Association for Public Policy Analysis & Management

Although fathers play an important role in families, and fathering is consistently linked to child well-being, existing research suggests that fathers are not often successfully engaged in healthcare services during pregnancy, birth and infancy. Research also indicates that the vast majority of new fathers (including low-income, young, unmarried, and non-residential fathers) are involved with their families at and around the birth of a child. Therefore, perinatal healthcare encounters provided around the birth of a child represent untapped opportunities to deliver health and parenting interventions to these young men and potentially improve outcomes for children.

A review of the existing literature reveals that little is known about what accounts for the frequency and quality of fathers’ participation in healthcare in general. Even less is known about the experiences of racial and ethnic minority fathers who are partnered with young mothers. Families that include young parents are at particular risk for poor health and well-being outcomes including low birth weight and child maltreatment. The increased risk shouldered by this population, coupled with their unique developmental needs, highlights the importance of research that focuses specifically on this population.

The aim of this study is to explore young, low-income, African American and Latino, first time fathers’ experience with perinatal healthcare services before, during, and after the birth of their first child. A total of 20 men between the ages of 15 and 24 whose partners were pregnant or had their first child in the last year participated in one-on-one 90 minute open-ended interviews and completed a brief (5 minute) demographic questionnaire. The aim of the qualitative analysis was to inform the design and development of a conceptual model of fathers’ engagement with the medical service system and the impact of those experiences on their own well-being and that of their young families. Two members of the research team independently conducted open-coding of the qualitative interviews using a constant comparative method of qualitative analysis using NVivo software.

Results of this study suggest that a variety of factors impact fathers’ participation in medical services immediately before, during and after the birth of their child. These factors are explored at multiple ecological levels including: the medical service system, community, family and individual levels. Fathers described mixed experiences at each level and a general decline in efforts to participate in services over time. A preliminary model of fathers’ engagement in perinatal healthcare services is proposed by the study team to organize the intersections between entrée into fatherhood and healthcare service engagement using these qualitative data.

This study begins to examine the experiences of young African American and Latino fathers and hint at potential opportunities for healthcare based interventions that might support their and their families’ optimal engagement with perinatal services. The results suggest areas for further exploration and the need for longitudinal research that would better describe these unfolding processes using a larger, more representative sample, and provide the opportunity to empirically validate the proposed model of service engagement.