Men's adjustment to fatherhood: implications for obstetric health care.

OBJECTIVE: To assess factors affecting first-time fathers' transition to parenthood.

DESIGN: A longitudinal repeated measures study in which participants were interviewed in mid-pregnancy and completed assessments in late pregnancy, in early postpartum, and at 4 months postpartum. SELLING AND PARTICIPANTS: Two hundred twenty-five first-time fathers were recruited from a major obstetric hospital in Melbourne, Victoria, from 1995 to 1998, via their partners.

MAIN OUTCOME MEASURES: Men were seen separately from their spouses, and questionnaires assessing parity history, social support, marital satisfaction, anger, anxiety, and gender role stress were completed at each time. Prenatal and postnatal distress were measured by the Edinburgh Postnatal Depression Scale.

RESULTS: Men's peak period of distress was at the first assessment in pregnancy, where there was an overrepresentation of younger men, who were employed part-time and in shorter relationships. For most of the men, their anxieties decreased steadily postpartum. Lower relationship satisfaction was associated with distress, as was gender role stress, both antenatally and postpartum. Distress was also seen to affect men's attachment to their infants.

CONCLUSIONS: Although most men deal effectively with the transition to fatherhood, a small group of distressed men may have continued problems in their role as a parent and partner. If more attention can be paid to their anxieties antenatally, it might benefit the men, their partners, and their infants.