Background to the study
Method
Steps Guiding the Review | Study Procedure |
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1. Identifying the research question | What literature exists that considers the father’s experience within the context of a high-risk pregnancy? |
2. Identifying relevant studies | The search strategy included a review of the EBSCOhost metadatabase, specifically the following nine databases were screened: Academic Search Complete; APA PsychArticles; CINAHL Plus with full-text; Health Source: Nursing/Academic Edition; MasterFILE Premier; MasterFILE Reference eBook Collection; MEDLINE; SocINDEX with full-text; and eBook Collection To further guide the review the following search terms were used: “Father” OR “Dad” OR “Paternal” AND “High risk pregnancy” OR “Complicated pregnancy” OR “Medical high-risk pregnancy” OR “Birth complications” OR “Pregnancy complications” There were no limitations in terms of the time period in order to fully provide a synthesis of the landscape of available literature. However, once all Boolean phrases were included in the Ebscohost metadatabase, the search results indicated a date period of 1948–2022 The study adopted a four-pronged approach in the screening and review of the various literature. The initial search which included a review of all titles, followed by a review of all the abstracts, a review of the full-text articles against the predetermined inclusion criteria and finally a reference mining review of the included articles |
3. Study selection | Throughout each stage of the review, all three authors applied the inclusion criteria to determine the appropriateness of the various titles, abstracts and full-texts in addressing the aim of the study The inclusion criteria: •Studies that focus on fatherhood and high-risk pregnancy •Studies that include both parents within the context of high-risk pregnancy (data on fathers was extracted) •Peer-reviewed studies published in English with full-text access •There were no limitations placed on the specific cause of the high-risk pregnancy •No limitations were placed on study designs The exclusion criteria: •Studies that focus on absent fathers •Studies that did not specifically focus on high-risk pregnancy •Studies that reported on mothers’ perceptions of father’s experiences |
4. Charting the data | The data extraction was completed using Microsoft Excel with the following headings used as a guide: Authors; Aim of the Study; Research Context; Research Design; Sample Characteristics; Key Findings (see Table 3) Furthermore, the Preferred Reporting Items for Systematic Reviews as well as the Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to delineate the review process (see Fig. 1) |
5. Collating, summarising and reporting the results | Narrative synthesis was used to collate, summarise and report the results of the study. This study adopted the last three steps in conducting a narrative synthesis specifically: developing a preliminary synthesis; exploring the relationships within and between studies; and finally assessing the robustness of the synthesis [17]. The second and third author conducted the synthesis as part of their thesis. This synthesis was repeated by the first author as a means of comparing and qualifying differences. These differences were discussed collectively and once an agreement was established the data was reported |
Ethics considerations
Results
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2190 hits were retrieved by using the Boolean phrases above. 149 duplicates were removed and 2041 titles were reviewed against the inclusion criteria.
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2007 articles were excluded and 34 article abstracts were reviewed of which 15 did not meet the stipulated inclusion criteria.
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19 articles were scrutinised in the full-text review phase and 7 were excluded.
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Finally, reference mining of all 12 articles was conducted and 2 additional articles met the inclusion criteria.
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A second round of reference mining took place on the 2 additional articles included and a third study was deemed appropriate for inclusion. This final study was also subjected to a review of the references but no additional articles were included.
Date of search | Keyword search | No. of publications retrieved | Database |
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11 February 2022 | “Father” OR “Dad” OR “Paternal” AND “High risk pregnancy” OR “Complicated pregnancy” OR “Medical high-risk pregnancy” OR “Birth complications” OR “Pregnancy complications” | 896 | Academic Search Complete |
11 February 2022 | “Father” OR “Dad” OR “Paternal” AND “High risk pregnancy” OR “Complicated pregnancy” OR “Medical high-risk pregnancy” OR “Birth complications” OR “Pregnancy complications” | 689 | SocINDEX with Full Text |
11 February 2022 | “Father” OR “Dad” OR “Paternal” AND “High risk pregnancy” OR “Complicated pregnancy” OR “Medical high-risk pregnancy” OR “Birth complications” OR “Pregnancy complications” | 383 | CINAHL Plus with Full Text |
11 February 2022 | “Father” OR “Dad” OR “Paternal” AND “High risk pregnancy” OR “Complicated pregnancy” OR “Medical high-risk pregnancy” OR “Birth complications” OR “Pregnancy complications” | 222 | APA PsycArticles |
Characteristics of the included studies
Authors | Year | Country | Research Aim | Research Design | Data Collection Methods | Sample Characteristics | Related Themes | |
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1 | Koppel & Kaiser [18] | 2001 | Germany | To examine the situation of fathers with a newborn child on an intensive care unit | Qualitative approach | In-depth individual interviews | 18 Fathers in NICU | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers Redefining the role of ‘father’ after experiencing high-risk pregnancy Focus on fathers: Recommendations for support during high-risk pregnancies |
2 | Moore et al. [19] | 2019 | United Kingdom | To explore the discursive construction and social actions achieved by accounts given by men following a birth in which the mother developed life-threatening complications | Qualitative approach | Individual interviews, Secondary data analysis | 4 Fathers | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers |
