Perinatal Fathers in the Context of the COVID-19 Pandemic and Beyond: Impacts and Implications
DOI:
https://doi.org/10.31674/mjn.2024.v16i02.023Abstract
Introduction: The COVID-19 pandemic introduced unprecedented challenges for fathers during the perinatal period, impacting family dynamics, especially among vulnerable groups such as first-time fathers, low-income fathers, and immigrant fathers. This paper explores these effects and proposes strategies for healthcare professionals and community organisations to ensure inclusive, family-centred care. The review aims to enhance fathers’ well-being and family resilience in both pandemic and post-pandemic contexts. Methods: A state-of-the-art review was conducted using MEDLINE, CINAHL, blogs, and advisory publications. A comprehensive literature search was performed, covering the period from March 2020 to March 2021, with an additional search extending to 2024. The review included 18 studies from the initial search period and 30 studies from the post-pandemic period. Results: Three specific themes emerged: fear of the virus, social isolation, and a mental health crisis. Fathers experienced significant anxiety about spreading COVID-19 to their partners and newborns, which increased stress during prenatal care and childbirth. Restrictions on hospital visits limited their involvement in the child birth process, leading to feelings of helplessness and disconnect during crucial bonding periods. Additionally, fathers faced heightened anxiety, depression, and role ambiguity due to caregiving and financial pressures exacerbated by the pandemic. These themes uniquely impacted perinatal fathers, affecting both paternal and maternal mental health and overall family well-being. Recommendations: The findings suggest several actions: customising training programs for healthcare professionals, promoting inclusive nursing practices, advocating for comprehensive parental leave policies, integrating telehealth services, and implementing father-centric interventions to enhance overall perinatal well-being. These recommendations are appropriate for the post-pandemic era as they address ongoing mental health challenges, ensure continuous support, and promote resilience in healthcare systems. These actions are essential to support perinatal fathers and their families in both current and future disruptions. Conclusion: The pandemic highlighted the need for personalised support for fathers to enhance their mental well-being and family welfare. Strategies such as customised training for healthcare professionals, inclusive nursing practices, comprehensive parental leave policies, and telehealth services are essential. These initiatives are crucial to ensure inclusive family-centred care, fostering fathers’ well-being and family resilience in both pandemic and post-pandemic contexts. Immediate and sustained efforts are needed to support perinatal fathers and improve family resilience.
Keywords:
Childbirth, COVID-19, Fathers, Pregnancy, Mental Health, Post-birth, PandemicDownloads
References
Ahmad, A. R., & Murad, H. R. (2020). The impact of social media on panic during the COVID-19 pandemic in Iraqi Kurdistan: Online questionnaire study. Journal of Medical Internet Research, 22(5). https://doi.org/10.2196/19556
American Psychological Association. (2021, March 11). Mothers — and fathers — report mental, physical health decalines: Stress in America 2021: One year later, a new wave of pandemic health concerns. https://www.apa.org/news/press/releases/stress/2021/one-year-pandemic-stress-parents. Accessed on 10th February, 2023.
