We conducted focus groups with mothers and fathers from the National and subsequent infant mortality were markedly higher for African-American mothers [ 1,2,4,7]. contributions fathers can make to improving birth outcomes [,]. . He must have a sense of responsibility for caring for the child and.
Table of contents
- Lost Mothers: Maternal Mortality In The U.S.
- Background
- A community perspective on the role of fathers during pregnancy: a qualitative study
- Racial Differences in Birth Outcomes: The Role of General, Pregnancy, and Racism Stress
Disparities due to socioeconomic factors have been exacerbated by advances in medical technology. Developed countries, most notably the United States, have seen a divergence between those living in poverty who cannot afford medical advanced resources, leading to an increased chance of infant mortality, and others.
In policy, there is a lag time between realization of a problem's possible solution and actual implementation of policy solutions. In most cases, war-affected areas will experience a significant increase in infant mortality rates. Having a war taking place where a woman is planning on having a baby is not only stressful on the mother and foetus, but also has several detrimental effects.
However, many other significant factors influence infant mortality rates in war-torn areas. Health care systems in developing countries in the midst of war often collapse. Attaining basic medical supplies and care becomes increasingly difficult. Preventable diseases can quickly become epidemic given the medical conditions during war. Many developing countries rely on foreign aid for basic nutrition. Transport of aid becomes significantly more difficult in times of war. In most situations the average weight of a population will drop substantially.
During the Yugoslav Wars in Bosnia the number of premature babies born increased and the average birth weight decreased. There have been several instances in recent years of systematic rape as a weapon of war. Women who become pregnant as a result of war rape face even more significant challenges in bearing a healthy child. Studies suggest that women who experience sexual violence before or during pregnancy are more likely to experience infant death in their children. Many women who became pregnant by rape in Bosnia were isolated from their hometowns making life after childbirth exponentially more difficult.
Developing countries have a lack of access to affordable and professional health care resources, and skilled personnel during deliveries. The American Academy of Pediatrics recommends that infants need multiple doses of vaccines such as diphtheria-tetanus-acellular pertussis vaccine , Haemophilus influenzae type b Hib vaccine , Hepatitis B HepB vaccine , inactivated polio vaccine IPV , and pneumococcal vaccine PCV. This tells us that not only is it extremely necessary for every child to get these vaccines to prevent serious diseases, but there is no reason to believe that if your child does receive an immunization that it will have any effect on their risk of SIDS.
Political modernization perspective, the neo-classical economic theory that scarce goods are most effectively distributed to the market, say that the level of political democracy influences the rate of infant mortality. Developing nations with democratic governments tend to be more responsive to public opinion, social movements , and special interest groups for issues like infant mortality. In contrast, non-democratic governments are more interested in corporate issues and less so in health issues. Democratic status effects the dependency a nation has towards its economic state via export, investments from multinational corporations and international lending institutions.
Levels of socioeconomic development and global integration are inversely related to a nation's infant mortality rate. A nation's internal impact is highly influenced by its position in the global economy and has adverse effects on the survival of children in developing countries. The dependency of developing nations can lead to a reduce rate of economic growth, increase income inequality inter- and intra-national, and adversely affects the wellbeing of a nation's population. A collective cooperation between economic countries plays a role in development policies in the poorer, peripheral, countries of the world.
These economic factors present challenges to governments' public health policies. Even with a strong economy and economic growth measured by a country's gross national product , the advances of medical technologies may not be felt by everyone, lending itself to increasing social disparities. High rates of infant mortality occur in developing countries where financial and material resources are scarce and there is a high tolerance to high number of infant deaths.
There are circumstances where a number of developing countries to breed a culture where situations of infant mortality such as favoring male babies over female babies are the norm. Another cultural reason for infant mortality, such as what is happening in Ghana, is that "besides the obvious, like rutted roads, there are prejudices against wives or newborns leaving the house. Cultural influences and lifestyle habits in the United States can account for some deaths in infants throughout the years.