3 | McCain & Deatrick [20] | 1994 | Ohio, America | To describe the experience of high-risk pregnancy from the perspectives of mothers and fathers | Qualitative approach | Individual interviews, Secondary data analysis | 21 Parents (12 mothers and 9 fathers) | The impact of high-risk pregnancies on fathers Redefining the role of ‘father’ after experiencing high-risk pregnancy |
4 | Nansubuga & Ayiga [21] | 2015 | Rakai District, Central Uganda | The study examined the roles played by men after the onset of maternal near miss complications in Uganda | Both qualitative and quantitative (retrospective, cross-sectional study) | Narratives and in-depth individual interviews | 40 maternal near-misses and 10 partners | Redefining the role of ‘father’ after experiencing high-risk pregnancy |
5 | Hsieh et al. [22] | 2006 | Southern Taiwan | To evaluate the experiences of first-time expectant fathers with a tocolyzed spouse | Qualitative approach: Descriptive phenomenological design | In-depth individual interviews | 6 first-time fathers | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers Focus on fathers: Recommendations for support during high-risk pregnancies |
6 | Aarnio et al. [23] | 2018 | Mangochi district, Malawi | To provide information about husbands’ role in decision-making and healthcare seeking in cases of pregnancy complications | A qualitative interview study | In-depth individual interviews | 24 individuals, with 12 of them being the fathers and the other 12 the mothers | The father versus the healthcare professional and the hospital environment Redefining the role of ‘father’ after experiencing high-risk pregnancy Focus on fathers: Recommendations for support during high-risk pregnancies |
7 | Cole et al. [24] | 2016 | Philadelphia, Pennsylvania | To describe the incidence of psychological distress (symptoms of post-traumatic stress and de pression as endorsed on objective measures) among expectant parents, shortly after they received the diagnostic confirmation of a fetal anomaly at a high-risk fetal centre | A 2-year retrospective medical chart review | CFDT mental health screening tool and the Revised Impact of Events Scale (IES-R) | 1820 participants were screened, with 788 being expectant fathers and 1032 expectant mothers | The impact of high-risk pregnancies on fathers |
8 | Linberg & Engström [25] | 2013 | Sweden | The objective of the study was to describe new fathers’ experiences of care in relation to complicated childbirth | A qualitative thematic content analysis | In-depth individual interviews | 8 fathers | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers Focus on fathers: Recommendations for support during high-risk pregnancies |
9 | Maloni & Ponder [26] | 1997 | United States | To describe the problems and stress of men whose pregnant partners are on bed rest and the assistance they received | Cross-sectional survey design (descriptive retrospective approach) | The Paternal Bed Rest Questionnaire (PBRQ) of open-ended questions | 59 Caucasian men of partners with prescribed antepartum bed rest | The impact of high-risk pregnancies on fathers Redefining the role of ‘father’ after experiencing high-risk pregnancy Focus on fathers: Recommendations for support during high-risk pregnancies |
10 | Patel et al. [27] | 2018 | Sweden | To explore the experiences of healthcare in fathers whose partner was suffering from peripartum cardiomyopathy | Qualitative research design | In-depth individual interviews | 14 fathers of which 8 are first-time fathers with partners presenting symptoms of peripartum cardiomyopathy (PPCM) | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers Redefining the role of ‘father’ after experiencing high-risk pregnancy Focus on fathers: Recommendations for support during high-risk pregnancies |
11 | Patel et al. [28] | 2019 | Sweden | To learn more about fathers’ reactions over their partner’s diagnosis of peripartum cardiomyopathy | Qualitative research design | In-depth individual interviews | 14 fathers of partners with (PPCM) | The impact of high-risk pregnancies on fathers Redefining the role of ‘father’ after experiencing high-risk pregnancy Focus on fathers: Recommendations for support during high-risk pregnancies |
12 | Tanasirijiranont et al. [6] | 2019 | Northern Thailand | The research question was: “What is going on in the process of becoming a first-time father among Thais whose wives have a high-risk pregnancy?” | Grounded Theory design | In-depth individual interviews | 23 Thai men informants | The impact of high-risk pregnancies on fathers Redefining the role of ‘father’ after experiencing high-risk pregnancy Focus on fathers: Recommendations for support during high-risk pregnancies |
13 | May [29] | 1994 | United States; Southern State | To describe the impact on expectant fathers of their partners' activity-restricted pregnancies | Qualitative | Phase 1: semi-structured interview Phase 2: semi-structured focus group discussion | Phase 1: 15 Fathers 2 weeks after partners restriction and Phase 2: 15 fathers 1–2 years after partners activity-restricted pregnancies | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers Redefining the role of ‘father’ after experiencing high-risk pregnancy |
14 | Kaye et al. [30] | 2014 | Uganda | To gain a deeper understanding of their experiences of male involvement in their partners' healthcare during pregnancy and childbirth | Qualitative | In-depth individual interviews | 16 Fathers whose wives were admitted to hospital for severe obstetric complications | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers Focus on fathers: Recommendations for support during high-risk pregnancies |
15 | Hinton et al. [31] | 2014 | UK | To explore the impact of near-miss obstetric emergency, focusing particularly on partners | Qualitative | In-depth individual interviews | 35 women, 10 male partners and 1 lesbian partner | The father versus the healthcare professional and the hospital environment The impact of high-risk pregnancies on fathers Focus on fathers: Recommendations for support during high-risk pregnancies |