Andrews, K., Ayers, S., & Williams, L. R. (2022). The experience of fathers during the COVID-19 UK maternity care restrictions. Midwifery, 113, 103434. https://doi.org/10.1016/j.midw.2022.103434
Avery, E. J., & Park, S. (2021). Perceived knowledge as [protective] power: Parents’ protective efficacy, information-seeking, and scrutiny during COVID-19. Health Communication, 36(1), 81-88. https://doi.org/10.1080/10410236.2020.1847438
Bouchacourt, L., Henson-Garcia, M., Sussman, K. L., Mandell, D., Wilcox, G., & Mackert, M. (2023). Web-based conversations regarding fathers before and during the COVID-19 pandemic: Qualitative content analysis. JMIR Pediatrics and Parenting, 6. https://doi.org/10.2196/40371
Cameron, E. E., Sedov, I. D., & Tomfohr-Madsen, L. M. (2016). Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. Journal of Affective Disorders, 206, 189-203. https://doi.org/10.1016/j.jad.2016.07.044
Cameron, E. E., Simpson, K. M., Pierce, S. K., Penner, K. E., Beyak, A., Gomez, I., Bowes, J. M., Reynolds, K. A., Tomfohr-Madsen, & Roos, L. E. (2023). Paternal perinatal experiences during the COVID-19 pandemic: A framework analysis of the reddit forum predaddit. International Journal of Environmental Research and Public Health, 20(5). https://doi.org/10.3390/ijerph20054408
Campbell-Yeo, M. (2023). Unintended consequences of restricting father presence during maternity care during the COVID-19 pandemic. Evidence-Based Nursing, 26(3), 109-109. https://doi.org/10.1136/ebnurs-2022-103614
Carroll, N., Sadowski, A., Laila, A., Hruska, V., Nixon, M., Ma, D. W., Haines, J., & Guelph Family Health Study. (2020). The impact of COVID-19 on health behavior, stress, financial and food security among middle to high income Canadian families with young children. Nutrients, 12(8), 2352. https://doi.org/10.3390/nu12082352
Cavicchiolo, M. E., Trevisanuto, D., Lolli, E., Mardegan, V., Saieva, A. M., Franchin, E., Plebani, M., Donato, D., & Baraldi, E. (2020). Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic. European Journal of Pediatrics, 179, 1949-1955. https://doi.org/10.1007/s00431-020-03765-7
Clifford, B. N., Rainey, V., & Eggum, N. D. (2024). Parental postpartum depression and children’s receptive and expressive language during the first six years of life: A systematic review of depression timing, status, and chronicity. Developmental Review, 71, 101105. https://doi.org/10.1016/j.dr.2023.101105
Dachew, B. A., Heron, J. E., & Alati, R. (2023). Parental depressive symptoms across the first three years of a child’s life and emotional and behavioural problem trajectories in children and adolescents. Journal of Psychiatric Research, 159, 135-144. https://doi.org/10.1016/j.jpsychires.2023.01.019
Das, R., & Hodkinson, P. (2020, June 22). Dad, distanced: The turbulence of new fatherhood amidst a pandemic. Discover Society. https://archive.discoversociety.org/2020/06/22/dad-distanced-the-turbulence-of-new-fatherhood-amidst-a-pandemic/. Accessed on 8th April, 2023.
Dennis, C. L., Marini, F., Dol, J., Vigod, S. N., Grigoriadis, S., & Brown, H. K. (2022). Paternal prevalence and risk factors for comorbid depression and anxiety across the first 2 years postpartum: A nationwide Canadian cohort study. Depression and Anxiety, 39(3), 233-245. https://doi.org/10.1002/da.23234
Deslauriers, J. M., & Kiselica, M. S. (2024). An ecological approach to understanding the paternal commitments of young fathers: From the pregnancy test to the child’s first birthday. Child and Adolescent Social Work Journal, 41(2), 249-268. https://doi.org/10.1007/s10560-022-00845-5
Erdei, C., & Liu, C. H. (2020). The downstream effects of COVID-19: a call for supporting family wellbeing in the NICU. Journal of Perinatology, 40(9), 1283-1285. https://doi.org/10.1038/s41372-020-0745-7
