Why men’s perinatal care matters: Healthy fathers create healthy families
“Starting tomorrow, you’ll first be a dad and second be a doctor,” proclaimed my supervising physician, who is a mother of two.
After I spent several chaotic weeks as a resident physician in the hospital, my wife was scheduled for an induction of labor. I hardly had time to sleep, let alone process my transition to fatherhood. I had spent my entire life focused on the training required to be a licensed provider, and I was not prepared to prioritize my role as “father” over “physician.”
Shortly after my son was born, I became dedicated to this dad-then-doctor hierarchy. But prioritizing and balancing these roles was difficult and something I wasn’t ready for. The stress of deciding between checking on my sickest patient one more time that day or making it home in time for dinner took a consistent toll on me.
Men’s perinatal health is a novel concept that focuses on the health of fathers from conception through the first year of their child’s life. This time period is ripe for research, public health messaging and clinical intervention to promote men’s health and, as a result, healthy fathers and healthy families.
Fatherhood affects men’s physical and mental health in multiple ways. During the mother’s pregnancy, fathers gain weight, so the “dad bod” is a real phenomenon. Decreased sleep, less exercise, less testosterone, more stress, partner diet changes and possibly the social acceptance of the “dad bod” may explain this trend.
Additionally, men experience changes to their organs as they prepare for fatherhood. For example, the social, cognitive, motivational and decision-making centers in a father’s brain grow during the perinatal period. Also, fathers are more likely to experience depression compared to other men: About 10% of fathers experience postpartum depression, a rate that is equivalent to that of mothers.
Despite this high prevalence, there is no system for checking fathers for mood disorders, and most men are not attending their own health care during this time period. The U.S. health care system could incorporate more mental and physical health screenings for fathers.
During my son’s care, I was a part of most prenatal appointments, delivery time at the hospital, the newborn nursery stay and almost all of his well-child checks. My wife was screened at least five times for postpartum depression, but, despite the screening tool being valid for men, I was never screened. Given the frequency that men interact with health care during the perinatal period, there could be a system to connect fathers to adult primary care providers.
Engaging fathers in health care and creating healthy fathering campaigns could capitalize on a father’s interest in changing his behavior during the perinatal period. Fatherhood helps men cut back on drinking, smoking and crime involvement. In addition, there is a strong connection between the health-related behavior of partners; for example, a woman is more than six times as likely to be obese if her partner is obese. Therefore, promoting healthy behaviors in fathers could influence maternal health and be an important tool to promote women’s health.
Behaviors as a young adult typically persist throughout a man’s life. Even if there is a desire to change, fathers often don’t have the time. Programs tailored for fathers in the perinatal period have the potential to meet a large need.
Promoting healthy behaviors in fathers could also help improve the health of additional children. A new field of study, men’s preconception health, evaluates how a man’s health affects his reproduction. For example, a man’s health status affects the quality and genetic makeup of his sperm. A new study found that men who are obese or have high blood pressure, high cholesterol or diabetes face a 10% higher risk of pregnancy loss compared to men without those conditions, even after controlling for maternal factors. If a man has three of these conditions, the chance of pregnancy loss is 19% higher.
It’s also been shown that obesity causes changes to the composition of the DNA in a man’s sperm. Since obese fathers are more likely to have obese children, sperm could be one of the mechanisms for passing along this health condition. As a father of two, I am surprised that a modifiable factor, such as a man’s health at the time of conception, affects the quality and type of genetic material passed on to his children.
Because of the pandemic, most men are spending more time working from home and helping with child care. Balancing work and family responsibilities in the same space can be stressful, but most men say the pandemic has strengthened their relationships with their children. Working from home also offers more time for exercise, healthy eating and sleep. It is imperative that we harness the potential this has for fathers and their health.
Another way we could support perinatal health for fathers is expanding our family leave policies. Having access to parental leave is associated with economic and health benefits for everyone in a family. In California, the statewide paid parental leave program is linked to a 12% decrease in infant death after the first 28 days of life, even after controlling for maternal factors.
There is federal legislation pending that will create four weeks of national paid family and medical leave. Additionally, if fathers are provided leave, they should feel compelled to take all the paternity time financially possible.
After years of struggling to find a balance between the roles of “father” and “physician,” as I learn about the impact I have on the health and well-being of my family, I now find it easier to focus first on my children and second on my career.