Fathers' experiences, views and perspectives of childbirth attendance: a qualitative evidence synthesis

Fathers' involvement in childbirth is common in most countries worldwide, yet an understanding of fathers' perspectives on childbirth attendance is lacking. To gain global insight and understanding of fathers' experiences and views of childbirth attendance, a synthesis of the qualitative evidence was performed.

To synthesise the qualitative evidence on fathers' views, perspectives, and experiences of childbirth attendance.

MEDLINE, CINAHL, MIDIRS, PsycINFO and Web of Science were searched from inception dates to May 2024 to identify eligible studies. Included studies were quality appraised using the critical appraisal skills programme (CASP) checklist. Extracted data were thematically synthesised. Confidence in the findings was assessed using GRADE-CERQual.

Thirty studies were included from which six analytical themes were generated. These were: Choices and challenges in birth attendance; Evolution of paternal role; Interplay of personal and cultural influences; Transformative impact of birth attendance; Transition to fatherhood; and Emotional complexity in childbirth attendance. Key findings revealed that fathers' experienced emotional duality, simultaneously feeling joy and distress, competence and inadequacy, connection and isolation. While many fathers chose to attend birth, others felt pressured by external variables. Cultural factors influenced experiences, and traditional values were sometimes in conflict with contemporary expectations. Birth attendance strengthened relationships, although fathers also struggled with feelings of exclusion, unpreparedness, or helplessness throughout attendance.

Findings from this qualitative evidence synthesis challenge assumptions that fathers universally benefit from birth attendance. The findings will help inform future policy and practice in supporting fathers' who attend childbirth.