Becoming a father: men’s role in antenatal care

When it comes to expecting a child and having a healthy pregnancy, the focus has long been on women. Men, rather expectant fathers have not been subjected to preconception care and pregnancy advice while the involvement or role of men during pregnancy is crucial. However, studies show that male participation in Tanzania during pre-pregnancy and post-delivery is still low.  According to a qualitative study, titled, “Perceptions on male involvement in pregnancy and childbirth in Masasi District, Tanzania,” despite the efforts to promote male involvement in maternal and child health, studies in low and middle income countries have reported that male participation is still low.

The findings of the study revealed that women preferred to be accompanied by their partners to the clinic especially on the first antenatal care visit. Men did not wish to be more actively involved in antenatal care and delivery. The study further stated that the society perceived men as being breadwinners and their main role in pregnancy and child birth was primarily to support their partners financially. The key factors which hindered male participation were traditional gender roles at home, fear of HIV testing and unfavourable infrastructure in health facilities.

In this view, when Your Health paid a visit at the maternity block of the Muhimbili National Hospital (MNH) in Dar es Salaam to survey the number of expectant fathers accompanying their partners to the clinic, it was noted that majority of the pregnant women weren’t escorted by their partners. These women looked tired sitting slumped on the bench, while some had fallen asleep waiting for hours for their turn. But there were those who caught Your Health’s attention. Curious to know why their thought process differed from the rest, the expectant fathers who were reached for comments, had a positive mind-set saying that they were keen on following up and knowing their pregnant wives’ health status, urging other fathers in the households to play the same role during the pregnancy. Here are their testimonials.

Couple 1:

Queuing on the hospital bench waiting to see the doctor, while carrying his wife’s handbag on his left shoulder, Richard Mwendilemo, 43, a resident of Mkuranga in the Coast Region told Your Health that he wasn’t shy to escort his pregnant wife to the hospital. He insisted that he religiously accompanied his wife every month during the antenatal classes.

“When we found out that we were going to have a baby, I initially couldn’t understand what she was going through, it was a challenge. Gradually, I began to understand the situation that she is going through. She sometimes yells at me for no reason, but I don’t take it too seriously,” he laughs.

“I sometimes make some jokes to make her laugh when I observe she is not happy. The aim is to make sure her unusual attitudes during the pregnancy doesn’t affect the development of the baby inside her,” he tells.

Commenting on the father’s responsibilities during the pregnancy, Mr Mwendilemo further expounds that the role played by the fathers during pregnancy was fundamental for the growth of the unborn child and the health of the mother-to-be.

“Personally, I understand that pregnancy is not a wife’s weight alone, it is for both husband and wife. It is an obligation for both the parents during pregnancy to ensure that the unborn child’s growth is progressing well,” he says.

Backing up her husband’s opinions, Ms Modesta Machengo, 38, describes her husband as “a good advisor” saying despite her current provocative attitudes against her husband due to pregnancy, her husband still showed her love and support.

 “I thank God for giving me this kind of a man. Apart from his daily parental responsibilities as the head of household, he supports me a lot during this period. The journey of pregnancy, we [expecting mothers] need more love and support from our husbands and he is doing just fine,” she says.

Couple 2:

Sitting next to his wife on the hospital bench awaiting to consult the doctor on the same day, Calvin Chezi, 36, a resident of Chang’ombe here in Dar es Salaam states, “I decided to come with my wife here to the hospital so that I can know the health status of my wife and the unborn child.”

On the new experiences that he was going through during his wife’s pregnancy, Mr Chezi said, “To be honest, she has not been showing any new attitudes during her pregnancy. Her condition is progressing very well.”

“I feel very relaxed when I see my husband sitting besides me whenever we come here at the hospital for maternal health services. It makes me believe that he is ready to help me and the child in case anything happens,” says [in a low tone] Mr Chezi’s wife, Hasia Bitigo when she was reached by Your Health for comments.

Couple 3:

Holding hands while walking towards the entrance door of the Maternity block in MNH, Vincent Balenge, 28, and his wife, Sarah Atanas, 27, both residents of Kimara in Dar es Salaam, were received by a nurse at the reception, and later they were directed to sit on the hospital bench awaiting their turn to see the doctor.

