A qualitative exploratory study of UK first-time fathers’ experiences, mental health and wellbeing needs during their transition to fatherhood

Abstract

ObjectivesTo develop an understanding of men’s experiences of first-time fatherhood, their mental health and wellbeing needs.DesignA qualitative study using semi-structured interviews. Data were analysed using framework analysis.SettingTwo large National Health Service integrated care trusts covering four London (UK) local authority boroughs.ParticipantsFirst-time fathers with children under 12 months of age were included. Maximum variation sampling was used, with 21 fathers recruited. Ten of these men described their ethnic background as Indian, seven as White British, one as Spanish, one as Black African, one as Black Caribbean and one as Pakistani. Participants’ ages ranged from 20 to over 60 years; completion of full-time education ranged from high school certificate to doctorate level; and annual income ranged from £15 000 to over £61 000. Non-English speaking fathers, those experiencing bereavement following neonatal death, stillbirth, pregnancy loss, sudden infant death, and fathers with existing severe mental illnesses were excluded.ResultsNine major categories were identified: ‘preparation for fatherhood’, ‘rollercoaster of feelings’, ‘new identity’, ‘challenges and impact’, ‘changed relationship: we’re in a different place’, ‘coping and support’, ‘health professionals and services: experience, provision and support’, ‘barriers to accessing support’, and ‘men’s perceived needs: what fathers want’. Resident (residing with their partner and baby) and non-resident fathers in this study highlighted broadly similar needs, as did fathers for whom English was their first language and those for whom it was not. A key finding of this study relates to men’s own perceived needs and how they would like to be supported during the perinatal period, contributing to the current evidence.ConclusionsThis study provides insight into first-time fathers’ experiences during their transition to fatherhood, with important implications for healthcare policy makers, service providers and professionals for how perinatal and early years services are planned and provided for both new parents.

Assessing the Mental Health of Fathers, Other Co-parents, and Partners in the Perinatal Period: Mixed Methods Evidence Synthesis

“…As shown in Table 2 , all of the 20 studies addressing acceptability were from high-income Westernized countries. Parent perspectives were reported in eight studies ( 34 , 49 , 78 – 83 ); nine reported health professional perspectives ( 84 – 92 ); none included both. A further three feasibility and implementation studies reported behavioral indicators (e.g., completion rates) without collecting participants' perspectives ( 93 – 95 ).…”

“…Despite the implications of partners' mental health and well-being for parents, their children, and health and care services, their difficulties largely remain undetected and unmanaged. This reflects that partners have not been prioritized in policy ( 34 ) and that universal services and specialist perinatal mental health services (where they exist) usually focus on the perinatal mental health of the woman, i.e., the birthing or gestational parent, while little support is available to partners ( 17 ). In several high-income settings where there is existing provision for routine mental health assessment (or “screening”) with mothers, researchers have called for this to be extended all partners and parents [e.g., ( 6 , 35 – 37 )].…”

The experience of first‐time Hong Kong Chinese fatherhood: A qualitative exploratory study

“…In a recent qualitative study of 21 first-time fathers in the United Kingdom, nine major categories were identified including preparation for fatherhood, rollercoaster feelings of excitement and apprehension, new identity with a sense of accomplishment and personal growth, physical and emotional challenges, changed relationship with partner, coping and support from family and friends, health professionals and services provision and support, barriers to accessing support, and men's perceived needs of more information on the physical and emotional demands of parenthood (Baldwin, Malone, Sandall, & Bick, 2019). In another qualitative study of 19 fathers in the United Kingdom, similar themes were identified involving legitimacy of paternal stress and entitlement to health professional support, protecting the partnership, navigating fatherhood, and diversity of men's support networks (Darwin et al, 2017).…”

“…Although research on first-time fathers' experience is growing, the majority of studies have been limited to the experiences of men in Western societies with predominantly Caucasian populations (Baldwin et al, 2019;Nešporová, 2019). Studies specifically investigating men's experience of fatherhood during the postnatal period in a Chinese context are rare.…”

Prenatal Mental Health: Continuous Care from Pregnancy

“…Maternal mental health is more directly related to mother-infant interaction and infants' outcomes (see the next chapter). Baldwin et al (2019) reported the importance of recruiting fathers. They reported that if relevant health professionals fail to engage with fathers, they will not identify the father's mental health needs.…”