To improve maternal and child health, include fathers

Every year in June, attention briefly turns to fathers. It’s great that we have a day dedicated to celebrating fathers. But we must urgently recognize fathers year-round as core family members who help to shape the health of their family. 

It’s a mission that goes beyond a new “World’s Greatest Dad” mug and a single day of observance.

As a social worker and a pediatrician working every day with families, we see the impact fathers have on maternal and child health. When fathers are involved and supportive during pregnancy, it helps to reduce stress for mothers and lower stress leads to better birth outcomes. 

After birth, fathers influence how children eat, sleep, play and form relationships through caregiving and by modeling healthy (or unhealthy) behaviors.  

A father’s well-being also influences the well-being of his children and family. Ten percent of new fathers suffer from postpartum depression. When a new father feels down, depressed, isolated or more irritable than usual, it can interfere with bonding with and caring for his infant. It can also lead him to feel disconnected from his partner.

When one parent struggles, it increases the burden on the other parent to care for the baby and hold the family together. And when both parents are struggling, it is even harder to meet the baby’s needs and support one another. 

Mothers and fathers even play an important role in one another’s mental health if they are not together — supportive co-parenting relationships are associated with better mental health for both parents.

Yet services and policies designed to support families routinely overlook or discount the role of fathers.

It’s past time we flip the dominant script about fathers and increase support for all new parents — regardless of gender or marital status. There are a number of actions at the local, state and national levels that can be taken to strengthen the inclusion of fathers and improve the lives of new families.  

But where do we start? We see tremendous opportunities.

At the local level, communities can come together to increase access and belonging for fathers in family services. 

The Alameda County Fathers Corps in California offers an example. A county-wide team of service providers, the Fathers Corps developed a set of father-friendly principles, such as “include positive and diverse images of fathers being fathers” in program materials. These principles are being applied throughout the county to ensure that fathers see themselves represented, feel welcome in agencies and organizations serving families and receive the services they need to improve their lives, for themselves and their children.

Home visiting programs are a widespread approach to support families during pregnancy and early childhood. In communities across the country, home visitors build close relationships with parents through weekly visits and work together to identify and meet goals related to child and family health and well-being. But most models weren’t designed with fathers in mind, and home visitors report difficulty recruiting and engaging fathers.

Two novel interventions, Dads Matter-Home Visitation and Fathers and Babies, offer promising strategies. These include simple changes like addressing all communication to both mother and father to emphasize that services are for both parents and incorporating fathers’ feedback to ensure that the curriculum resonates with men.  

Additionally, 12 U.S. states have commissions established through legislation to strengthen support for fathers and improve outcomes for children and families. These entities support programming to help men become the best fathers they can be and serve in an advisory capacity to state agencies regarding fatherhood issues and supportive family policies. State-level fatherhood commissions are a promising mechanism to promote father engagement at multiple levels.

The federal government funds states for maternal and child health services through a block grant program. Each state decides how to use the funding. Only a few states, like Georgia, Massachusetts and South Carolina, have identified father engagement as a priority for investment and part of a holistic strategy to improve maternal and child health and health equity. Other states should follow suit. 

At the national level, we need to talk more openly about men’s mental health and spread awareness that while men can be an important source of support to their partners during pregnancy and early parenthood, they also may need support of their own. 

National professional associations like the American Academy of Pediatrics still do not call for routine universal screening of all new parents for depression, an easy change that could facilitate early identification and care referrals.  

Since 1987, the Pregnancy Risk Assessment Monitoring System (PRAMS) has provided national data about mothers’ experiences before, during and shortly after pregnancy. A parallel survey, PRAMS for Dads, was piloted in Georgia and is now being used to gather data on men’s experiences as they enter fatherhood in five states. 

Recently, the leadership of the Congressional Dads Caucus and the Black Maternal Health Caucus recognized that implementing PRAMS for Dads on a national scale would provide the understanding needed to respond to the needs of new fathers and promote better health for the whole family.

Fathers are central, not peripheral, to their families. When we fail to take into account the impact they have on mothers and children, we miss opportunities to promote the well-being of the whole family. 

This Father’s Day, instead of a coffee mug, let’s commit to offering the services our families need.

Tova Walsh is an associate professor in the Sandra Rosenbaum School of Social Work at the University of Wisconsin-Madison. Craig Garfield is a professor at the Northwestern Feinberg School of Medicine and an attending physician at Lurie Children's Hospital of Chicago.