Fathers' involvement during pregnancy and childbirth: An integrative literature review

Abstract

Objective: To provide an overview of existing literature on the current perceived levels of paternal involvement during the pregnancy and childbirth periods and the factors influencing this involvement.

Design: An integrative literature review.

Data sources: A systematic search was conducted using the databases of PubMed, CINAHL, PsycINFO, Web of Science, and Scopus.

Review methods: Studies were included for the review if they were published in English from the period of 2005-2015. Studies that focused on fathers' involvement until one-year postpartum were also included and information on parental involvement during the pregnancy and childbirth periods was extracted. A report of the search outcomes was guided by the Preferred Reporting Items for Systematic Reviews and Meta Analyses. The studies were appraised using the Joanna Briggs Institute's Critical Appraisal Checklists.

Findings: Thirty-one studies (17 quantitative, 9 qualitative, and 5 reviews) were included in this appraisal. While fathers desired to be actively involved in the antenatal and intrapartum periods, they cited several barriers that impeded their involvement. These barriers were examined as part of the factors influencing their levels of involvement, including the levels of informational support, attitudes towards involvement, qualities of marital relationship, relationships with their own parents, and sociodemographic factors.

Key conclusions: There was a lack of literature that focused on enhancing fathers' involvement during pregnancy and childbirth. Few studies attempted to evaluate fathers' levels of involvement in association with its influencing factors. Instruments that were used by the studies to measure paternal involvement did not comprehensively capture the actual phenomenon of fathers' involvement.

Implications for practice: Prospective studies examining the factors influencing fathers' involvement in greater depth will help to inform interventions to increase their involvement during pregnancy and childbirth. The effects of the interventions can be evaluated based on improved paternal involvement, maternal satisfaction, and relevant health outcomes. Future research can also focus on the development of a more robust tool to measure fathers' involvement.

Keywords: Childbirth; Factors; Fathers; Paternal involvement; Pregnancy; Review.