Fisher, S. D., Cobo, J., Figueiredo, B., Fletcher, R., Garfield, C. F., Hanley, J., Ramchandani, P., & Singley, D. B. (2021). Expanding the international conversation with fathers’ mental health: Toward an era of inclusion in perinatal research and practice. Archives of Women’s Mental Health, 24(5), 841-848. https://doi.org/10.1007/s00737-021-01171-y
Geller, P. A., Spiecker, N., Cole, J. C., Zajac, L., & Patterson, C. A. (2021). The rise of tele-mental health in perinatal settings. Seminars in Perinatology, 45(5). https://dx.doi.org/10.1016/j.semperi.2021.151431
Goyal, D., Dol, J., Huynh, J., Anand, S., & Dennis, C. L. (2023). Postpartum mental health and perceptions of discrimination among Asian fathers during the COVID-19 pandemic. MCN: The American Journal of Maternal/Child Nursing, 49(2), 88–94. https://doi.org/10.1097/NMC.0000000000000984
Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26(2), 91-108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
Higashio, K., & Sasaki, A. (2021). The paternal mental health, difficulties for fathers with children in early infancy, and their educational support needs. Health, 13(8), 789-811. https://doi.org/10.4236/health.2021.138061
Hwang, T. J., Rabheru, K., Peisah, C., Reichman, W., & Ikeda, M. (2020). Loneliness and social isolation during the COVID-19 pandemic. International Psychogeriatrics, 32(10), 1217-1220. https://doi.org/10.1017/S1041610220000988
Iztayeva, A. (2021). Custodial single fathers before and during the COVID-19 crisis: Work, care, and well-being. Social Sciences, 10(3), 94. https://doi.org/10.3390/socsci10030094
Kelly, H. K., Geller, S., Swami, V., Shenkman, G., Levy, S., & Ridge, D. (2023). A relational investigation of Israeli gay fathers’ experiences of surrogacy, early parenthood, and mental health in the context of the COVID-19 pandemic. PloS One, 18(2). https://doi.org/10.1371/journal.pone.0282330
Khanlou, N., Ssawe, A., Zahraei, S., Connolly, J. A., Pashang, S., Bohr, Y., & Vazquez, L. M. (2020). Information sheet 16: Gender-based violence and the COVID-19 pandemic: Risk factors and systemic challenges. York University. https://nkhanlou.info.yorku.ca/files/2020/07/Info-Sheet-on-GBV-and-COVID19-pandemic-Khanlou-et-al.22July2020.pdf?x68747. Accessed on 20th February, 2023.
Kurimay, T., Fenyves, T., Szederkényi, J., Mező, G., & Pelikán, A. (2022). The usefulness of telemedicine in perinatal mental health services during and after COVID-19 pandemic: Detailed experience of the team of together baby-mother-father unit in Budapest. European Psychiatry, 65(S1), S20-S21. https://doi.org/10.1192/j.eurpsy.2022.79
Lambregtse-van den Berg, M., & Quinlivan, J. (2021). Understanding psychological wellbeing in pregnant women in and outside COVID-19 and the importance of including fathers. Journal of Psychosomatic Obstetrics & Gynecology, 42(2), 89-90. https://doi.org/10.1080/0167482X.2021.1920183
Lista, G., & Bresesti, I. (2020). Fatherhood during the COVID-19 pandemic: An unexpected turnaround. Early Human Development, 144, 105048. https://doi.org/10.1016/j.earlhumdev.2020.105048
Marcell, A. V., Van Eck, K., Veira, O., Johnson, S., Nelson, T., Labrique, A., Skelton, S., & Gibson, D. (2022). 105. Perceived COVID-19-related stress & other impacts among lower income expectant young adult fathers. The Journal of Adolescent Health, 70(4), S55. https://doi.org/10.1016/j.jadohealth.2022.01.200
Mazza, M., Kotzalidis, G. D., Avallone, C., Balocchi, M., Sessa, I., De Luca, I., Hirsch, D., Simonetti, A., Janiri, D., Loi, E., Marano, G., Albano, G., Fasulo, V., Borghi, S., Del Castillo, A. G., Serio, A. M., Monti, L., Chieffo, D., Angeletti, G., Janiri, L., & Sani, G. (2022). Depressive symptoms in expecting fathers: Is paternal perinatal depression a valid concept? A systematic review of evidence. Journal of Personalized Medicine, 12(10), 1598. https://doi.org/10.3390/jpm12101598
