CLINICAL RESEARCHFathers’ Perceptions of the Immediate Postpartal Period
Section snippets
Background
Although parenting issues have been dealt with for more than 50 years, early work has focused almost exclusively on the mother’s experiences. Studies about fathers tend to explore the pathology of fatherhood (Freeman, 1951, Towne and Afterman, 1955, Wainwright, 1966). Research on fathers’ experiences with pregnancy, childbirth, and the post-partum period began to emerge in the mid-1970s (Bittman and Zalk, 1978, Fein, 1976, Parke and Sawin, 1978, Wente and Crockenberg, 1976). Initial reports
Objective
This qualitative study used the critical incident technique to reveal 13 fathers’ perceptions of significant moments of the immediate postpartum period (first 48 to 96 hours) in hospital. These results are part of an investigation of both parents’ experiences (de Montigny and Lacharité, 2002, de Montigny and Lacharité, 2004). Approval of the study was obtained from the institutional ethics committee (de Montigny, 2002). The activity under study consists of “significant moments of the immediate
The Critical Incident Technique
Because it allows the “lived experience” (Wilson & Hutchinson, 1991) of fathers to unfold, the critical incident technique seemed particularly appropriate to fulfil our study’s purpose. The critical incident technique stimulates participants to reflect analytically on a past experience (Rosenal, 1995). Critical incidents are “brief but vivid descriptions of an event” (Brookfield, 1990, p. 84), therefore, interpretations of the fathers’ discourse should reveal the complexity of fathers’
Defining a Frame of Reference
Although the critical incident technique allows for the use of a specific predefined theoretical model to categorize data, a more flexible frame of reference was chosen and defined as fathers’ perceptions of significant moments of the immediate postpartum period that are likely to influence their adaptation.
Developing Categories
The primary investigator first transcribed recorded data by hand. To ensure accuracy, audiotapes were reviewed twice while transcriptions were read. Critical incidents were then extracted from the transcriptions, and noted on index cards. Thematic content analysis was carried out, keeping in mind the objective of providing a detailed, complete, and valid description of significant moments of the postpartum period for firsttime fathers. During this initial categorization, incidents were grouped
Establishing Their Degree of Specificity
A second categorization was intended at finding differences between incidents. As incidents were examined, it was questioned whether they belonged in a given category or not. Five domains were thus identified: self and other as individual, self and other as a parent, self and other as a couple, self and other interacting with the environment, and self and other interacting with nurses, each domain heading one category and a total of 12 subcategories (Table 1). Domains are distinct from
Results
Thirteen fathers identified 289 incidents, with a range of 7 to 46 incidents each, which accounted for 47% of the 610 incidents reported by both parents; 39% of these incidents were positive (n = 107), whereas 60.9% (n = 176) were negative, meaning that fathers stated that these incidents had a positive or negative impact on them.
Self and Other as Individual: Coming to Terms With the Physical and Emotional Changes During the Postpartum Period
Five incidents related to fathers’ adaptation to the intense changes inherent to the postpartum period were reported in this category, which was filled with negative experiences for fathers. Being exhausted is the most significant event of the postpartum period, as reported by 69% of fathers.
“The first night after the birth, it was time I lie down, I was so tired. I wasn’t worried, just exhausted,” said Peter, while Brian shared, “Taking care of my wife, and then the baby, I became so tired.”
Self and Other as a Parent: Coping With Parental Demands
This category is divided into three subcategories: knowing, taking care, and feeding their infant, which are all related to parents’ adaptation to their new role. Although fathers report a number of negative incidents in this category, it contains the largest proportion of positive incidents (53%). Knowing their infant and taking care of their infant are mostly positive experiences for fathers. Brian and Phil shared how holding and comforting their infant, giving the infant bath and changing
Self and Other as a Couple: Maintaining Conjugal Functioning
Maintaining conjugal functioning divides into three subcategories: responding emotionally, emotion sharing, and problem solving and communicating (Table 1). One incident that stands out in the first subcategory is related to fathers’ experiencing a loss of intimacy with their spouse as Max confided:
During the hospital stay, we would take time to be together just the two of us, but the feeling of closeness was different, as if I could only see my baby’s mother in her and not my spouse. It was
Self and Other Interacting With the Environment: Coming to Terms With Environmental Demands
This category also branches into three subcategories: knowing hospital routines, coping with hospital routines, and coming to terms with loss of control over time. Several interesting data emerge from the analysis of this category’s incidents, which are highly negative for fathers. To be informed of hospital routines represents half the incidents described by fathers, all of which are negative. Kevin testified in this sense:
I was filling out forms on breastfeeding, nobody had explained them,
Self and Other Interacting With Nurses: Exchanging Information With Nurses
Interestingly, although the critical incident interview did not encourage stories of interactions with a specific category of personnel, only nurses are mentioned as having been part of significant incidents with fathers during the postpartum period. Unfortunately, fathers’ experiences with nurses tend to be more negative (63%) than positive (36.9%). Giving and receiving information in regard to mothers’ and infant’s health, breastfeeding, infant care, and hospital discharge was generally
Typology of Fathers’ Experience
After gaining awareness of fathers’ experiences of the postpartum period, we wondered if there was a pattern to these experiences. Further data analysis was done to verify if fathers’ experiences varied according to their involvement in the postpartum period. The purpose of this analysis was to identify what incidents fathers were sensitive to, related to their postpartum involvement. Postpartum involvement was defined on the basis of two criteria: (a) fathers’ perceptions of themselves as
Limits
There are two limiting elements in this study. First, the retrospective interview method depends on individuals’ memory and their ability to remember specific events relating to the desired theme (Care, 1996). To minimize this effect, we proceeded to collect data as soon as possible, following hospital discharge (X = 7-8 days after birth). Another limit pertains to all fathers being recruited from the same hospital, thus exposed to the same kind of environment.
Discussion
When this study was begun, it was wondered how fathers perceived the immediate postpartum period and the nursing interventions in hospital. Because their view-point is different from the mothers’, it was assumed that fathers’ experience of the immediate postpartum period would also be different. The analysis allowed the research team to develop an understanding of the paternal experience of the postpartum period, its similarities and differences with mothers’ experience, and most important, its
Implications for Practice
Pregnancy and childbirth are periods where individuals can grow as they attempt to reorganize their life. For the couple, this period is a “critical developmental touch point” (Belsky, 1994, Pruett, 1998) where nurses can and should grasp every opportunity to support fathers and mothers in their transition. Gottman (1991) holds the opinion that when individuals reorganize their life, they are more open to interventions. Interventions should be intended for both partners (Tomlinson, 1996)
Conclusion
The culture of fatherhood has been known to change more rapidly than practice (LaRossa, 1988). This study raises questions on how the modern hospital environment has been able to develop father-friendly practices and attitudes. These fathers’ testimonies emphasize the fact that there seems to coexist more than one form of fathering, characterized by a diversity of behaviors and styles of involvement. For all fathers involved, interactions with their babies and with nurses are significant
Acknowledgments
This research was funded by a doctoral grant from the SCHRC (Social Sciences and Humanities Research Council of Canada). We would like to thank Ms. Noëlla Tremblay-Carreau, Ms. Françoise Courville, and Ms. Linda Bell, who have gracefully judged this research’s domains, categories, and incidents, and Ms. Marlise Vlasblom and Ms. Nicole Duquet for the revision of the English version of this text.
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