Lost Mothers: Maternal Mortality In The U.S.
According to the Journal of the American Medical Association "the post neonatal mortality risk 28 to days was highest among continental Puerto Ricans" compared to babies of the non-Hispanic race. Examples of this include teenage pregnancy, obesity, diabetes and smoking. All are possible causes of premature births, which constitute the second highest cause of infant mortality. Historically, males have had higher infant mortality rates than females. The difference between male and female infant mortality rates have been dependent on environmental, social, and economic conditions.
More specifically, males are biologically more vulnerable to infections and conditions associated with prematurity and development.
Background
Before , the reasons for male infant mortality were due to infections, and chronic degenerative diseases. However, since , certain cultures emphasizing males has led to a decrease in the infant mortality gap between males and females. Also, medical advances have resulted in a growing number of male infants surviving at higher rates than females due to the initial high infant mortality rate of males. Genetic components results in newborn females being biologically advantaged when it comes to surviving their first birthday.
Males, biologically, have lower chances of surviving infancy in comparison to female babies. As infant mortality rates saw a decrease on a global scale, the gender most affected by infant mortality changed from males experiences a biological disadvantage, to females facing a societal disadvantage. A country's ethnic composition, homogeneous versus heterogeneous, can explain social attitudes and practices. Heterogeneous level is a strong predictor in explaining infant mortality. Birth spacing is the time between births.
Births spaced at least three years apart from one another are associated with the lowest rate of mortality.
The longer the interval between births, the lower the risk for having any birthing complications, and infant, childhood and maternal mortality. Unplanned pregnancies and birth intervals of less than twenty-four months are known to correlate with low birth weights and delivery complications. Also, women who are already small in stature tend to deliver smaller than average babies, perpetuating a cycle of being underweight.
To reduce infant mortality rates across the world health practitioners, governments, and non-governmental organizations have worked to create institutions, programs and policies to generate better health outcomes. Improvements such as better sanitation practices have proven to be effective in reducing public heath outbreaks and rates of disease among mothers and children.
Efforts to increase a households' income through direct assistance or economic opportunities decreases mortality rates, as families possess some means for more food and access to healthcare. Education campaigns, disseminating knowledge among urban and rural regions, and better access to education attainment prove to be an effective strategy to reduce infant and mother mortality rates.
Current efforts from NGOs and governments are focused developing human resources, strengthening health information systems, health services delivery, etc. Improvements in such areas have increased regional health systems and aided in efforts to reduce mortality rates. Reductions in infant mortality are possible in any stage of a country's development. Governments can reduce the mortality rates by addressing the combined need for education such as universal primary education , nutrition, and access to basic maternal and infant health services.
- Focus On Infants During Childbirth Leaves U.S. Moms In Danger.
- Racial Differences in Birth Outcomes: The Role of General, Pregnancy, and Racism Stress!
- Feral Desires.
A policy focus has the potential to aid those most at risk for infant and childhood mortality allows rural, poor and migrant populations. Reducing chances of babies being born at low birth weights and contracting pneumonia can be accomplished by improving air quality. Improving hygiene can prevent infant mortality. Overall, women's health status need to remain high. Simple behavioral changes , such as hand washing with soap, can significantly reduce the rate of infant mortality from respiratory and diarrheal diseases. Future problems for mothers and babies can be prevented.
It is important that women of reproductive age adopt healthy behaviors in everyday life, such as taking folic acid, maintaining a healthy diet and weight, being physically active, avoiding tobacco use, and avoiding excessive alcohol and drug use. If women follow some of the above guidelines, later complications can be prevented to help decrease the infant mortality rates.
Attending regular prenatal care check-ups will help improve the baby's chances of being delivered in safer conditions and surviving. Focusing on preventing preterm and low birth weight deliveries throughout all populations can help to eliminate cases of infant mortality and decrease health care disparities within communities. In the United States, these two goals have decreased infant mortality rates on a regional population, it has yet to see further progress on a national level.