Merih, Y. D., Karabulut, O., & Sezer, A. (2021). Is online pregnant school training effective in reducing the anxiety of pregnant women and their partners during the COVID-19 pandemic?. Bezmialem Science, 9(S1), 13-25. https://doi.org/10.14235/bas.galenos.2020.4718
Mertens, G., Gerritsen, L., Duijndam, S., Salemink, E., & Engelhard, I. M. (2020). Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020. Journal of Anxiety Disorders, 74. https://doi.org/10.1016/j.janxdis.2020.102258
Montez, K., Thomson, S., & Shabo, V. (2020). An opportunity to promote health equity: National paid family and medical leave. Pediatrics, 146(3). https://doi.org/10.1542/peds.2020-1122
Mortazavi, F., Nikbakht, R., Mehrabadi, M., & Shahhosseini, Z. (2023). A structural equation model analysis of the relationship between expectant fathers’ fear of COVID-19 and their fear of childbirth: The mediating role of maternal fear of childbirth. Midwifery, 125.. https://doi.org/10.1016/j.midw.2023.103790
Obikane, E., Nishi, D., Morisaki, N., & Tabuchi, T. (2023). Risk factors of paternal perinatal depression during the COVID-19 pandemic in Japan. Journal of Psychosomatic Obstetrics & Gynecology, 44(1), 2245556. https://doi.org/10.1080/0167482X.2023.2245556
Pasadino, F., DeMarco, K., & Lampert, E. (2020). Connecting with families through virtual perinatal education during the COVID-19 pandemic. MCN: The American Journal of Maternal/Child Nursing 45(6), 364–370. https://doi.org/10.1097/NMC.0000000000000665
Pereira, D., Macedo, A., Cabaços, C., Wildenberg, B., Madeira, N., & Pereira, A. T. (2023). Perinatal depressive symptoms in Portuguese new fathers and mothers during COVID-19 pandemic. European Psychiatry, 66(S1), S784-S785. https://doi.org/10.1192/j.eurpsy.2023.1656
Pinto, T. M., & Figueiredo, B. (2023). Positive coparenting previous to the COVID‐19 pandemic can buffer regulatory problems in infants facing the COVID‐19 pandemic. Infancy, 28(6), 1067-1085. https://doi.org/10.1111/infa.12561
Poornaselvan, C. (2020). Basic life support for mental health crisis: You can be a hero. Indian Journal of Continuing Nursing Education, 21(1), 12-16. https://doi.org/10.4103/ijcn.ijcn_60_20
Poulos, N. S., Donovan, E. E., Mackert, M., & Mandell, D. J. (2024). Missed opportunities for prenatal family-centered care during the COVID-19 pandemic: A qualitative study. Journal of Communication in Healthcare, 17(1), 111-117. https://doi.org/10.1080/17538068.2024.2313246
Prikhidko, A., Long, H., & Wheaton, M. G. (2020). The effect of concerns about COVID-19 on anxiety, stress, parental burnout, and emotion regulation: the role of susceptibility to digital emotion contagion. Frontiers in Public Health, 8, 567250. https://dx.doi.org/10.3389/fpubh.2020.567250
Recto, P., Lesser, J., Moreno-Vasquez, A., Zapata Jr, J., & Zavala Idar, A. (2020). Supporting the mental health needs of adolescent fathers during COVID-19: Opportunities for nursing practice and community-based partnerships. Issues in Mental Health Nursing, 42(7), 702-705. https://doi.org/10.1080/01612840.2020.1850951
Rice, K., & Williams, S. (2024). Partner exclusion from childbirth during COVID-19 in Canada: Implications for theory and policy. Medical Anthropology, 43(1), 5-16. https://doi.org/10.1080/01459740.2023.2269467
Roy, J. G., & Roy, S. (2022). The Structural and Social Determinants of Reproductive Behavioural Health: A Brief Appraisal of Indian Scenario. Malaysian Journal of Medical Research (MJMR), 6(3), 48-54. https://doi.org/10.31674/mjmr.2022.v06i03.006
