REPRODUCTIVE JUSTICE

REPRODUCTIVE JUSTICE

MEDICALIZATION IN MATERNAL HEALTHCARE

 

**NOTE**

Medical advancements have saved the lives of women and babies at risk for injury or death during pregnancy and birth.  This site is not about the doctors who properly use interventions to save lives; it is about those who use them unethically for profit or convenience.   Improperly used interventions have led to harm and death of women and babies and obstetrics  is the only field in which mortality rates are rising and non-medically needed interventions such as c-sections are related to 66% of maternal deaths. 

**NOTE**  This site is designed to share valid evidence for those working to change the maternal healthcare system who do not have access to databases of peered research. 

**NOTE**  Chronological order allows users to find new data.  It also begs the question of why, when we have known for decades that such practices are harmful, do they not only continue to be used but are increasingly used.

 

FATHERS, PARTNERS AND FAMILIES

 

WHAT DOES THE LITERATURE SAY? 

 

 

2024

 

Reay, M., Mayers, A., Knowles-Bevis, R., and Knight, M. (2024). Understanding the Barriers Fathers Face to Seeking Help for Paternal Perinatal Depression: Comparing Fathers to Men Outside the Perinatal Period.  International Journal of Environmental Research and Public Health.  Accessed https://www.mdpi.com/1660-4601/21/1/16

 

2023

Firth, S. (2023) Postpartum depression in dads linked to adverse experiences for their kids.  Accessed https://www.medpagetoday.com/meetingcoverage/aap/106971

Stone, E. (2023) Should fathers be screened for postpartum depression?  Accessed https://today.uic.edu/postpartum-depression-in-fathers/

 

2022

National Institute for Children's Health Quality (2022).  Fathers: Powerful allies for maternal and child health.  Accessed https://www.nichq.org/insight/fathers-powerful-allies-maternal-and-child-health

Novak, S. (2022) This is why postpartum depression in men is extremely underreported.  Accessed https://www.fatherly.com/health/why-postpartum-depression-in-men-underreported

Rowe, S.(2022). Can men have postpartum deression? The answer is yes.  (2022).; Accessed https://psychcentral.com/depression/postpartum-depression-in-men

 

2021

Garrod, D. (2021). How do midwives and fathers communicate during labour and birth? An ethnographic study in the North West of England.  Accessed https://etheses.whiterose.ac.uk/29215/

Ghaffari, S. F., Sharif Nia, H., Elyasi, F., Shahhosseini, Z., & Mohammadpoorsaravimozafar, Z. (2021). Design and psychometric evaluation of the fathers’ fear of childbirth scale: a mixed method study. BMC Pregnancy and Childbirth21(1), 222–222. https://doi.org/10.1186/s12884-021-03696-7 

Masoumi, M., & Elyasi, F. (2021). Tokophobia in Fathers: A Narrative Review. Iranian Journal of Psychiatry and Behavioral Sciences15(1).  

National Institute for Children’s Health Quality. (2021).  Fathers: Powerful allies for maternal and child health.  Accessed https://www.nichq.org/insight/fathers-powerful-allies-maternal-and-child-health   

2020

Jarneid, H., Gjestad, K., Roseth, I., & Dahl, B. (2020). Fathers’ Experiences of Being Present at an Unplanned Out-of-Hospital Birth: A Qualitative Study. Journal of Multidisciplinary Healthcare13, 1235–1244. https://doi.org/10.2147/JMDH.S272021 

Masoumi, M. and Elyasi, F. (2020). Tokophobia in Fathers; a Narrative Review.  Iranian Journal of Psychiatry and Behavioral Science;  vol 15, issue 1.  DOI: 10.5812/ijpbs.104511  Accessed https://brieflands.com/articles/ijpbs-104511.html

National Fatherhood Initiative. (2020).  Dad's absence at birth linked to adverse health outcomes for mom and baby.  Accessed https://www.fatherhood.org/championing-fatherhood/dads-presence-healthier-baby-mom

