Being together and separate: a grounded theory study of the experience of first-time fathers during childbirth

This grounded theory study explored the experience of first-time fathers during the time of birth with the aim of developing a conceptual framework to explain how they managed the process. In sharp contrast to the recognised maternity care practices of a generation ago, most fathers in New Zealand are currently expected to be present when their babies are born. There has been little New Zealand-based research to determine what the birth experience is like for fathers. Because contemporary fathers are expected to fulfil a major role in the care and support of mother and baby from pregnancy through to new parenthood and beyond, exploring the experience of fathers during birth is a way to understand part of the childbirth process from the perspective of husbands or partners in the developing new family. Eleven first-time fathers from the North Island of New Zealand participated in antenatal and postnatal interviews that were conducted over a 20-month period. Transcripts were analysed using grounded theory processes of coding, constant comparative analysis and theoretical sampling, and a conceptual diagram was developed to explain the core process which was discovered, namely, 'being together and separate'. It emerged that fathers could feel separate from the birth process, together with the birth process and at times they could experience both positions concurrently. Influences on participants' experience of 'being together and separate' included social expectations, the level of control that participants wished to have during the birth and the ways in which fathers were drawn in or excluded by wives/partners and maternity caregivers. The ways in which maternity caregivers responded to the involvement of fathers in the birth process was found to have a significant impact on the participants' experience of the process. Implications for the practice of maternity caregivers and childbirth educators are the importance of assessing each father's needs antenatally and of assisting them to develop strategies for participating comfortably in the birth experience. The relevance of supporting fathers to participate in the childbirth process at a level that promotes positive birth outcomes for the entire expectant family is demonstrated, and some practical strategies are provided that can assist health professionals and others to support fathers