First-time fathers' inclusion in, and engagement with, perinatal primary care: An integrative review

Abstract

Problem: Research about first-time fathers' inclusion in, and engagement with, perinatal primary care is limited.

Background: Globally, fathers' engagement with perinatal healthcare services is low. First-time fathers experience more distress, have unique support needs and are more willing to engage with perinatal healthcare than experienced fathers. Yet, primary care's role in supporting perinatal first-time fathers has received little research attention.

Aim: To examine first-time fathers' inclusion in, and engagement with, perinatal primary care and the feasibility of engaging them through primary care pathways.

Methods: Integrative review of international peer-reviewed and grey literature.

Findings: Thirty-three studies (16 quantitative, 13 qualitative, 4 mixed-methods) were included, comprising 3712 first-time fathers. Almost half (46 %) of the fathers in 19 suitable studies were first-time fathers. Parents' perceived barriers to father engagement included providers being mother-focused and fathers' mistrust of providers. Provider barriers included father absence, perceived father disinterest, workload and low managerial support. Promising strategies for engagement included provider-initiated interactions with fathers and postnatal home visits. Systemic barriers received limited attention.

Discussion: The lack of complete father-specific data in several studies hindered the review process and limited the strength of conclusions. Since first-time fathers may comprise about half of fathers in perinatal primary care, universal services risk overlooking their specific needs. While strategies like postnatal home visits show promise for father engagement, limited consensus about engagement strategies and unaddressed systemic issues may limit their effectiveness.

Conclusion: Further research exploring parents' and providers' views is required to guide more effective father-inclusive care. Engaging first-time fathers in primary care must go beyond practical strategies and address deeper systemic issues.

Keywords: Father engagement; First-time fathers; Integrative review; Perinatal care; Primary care.