Neri Mini, F., Saltzman, J. A., Simione, M., Luo, M., Perkins, M. E., Roche, B., Blake-Lamb, T., Kotelchuck, M., Arauz-Boudreau, A., Davison, K., & Taveras, E. M. (2020). Expectant Fathers’ Social Determinants of Health in Early Pregnancy. Global Pediatric Health7, 2333794X20975628–2333794X20975628. https://doi.org/10.1177/2333794X20975628

Rao, W.-W., Zhu, X.-M., Zong, Q.-Q., Zhang, Q., Hall, B. J., Ungvari, G. S., & Xiang, Y.-T. (2020). Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys. Journal of Affective Disorders263, 491–499. https://doi.org/10.1016/j.jad.2019.10.030 CONCLUDED: "In conclusion, this meta-analysis found that paternal depression was common, affecting 7.82%−13.59% of the fathers in different stages of their partners’ pregnancy and child-birth. Health authorities and professionals should pay more attention to the early identification of prenatal and postpartum paternal depression and implement effective treatment"

Tarsuslu, B., Durat, G., & Altınkaynak, S. (2020). Postpartum Depression in Fathers and Associated Risk Factors: A Systematic Review. Türk psikiyatri dergisi31(4), 280–289. https://doi.org/10.5080/u25084

2019

Albuja, A. F., Sanchez, D. T., Lee, S. J., Lee, J. Y., & Yadava, S. (2019). The effect of paternal cues in prenatal care settings on men’s involvement intentions. PloS One14(5), e0216454–. https://doi.org/10.1371/journal.pone.0216454

Brandon Eddy, Von Poll, Jason Whiting, Marcia Clevesy. Forgotten Fathers: Postpartum Depression in MenJournal of Family Issues, 2019; 0192513X1983311 DOI: 10.1177/0192513X19833111 Accessed https://www.sciencedaily.com/releases/2019/03/190307091448.htm

Philpott, L., Savage, E. FitzGerald, S., and Leahy-Warren, P.  (2019). Anxiety in fathers in the perinatal period: A systematic review. Midwifery Volume 76, September 2019, Pages 54-101  Accessed https://www.sciencedirect.com/journal/midwifery/vol/76/suppl/C  

  • CONCLUDED: "The findings from this systematic review indicate that experience anxiety which increases from the antenatal period to the time of birth, with a decrease in anxiety from the time of birth to the later postnatal period (Keeton et al., 2008, Castle et al., 2008, Armstrong et al., 2009, Vismara et al., 2016, Figueiredo and Conde, 2011a, Figueiredo and Conde, 2011b). An increase in anxiety from the antenatal period to the time of birth, was followed by a decrease in anxiety from the time of birth"

Scarff, J. (2019) Postpartum Depression in men.  Journal of Innovations in Clinical Neural Science 16(5-6).  PMCID: PMC6659987

  • From conclusion "PPD has been associated with adverse consequences, yet it is a treatable condition. Clinicians are encouraged to screen for depression in fathers, particularly during the first year postpartum, especially if anxiety or risk factors are present. Antidepressant therapy or psychotherapy have been shown to be effective treatment modealities. Recognizing and treating paternal PPD can improve quality of life for the father and the family unit and decrease the risk for emotional and behavioral problems in children. "

Wen-Wang, R, Xiao-Min, Zhu, Qian-Qian, Z. Zhang, Q., Hall, B. Ungvari, G. and Ziang, Yu-Tao. (2019). Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys.  Accessed https://www.sciencedirect.com/science/article/abs/pii/S016503271931496X    https://doi.org/10.1016/j.jad.2019.10.030

  • Conclusion: "This meta-analysis found that the prevalence of prenatal and postpartum depression in fathers was relatively common. Regular screening, effective prevention and appropriate treatment need to be implemented in this population."

2018

American Academy of Pediatrics. (2018), Dads can get Depression During and After Pregnancy, too. Accessed https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Dads-Can-Get-Postpartum-Depression-Too.aspx

  • Depression in dads is, in fact, a relatively common phenomenon―affecting anywhere between 2% and 25% of them during their partner's pregnancy or in the first year postpartum.   According to the American Academy of Pediatrics (AAP), this rate can increase to 50% when the mother also has perinatal/postpartum depression. And it can take a serious toll on the family's wellbeing, specifically their children's.

