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
This research suggests that fathers with PPD experience many of the same barriers to accessing psychological support as men with depression occurring at another stage of life. These include conformity to masculine stereotypes, a lack of awareness of paternal perinatal depression, exclusion from services, and self-stigma. Developing interventions which aim to reduce these barriers at the personal and public level should be a key target in encouraging more fathers to access the support they require for their mental health
2023
Firth, S. (2023) Postpartum depression in dads linked to adverse experiences for their kids. Accessed https://www.medpagetoday.com/meetingcoverage/aap/106971
Among 1,933 father and child pairs, 9% of fathers experienced depression within the year after their children were born and 70% of the children experienced at least one ACE at 5 years, reported Kristine Schmitz, MD, of Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, during the American Academy of Pediatrics Annual Meeting
Stone, E. (2023) Should fathers be screened for postpartum depression? Accessed https://today.uic.edu/postpartum-depression-in-fathers/
Dads can suffer from postpartum depression, and a new pilot study at the University of Illinois Chicago suggests they can and should be screened for the condition. Given the intertwined effects of mothers’ and fathers’ physical and mental health, addressing the health of fathers may be a powerful untapped tool in improving the nation’s ongoing maternal health crisis.
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
From article: "Evidence demonstrates that fathers play a critical role in children’s health and development, beginning in the prenatal period and continuing through early childhood and adolescence. When fathers are involved during pregnancy, mothers are 1.5 times more likely to receive prenatal care in the first trimester, which has positive implications for both maternal and infant 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
From article: Paternal postpartum depression impacts 1 in 10 new fathers, who experience a range of symptoms that may differ from Levine’s. Yet postpartum depression in men often goes undiagnosed, and there’s a lack of awareness about it within the medical community. In fact, there are no established criteria a man must meet to have postpartum depression, and there is no universally accepted diagnosis.
Rowe, S.(2022). Can men have postpartum deression? The answer is yes. (2022).; Accessed https://psychcentral.com/depression/postpartum-depression-in-men
Postpartum depression in men and is more common than most people think and may even affect the non-birthing parent more severely in some cases. It’s also not something you can just “tough out” or “get over.”
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/
CONCLUDED: " This study set out to explore communications between midwives and fathers during childbirth, within the context of the triadic mother / father / midwife relationship. It found that even though the father is a relative newcomer to the world of childbirth, he has already become part of the ‘taken for granted’ features of the landscape. This is one of the key messages from this thesis. It underpins the central findings about the nature of the midwife-father relationship, its current dependence on non-verbal elements and guesswork. It can result in the father feeling ‘in the dark’ as he works to find his way" (material omitted)
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 Childbirth, 21(1), 222–222. https://doi.org/10.1186/s12884-021-03696-7
CONCLUDED: "FFCS (Supplementary file 1) is a simple report instrument with proper validity and reliability for the assessment of fear of childbirth in fathers. It can be easily implemented by researchers, midwives, obstetricians and health care providers. This tool allows for designing interventions and studies that may result in turning labor and delivery into a positive experience for fathers in future."
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 Healthcare, 13, 1235–1244.
https://doi.org/10.2147/JMDH.S272021
CONCLUDED: "
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
On the other hand, when dad is absent, baby and mom are less likely to be healthy. A research brief from the Child & Family Research Partnership at the University of Texas at Austin sums up their research on a large sample of unmarried moms in Texas in this way: For unmarried parents there may be a connection between child health and fathers’ birth attendance after all—albeit a very different connection from the one feared in the past. Newly collected data show that a father’s absence at this key event, though not directly harmful, may nonetheless be a harbinger of early health complications for the newborn. These findings indicate that dad’s attendance is more than a mere gesture of support and commitment—it’s a window into the health and wellbeing of mother and child, and an opportunity for health policies that might anticipate and counteract adverse health outcomes for newborns.
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 Health, 7, 2333794X20975628–2333794X20975628.
https://doi.org/10.1177/2333794X20975628
CONCLUDED (material omitted) "
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 Disorders, 263, 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
dergisi, 31(4), 280–289.
https://doi.org/10.5080/u25084
Concluded:
"A history of paternal mental illness, maternal depression, and diverse
psychosocial factors were associated with depressive symptoms among fathers
postnatally. These findings can guide the development of family-level
interventions for early identification and treatment and social media
campaigns to promote help-seeking behaviors and engagement in preventive
strategies.
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 One, 14(5), e0216454–. https://doi.org/10.1371/journal.pone.0216454
C
Brandon Eddy, Von Poll, Jason Whiting, Marcia Clevesy. Forgotten Fathers: Postpartum Depression in Men. Journal 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
From conclusion "
Conclusion: "
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 Practice, 2018,
9618036–9618037.
https://doi.org/10.1155/2018/9618036
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:
Scarff, J. R. (2019). Postpartum Depression in Men. Innovations in Clinical Neuroscience, 16(5-6), 11–14. Accessed: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6659987/
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
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 Childbirth, 18(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. Midwifery, 62,
135–145.
https://doi.org/10.1016/j.midw.2018.04.013
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.2016.12.001From 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/hkw057CONCLUDED: (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: "
Jouhki, M.-R., Suominen, T., & Åstedt-Kurki, P. (2015). Supporting and
Sharing—Home Birth: Fathers’ Perspective. American Journal of Men’s Health, 9(5),
421–429.
https://doi.org/10.1177/1557988314549413
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 Childbirth, 13(1), 60–60.
https://doi.org/10.1186/1471-2393-13-60
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
Conclusion: Men who suffer from antenatal FOC are at higher risk of experiencing childbirth as frightening. Childbirth preparation including training as a coach may help fearful men to a more positive experience of the childbirth event. Additional studies are needed to support this conclusion.
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
CONCLUDED: "From the women’s point of view the majority of recent fathers are clearly actively engaged in pregnancy, childbirth and afterwards. The positive association with women themselves accessing maternity care during pregnancy and postnatally and with outcomes including breastfeeding, reinforce a position that values fathers and their important role in supporting women at this critical time in the lives of their partners and children. Most fathers were very positive about their partner’s pregnancy; almost all were present for pregnancy ultrasound examinations and for labour. Three-quarters of fathers took paternity leave and, during the postnatal period, most fathers helped with infant care. Greater paternal engagement was positively associated with timing of first contact with health professionals, having a dating scan, number of antenatal checks, offer and attendance at antenatal classes, and breastfeeding. Paternity leave was also strongly associated with maternal well-being at three months postpartum."
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
Conclusion: Results suggest that the umbilical cord cutting experience benefits the father’s emotional involvement with the neonate, supporting the benefits of his participation and empowerment in childbirth.
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
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
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
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
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
W
illiams, 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:1018898027379A
Last updated June 2024