Schmid, S., Imthurn, B., Feki, A., Mathis, J., de Tejada, B. M., von Wolff, M., ... & Eggimann, T. (2023). Société Suisse de Gynécologie et d'Obstétrique (SGGG) Congress [Swiss Society of Gynecology and Obstetrics (SGGG) Congress]. Gynecologic and Obstetric Investigation, 88(1), 1-99. https://doi.org/10.1159/000531140
Schobinger, E., Vanetti, M., Ramelet, A. S., & Horsch, A. (2024). First-time parents’ perception of midwives’ and other healthcare professionals’ support behaviours: A qualitative study. Midwifery, 135. https://doi.org/10.1016/j.midw.2024.104028
Shorey, S., Law, E., Thilagamangai, Mathews, J., Lim, S. H., Shi, L., Chua, J. S., Du, R., Chan, Y. K., Tan, T. C., Chee, C., & Chong, Y. S. (2023). Evaluating the effectiveness of the supportive parenting app on parental outcomes: Randomized controlled trial. Journal of Medical Internet Research, 25. https://doi.org/10.2196/41859
Shorey, S., Tan, T. C., Thilagamangai, Mathews, J., Yu, C. Y., Lim, S. H., Shi, L., Ng, E. D., Chan, Y. H., Law, E., Chee, C., & Chong, Y. S. (2021). Development of a supportive parenting app to improve parent and infant outcomes in the perinatal period: Development study. Journal of Medical Internet Research, 23(12). https://doi.org/10.2196/27033
Smith, C., Pitter, C., & Udoudo, D. A. (2024). Fathers’ experiences during delivery of their newborns: A content analysis. International Journal of Community Based Nursing and Midwifery, 12(1), 23-31. https://doi.org/10.30476/IJCBNM.2023.100009.2337
Stein, S., & Bloomberg, B. (2021). Low vaccination rate among pregnant people is causing a ‘perfect storm’, doctors warn. Fortune. https://fortune.com/2021/08/24/pregnancy-covid-19-vaccination-rates/. Accessed on 15th June, 2023.
Sun, G. Q., Wang, Q., Wang, S. S., & Cheng, Y. (2021). Risk assessment of paternal depression in relation to partner delivery during COVID-19 pandemic in Wuhan, China. BMC Psychiatry, 21, 1-8. https://doi.org/10.1186/s12888-021-03325-9
Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2022). Post-pandemic health and its sustainability: Educational situation. International Journal of Health Sciences, 6(1). https://doi.org/10.53730/ijhs.v6n1.5949
Taubman-Ben-Ari, O., & Ben-Yaakov, O. (2020). Distress and apprehension among new parents during the COVID-19 pandemic: The contribution of personal resources. American Journal of Orthopsychiatry, 90(6), 810-816. https://dx.doi.org/10.1037/ort0000497
Taubman-Ben-Ari, O., Ben-Yaakov, O., & Chasson, M. (2021). Parenting stress among new parents before and during the COVID-19 pandemic. Child Abuse & Neglect, 117. https://doi.org/10.1016/j.chiabu.2021.105080
Vogel, L. (2011). Paternal depression often unrecognised. Canadian Medical Association Journal (CMAJ), 183(18). https://doi.org/10.1503/cmaj.109-4060
Waite, R., & Hassouneh, D. (2021). Structural competency in mental health nursing: Understanding and applying key concepts. Archives of Psychiatric Nursing, 35(1), 73-79. https://doi.org/10.1016/j.apnu.2020.09.013
Wells, M. B., Giannotti, M., & Aronson, O. (2024). Partner and professional support are associated with father-infant bonding: A cross-sectional analysis of mothers, midwives, and child health nurses’ influence on primiparous and multiparous fathers of infants in Sweden. Midwifery, 136. https://doi.org/10.1016/j.midw.2024.104076
Yazdanpanahi, Z., Vizheh, M., Azizi, M., & Hajifoghaha, M. (2022). Paternal postnatal depression during COVID-19 pandemic: The role of health care providers. Journal of Primary Care & Community Health, 13. https://doi.org/10.1177/21501319221110421
Zipursky, J. S., Greenberg, R. A., Maxwell, C., & Bogler, T. (2021). Pregnancy, breastfeeding and the SARS-CoV-2 vaccine: An ethics-based framework for shared decision-making. Canadian Medical Association Journal, 193(9). E312–E314. https://doi.org/10.1503/cmaj.202833
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