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Paternal involvement after perinatal death
1Department of Obstetrics and Gynecology, University of Florida, Gainesville 32610.
Insights
Many fathers experience grief after perinatal death. Paternal involvement, including birth presence and holding the baby, was linked to cohabitation and gestational age, highlighting the need for father-inclusive grief support.
Area of Science:
- Perinatal Health
- Sociology
- Psychology
Background:
- Perinatal death significantly impacts families, yet paternal involvement in grief processes is understudied.
- Understanding fathers' roles is crucial for comprehensive bereavement care.
Purpose of the Study:
- To examine paternal involvement following perinatal death in a diverse, lower socioeconomic status population.
- To identify factors influencing paternal engagement during bereavement.
Main Methods:
- Retrospective chart review of 722 perinatal death cases (miscarriage, stillbirth, neonatal death ≤12 hours).
- Indicators of paternal involvement included presence at birth, holding the baby, and attending follow-up appointments.
- Data collected from Shands Hospital at the University of Florida (July 1978–April 1991).
Main Results:
- Over half of fathers attended the birth; a quarter held their baby; one-fifth attended follow-up appointments.
- Paternal-maternal cohabitation was the strongest predictor of involvement.
- Race, marital status, employment, and gestational age also influenced paternal presence and engagement.
Conclusions:
- Fathers experience significant perinatal grief, necessitating their inclusion in bereavement counseling.
- Further research is needed to fully understand and support paternal involvement after perinatal loss.
- Clinical interventions should consider socioeconomic and demographic factors influencing paternal engagement.
Abstract:
This study describes paternal involvement after perinatal death in a large, mostly minority, lower socioeconomic status sample. Paternal presence at birth, holding the baby, and presence at a follow-up appointment were the indicators of paternal involvement. Perinatal death was defined as miscarriage, stillbirth, or neonatal death within 12 hours of birth. Data were collected from a retrospective chart review under the auspices of the Perinatal Mortality Counseling Program at Shands Hospital at the University of Florida, a tertiary care referral center in north central Florida. The sample included 722 cases of perinatal death between July 1978 and April 1991. The results indicated that many fathers experienced perinatal grief. More than half attended the birth, a quarter chose to hold their baby, and one fifth returned with the mother to follow-up appointments. Paternal-maternal cohabitation was the variable most predictive of the fathers' involvement after perinatal death. Race was predictive of the father being present at birth and at the follow-up visit, with white fathers more likely to be present than black fathers. Married fathers and those employed in a professional or manual labor occupation were more likely to be present at the birth than fathers who were unemployed, students, incarcerated, or in the military. Gestational age was predictive of the father holding the baby, with the likelihood increasing 1.04 times for each week of increase in gestational age. This study supports the need to include fathers in grief counseling, and the further investigation of the involvement of fathers when a perinatal death occurs.