Technological advances in medicine would decrease the infant mortality rate and an increased access to such technologies could decrease racial and ethnic disparities. It has been shown that technological determinants are influenced by social determinants. Those who cannot afford to utilize advances in medicine tend to show higher rates of infant mortality. Technological advances has, in a way, contributed to the social disparities observed today. Providing equal access has the potential to decrease socioeconomic disparities in infant mortality.
The symptoms only last 24 hours and the result is death. As stated if technological advances were increased in countries it would make it easier to find the solution to diseases such as this. Advancements in the Neonatal Intensive Care Unit can be related to the decline in infant mortality in addition to the advancement of surfactants. It has been well documented that increased education among mothers, communities, and local health workers results in better family planning, improvement on children's health, and lower rates of children's deaths.
Educational attainment and public health campaigns provide the knowledge and means to practice better habits and leads to better outcomes against infant mortality rates. Awareness of health services, education, and economic opportunities provide means to sustain and increase chance of development and survival. A decrease on GPD, for example, results in increased rates of infant mortality. On the contrary, increased household income translates to more access to nutrients and healthcare, reducing the risks associated with malnutrition and infant mortality. Granting women employment raises their status and autonomy.
Having a gainful employment can raise the perceived worth of females. This can lead to an increase in the number of women getting an education and a decrease in the number of female infanticide. Higher number of skilled workers means more earning and further economic growth. According to the economic modernization perspective, this is one type economic growth viewed as the driving force behind the increase in development and standard of living in a country. This is further explained by the modernization theory - economic development promotes physical wellbeing.
As economy rises, so do technological advances and thus, medical advances in access to clean water, health care facilities, education, and diet. These changes may decrease infant mortality. Economically, governments could reduce infant mortality by building and strengthening capacity in human resources. Increasing human resources such as physicians , nurses , and other health professionals will increase the number of skilled attendants and the number of people able to give out immunized against diseases such as measles.
Increasing the number of skilled professionals is negatively correlated with maternal, infant, and childhood mortality. Between and , the infant mortality rate decreased by half as the number of physicians increased by four folds. In certain parts of the U. It intends to identify factors that contribute to negative birth outcomes throughout a county area.
The BBZ uses the life course approach to address the structural causes of poor birth outcomes and toxic stress in three U. By employing community-generated solutions, the Best Babies Zone's ultimate goal is to achieve health equity in communities that are disproportionately impacted by infant death. The infant mortality rate correlates very strongly with, and is among the best predictors of, state failure.
However, the method of calculating IMR often varies widely between countries, and is based on how they define a live birth and how many premature infants are born in the country. Reporting of infant mortality rates can be inconsistent, and may be understated, depending on a nation's live birth criterion, vital registration system, and reporting practices. Changes in the infant mortality rate reflect social and technical capacities [ clarification needed ] of a nation's population. France and Japan, only count as live births cases where an infant breathes at birth, which makes their reported IMR numbers somewhat lower and increases their rates of perinatal mortality.
Although many countries have vital registration systems and certain reporting practices, there are many inaccuracies, particularly in undeveloped nations, in the statistics of the number of infants dying. Studies have shown that comparing three information sources official registries, household surveys, and popular reporters that the "popular death reporters" are the most accurate.
Popular death reporters include midwives, gravediggers, coffin builders, priests, and others—essentially people who knew the most about the child's death. In developing nations, access to vital registries, and other government-run systems which record births and deaths, is difficult for poor families for several reasons. These struggles force stress on families [ clarification needed ] , and make them take drastic measures [ clarification needed ] in unofficial death ceremonies for their deceased infants. As a result, government statistics will inaccurately reflect a nation's infant mortality rate.
UNICEF compiles infant mortality country estimates derived from all sources and methods of estimation obtained either from standard reports, direct estimation from micro data sets, or from UNICEF's yearly exercise. In order to sort out differences between estimates produced from different sources, with different methods, UNICEF developed, in coordination with WHO, the WB and UNSD, an estimation methodology that minimizes the errors embodied in each estimate and harmonize trends along time.
