal: Talking to Dads

 

A guide for health practitioners

Do you work with people who are planning to have a child? Those who are pregnant? Or families that have recently had a baby?

Chances are you will have great skills and experience in working with mothers and birthing parents. Are you as confident when it comes to working with fathers and non-birthing parents? Do you know how best to engage with them and to inspire them to be confident, committed, equal parents? Would different words and/or messages have a better impact?

As the health systems evolves from a mother-focused to a more family-centred approach, health practitioners are uniquely placed to create more inclusive experiences and environments for all parents.

By communicating intentionally, and by being attuned to each parent’s needs, you can set the scene early for a positive parenting experience that will help families to thrive.

This tool provides practical recommendations for improving your communication with fathers and non-birthing parents — some may appear obvious, or only subtly different to how you would communicate with mothers and birthing parents. However, small changes can make a significant difference to the way each parent engages, learns and views themselves, and to how they make informed choices about parenting or help-seeking.

Whether you’re new to working with families, or have been doing so for a long time, these recommendations should help you to inspire fathers and non-birthing parents to be engaged, confident, committed and equal parents.

 

Our evidence-informed recommendations are based on well-established theories about communication, family systems, attachment and gendered stereotypes and norms.

These concepts are described and applied to practice in our Talking to Dads online learning module. This self-paced eLearning activity provides practical tips and examples for improving care providers’ communication with fathers and non-birthing parents. It’s applicable for a wide range of health practitioners, including GPs, midwives, nurses, parenting educators, obstetricians, gynaecologists and fertility specialists.

Those wanting a closer look at the theoretical concepts and frameworks that relate to language and communication with fathers, please see our Theories Paper.

 

Why language matters

The transition to parenthood is a challenging time for all parents1,2. It is also a time when parents are potentially interacting with many health practitioners across a range of reproductive and perinatal health services. These interactions, whether positive or negative, can be highly influential in helping shape parents’ knowledge, skills, attitudes and behaviours.

Although possibly unintentional, many fathers do not feel meaningfully engaged by the health system from preconception through to parenthood3, 4, 5, 6, 7. This can raise their anxiety and create a sense of helplessness8, 9.

 

Plus Paternal: Talking to Dads

 

Communication is likely to be a contributing factor. The words and images health practitioners (and the system) use, and the messages they convey, can work to include or exclude individuals from health care. Messages can also reinforce traditional gendered stereotypes that may influence roles within families.

And your choice of words matters too — too much jargon leaves fathers feeling dissatisfied and frustrated10.

Getting the language and messaging right can make a big difference to fathers and non-birthing parents’ experiences, and in turn, their families.

 

What do we mean by language?

We have taken a broad definition of language and communication to incorporate words (written and spoken), messages, non-verbal communication, visual elements and environments.

 

Tuning-in to fathers

Do you routinely look for meaningful ways to include each parent and to tune-in to their particular questions or needs?

It is worth remembering that fathers, and indeed all parents, are products of their environments. Their knowledge, skills and attitudes will have been influenced by the worlds they live in — their own childhood experiences, their families and friends, their culture, their education, their socio-economic status, the media, our health system, and so on11, 12, 13. All these factors work to develop a father’s identity; how they perceive their role/s and their engagement with their child and family.

Although all men are different, there are some trends in their preferences for receiving information. An Australian study showed that14:

  • Men generally appreciate a competent, “frank approach”
  • They often seek information online, particularly if related to issues such as fertility
  • Men usually want to receive factual, statistical and/or practical information about pregnancy
  • They tend to respond well to the thoughtful use of humour
  • Men typically value health practitioners’ empathy — their ability to communicate easily and on the person’s level, and to listen and understand the person’s perspective.

Most men appreciate that the focus of perinatal appointments and education needs to be about the mother and/or child. They don’t necessarily want the spotlight to be on them, but many do want to be actively included in the journey, and certainly not left out.

 

“I understand that the majority of attention needs to be provided to the mother and I am supportive of this. However, having a child was still the most important event of my life, and yet I was often ignored completely during preconception consultations, during the pregnancy, and perinatally. Being treated like a member of the team on more occasions would have been valued.”

Father - Plus Paternal Survey Participant


Why engage fathers?

  • Many men’s knowledge about preconception, fertility, pregnancy, birth and early fatherhood is limited15.
  • If men are not engaged by the health system during the transition to fatherhood their frustration can leave them feeling uninformed and ill-equipped16.
  • One in five fathers report feeling totally isolated in the first year of fatherhood17.
  • One in 10 fathers experience depression and/or anxiety before or soon after birth18.
  • Men’s preconception health affects fertility and the health of their children19.
  • Opportunities may be lost to prepare fathers for the impact parenthood will have on their lives, and their families.
  • If men become engaged, active parents there are likely to be better relationships within their families, improved family wellbeing and healthier child development20, 21, 22.