Huusko, L., Sjöberg, S., Ekström, A., Hertfelt Wahn, E., & Thorstensson, S. (2018). First-Time Fathers’ Experience of Support from Midwives in Maternity Clinics: An Interview Study. Nursing Research and Practice2018, 9618036–9618037. https://doi.org/10.1155/2018/9618036  

  • CONCLUDED: (Material omitted). "Our result pointed out the importance of midwives having eye contact with both parents and actively posing question to both parents as well as offering both parents the opportunity to pose questions. It is important for first-time fathers that time for discussion is planned in parental education classes. Midwives should strive to include fathers in information about the baby’s needs and breastfeeding since this is important for them as becoming parents. Parts of our result are in line with earlier research, for decades; therefore it is necessary to focus more of support for fathers."

Netsi, E., Pearson, R., and Murray, L. (2018). Associaton of persistent and severe postnatal depression with child outcomes. Accessed https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2670696

  • The analyses we conducted highlight that women with persistent depression in the postnatal year continue to experience elevated levels of depressive symptoms until at least 11 years after childbirth. Children of women with persistent PND, especially when it is severe, are at an increased risk for a number of adverse outcomes. 

Peyton, T. and Wisniewski, P. (2018). Improving a design space: Pregnancy as a collaborative information and social support ecology. Accessed https://www.researchgate.net/publication/327746072_Improving_a_Design_Space_Pregnancy_as_a_Collaborative_Information_and_Social_Support_Ecology

  • Abstract: Pregnancy is a major life experience that changes relationships, identities, and home environments. It is a personal, collaborative, and domestic process of health changes, behavioral adaptations, and social adjustments that goes beyond the medical care of a pregnant woman. Using the lenses of information and support ecologies, we examine whether the complexities of pregnancy are reflected in the design of mobile technologies that support this life altering experience. To do this, we analyzed 191 iOS pregnancy applications ("apps") to understand the types of functionality they supported. We found that the majority provided static medical and birth event information but had shallow functionality for leveraging social support. Almost all apps excluded expectant fathers, used gendered interfaces and information choices, and focused primarily on fetal development or the pregnant woman's physical health. We call for less gendered and more meaningfully collaborative mobile health technologies to support pregnancy.

Scarff, J. R. (2019). Postpartum Depression in Men. Innovations in Clinical Neuroscience16(5-6), 11–14. Accessed: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6659987/

  • CONCLUDED: "PPD has been associated with adverse consequences, yet it is a treatable condition. Clinicians are encouraged to screen for depression in fathers, particularly during the first year postpartum, especially if anxiety or risk factors are present. Antidepressant therapy or psychotherapy have been shown to be effective treatment modealities. Recognizing and treating paternal PPD can improve quality of life for the father and the family unit and decrease the risk for emotional and behavioral problems in children. Further studies should determine the prevalence, comorbidity, and efficacy of treatments for paternal PPD while including fathers from various demographic groups. Such groups could include single and two-father households, stepfathers, fathers from various socioeconomic, racial, and ethnic groups, and those residing in urban and rural areas."

Solberg, G. and Glavin, K. (2018). Fathers want to play a more active role in pregnancy and maternity care and at the child health center. Norwegian Journal of Nursing Research.  DOI: 10.4220/Sykepleienf.2018.72006en   Accessed: https://sykepleien.no/en/forskning/2018/10/fathers-want-play-more-active-role-pregnancy-and-maternity-care-and-child-health 

  • CONCLUDED:   "The study describes a healthcare service related to pregnancy, childbirth and infancy that still focuses on mother and child, even though the objective is to have a family perspective. The fathers found that their inclusion in the healthcare services varied. They wanted to play a more active role and to be included during pregnancy, childbirth and follow-up at the child health centre. This requires a change of focus in the healthcare services, where greater emphasis is placed on fathers as independent and equal carers. Moreover, provision should be made for fathers to participate to a greater degree."

