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Key takeaways for caregivers
- It is important for fathers to begin bonding with their baby during pregnancy; singing, reading, and talking to their baby can support this early bond.
- Fathers can also talk with their partner and trusted others about their hopes and concerns for their baby during pregnancy as a way to prepare for early parenting.
- During pregnancy, fathers are encouraged to connect with other expectant or new fathers to begin building a parenting support network.
Key takeaways for healthcare and social services programs
Make pregnancy spaces father friendly
- Encourage fathers to attend obstetrics and ultrasound appointments, and provide a welcoming space for addressing fathers directly, asking if they have questions or concerns, and supporting their involvement in the pregnancy process.
- Provide supportive spaces and programs for fathers to connect with each other and learn about topics related to pregnancy and early infant care.
- Include pictures of fathers and infants in obstetrics and pediatrics offices and reading material that may appeal to men in waiting rooms.
Talk with fathers directly about their past and present experiences
- Ask fathers about their own experiences with the pregnancy and their hopes and concerns for their infant.
- Include fathers in early intervention programs beginning at intake and highlight fathers’ importance for the health and well-being of their infant.
- Screen expectant fathers (and mothers) for Perinatal Mood and Anxiety Disorders, past maltreatment and trauma histories, and current exposure to adversity, and connect them with mental health services as needed.
Key takeaways for policymakers
- Create systems that coordinate and connect fathering programs, such as state-level fatherhood commissions.
- Require early intervention programs to include fathers whenever possible as a central component of interventions rather than a suggested add-on service to families.
- Create programs and services that support fathers in bonding with their babies during the perinatal period, such as establishing ‘fatherhood navigators’ at hospitals that support fathers during prenatal visits, labor and delivery, and with post-natal infant care.
While fathers are increasingly expected to be actively involved in the pregnancy and post-natal care of their newborn, social narratives have not kept pace with these expectations.
Prenatal emotional bonds are a foundation for healthy parent-child relationships
Expecting and preparing for a baby is a time of excitement and joy for many parents. In addition to stocking up on diapers and onesies, parents-to-be are also preparing psychologically for the birth of their new baby (Dayton et al., 2020). The prenatal emotional bond parents form with their baby is essential and powerful – it prepares them to care for their newborn (Raphael-Leff, 2005).
In turn, early sensitive parenting – feeding, bathing, changing, holding, and soothing the baby – sets the stage for a strong and enduring parent-child relationship. For fathers, early infant care is associated with feelings of parenting competence (Dayton et al., 2015), and thereby supports their growing bond with their baby.
Prenatal bonding is often different for mothers and fathers
For the person carrying the baby (typically the mother), the prenatal emotional bond with the infant is supported by the biology of pregnancy – hormonal changes, the baby’s movements inside her (“quickening”), and a growing baby bump all contribute to her emotional connection with her baby.
Her growing body also alerts the outside world that she is expecting a baby and, across cultures, many social practices acknowledge, honor, and support her mothering role. The baby bump may compel passengers on the bus to give up their seat, accommodates nearby parking at the grocery store, and can inspire smiles and kind words from strangers.
In contrast, the parent who is not carrying the baby (the father or the mother’s partner) is an external observer of the baby’s prenatal growth. Expectant fathers also undergo prenatal hormonal and physiological changes that support post-natal parenting behaviors (Saxbe et al., 2017), but because these changes are not visible to others, expectant men experience fewer social acknowledgements of their status as fathers-to-be than do expectant women.
Prenatal bonding is also a slower process for fathers than it is for mothers. A father’s prenatal bond with his baby tends to increase as the pregnancy progresses (Habib & Lancaster, 2010) and is influenced by his own mental health (e.g., depression, anxiety; Cameron et al., 2016) and by his relationship with the mother of his baby (Ahlqvist-Björkroth et al., 2016).
Dispelling misconceptions about the importance of fathers’ early involvement
However, when expectant fathers are given time and space to talk, they have a lot to say! In addition to feelings of excitement and pride, fathers describe their growing feelings of responsibility – not just for the immediate post-natal period, but also for the care their child will need throughout life.
However, while fathers are increasingly expected to be actively involved in the pregnancy and post-natal care of their newborn, social narratives have not kept pace with these expectations. Therefore, fathers may wrongly believe that their most important parenting role does not begin until their children are older (Dayton et al., 2016). Notably, fathers who believe strongly in the importance of early fathering for the health and well-being of young children are also more likely to feel a strong emotional bond with their infant prenatally (Dayton et al., 2019), and may therefore be more prepared for post-natal infant care.
