Two investigations into fatherhood: paternal postpartum depression and paternal substance use

Abstract

Historically, in many areas of research examining birth and parenthood the role of the mother often took precedence over the role of the father. This may be because, within a traditional family system, the father took the role of the provider, while the mother was responsible for child care and household. Societal and cultural changes over the past few decades have highlighted the importance and competence of fathers in less traditional roles and scientific research is currently aiming to fill the gap of knowledge pertaining to fatherhood. One field of research that has traditionally been neglected in fathers is postpartum depression (PPD), even though prevalence rates for fathers were estimated to be almost as high as for mothers. Research into the risk factors for paternal PPD has only grown substantially within the past two decades. The first part of this thesis provides a systematic review of the available evidence for psychosocial risk factors in the development of paternal PPD as examined by longitudinal research designs. Results of the review indicated that there was a general lack of high quality research, but there was some evidence for higher risk of PPD if fathers experienced disconfirmed expectations of parenting demands, low parenting efficacy, low relationship satisfaction, concerns/anxiety about the birth, disagreement about pregnancy intendedness, low prenatal life satisfaction and stress, and high role strain. The results were discussed in the context of implications for antenatal interventions for fathers. The second part of this thesis was concerned with another neglected group of fathers – fathers who were addicted to opiate drugs. While there is a large research base for the risk to children exposed to parental substance use, fathers’ views on their parenting role and the cross-generational transmission of risk of child maltreatment and substance use has only partially been examined. Using Interpretative Phenomenological Analysis with a small sample of opiate-using fathers (N = 6), it was found that fathers experienced dichotomy in their father role. Their addiction caused them to be ‘disabled’ in the ir father role, characterised by selfishness, abandonment and an inability to meet their children’s needs. In contrast, the ‘Able Father’ came to light during stable periods of prescribed opiates or abstinence, and he was an involved, hands-on parent, sensitive to the child’s needs and motivated to repair the ill-effects of being ‘disabled’ by addiction. By ‘Connecting the Dots’ with their own upbringing, fathers were motivated to be better fathers than their own fathers, but they only had limited insight into the risk the ir ‘disabled’ parenting posed for their own children. The findings suggest that harnessing fathers’ motivation to be better fathers may be a useful asset in drug treatment and parenting interventions. Interventions aimed at increasing reflective functioning may contribute to positive outcomes for substance-using parents at the same time as reducing risk to their children, but more evidence is needed.