Werner-Bierwisch, T., Pinkert, C., Niessen, K., Metzing, S., & Hellmers, C. (2018). Mothers’ and fathers’ sense of security in the context of pregnancy, childbirth and the postnatal period: an integrative literature review. BMC Pregnancy and Childbirth18(1), 473–473. https://doi.org/10.1186/s12884-018-2096-3

  • CONCLUDED:  "For both parents, the presence and support of midwives and other professional caregivers play important roles in developing confidence in the caregivers. A trusting relationship with midwives and other healthcare professionals is associated with parents’ sense of security. As such, midwives and other involved health professionals should be aware of their role in creating a sense of security among parents. Via targeted communication and advice, caregivers must determine what women and their partners need to feel secure during pregnancy, childbirth and the postnatal period. Based on these findings and a culture-specific understanding of security, midwives and other professional caregivers can effectively support parents with regard to their specific security needs and increase their chances for positive experiences during the transition to parenthood."

Xue, W. L., Shorey, S., Wang, W., & He, H.-G. (2018). Fathers’ involvement during pregnancy and childbirth: An integrative literature review. Midwifery62, 135–145. https://doi.org/10.1016/j.midw.2018.04.013 

  • CONCLUDED: "This study reviewed existing literature on fathers’ involvement during their wives’ pregnancy and childbirth and identified factors that influence it. Of the studies that explored fathers’ involvement during pregnancy and childbirth, there is a general consensus that expectant fathers desired to be actively engaged partners. This view is supported by the benefits and significance of paternal involvement during pregnancy and childbirth, which were discussed by several studies (Alio et al., 2013,"

2017

Eggermont, K., Beeckman, D., Van Hecke, A., Delbaere, I., & Verhaeghe, S. (2017). Needs of fathers during labour and childbirth: A cross-sectional study. Women and Birth : Journal of the Australian College of Midwives, 30(4), e188–e197. https://doi.org/10.1016/j.wombi.2016.12.001

  • From abstract: Information needs are more important to fathers compared to needs focusing on the birth experience or their involvement. Socio-demographic variables like educational level, parity, and marital status were associated with fathers’ needs. Midwives need to be aware of fathers’ needs during the birth process and to fulfill these needs appropriately.

King, L. (2016). Hiding in the pub to cutting the cord? Men’s presence at childbirth in Britain 1940s – 2000s.  Social History of Medicine.  Volume 30, Issue 2, May 2017, Pages 389–407, https://doi.org/10.1093/shm/hkw057

  • CONCLUDED: (Material omitted)  "If health care professionals aim to provide the best possible experience of a milestone in one’s life, then the needs of the father become far more important than if their exclusive goal is a medically safe delivery"

2015

Houser, P. (2015). Fathers present at birth. Pathways to Family Wellness (46). Accessed https://pathwaystofamilywellness.org/Pregnancy-Birth/fathers-present-at-birth.html

  •  CONCLUDED:  "A father’s participation during birth can be highly advantageous for the laboring mother. When a couple’s relationship is loving and its sanctity preserved and supported, they are a virtual oxytocin generator. However, fathers can also be a significant impediment if they are ill-prepared, do not understand or embrace their role, or are afraid. Gender-specific educational programs for expectant dads, father to father, are a crucial and necessary element for ensuring strong and lasting foundations for a family’s structure and legacy."

Jouhki, M.-R., Suominen, T., & Åstedt-Kurki, P. (2015). Supporting and Sharing—Home Birth: Fathers’ Perspective. American Journal of Men’s Health9(5), 421–429. https://doi.org/10.1177/1557988314549413

  • CONCLUDED: "This study confirms that father’s home birth experience means sharing responsibility and supporting the woman in the home birth process. The findings indicate a need to educate health care professionals on different birth options, including knowledge of medical and social aspects of home birth. Both parent and birth education classes should include information of the home birth option. Hospitals providing birthing services should pay additional attention to family and client centered care, and to families’ autonomy and personal wishes. As home birth option is not included in public health care services, problems in the small number of home birth arrangements and associated emergency situations should be considered as a possibility and should be addressed and remedied."