Fathers’ involvement improves babies’ development
The research is clear: When fathers are involved in the lives of their babies beginning in pregnancy, healthy outcomes for their babies are improved – prenatal, birth, and newborn health outcomes are better and per-infant health care costs are reduced (Alio et al., 2010; Salihu et al., 2014). For mothers and fathers in areas of the United States like Detroit, where maternal and infant morbidity and mortality rates constitute a public health crisis, fathers’ involvement can reduce the negative effects of systemic factors such as institutional racism that are literally killing black mothers and babies.
So how do men bond with their babies and what can be done to support them? Research is beginning to shed light on the ways in which men form prenatal relationships with their babies and this work suggests some ways to help.
Encouraging fathers’ involvement supports father-infant bonding
Research has demonstrated that the quality of the prenatal father-infant relationship is related to the quality of the post-natal father-infant relationship (Vreeswijk et al., 2014). However, research also suggests that expectant fathers’ emotional connection to their infant begins somewhat later in pregnancy than it does with mothers (Ives, 2014) – likely due to the physiological and social differences they experience. Many men say they must rely on the mother as a gatekeeper (Draper, 2002), for example, to be invited to feel the baby’s movements in utero and to be notified of obstetrics visits. These experiences may create a sense of distance from the infant.
When fathers are involved during pregnancy, outcomes for infants improve.
Mothers can support the father-infant bond by encouraging fathers to be actively involved in the pregnancy. Fathers’ involvement can include talking and singing to their babies and attending prenatal medical appointments. They can also talk with the baby’s mother about important newborn care decisions, such as whether the baby will be breast- or bottle-fed (Dayton et al., 2019). In this way, fathers can care for and bond with their baby even before the baby is born.
Fathers can also feel closer to their baby by talking about them with others. Friends and family members can provide spaces for expectant fathers to talk about their hopes and dreams for their baby, as well as their worries and concerns.
Perhaps because mothers are still perceived as the “primary” parent in infancy and early childhood, many fathers connect with the women in their lives to support them during pregnancy and early parenting (Dayton et al., 2016). But when other fathers reach out to share pregnancy expectations and answer questions, expectant fathers describe feeling a deep sense of support and connection with them (Walsh et al., 2014). Programs that encourage men to develop parenting support systems with each other may have powerful effects on improving mental health and increasing feelings of parenting confidence.
Social systems should emphasize the importance of fathers’ role and services for expectant dads
Social systems also play a role. Within the health care system, fathers often feel ignored and report feeling unwelcome at obstetrics appointments and ultrasound scans (Widarsson et al., 2015). Yet when fathers are included and involved in these appointments, they feel more connected to their baby, and they often feel a surge of pride and motivation to be good fathers and partners to the baby’s mother (Walsh et al., 2014).
To support and encourage these feelings, medical personnel can involve fathers in medical appointments by including them in conversations about the medical status of the mother and baby, and by explicitly asking fathers if they have questions or concerns. In addition, by intentionally featuring pictures of fathers and infants in obstetrics and pediatric waiting rooms and displaying magazines that appeal to fathers, health care professionals can help fathers feel welcome in the space (Albuja et al., 2019).
Health care providers’ offices are often the first (and sometimes only) place where parental well-being can be assessed. Although stigma still exists that may prevent fathers from talking about their mental health, many fathers struggle with feelings of depression and anxiety as they prepare for the birth of their baby – just as many mothers do (Dayton et al., 2017).
Fathers may also find that past exposure to traumatic events influences their ability to bond with their baby during pregnancy (Dayton et al., 2019). Health care providers are encouraged to screen fathers (and mothers) for Perinatal Mood and Anxiety Disorders, and to provide compassionate support and referrals to mental health services as needed (Walsh et al., 2020).
Within most social services systems, prenatal and early childhood intervention services are targeted almost exclusively to mothers. Despite increased efforts to also provide programs for fathers, services for dads are often designed and delivered as both optional and secondary to the central intervention with the mother.
This approach reinforces social narratives that fathers are less important than mothers during pregnancy and as parents to their young children. It also ignores growing evidence that interventions that target the co-parenting relationship, and therefore attend equally to both parents, yield positive effects on child outcomes (Hawkins et al., 2022).
Parenting programs should include fathers in early childhood interventions from the very beginning of the service delivery process. Ensuring that agencies are father friendly, in terms of office décor and a welcoming approach to fathers, for example, is also crucial.
Conclusions: Fathers’ involvement has a significant and enduring impact
When fathers are involved during pregnancy, outcomes for infants improve. Fathers form early, prenatal, relational bonds with their babies that support their parenting after the birth of their child. Improving services to expectant fathers, especially in communities where infant mortality and morbidity are high, can help the negative effects of racism, poverty, and violence on maternal and infant outcomes. Programs and policymakers can help support prenatal father-infant relationships by creating prenatal spaces that include fathers and by implementing early intervention programs for fathers, and by making sure dads are a part of existing programs.