Since the estimates are not necessarily the exact values used as input for the model, they are often not recognized as the official IMR estimates used at the country level. However, as mentioned before, these estimates minimize errors and maximize the consistency of trends along time.
Another challenge to comparability is the practice of counting frail or premature infants who die before the normal due date as miscarriages spontaneous abortions or those who die during or immediately after childbirth as stillborn. Therefore, the quality of a country's documentation of perinatal mortality can matter greatly to the accuracy of its infant mortality statistics. This point is reinforced by the demographer Ansley Coale , who finds dubiously high ratios of reported stillbirths to infant deaths in Hong Kong and Japan in the first 24 hours after birth, a pattern that is consistent with the high recorded sex ratios at birth in those countries.
It suggests not only that many female infants who die in the first 24 hours are misreported as stillbirths rather than infant deaths, but also that those countries do not follow WHO recommendations for the reporting of live births and infant deaths.
A community perspective on the role of fathers during pregnancy: a qualitative study
Another seemingly paradoxical finding, is that when countries with poor medical services introduce new medical centers and services, instead of declining, the reported IMRs often increase for a time. This is mainly because improvement in access to medical care is often accompanied by improvement in the registration of births and deaths. Deaths that might have occurred in a remote or rural area, and not been reported to the government, might now be reported by the new medical personnel or facilities. Collecting the accurate statistics of infant mortality rate could be an issue in some rural communities in developing countries.
In those communities, some other alternative methods for calculating infant mortality rate are emerged, for example, popular death reporting and household survey. Among the world's roughly nations, only Somalia showed no decrease in the under-5 mortality rate over the past two decades. The lowest rate in was in Singapore, which had 2. The highest was in Sierra Leone, which had child deaths per 1, births. The global rate is 51 deaths per 1, births. For the United States, the rate is eight per 1, births. Infant mortality rate IMR is not only a group of statistic but instead it is a reflection of the socioeconomic development and effectively represents the presence of medical services in the countries.
IMR is an effective resource for the health department to make decision on medical resources reallocation. IMR also formulates the global health strategies and help evaluate the program success. The existence of IMR helps solve the inadequacies of the other vital statistic systems for global health as most of the vital statistic systems usually neglect the infant mortality statistic number from the poor. There are certain amounts of unrecorded infant deaths in the rural area as they do not have information about infant mortality rate statistic or do not have the concept about reporting early infant death.
Racial Differences in Birth Outcomes: The Role of General, Pregnancy, and Racism Stress
The exclusion of any high-risk infants from the denominator or numerator in reported IMRs can cause problems in making comparisons. Many countries, including the United States, Sweden and Germany, count an infant exhibiting any sign of life as alive, no matter the month of gestation or the size, but according to United States some other countries differ in these practices. All of the countries named adopted the WHO definitions in the late s or early s, [89] which are used throughout the European Union.
In certain rural developing areas, such as northeastern Brazil, infant births are often not recorded in the first place, resulting in the discrepancies between the infant mortality rate IMR and the actual amount of infant deaths. Access to vital registry systems for infant births and deaths is an extremely difficult and expensive task for poor parents living in rural areas. Table 2 demonstrates that, for the multiple factors that affect pregnancy outcomes, non-Hispanic blacks cluster on the high-risk end of the spectrum. This finding is consistent with Geronimus's notion of cumulative stress 23 as described in the weathering hypothesis, where cumulative stress is now defined to include physical environmental exposures.
So, the resiliency to environmental exposures that can be created by positive social and host factors is more likely to be absent for non-Hispanic blacks compared with non-Hispanic whites. Despite extensive public policy efforts to maximize access to prenatal care, significant racial disparities in pregnancy outcomes persist. We argue that research that carefully examines the joint effects of social and environmental stressors—conducted at the individual level so that we truly know who is experiencing multiple stressors—holds potential for revealing the complex etiology that likely drives disparities in pregnancy outcomes.