“As a father-to-be, I am here to escort my wife for the prenatal clinics. Despite having fixed daily routines, I always escort her whenever she is scheduled for her clinics,” says Mr Balenge.

When asked to explain whether he was subjected to difficulties during his wife’s pregnancy, Mr Balenge states, “Of course since she got pregnant, I have been experiencing some changes in her attitudes, but I can handle them because I know it is temporal.”

“She sometimes wants me to take her to a place where we have never been there before. I therefore now take her to different places for exposure. But before pregnancy, she had never asked me to do so,” he adds.

For her part, Ms Atanas says that she enjoys her husband’s support, saying it is a great pleasure to see her husband escorting her to the hospital during her monthly clinics.

“It always feels good to see him sitting beside me on the bench. More interesting is when he carefully listens to the doctor’s instructions on the proper use of medicines and other instructions,” she expresses.

“When we are home, he also reminds me to take the medication as per the doctor’s instructions. I urge other men to do the same because pregnancy comes along with a variety of health complications; this is why it is very important to escort pregnant women to the hospital,” Ms Atanas urges.

A call upon all expectant fathers

Speaking to Your Health during the interview on the same day, the MNH Manager of Maternity Block B, Ms Stella Medadi, established that according to her office’s observation and records, only a few male parents were escorting their pregnant wives to the hospital for maternal health services during pregnancy.

“Honestly, most of the pregnant women come here without their men. Majority of them are being escorted by their relatives. To us, this is a challenge because we sometimes need to speak to the responsible father about the progress of the unborn child and the health of the mother,” she says.

“But we fail to do so because majority of them do not come with their wives to the hospital,” she adds.

She mentions about the urban lifestyle as one of the factors that influences majority of men’s failure to escort their women to the hospital for maternal health, calling on male parents to be there for their wives at the health facilities.

“Pregnant women need to eat healthy food with a view to ensuring the unborn child grows healthy. Therefore it is very important for men to be there while we are giving the instructions to the pregnant women about the type of food and other issues to be highly considered during the pregnancy,” she informs.

Explaining on the maternal health services that are offered in the national hospital, Ms Medadi states, “Here at the maternity block, we offer maternal health services to women, men and children.

Therefore we normally expect to see men escorting their pregnant women for clinic services. The move helps the fathers to be aware of their wives’ health status during pregnancy.”

She further expounds that her office was committed to help the fathers through comprehensive reproductive health counselling programmes on how they can deal with various changes that occur during pregnancy.

“Speaking of experience, it is easier to tell that a pregnant woman feels more comfortable when she sees her man sitting beside her while awaiting to see a doctor at the hospital,” she reveals. “It becomes easier to help a pregnant woman when her man is around. I also encourage the government to enhance public awareness campaigns on the importance of supporting pregnant women by their men,” Ms Medadi suggests.

Men, too , go through ‘pregnancy’

Moreover, fathers not only have an important role to play during pregnancy, but they too are subjected to changes, physically, emotionally, to mention a few, from the time the mother gets pregnant to post-delivery.

According to the study titled “Fathers’ experiences of being in change during pregnancy and early parenthood in a context of intimate partner violence,” published by the US National Library of Medicine in 2016, indicated that the transition to fatherhood can be experienced by men as being very stressful.

It also involves a number of different emotional reactions, including a need to identify with the role of father and a redefining of self and the relationship with the partner, according to the study.

Speaking to Your Health via telephone, the Emergency Medicine Resident at Muhimbili University of Health and Allied Science, Dr Deus Kitapondya states, “When a women delivers everything changes inside the house! So there are lot of things a husband has to conform! This may bring a kind of panic and sometimes psychological tension.”

He further adds, “There is also an increased family expenditure during pregnancy and delivery, all these add up to bring about psychological discomfort to a husband (stress), fatigue and nervousness.”

Meanwhile, White Ribbon Alliance [an organisation, through its vast network of National Alliances, WRA is activating the global movement for reproductive, maternal and newborn health and rights] and partners are calling upon all current and prospective fathers to get involved in the “What Women Want” campaign.

For far too long, reproductive and maternal health is seen as primarily women’s responsibility.

But the fact is, fathers occupy a special position of influence with the women and girls in their families.