Male partner participation in maternity care and social support for childbearing women: a discussion paper

Abstract

Male partners/fathers are key support persons for many childbearing women and their involvement in pregnancy, childbirth and the postpartum/postnatal period has beneficial effects on a wide range of outcomes related to maternal and child health and family wellbeing. Social support is implicated in the relevant causal pathway, but has received largely tangential attention in the public health literature. This discussion paper aims to reframe men's participation in maternity care as an opportunity to enhance their readiness and ability to provide social support to women, contributing to the debate on the definition and rationale for male partner involvement, and paving the way for further empirical work. I begin by presenting a theory of change illustrating the causal pathway leading from male partner participation, through the key intermediate step of social support, to improved health and wellbeing for women and children. I proceed by arguing that many people desire male partner participation in maternity care; however, in practice, this is often limited owing to cultural, social and institutional barriers. I use examples from the intervention literature to demonstrate how participation in care can boost men's motivation to support women and enhance their ability to do so by increasing their knowledge and skills. Finally, I draw up general implications for further male partner involvement programmes, suggesting that in order to achieve meaningful and sustainable gains, attention to design is crucial in order to avoid reinforcing patriarchal gender norms. Programmes should be implemented alongside other efforts to improve quality and promote woman-centred care. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.

Perinatal depression in migrant and refugee women on the Thai–Myanmar border: does social support matter?

“…As Spry et al discuss in their piece [37], interventions promoting social support antenatally can reduce rates of depression postnatally. Although in our setting, partner support appeared to play a less significant role than perceived and received support, other studies have found that increasing partners' involvement in women's care can enhance support to women [38].…”

The Effects of the Maternal Health Improvement Project in the Louga Region of Senegal

“…The percentage of respondents who answered that they received support from their husbands during pregnancy did not show any statistical significance but did show an increase compared to before the implementation of IEC activities. In developing countries, the male plays the role of the decision-maker in the household, thus being aware of when to actively support women during pregnancy or reacting sensitively to the women’s abnormal signal is important to the improvement of women’s health by increasing the use of prenatal medical services [ 23 , 24 , 25 , 26 ]. Therefore, previous studies are continuing research on methods to increase the participation of spouses and are actively trying to resolve negative factors.…”

The male breadwinner nuclear family is not the ‘traditional’ human family, and promotion of this myth may have adverse health consequences

“…Public health initiatives around maternal and child health in lower-and middle-income countries typically also assume a default nuclear family structure in which mothers are largely responsible for the health of their children-this excludes vital support structures such as grandmothers (see [92]). There are even some perceptions in global health that grandmothers are the 'guardians of tradition' [93] and that, if they have a role at all, it is a role that has the potential for negative maternal and health outcomes, given that the advice of older women may contradict that of public health professionals.…”