Six major themes were identified pertaining to male partners experiences and needs in their involvement in pregnancy and childbirth: gender roles, antenatal involvement, care costs and delivery choices, need to be informed, dealing with emotions, and dealing with delivery day. From the theme dealing with emotions and dealing with delivery day, sub themes emerged highlighting male partners experiences during the pregnancy and delivery period.
Overall, the male partners placed emphasis on the primary role expected of the traditional Igbo man which is to be the provider of his family. As illustrated by an expectant father,
‘I do my part like all men should, I give her money for food, I provide money to go to health centre’. (H-SS 41)
Here, the male partners reported feeling satisfied that their wives are well taken care of, because they ensure they are provided for. Some male partners strongly affirmed that both men and women have culturally defined roles that remain the same whether a woman is pregnant or not. One male partner expressed this by saying: ‘In the family everybody has his or her role. I don’t expect my wife to bring money, it’s not her duty to wash the car or change the light bulb. It is the duty of the man… when I come home, I expect her to go and prepare food’. In contrast, there were male partners who willingly shared domestic responsibilities with their spouses within the confines of their homes alone. These male partners were willing to take up extra responsibilities because they wanted to make their spouses feel loved and happy in pregnancy. Less common were reports of participants who were willing to go beyond the norm to be supportive despite the risk of ridicule by their peers. These male partners admitted to being more concerned with the wellbeing of their spouses even if they were perceived as ‘weak men’ in the eyes of the society.
Antenatal involvement here refers to men accompanying their spouses to health settings for antenatal appointments. One reoccurring discussion with male partners during the interviews addressed the issue of antenatal attendance. Evident in the male partners descriptions were conflicting views of how men could be involved in antenatal care. There were men in the urban settings, who spoke about their willingness to participate occasionally in hospital settings but could not because of their jobs. Several of such male partners acknowledged dropping their spouses off for their antenatal appointments and calling often to check up on their spouses. One male partner said that he made up for his absence during the day by coming home early and taking exercise walks with his wife most evenings after work. In the rural settings, more male partners occasionally attended antenatal care appointments with their spouses than in the urban settings. Most of these men were local transporters, owners of local businesses or farmers who acknowledged their ability to attend these sessions because they had flexible work hours. In addition, most of the men in this category, acknowledged several motivations to attend antenatal sessions which was mainly to know about pregnancy and to make their spouses happy.
We visit the clinic together because we do get information about a lot of things. Being here with her in the hospital does not mean that I don’t have work to do now, but I want to make her feel happy. Seeing me around her makes her feel like she is not the only one carrying the pregnancy. (AM H1)
In contrast, there were male partners who believed that antenatal care attendance was strictly for the pregnant woman. Among these, where male partners who provided money for their spouses to register in a health setting and let their spouses manage the pregnancy with the help of other experienced women. One participant’s response regarding this was:
‘My wife is a very matured person in mind, she handled the pregnancy well. She had adults around her, her friends, our mothers and her sisters. She did all the consultations by herself. Sometimes, she told me about them, only if it had to do with money.’ (H-FMC 9)
- Care costs and delivery choices
Occasionally male partners admitted their concerns over costs especially those associated with delivery. There was a common desire among male partners to know about the cost of care for normal and caesarean births in both public and private hospital settings. Considering that hospitals require that payments are made before care is given, the knowledge about cost was important for most to know their options and to compare costs, before deciding on which health setting to choose for delivery. In most cases, the choice of a delivery place as acknowledged by most male partners was strongly influenced by the availability of funds.
‘You know money plays a very big role in deciding where your wife is going to deliver.’ (FMC,001)
‘Like I told you before, I had lost my job and we could not even afford to go to a hospital…. we had this maternity close to our home. That’s where my wife registered…. The midwife understood our financial condition and took care of my wife properly from pregnancy until she gave birth’. (H-FMC–002)
On the other hand, there were male partners who had no worries about funding care costs. Among these were civil servants working with the government who had opted for the national health insurance scheme (NHIS). These male partners acknowledged the freedom to choose quality safe services without worrying over costs of care on the day of delivery.In addition, an uncommon conversation with a participant revealed a preference for an affordable health facility in a foreign country because he desired a safe birth and an opportunity to give his unborn child a good start in life.Here is what he said, ‘When my wife’s pregnancy was confirmed, I started making plans to fly her abroad. It is a very expensive venture, but you are sure she is in good hands.…. …. later when he grows up, he can attend a proper school there too.
Common across the male partners accounts was the feeling of ignorance concerning pregnancy and childbirth due to inexperience. Most expressed the need to be informed. Although the male partners expressed their ignorance on what to expect during pregnancy and childbirth, they preferred to handle this in a 'manly’ way by quietly seeking the opinions of people they trust or send their spouses with questions to the health centres. Often this support came from few close friends and neighbours, family members, experienced mothers, experienced colleagues, and most especially from spiritual leaders. Some male partners shared stories from the experiences of others and related these stories to their situations.
