Review date: September 2019

Citation: Albuja, A.F., Sanchez, D.T., Lee, S.J., Lee, J.Y., and Yadava, S., 2019. The effect of paternal cues in prenatal care settings on mens involvement intentions. PLoS ONE.


There are many benefits for families when fathers are involved and engaged during pregnancy. Their partner’s prenatal care and health behaviours may be better and their children may be less likely to be born preterm or with low birth weight. Fathers themselves are likely to be more confident parents if they are involved before their children are born, to have better relationships with their children and partners, and to maintain involvement in their children’s lives. They’re also more likely to feel physically and mentally healthy.

Australian men want to be involved with their partners’ pregnancies but they feel excluded. This is not surprising, given that societal norms have developed over generations to focus on the mother as the primary parent, with the father less involved in caring for their children. To make men feel more included, so that we can realise the potential of greater paternal involvement throughout pregnancy, birth and childhood, we need to identify ways to overcome generations of social conditioning.

Drawing upon social psychological theory, Analia Abuja and colleagues (PLOS ONE 14(5): e0216454, 2019) hypothesised that simple environmental cues could suggest to men that they are welcome and valued in prenatal care environments, and that this would motivate them to be more confident and active in their roles as fathers.

The researchers used three independent experimental scenarios to identify whether they could influence men’s beliefs and intentions about their roles as fathers, by including or excluding images of men with babies, and men’s magazines, in waiting areas of prenatal health care services.

They surveyed groups of men to measure their beliefs about: doctors’ expectations of fathers; how comfortable they would feel in the waiting rooms; their confidence as fathers; and their intentions to learn more about pregnancy and parenting, and; their intentions to support their partners’ health. PROCESS analysis was used to identify direct effects between waiting room appearance and these measures, and indirect effects of men’s interpretation of doctors’ expectations on the other variables.

In one scenario, they showed 3 minutes of video footage of a mock waiting room, to nearly 300 men (average age 37 years); all were either already parents, expecting children or wanting to one day become fathers. For about half of the men, the waiting room included pictures only of women and babies, and magazines targeted at a female audience. The other men viewed the same waiting rooms, but half of the pictures showed men and babies, and there were magazines targeting a male audience.

Men who viewed the waiting room with images of men and men’s magazines thought that the doctor’s expectations of fathers were higher than the men who viewed the waiting room with only female imagery. The waiting room with imagery of men was judged more comfortable. The waiting room appearance did not directly influence confidence, or intentions for learning and health behaviour but these indirectly affected men’s impression of doctor’s expectations.

For the second scenario, the researchers showed 228 young men (average age 19 years) around the mock waiting room (either with or without mens magazines and images of men and babies) and told them it was for a doctor who specialised in pregnancy and childbirth. The participants spent another 3 minutes in the room, as though waiting for an appointment. This group of young men, only two of whom were fathers, believed doctors had higher expectations of fathers, felt more comfortable and more motivated to learn about pregnancy and childrearing if they were in the waiting room with images of, and items for, men.

In the third scenario, the researchers recruited expectant fathers for a similar video-based study as scenario one. From this sample of 111 men (average age 32 years), 61 watched the video with pictures of men and magazines for men, and 50 watched the video without. In the researchers own words, “Men in the father-friendly condition reported greater doctor expectations, which predicted greater confidence, learning intentions and consonant health behavior intentions.”

This study suggests that this simple inexpensive intervention could be used to signal to men that their involvement in prenatal care and parenthood is expected by those providing prenatal care, leading them to be more confident and involved fathers. This is a simple step that can be taken towards better outcomes for families.


1Alio, A.P., Salihu, H.M., Kornosky, J.L., Richman, A.M., and Marty, P.J., 2010. Feto-infant Health and Survival: Does Paternal Involvement Matter?. Maternal and Child Health Journal