“I came to escort someone”: Men’s experiences of antenatal care services in urban Ghana—a qualitative study

Abstract

Background Male involvement in maternal healthcare has been widely recognized as essential for positive health outcomes for expectant mothers and their unborn babies. However, few studies have explored men’s experiences of maternal health services. The purpose of this paper is to explore men’s involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of space, place, and gender. Methods A qualitative exploratory study using semistructured interviews, focus group discussion, and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed, and observation was conducted at a selected public hospital in Accra. Results The findings suggest that the few men who attend antenatal care with their expecting partners become involved to a limited extent in the clinic’s activities. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds and rarely participate in consultations with their partner and midwife. Men still view their presence as necessary to acquire knowledge and as sources of emotional, financial, and physical support for their partners. On the health workers’ side, the study found no clear agenda for engaging men at the clinic, and nurses/midwives felt there was a lack of staff who could engage more directly with the men. Conclusion The study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care/maternity wards. Health workers do not feel they have the necessary resources to involve men fruitfully. Thus, men do not engage in the activity as hoped but rather remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space in which both expecting mothers and fathers can actively participate and be engaged to the benefit of all.

Access to support during childbirth?: women’s preferences and experiences of support person integration in a cross-sectional facility-based survey

“…Further, the increased likelihood of wanting to consult for decisions with mothers, male partners, sisters and other family members implies maternity care needs to expand access to a variety of other support persons. Literature and health policies have predominantly focused on male partner involvement and providers frequently give preferential treatment to male partners [ 8 , 33 , 41 – 44 ]. Yet, many studies have found preferences for mothers and other female relatives, often stemming from cultural preferences [ 12 , 22 , 45 , 46 ].…”

“…Provision of information and education facilitates support persons’ involvement in care and clarifies their roles [ 16 , 30 – 32 ]. The ability to ask questions and express concerns acknowledges the importance of engagement with providers during care, especially as an avenue to advocate on behalf of the supported women [ 13 , 16 , 23 , 33 ].…”

Association of Male Partners’ Gender-Equitable Attitudes and Behaviors with Young Mothers’ Postpartum Family Planning and Maternal Health Outcomes in Kinshasa, DRC

“…The lack of significance of male partners' gender-equitable attitudes and behaviors as predictors of the FTM's completion of the MH continuum of care may be partly explained by the fact that men may generally feel disengaged and out of place at maternal healthcare services; and may be physically distanced outside the clinic. Even though men tend to be the primary decision makers for women's access to care, prevailing sociocultural norms defining pregnancy and childbirth as women's spaces may leave men disempowered and spatially and socially marginalized in maternal healthcare settings [61]. However, the low concordance between FTMs and male partners reports of joint decision making suggests that further research is needed to better understand effective couple communication and couples' interpretation of each other's role in the decision-making process.…”

The Effects of the Maternal Health Improvement Project in the Louga Region of Senegal

“…In areas where ambulances do not have access due to a lack of roads, providing villagers with practical means of transportation such as bicycles or donkey carts, according to the characteristics of the terrain, would enable villagers not only to cope with maternal emergency situations but also to receive appropriate ANC [ 8 ]. Lastly, in the case of men accompanying their wives to a medical facility, in many cases they are required to remain in the waiting area and choose an isolated place outside the medical facility until the treatment is completed [ 28 ]. In addition, the attitude of medical staff who fail to encourage male participation in the ANC process is perceived as a negative experience, which reduces active participation among men [ 24 , 25 ].…”

“…In addition, for women with limited social relationships, the space for receiving prenatal care needs to be not just a physical place but a space in which they can form social relationships with other pregnant women and share reproductive health information. Therefore, changes in social norms are necessary to enhance women’s autonomy and to recognise that the medical waiting space is a space that includes men, not just women [ 28 ].…”