‘I heard all sorts of stories about delivery. You have to pay for everything before they even touch your pregnant wife, no one will attend to you without money……… I just knew I had to start saving money. (H-SS–015)
‘You know my brother’s experience taught me a lot of things about pregnancy. You cannot give a pregnant woman medication no matter what. Now, if she complains about something as little as fever, we go to the hospital’ (HSS–039)
Whilst some male partners acknowledged their principal support from their relationships and networks, there were others who preferred not to discuss with people in their support networks. They admitted to reading books, surfing the internet and speaking only with health professionals for their information needs. Among these were male partners who desired to keep the pregnancy news a secret. One male partner said,
‘You know that this Igbo culture has made it that you don’t go about telling people that your wife is pregnant. For me too, I didn’t tell people. I was building information from the internet and from books and I will probably go to the hospital only when there is emergency or sickness’ (H-FMC–005)
Feeling overwhelmed, worried and scared
Male partners voiced their feelings on how the experiences of their wives during the pregnancy and delivery affected them. Some comments such as ‘the feelings this process created in me was overwhelming’, ‘I became very worried’, ‘I was so scared’ reflected this. One participant feared so much for the life of his pregnant wife that he took his wife to see a doctor for an abortion.
‘Honestly, I did not know that a pregnant woman can be sick and vomit continuously like that for days. After preparing delicious foods, she eats and then vomits everything. She sometimes would vomit like she is going to die. One day I was so afraid that I told her let’s go to the hospital and terminate the baby……. I told the doctor clearly that I wanted an abortion. The doctor smiled and started educating me’(H-SS–011)
Also, some male partners spoke about the unpleasantness of their spouse’s changing food cravings. In his own words, a male partner said:
‘Managing her cravings was a horrible experience for me…. One late evening, she demanded for Pepsi, on arrival, she demanded for malt. I had to go out again to buy that. Sometimes after cooking, she will not feel like eating anymore, she will ask me to find one roadside food for her. (H-FMC–005)
Then, there were male partners who felt differently about being around their pregnant spouses. These fathers described the emotional mood swings their spouses experienced and how irritable that made them feel. One partner admitted that ‘when a woman feels this way she should be left alone’. For him, on days like that, he preferred to go out in the evening with his friends than stay at home to keep his sanity.
Being strong for their spouses
This refers to male partners need to be strong and supportive to their spouses despite their own feelings. Several male partners relayed peculiar situations where they had to be in control in other for their spouses to feel secure. Even though these men had to deal with the emotions of their own, they admitted to masking their emotions in the masculine appearances of strength and courage as is expected of men in these settings.
‘She made me worry a lot when I look at her, I say every woman can give birth, but I don’t know if she can because she was so fragile in my eyes.…. I had to be the strong one. (H-SS 12)
Some male partners spoke about discussions they had with other men in their networks, which gave them the opportunity to see the experiences of other men in the light of their daily struggles. For many, having these types of discussions in their workplace or among ‘hangout’ associates, prepared them to tackle their own problems.
- Dealing with delivery day
To be present or not
During the interviews, male partners shared their thoughts about their experiences on the day of delivery. It was clear from their responses, that been present in the delivery room was not a popular opinion. Most male partners believed that the maternity ward is a strictly feminine environment, while some others were afraid of witnessing the delivery experience. A few male partners acknowledged their willingness to be present but could not because they were not given the choice to be present or involved. Here are some comments
‘they will not allow you in; I was told to stay outside. (H-LGA–1)
‘From my experience, I think all men should be in there. But you know all men will not have the mind to be in the delivery room, for those who can withstand these things, I will encourage them to attend’. (H-FMC–6)
‘I did not want to go into that room at all. I prefer to stay outside and hear the news from outside. I don’t think it will make any difference if am there or not. Some friends told me that if I go in there, I should not be surprised if my woman starts to beat me and kick me because I am the cause of her pain. (H-FMC–4)
To cover for their absence during delivery, the male partners said they ensured that an experienced woman they could trust like their sisters, mothers or mothers in law was present to help their spouses prepare for delivery and be present with their spouses during delivery. Here is what one male partner said, ‘Towards the delivery period, all I need to do is to arrange my mother or hers to come and hang around’. (H-FMC–005) The male partners referred to some activities they were involved in hospital settings such as: offering spiritual support, empathizing with their spouses, running errands, and for some they were needed to sign papers for surgeries to be performed.
Social support in health settings
The male partner’s stories especially in urban locations indicated how the presence of a friend working in the hospital or a health personnel known to them personally was important for their spouses to receive care faster especially if labour occurs at night. Some male partners voiced their feeling that their spouses might be neglected or maltreated if they do not know someone in the hospital. One male partner would rather go to a known local midwife than go to a hospital where they knew no one.
‘My friend had a bad experience at the public hospital, he got there past 10pm in the night, the doctors had deserted, the nurses were busy chatting and gossiping, his wife was in labour. He really caused a scene before they could attend to him. He told me, it had to take him calling a doctor he knew before he could receive the appropriate assistance that night. She nearly lost her life due to their negligence’. (HSS–015)