The transformation to fatherhood can be a demanding life-phase, less extensively studied than motherhood, but emerging as a significant research area (Goldstein et al., 2020; Fletcher, 2011).
It is postulated that the physical, emotional and social wellbeing of men can be compromised during this time by deeply constructed traditional male gender roles of stoicism, emotional repression and stymied health-seeking behaviours. Evidence suggests that around 10% of men suffer from perinatal depressive disorders which can also negatively impact the infant’s development and partner relationships (Fletcher et al., 2011; Fletcher et al., 2018). SMS4dads is a text-based intervention that aims to support men through this time period, from 16 weeks pregnancy to 48 weeks post-birth, by delivering clear, informative and relevant messages to the participants mobile phone (Fletcher et al., 2016; Redfern et al., 2014).
The aim is to emphasise the salience of fathering within three domains of self-care, infant bonding and positive partnering using primary and secondary prevention strategies.
The program has been evaluated as an acceptable conduit to provide dads-to-be and new dads with timely, unobtrusive and beneficial advice and information using a feasible and scalable process (Fletcher et al., 2017a; Fletcher et al., 2017b). However, the corpus of 184 evidence-based messages is mapped chronologically, dependent on uneventful progress through pregnancy, birth and normal development of the baby at home. Unfortunately, for some families the prescribed context is different, and the frame of reference is thus discordant. An equitable public health approach is required to meet the needs of these fathers.
The unexpected premature arrival of a baby, defined as less than 37 weeks of gestation, occurs in 8.7% of births in Australia (AIHW 2020).
This scenario can further inhibit a safe transition to fatherhood due to increased levels of stress, disempowerment in the hospital environment and mitigation of infant care opportunity. Qualitative research has further unpacked these factors and a rapid systematic review by Fletcher et al. (n.d.) deduced that proximity, vulnerability, communication and isolation are themes that need to be addressed with respect to fathers.
Moreover, maternally biased health services and a general lack of father-inclusive practices are posited as underpinning the marginalisation that they experience (Fletcher et al., 2006).
SMS4dads has the capability and capacity to fill this service void by delivering a targeted set of messages to the group of new dads (Fletcher et al. 2018). The messages would facilitate the reframing of the roles appropriated to these men, so they feel more confident in the neonatal intensive care unit and have access to a suite of coping skills (Fletcher et al., 2019).
This paper describes a positivist approach to establish a useful, supportive and validated bank of messages that could be sensitively delivered to dads whose babies are born prematurely and are admitted to a neonatal intensive care unit (May & Fletcher, 2017).
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