Continue reading: Inclusive language

 

References

1. Baldwin S, Malone M, Sandall J, et al. Mental health and wellbeing during the transition to fatherhood: a systematic review of first time fathers' experiences. JBI Database System Rev Implement Rep 2018;16(11):2118-91. doi: 10.11124/JBISRIR-2017-003773 [published Online First: 2018/10/06]

2. Chin R, Hall P, Daiches A. Fathers' experiences of their transition to fatherhood: a metasynthesis. Journal of Reproductive and Infant Psychology 2011;29(1):4-18. doi: 10.1080/02646838.2010.513044

3. Healthy Male, Plus Paternal Case for Change, Melbourne 2020

4. Chin R, Hall P, Daiches A. Fathers' experiences of their transition to fatherhood: a metasynthesis. Journal of Reproductive and Infant Psychology 2011;29(1):4-18. doi: 10.1080/02646838.2010.513044

5. Dheensa S, Metcalfe A, Williams RA. Men's experiences of antenatal screening: a metasynthesis of the qualitative research. Int J Nurs Stud 2013;50(1):121-33. doi: 10.1016/j.ijnurstu.2012.05.004 [published Online First: 2012/06/12]

6. Kowlessar O, Fox JR, Wittkowski A. The pregnant male: a metasynthesis of first-time fathers’ experiences of pregnancy. Journal of Reproductive and Infant Psychology 2014;33(2):106-27. doi: 10.1080/02646838.2014.970153

7. Steen M, Downe S, Bamford N, et al. Not-patient and not-visitor: a metasynthesis fathers' encounters with pregnancy, birth and maternity care. Midwifery 2012;28(4):362-71. doi: 10.1016/j.midw.2011.06.009 [published Online First: 2011/08/09]

8. Fenwick J, Bayes S, Johansson M. A qualitative investigation into the pregnancy experiences and childbirth expectations of Australian fathers-to-be. Sex Reprod Healthc 2012;3(1):3-9. doi: 10.1016/j.srhc.2011.11.001 [published Online First: 2012/02/14]

9. Elmir R, Schmied V. A meta-ethnographic synthesis of fathers' experiences of complicated births that are potentially traumatic. Midwifery 2016;32:66-74. doi: 10.1016/j.midw.2015.09.008 [published Online First: 2015/10/13]

10. Vallin E, Nestander H, Wells MB. A literature review and meta-ethnography of fathers' psychological health and received social support during unpredictable complicated childbirths. Midwifery 2019;68:48-55. doi: 10.1016/j.midw.2018.10.007 [published Online First: 2018/10/27]

11. Roberts, D. Coakley, T, Washington, Kelley, A. Fathers’ Perspectives on Supports and Barriers That Affect Their Fatherhood Role. SAGE Open, 2014: 4 (1). doi:10.1177/2158244014521818

12. de Montigny, F., & Lacharite´, C. (2005). Perceived parental efficacy: Concept analysis. Journal of Advanced Nursing, 49(4), 387Y396. doi:10.1111/j.1365-2648.2004.03302.x

13. Sevigny, P. R., & Loutzenhiser, L. (2010). Predictors of parenting self-efficacy in mothers and fathers of toddlers. Child: Care, Health &Development, 36(2), 179Y189. doi:10.1111/j.1365-2214.2009.00980.x

14. Smith, J, Braunack-Mayer, A, Wittert, G, Warin, M. Qualities men value when communicating with general practitioners: implications for primary care settings. MJA 2008; 189: 618–621

15. Fenwick J, Bayes S, Johansson M. A qualitative investigation into the pregnancy experiences and childbirth expectations of Australian fathers-to-be. Sex Reprod Healthc 2012;3(1):3-9. doi: 10.1016/j.srhc.2011.11.001]

16. Ibid

17. Global Research Report on Male Social Connection – Fatherhood and Social Connections, Movember 2019

18. The cost of perinatal depression and anxiety in Australia, Pricewaterhouse Coopers, 2019

19. Healthy Male, Want to become a dad? Your health makes a difference to your baby’s health 

20. Fletcher, R. (2011). The dad factor: How father-baby bonding helps a child for life. Sydney: Finch Publishing. 

21. Panter- Brick,C.,Burgess,A.,Eggerman,M.,McAllister,F.,Pruett,K.,&Leckman,J.F.(2014).Practitioner review: Engaging fathers–recommendations for a game change in parenting interventions based on a systematic review of the global evidence. Journal of Child Psychology and Psychiatry, 55(11), 1187–1212.

22. Cabrera, N.J., Volling, B.L., & Barr, R. (2018). Fathers are parents, too! Widening the lens on parenting for children’s development. Child Development Perspectives, 12(3), 152–157