Such understanding is critical to the development of successful intervention programs aimed at narrowing the health disparities in pregnancy outcomes, which will need to jointly address the multiple components shaping the lives of women during the preconception, prenatal, and postnatal periods. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Close mobile search navigation Article navigation.
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Abstract One of the most persistent disparities in American health status is the pronounced difference in birth outcomes between non-Hispanic black and non-Hispanic white women. View large Download slide. Infant mortality in the United States: Accessed January 6, Vagal regulation of heart rate in the prediction of developmental outcome for very low birth weight preterm infants.
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Social network and marital support as mediators and moderators of the impact of stress and depression on parental behavior. Risk of spontaneous preterm birth is associated with common proinflammatory cytokine polymorphisms. Risk of small-for-gestational age is associated with common anti-inflammatory cytokine polymorphisms.
Interleukins-1, -4, -6, , tumor necrosis factor, transforming growth factor-beta, FAS, and mannose-binding protein C gene polymorphisms in Australian women: Adverse outcomes after preterm labor are associated with tumor necrosis factor-alpha polymorphism , but not , in mother-infant pairs.
Association of polymorphism within the promoter of the tumor necrosis factor alpha gene with increased risk of preterm premature rupture of the fetal membranes. A molecular variant of angiotensinogen is associated with idiopathic intrauterine growth restriction. Maternal cigarette smoking, metabolic gene polymorphism, and infant birth weight. Transgenic mouse blastocysts that overexpress metallothionein-I resist cadmium toxicity in vitro. Cadmium reduces 11 beta-hydroxysteroid dehydrogenase type 2 activity and expression in human placental trophoblast cells [electronic article].
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Residential proximity to traffic and adverse birth outcomes in Los Angeles county, California, — Metals content in placentas from moderate cigarette consumers: Prevalence of fetal exposure to environmental toxins as determined by meconium analysis. Pregnancy outcomes, infant mortality, and arsenic in drinking water in West Bengal, India.
Blood lead levels in the US population. Patterns of blood lead levels in US black and white women of childbearing age. Chlorination disinfection byproducts in water and their association with adverse reproductive outcomes: Relation between stillbirth and specific chlorination by-products in public water supplies. Maternal exposure to trichloroethylene in drinking water and birth-weight outcomes. Intrauterine growth retardation in Iowa communities with herbicide-contaminated drinking water supplies.
Unequal exposure to ecological hazards: Within- and between-home variability in indoor-air insecticide levels during pregnancy among an inner-city cohort from New York City. Biomarkers in assessing residential insecticide exposures during pregnancy and effects on fetal growth. Outdoor exposure to airborne polycyclic organic matter and adverse reproductive outcomes: Neural tube defects and maternal residential proximity to agricultural pesticide applications. Birth malformations and other adverse perinatal outcomes in four U. America's Children and the Environment: Measures of Contaminants, Body Burdens, and Illnesses.
Racial differences in exposure to environmental tobacco smoke among children. Physical abuse, smoking, and substance use during pregnancy: Smoking in pregnancy in North Carolina. Maternal characteristics and trends, — Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy. The effect of passive smoking and tobacco exposure through breast milk on sudden infant death syndrome.
Molecular evidence of an interaction between prenatal environmental exposures and birth outcomes in a multiethnic population. Prenatal exposure to airborne polycyclic aromatic hydrocarbons and risk of intrauterine growth restriction. Centers for Disease Control and Prevention. Measuring the built environment: Do neighborhood economic characteristics, racial composition, and residential stability predict perceptions of stress associated with the physical and social environment? Findings from a multilevel analysis in Detroit. Neighborhood problems as sources of chronic stress: Neighborhood-based differences in physical activity: Environmental correlates of walking and cycling: Confronting the challenges in reconnecting urban planning and public health.