Wendell-Hummell. C. (2-15). Journey to Parenthood - How new fathers and mothers make sense of perinatal emotional distress.  Accessed https://kuscholarworks.ku.edu/handle/1808/24840  

  • CONCLUDED: (from intro) "Nonetheless, the postpartum depression diagnosis is being extended to fathers and additional conditions are coming to be recognized as perinatal mental health disorders (e.g., anxiety, PTSD). In light of the contested nature of these conditions, I drew on social constructionist theories on health and illness to examine how lay parents made sense of and acted on their perinatal mental health symptoms"

2014

Child and Family Research Partnership. (2014). Dad’s absence at birth linked to adverse health outcomes for mom and baby.  Accessed https://childandfamilyresearch.utexas.edu/dads-absence-birth-linked-adverse-health-outcomes-mom-and-baby 

  • CONCLUDED: "..., health officials should consider developing early interventions for mothers whose partners are not present at prenatal appointments. Fathers’ absence at the 20-week ultrasound, in particular, strongly predicts fathers’ absence at the child’s birth and should be considered a signal that a mother is at elevated risk for prenatal stress and adverse child health outcomes."

Poh, H. L., Koh, S. S. L., & He, H.-G. (2014). An integrative review of fathers’ experiences during pregnancy and childbirth. International Nursing Review, 61(4), 543–554. https://doi.org/10.1111/inr.12137

  • Conclusion: This review provides evidence for healthcare professionals to pay more attention to fathers when delivering perinatal care. Sociocultural-sensitive interventions should be developed to facilitate a smoother transition to fatherhood.

 

2013

Alio, A. P., Lewis, C. A., Scarborough, K., Harris, K., & Fiscella, K. (2013). A community perspective on the role of fathers during pregnancy: a qualitative study. BMC Pregnancy and Childbirth13(1), 60–60. https://doi.org/10.1186/1471-2393-13-60  

  • CONCLUDED: "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. " (Material omitted)

Bergström, M., Rudman, A., Waldenström, U., & Kieler, H. (2013). Fear of childbirth in expectant fathers, subsequent childbirth experience and impact of antenatal education: subanalysis of results from a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 92(8), 967–973. https://doi.org/10.1111/aogs.12147

Redshaw, M and Henderson, J (2018). Fathers' engagement in pregnancy and childbirth: evidence from a national survey. Accessed. https://doi.org/10.1186/1471-2393-13-70

2012

Brandão, S., & Figueiredo, B. (2012). Fathers’ emotional involvement with the neonate: impact of the umbilical cord cutting experience. Journal of Advanced Nursing, 68(12), 2730–2739. https://doi.org/10.1111/j.1365-2648.2012.05978.x

 

2011

Plantin, L., Olukoya, A. A., & Ny, P. (2011). Positive health outcomes of fathers’ involvement in pregnancy and childbirth paternal support: a scope study literature review. Fathering (Harriman, Tenn.)9(1), 87–. https://doi.org/10.3149/fth.0901.87

  • CONCLUDED: "Maternal health services are much more focused on the mother and infant's health and often exclude men and their needs as parents." (material omitted)

2010

University of South Florida (USF Health). (2010, June 17). Father involvement in pregnancy could reduce infant mortality. ScienceDaily. Retrieved October 8, 2021 from www.sciencedaily.com/releases/2010/06/100617111245.htm

  • CONCLUDED: "Improving the involvement of expectant fathers holds promise for reducing costly medical treatments for the complications of premature births as well as reducing infant mortality rates, particularly in black communities, Dr. Alio said. "When fathers are involved, children thrive in school and in their development. So, it should be no surprise that when fathers are present in the lives of pregnant mothers, babies fare much better."

