It’s time to help men become fathers by giving them the prenatal care they need.
It’s time to help men become fathers by giving them the prenatal care they need
The rise of absent fathers over the last halfcentury poses one of the greatest threats to the health of our nation because children without fathers are more likely to grow up in poverty, have trouble keeping up in school, and experience psychological problems, such as depression.
And the tragedy is that most fathers start out wanting to be good parents and partners, but some do not know what to do when their relationships go sour or their personal problems undermine their ability to be effective and loving parents.
Over the last 25 years, our research into the lives of young men navigating fatherhood demonstrates that many young fathers need psychological support to prepare for the challenges of parenting. We have also found that a little help can go a long way.
While no one disputes that a stable family essential to child health, there are wide
disagreements about why some men are disengaging from their children and what to do about it. Some argue that the problem is due to a decline in traditional family values, fueled by the welfare state, which they believe has weakened the institution of marriage. Others see the problem as rooted in a social and economic environment that does not support the role of men in families, pointing to the decline in living-wages for unskilled workers and a bloated, broken criminal justice system.
Whatever the causes, the upshot is that when fathers do not function well as partners and parents, mothers and children suffer the consequences.
What is most surprising about all this is the lack of effort given to helping young men ready themselves for fatherhood. Indeed, there are no expectations that fathers receive services to prepare for parenthood. This stands in stark contrast to how we — as a society — respond to pregnant women, who are expected to get prenatal care and take care of themselves for the sake of their babies.
A common-sense approach to helping fathers get ready for fatherhood would be to provide services in tandem with their partner's prenatal care. Prenatal clinics are designed to address the medical and psychological needs of pregnant women, but they are also wellpositioned to address the needs of fathers, too.
Our work has taught us that young expectant fathers have tremendous respect for prenatal care doctors, nurses, and midwives, who are there to make sure that babies get off to good start. This is why we have partnered with prenatal clinics when providing programs designed to help fathers prepare for the challenges and opportunities of parenthood.
How one couple coped - with help
Victor is a father who participated in one of our programs designed to help fathers and mothers work together to provide their child with a stable home. Despite his inauspicious circumstances, Victor's story illustrates the value of stepping in to help fathers who need assistance adjusting to parenthood and learning how to work things out with their partners.
Just out of jail, Victor fell into a Romeo and Juliet romance with Laura, whose father and brothers belonged to a rival gang. Before they had time to get to know each other well, Laura became pregnant and decided to keep the baby. Victor was frightened by the idea of fatherhood and uncertain about whether he was up to the challenge, but he didn't disappear.
Nonetheless, Laura distrusted Victor. Having been physically abused by her father and brothers, Laura had reasons to think that most men are bad bets. Her friends were feeding her doubts, telling her that Victor was not to be trusted or relied upon. Worried about how she would take care of a baby, all her anticipatory disappointment was focused on Victor, and she was quick to find fault with almost everything he did.
Victor tried to win Laura's trust. He said he wanted to find a job, to be a good father, to stay out of trouble, but he seemed clueless about how to make any of that happen. He was still hanging out with his gang friends and hadn't really looked for a job. Victor wasn't lying about wanting to step up to the plate, but he lacked the confidence and the competence to make good on his intentions. And like many young expectant couples, neither Laura or Victor knew how to offer each other the sort of understanding and support they both needed.
When we invited Victor and Laura to be in a study to test our co-parenting program, they looked skeptical but agreed. Over the course of several months, with help from a counselor, they learned to express themselves more openly, listen to each other more carefully, and solve problems together rather than blame and criticize.
Feeling more motivated, Victor found a job, and when the baby arrived, he asked Laura to move into his parents' basement apartment. This move was challenging because it required a dramatic leap of faith during a highly emotional moment in their lives. But with their new skills, they worked through the stress of taking care of a new baby and the difficulty of learning to depend on each other.
Two years later, when we met Victor and Laura for a follow-up interview, Victor was clearly proud that he had cleaned up his act, and Laura, who was hard to please, gave him high marks as a father.
Our work with men like Victor has convinced us that it is possible to help even the most unlikely young fathers successfully adjust to fatherhood. What would it take to implement this approach on a larger scale?
Good policy can change health outcomes
First, prenatal providers would need to open their doors to fathers. Second, they would need to hire staff trained to deliver a new array of services, like coparenting counseling and father-focused mental health and substance abuse treatments. Third, we would need to use research to optimize the quality of this new approach so that it can be tailored to help fathers with different needs.
This sounds like a tall order, but history offers some inspiration.
One hundred years ago, about eight of every 1,000 mothers died of birth complications, and about 100 out of 1,000 babies died before they turned 1. Following a heated debate about how to address the problem, the U.S. Congress agreed to fund a pilot program that made prenatal care accessible to disadvantaged women.
This program showed slow but steady positive results and Congress eventually passed a law, which still stands today, to guarantee prenatal care and medically assisted childbirth to all pregnant women. This law proved to be a great public health success, diminishing the rate of maternal death by 90% and decreasing infant mortality by 99%.
We can still do better, but the point here is that a simple policy change, greased with some political will, can have a dramatic impact on the health of a nation.
The time has come to help men become fathers by providing them with the prenatal care they need. Father-inclusive prenatal care is necessary to help expectant fathers who need support and instruction to meet the challenges of fatherhood, but this idea is also important for the well-being of mothers and babies, who need fathers to be healthy.
And now that the groundwork for father-inclusive prenatal care has been laid, the next step is for expectant parents to ask their prenatal care providers about services for fathers as if the need for such services is as obvious as it sounds.
Paul Florsheim is a clinical psychologist and professor of public health at the University of Wisconsin Milwaukee. David Moore is a professor of psychology at the University of Puget Sound. Together they recently wrote Lost and Found: Young Fathers in the Age of Unwed Parenthood published this year by Oxford University Press.