Not surprisingly, public health professionals, researchers and clinicians in the maternal and child health field have traditionally focused primarily on the mother and the child. Interventions aimed at encouraging antenatal care attendance, facility-based delivery and exclusive breastfeeding have generally targeted the pregnant woman or mother, often without much attention to her partner, surrounding family or social network.
Duncan Fisher, Co-Founder and Director of the Family Initiative, traveled from the United Kingdom to give a lecture at the Women and Health Initiative at the Harvard T.H. Chan School of Public Health about the importance of expanding the focus of maternal health. While there has been some effort to engage men in maternal health, few studies examining this issue have been conducted and even fewer interventions have been designed, implemented or evaluated.
Fisher noted that throughout human history, even before we were homo sapiens, child rearing has been a communal effort: fathers, family and even other community members have been instrumental in helping mothers to raise children. In fact, fathers experience similar hormonal changes to mothers (albeit somewhat less intensely) when they hold their babies, triggering a biological, instinctual sense of attachment. “An aspect of patriarchy and gender inequality,” Fisher suggested, “is suppressing that nurturing activity in men.”
Engaging fathers, family members and women’s communities of care during pregnancy, delivery and postpartum may have numerous health benefits for mothers and babies. Not involving fathers during pregnancy is one missed opportunity. Fisher recalled a visit he made to a clinic in Nigeria where fathers rarely accompanied their pregnant wives to antenatal care appointments. When he asked a large room full of pregnant women, “Do you think your husband should be here?” the room erupted into chaos: “Do not ask us to tell him everything because he just thinks we’re nagging—you tell him!” many of the women responded. In many settings around the globe where men typically do not accompany their pregnant wives to antenatal care appointments, health care providers assume that their pregnant patients will relay all of the information discussed to their husbands. In reality, as the women at the Nigerian clinic stated, this assumption more often results in fathers being uninformed and uninvolved. Similarly, despite the important role that fathers and family members play in supporting mothers to breastfeed, efforts to encourage breastfeeding often target new mothers in isolation.
Because of the potential negative consequences of promoting male involvement in maternal health and the diversity of family structures—particularly those that do not include a father—focusing on women’s families and communities of care more broadly is crucial. In its 2015 report, the World Health Organization (WHO) emphasized the importance of engaging families and communities to improve maternal and child health outcomes. Much work is needed to mobilize efforts to address these WHO recommendations, including developing consensus on the definition of “family inclusive maternal health care”, conducting research to understand global perspectives on the issue and designing effective, inclusive interventions that improve not just the health of mothers and babies, but also the functioning of family units and communities of care.
Learn more about engaging fathers and families in maternal and infant health from Family Included.
Explore perspectives on the Child and Family Blog.
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