World Health Or fganization. (2007). Fatherhood and health outcomes in Europe. Accessed https://www.euro.who.int/__data/assets/pdf_file/0017/69011/E91129.pdf  

  • CONCLUDED: "In conclusion, although many fathers want to be involved with their children and there is evidence that this can positively influence the health outcomes for both the man, his partner and children, very few activities and initiatives are planned to help most men in their parenting. Maternal and child health services are much more focused on the health of the mother and child and therefore often exclude men and their needs for information as parents. Support is better accessed by the middle classes or by parents with better life conditions, whereas contact with other groups who show poorer health is weaker. This shows that not only do resources need to be increased to reach these men but also a new way to distribute or restructure the contributions is needed so that they address both parents. Perhaps information and advice can take place through more effective paths of communication (such as the Internet) and thus provide opportunities for channelling more resources to groups that are more difficult to reach and who have poorer health."

2008

Ivry, T. and Teman, E. (2008). Expectant Israeli fathers and the medicalized pregnancy: Ambivalent compliance and critical pragmatism.  Cultural Medical Psychiatry.  DOI https://doi.org/10.1007/s11013-008-9099-x   

  • From abstract: "It is suggested that the anthropological scholarship on reproduction assumes that men benefit from the medicalization of pregnancy and birth and comply with medicalization. Women, on the other hand, are often depicted as being subjected to harmful medical surveillance and responding to it in degrees, ranging from compliance to resistance, and mediated by pragmatism. Data derived from participant observation in multiple arenas and from 16 in-depth interviews with Israeli men whose female partners were pregnant or had recently given birth suggest that although some Israeli men regard the biomedicalization of pregnancy positively, most tend toward varying degrees of criticism. It is suggested that men's responses to reproductive biomedicine are far more complex than portrayed to date in the existing scholarship and that men's responses to biomedicalization reveal complex power negotiations"

2007

World Health Organization Europe (2007). Fatherhood and health outcomes in Europe.   Accessed https://www.euro.who.int/__data/assets/pdf_file/0017/69011/E91129.pdf

  • From executive summary: "Examination of the research literature shows, generally speaking, that increased involvement by men in fatherhood can benefit men, as well as women and children, in the form of better health. For example, men can give important psychological and emotional support to the woman during pregnancy and delivery. This, in turn, can reduce pain, panic and exhaustion during delivery. Studies have also shown that men’s involvement in maternal and child health programmes can reduce maternal and child mortality during pregnancy and labour by being prepared, for example, for obstetric emergencies."

2003

Leavitt, J. W. (2003). What Do Men Have to Do with It? Fathers and Mid-Twentieth-Century Childbirth. Bulletin of the History of Medicine, 77(2), 235–262. https://doi.org/10.1353/bhm.2003.0073 

  • This article addresses the role of fathers during the births of their children, focusing on the United States in the mid-twentieth century when childbirth was a highly medicalized, in-hospital experience for the large majority of American women. It puts this period into the perspective of changing birth practices over time, and, using sources rich in the voices of all birth participants, especially the fathers-to-be, traces some significant changes in hospital practices. Specifically examined are men's feelings and activities while their wives were in labor and delivery, and their participation in decisions about labor induction, anesthesia, and cesarean section. In contrast to earlier writings of the author, this essay puts men at the center of some of the changes identified.

1999

Williams, K and Umberson, D. (1999). Medical technology and childbirth: Experiences of expectant mothers and fathers. Accessed Sex Roles41, 147–168 (1999).  Accessed  https://doi.org/10.1023/A:1018898027379

  • Abstract: "Research and theory on medical technologysuggests that, for many expectant mothers, medicalintervention in pregnancy and childbirth results infeelings of alienation from their bodies and a lack ofcontrol over the childbirth experience. Few studies,however, examine the influence of medical interventionon the expectant father's experience of this significantlife event. In this study, we compare expectant fathers' and mothers' experiences with medicaltechnology during pregnancy and childbirth. In-depthinterviews were conducted with 15 primarily White,middle-class, married couples prior to and after the birth of their first child. Our findings revealdifferences in the impact of medical technology onexpectant mothers' and fathers' perceptions ofinvolvement and control over pregnancy andchildbirth."

 

INTRODUCTION PAGE

Last updated June 2024