Race and ethnic differences in determinants of preterm birth in the USA: Not only that, the divorce rate is high in African-Americans too so we need to establish strong relationships and build stronger marriages. Within in each sphere of influence starting from the individual and extending out towards the policy level, detail is provided about the potential barriers categorized at this level as revealed in the focus group data. Actual quotes from participants are inserted at each level to provide examples.
They attribute this largely to general lack of education available for expecting men, lack of positive role models in the family sphere, and dysfunctional family foundations. The expense and insufficient availability of paternity testing can also be a deterrent for involvement if the man questions the legitimacy of the child being his. Participants also bemoaned the popular public acceptance of casual sexual encounters which belittles the role of parenting. Participants felt that males do not adequately prepare for the possibility of pregnancy.
Furthermore, they believed that societal, perpetuation of gender roles places the responsibility of caring for children on women. Men are expected to provide financially, but media based stereotypes, are not obligated to provide emotional or physical support. Participants wished examples of men being good fathers were better marketed. In addition, participants felt that social problems such as involvement in gangs and violence contributed to absent fathers through incarceration or homicide.
Specifically, respondents felt that if the mother of the mother, i. This is in line with family systems theory, which posits that cross generational triangulation patterns can reverberate across generations [ 22 ]. In sum, participants viewed involvement of fathers during pregnancy time as very positive for the mother and the child. However, they also recognized many prevailing barriers to a man fully realizing his role as an expectant father.
Participants identified a number of strategies that could increase the involvement of men during pregnancy. Primarily, participants were unanimous that there needed to be education for men to increase their knowledge of paternity rights and expectations, as well as the pregnancy process. Alongside educational efforts, participants desired interventions that provided men with links to vital resources paternity testing, information on child support regulations, second chance programs and employment opportunities, especially for those with a disability or previous incarceration.
Participants also emphasized that health care providers and women also need to appreciate the involvement of men during the prenatal period and its impact on maternal and child health. Recommendations for programs aimed at improving pregnancy outcomes by increasing male involvement.
Recommendations were provided throughout the focus group data and focused mainly on education for men and the services that should be provided to promote ideal paternal involvement. In this study, an involved man or father during pregnancy is defined by participants as being accessible e. These dimensions refer to father-child relationships. These concepts would then be applied to the father in relation to the mother carrying the child. Paternal involvement during pregnancy, though similar to paternal involvement during childhood, has a specific difference which we identify as the relationship between the father and the mother carrying the child.
The couple relationship element is intertwined within each of the first three components of paternal involvement during pregnancy. The model conceptualizes the 4 components of a proposed framework for paternal involvement during pregnancy. In pregnancy, the extent of these fundamental characteristics is mediated by the nature of the relationship between the mother and the male involved. Participants honed in on the terms present, accessible and available to describe one level of male involvement during pregnancy, which aptly encapsulates the concept of Accessibility referred to by researchers in the field of childhood development [ 23 - 25 ].
During childhood, accessibility refers to the father being physically present and available to supervise the child, but not actively participating in the same activities as the child. For instance the father may be at the playground observing the child, but not playing with the child [ 23 , 25 ]. Similar to parents raising a child, the quality of the parental relationship often impacts subsequent involvement with the child [ 26 - 28 ].
Communication between parents, whether prenatally or postnatally, is important to ensuring that fathers are involved. This becomes even more crucial when parents are not in the same household. In infancy, engagement is the direct interaction of the father with the child, playing with him, reading books to the child etc. In pregnancy however, this interaction is directed towards the mother and requires active participation in prenatal activities e.
Analogous to paternal involvement in child rearing, in pregnancy the interplay between Accessibility and Engagement is a rhetorical relationship. As the father avails himself to the mother by being physically present, the expectation for him to also be an active participant or actively engaged in the prenatal process becomes evident.
