The six themes were: (I) gender roles, (II) antenatal involvement, (III) care costs and delivery choices, (IV) need to be informed, (V) dealing with emotions, and (VI) dealing with the delivery day. Themes (V) (dealing with emotions) and (VI) (dealing with the delivery day) have two sub-themes each, that highlight first-time father’s accounts regarding their emotions and perceptions about the delivery day.
I. Gender roles
Overall, the first-time fathers emphasised 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 as all men should, I give her money for food, I provide money to go to the health centre”. (H-SS 41)
Here, the first-time fathers reported feeling satisfied that their wives are well taken care of because they were providing financially. Some first-time fathers 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 do not expect my wife to bring money; it is 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, some first-time fathers willingly shared domestic responsibilities with their spouses within the confines of their homes alone. These first-time fathers were willing to take up extra duties to make their spouses feel loved and happy in pregnancy. Less common were accounts of first-time fathers ready to be more involved in hospital settings despite the risk of ridicule by their peers. This category of fathers admitted to being more concerned with the wellbeing of their spouses even if they were perceived as ‘weak men’ in the eyes of society.
II. Antenatal involvement.
Antenatal involvement here refers to men accompanying their spouses to health settings for prenatal appointments. One reoccurring discussion with first-time fathers during the interviews addressed the issue of antenatal attendance. Evident in the male partner’s descriptions were conflicting views of how men could be involved in prenatal care. There were men in urban settings, who spoke about their willingness to participate occasionally in hospital settings but could not because of their jobs. Several of such first-time fathers acknowledged dropping their spouses off for their antenatal appointments and often calling 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 rural settings, more first-time fathers occasionally attended antenatal care appointments with their spouses than in urban environments. 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. Also, most of the men in this category, acknowledged several motivations to participate in antenatal sessions which were 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 do not 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, some first-time fathers believed that antenatal care attendance was strictly for the pregnant woman. Among these, where first-time fathers 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 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).
III. Care costs and delivery choices
Occasionally first-time fathers admitted their concerns over costs, especially those associated with delivery. There was a common desire among first-time fathers to know about the cost of care for vaginal and caesarean births in both public and private hospital settings. The knowledge about the financial cost of care was necessary for most to know their options and to compare prices, before deciding on which health setting to choose for delivery. In most cases, most first-time fathers admitted that the availability of funds influenced the choice of a delivery place.
“You know money plays a huge role in deciding where your wife is going to deliver” (FMC,001).
“As 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 is 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, some first-time fathers 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 first-time fathers acknowledged the freedom to choose quality safe services without worrying over costs of care on the day of delivery. Besides, 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. The participant stated, “When my wife’s pregnancy was confirmed, I started making plans to fly her abroad. It is a costly venture, but you are sure she is in good hand. Later, when the child grows up, he can attend a proper school there too” (PP-003).
IV. Need to be informed
Familiar across the first-time fathers’ accounts was the feeling of ignorance concerning pregnancy and childbirth because they lacked experience. The first-time fathers admitted to tackling their inexperiences in a ‘manly’ way, by seeking the opinions of people they trust or sending their spouses with questions to the health centres. Often this form of support came from a few close friends and neighbours, family members, experienced mothers, experienced colleagues, and most especially from spiritual leaders. Some first-time fathers 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).
While some first-time fathers acknowledged their principal support from their relationships and networks; others preferred not to discuss this 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 first-time fathers 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 books, and I will probably go to the hospital only when there is an emergency or sickness” (H-FMC-005).
V. Dealing with emotions
V(i) Feeling overwhelmed, worried and scared
First-time fathers 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 first-time fathers spoke about the unpleasantness of their spouse’s changing food cravings. In his own words, a male partner said:
“Managing her food cravings was a horrible experience for me... One late evening, she demanded Pepsi, on arrival, she demanded 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, some first-time fathers 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”. He said that he often chose to hang out with his friends to keep his sanity than stay home with his spouse at such times.
V(ii) Being strong for their spouses
‘Being strong for their spouses’ refers to first-time fathers need to be the strong and supportive one despite their feelings. Several first-time fathers relayed peculiar situations where they had to be in control in other for their spouses to feel secure. While these men had their own emotions to deal with, they admitted to masking these emotions in a masculine appearance 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 first-time fathers talked about some discussions they had with other men in their networks, which allowed them 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 problems.
VI. Dealing with delivery day
V(i) To be present or not
During the interviews, first-time fathers shared their thoughts about their experiences on the day of delivery. It was clear from their responses that being present in the delivery room was not a popular opinion. Most first-time fathers believed that the maternity ward is a strictly feminine environment, and some others were afraid of witnessing the delivery experience. A few first-time fathers acknowledged their willingness to be present but could not because the choice to be involved was not given to them by the hospitals. Here are some comments
“they will not allow you in; they told me 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 I 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).
Although absent in health settings; some first-time fathers mentioned how they ensured that an experienced woman (examples: sisters, mothers or mothers in law) was always present. Her role was to assist their spouses during delivery and afterwards for at least three weeks. One participant stated,
“Towards the delivery period, all I need to do is to arrange my mother or hers to come and hang around” (H-FMC-005).
Other supportive activities mentioned by the first-time fathers during delivery were offering spiritual support, running errands for their spouses, and signing relevant documents when needed.
V (ii) Social support in health settings
The accounts of first-time fathers, especially in urban locations, indicated how the presence of a friend working in the hospital could facilitate access to care, especially if labour occurred at night. These first-time fathers shared instances of pregnant women being neglected or maltreated in the hospital in the absence of this type of support.
“My friend had a bad experience at the public hospital. He got there past 10 pm in the night; the doctors had deserted, the nurses were busy chatting and gossiping, his wife was in labour. He 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).