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The marginalisation of fathers
Marginalisation is the treatment of a person, or group of people, as insignificant or peripheral, causing them to feel isolated, unimportant or excluded. Marginalisation has deleterious effects on health service access and use, and on health outcomes.
There are not many circumstances in which men are marginalised, but when it comes to healthcare services for fertility and reproduction, they are. Men commonly report feeling ignored or excluded by health service providers when accessing services with their partners for fertility problems or prenatal care, or during labour and childbirth1.
Of course, it's not only men who can be marginalised by infertility and reproductive healthcare service providers. Females accompanying their pregnant partners to antenatal care appointments can have the same experiences as their male counterparts2. (The term ‘father’ in this article refers to any parent who isn’t the one giving birth).
The marginalisation of fathers (or prospective fathers) affects not only them, but also their partners and children. It misses opportunities to capitalise on the benefits of engaged and active fathers, which include better pregnancy outcomes, enhanced maternal and child health, and improved family function3.
There’s more to language than just words. The ways in which words are spoken, the environment and other circumstances, affect the message that is received. In the context of healthcare, eye contact and the time taken to deliver a message are critical for helping people to feel welcome, valued and involved.
The language used by health professionals and service providers influences fathers’ engagement during critical stages of their family members’ lives. Language can thereby influence preparation for fatherhood and fathers’ behaviour.
Talking to dads
When it comes to communicating, it pays to know your audience. Not all fathers will be the same, but men generally appreciate a frank approach when it comes to receiving information from health professionals, and they value communication that displays empathy, expertise and competency, and which focuses on how to achieve desired outcomes4.
Unfortunately, in the context of pregnancy, childbirth and raising children, the term ‘parent’ is often equated with ‘mother’, likely due to historical gender biases in these situations. Gender neutral language can help to include some non-birthing parents, but might exclude men who do not identify with it. Deliberate use of words like ‘men’, ‘dads’ and ‘fathers’ can increase men’s engagement with parenting services5.
Listening to dads is important too; to understand how they’re coping with the changes and challenges associated with fatherhood. Men’s descriptions of themselves as ‘useless’, ‘worthless’ or ‘over it’ should ring alarm bells and prompt investigation of fathers’ mental health6.
The transition to fatherhood
Becoming a parent results in a profound change in the lives of most people. The first steps they take in their new role can determine the course of their journey ahead. Fathers can be helped to take on their new role from a position of confidence and optimism, by father-inclusive practice that includes intentional and specific communication with them7.
Healthy Male’s Plus Paternal project has produced ‘Talking with Dads’ to help health professionals communicate effectively with fathers. The resource is available here.
How can you find out more?
We have some excellent resources available should you want to learn more about this project.
- Find the Plus Paternal webpage here
- Download the Case for Change report here
- Check out the Talking to Dads Language Guide here
- Access the eLearning course here
- Download the resource kit here
- Plus Paternal: Conversations webinars: Healthy Male hosted a series of free webinars to explore ways to systematically improve men’s engagement and support as they seek to, or become fathers. The webinars featured panellists from a range of disciplines, with opportunities for the audience to raise questions.
- Odonde et al., 2022. The Swedish father/non-birthing parent visit: evaluating implementation fidelity among child health nurses one year after voluntary implementation. BMC Nursing
- Appelgren Engström et al., 2022. Associations between heteronormative information, parental support and stress among same‐sex mothers in Sweden—A web survey. Nursing Open
- Silver et al., 2022. Stakeholder engagement in developing a father-inclusive early life obesity prevention intervention: First Heroes. BMC Pregnancy and Childbirth
- Smith et al., 2008. Qualities men value when communicating with general practitioners: implications for primary care settings. Medical Journal of Australia
- Tehan & McDonald, 2010. Engaging fathers in child and family services. Australian Institute of Family Studies
- Shand et al., 2015. What might interrupt men's suicide? Results from an online survey of men. BMJ Open
- Fletcher, 2008. Father-inclusive practice and associated professional competencies. Australian Institute of Family Studies