However, prenatally, this responsibility towards the coming child is directed towards the mother carrying the child and extends beyond finances. In our study the concept of Responsibility was manifested in the father assuming the roles of caregiver, provider, nurturer and protector. This has been demonstrated in the literature on pregnancy outcomes. Women whose partners were involved in their pregnancy were more likely to receive prenatal care [ 9 , 34 ], and less likely to give birth to low birth weight and premature infants [ 33 , 34 ] and to promote positive maternal behaviors [ 9 ].
The use of community based participatory research to develop and implement the research project is an important aspect that lends additional credence to the study findings. A limitation of the study is that participants were limited to those who attended the National Healthy Start Association conference. Of note is that funding was given across sites to help ensure that those who could not afford it would still be able to participate, ensuring representation across sites as well as across socio-economic status.
Initial data on fatherhood during pregnancy can only be gathered through in-depth conversations with parents and those involved in the day-to-day work with families. However males must first be educated about specific expectations of a father, the importance of his role to healthy child development and how he can best support the mother to improve pregnancy outcomes [ 36 ].
Information on biological changes in the mother and issues surrounding risk factors for infant mortality would also be integral components of any proposed educational curriculum. To have greater impact, this education process should begin prior to conception and should be targeted specifically to males, addressing their distinctive concerns [ 26 , 36 , 41 ]. Furthermore, though there are existing parenting programs that provide support for new parents, these often lack the comprehensiveness of co-parent counseling support, male only counseling, resource support e.
A one-on-one male mentoring approach would also be helpful in teaching males how best to fulfill their role, as this community group has highlighted. Improving existing prenatal services for women should also be modified to include information on the importance of paternal involvement to infant health outcomes. Importantly, improved communication skills are crucial to developing better relationships between parents and facilitate increased male involvement to benefit the child. Paternal involvement is as crucial prenatally as it has been shown to be postnatally for infants. Fathers are to be accessible and engaged during the pregnancy and begin to demonstrate responsibility towards the coming child by helping the mother.
Because all of the involvement is through the mother carrying the child, the relationship between the two parents is of utmost importance and determines the level of involvement. Of note, is that while in the postnatal phase, the financial ability of the father is of paramount importance [ 26 , 32 ], the financial support appears to be much less emphasized during pregnancy when compared with emotional and physical support. The authors of this manuscript have no significant competing financial, professional or personal interests that might have influenced the performance or presentation of the work described in this manuscript.
APA designed and implemented the study, conducted the qualitative analyses and was the primary contributor to manuscript development. CL shared in the preparation of the manuscript with Dr. APA and also conducted the qualitative analyses. KS and KH participated in the study design, implementation and data collection, reviewed manuscript and made revisions to ensure that community interests were well represented.
KH reviewed and made edits of the manuscript to ensure that the content and structure was in keeping with National Healthy Start objectives. KF reviewed the manuscript for accuracy and goals of research project. All authors read and approved the final manuscript. We thank the National Healthy Start Association for their financial support for this study. We are also grateful to the mothers and fathers who so willingly shared their stories in the focus group discussions.
National Center for Biotechnology Information , U. Published online Mar 7. Received Jul 18; Accepted Feb This article has been cited by other articles in PMC. Abstract Background Defining male involvement during pregnancy is essential for the development of future research and appropriate interventions to optimize services aiming to improve birth outcomes.
Methods We conducted focus groups with mothers and fathers from the National Healthy Start Association program in order to obtain detailed descriptions of male involvement activities, benefits, barriers, and proposed solutions for increasing male involvement during pregnancy. Conclusions Individual, family, community, societal and policy factors play a role in barring or diminishing the involvement of fathers during pregnancy. Pregnancy, Father involvement, Healthy start and fathers. Background Paternal involvement PI has been recognized to have an impact on pregnancy and infant outcomes [ 1 - 6 ].
Procedures The research and focus group protocols were developed by the research workgroup and approved by the University of Rochester Medical Center Research Subjects Review Board RSRB , to ensure the protection of the subjects participating in this research. Analysis Content and thematic analyses were conducted from transcriptions of the focus groups recordings. Open in a separate window.