By Candice J.T. Simon, MPH, Program Manager, Workforce Development and Capacity Building, Association of Maternal & Child Health Programs (AMCHP)

Introduction

Few resources are available to help fathers cope with losing a child or partner during childbirth. Even when a mother and father experience grief and loss when their baby dies during childbirth, fathers are expected to suppress their grief, be strong for the mothers, and support them during the loss. Western culture tends to influence how masculinity should look in men, and traditional male gender roles limit the emotions men should express. Not only that, in Western culture, when men seek help, they are often viewed as weak. Fathers are instrumental in caring for their children, yet society often doesn’t recognize the role fathers play without attaching their involvement in sports.

Background

Grief is challenging and overwhelming, and losing a partner or child has a strong impact on a father’s life. Coping with grief is a highly personal experience. When fathers have limited resources or support systems, grief becomes even more challenging to manage. In addition, the number of practical responsibilities, such as caring for other children, managing household tasks, or navigating legal and financial matters, is overwhelming.

Many fathers have been conditioned to uphold societal expectations to suppress their emotions or risk feeling stigmatized. Shame and stigma add more challenges to their ability to grieve properly. Men are often expected to be tough, apathetic, and suppress their emotions. As a result, fathers end up feeling isolated and unsupported. If they express their grief openly, they can even feel judged. Limited resources and a lack of understanding from friends, family, or colleagues can exacerbate these challenges.

The workplace does not always accommodate maternity leave and even less often does it cover paternal leave. Fathers then find it difficult to try to justify to an employer their need for time off to grieve the loss of a child, especially when the loss is due to miscarriage or stillbirth. Research has shown that due to the systemic issues and policies regarding bereavement, leave is not given the same for men and women. Some fathers have reported less access to paid leave following their loss than women (Weaver-Hightower, 2012). Fathers have reported returning to work soon after pregnancy loss or neonatal death, and bereavement leave policies may affect grief outcomes.

Men may also experience more difficulty than women in seeking or accepting help for mental health concerns and grief (Addis & Mahalik, 2003; Doka & Martin, 1998; Seidler et al., 2016). The emotional support fathers receive should be tailored to their needs and desires. Although some men may find support groups and individual counseling helpful, others may thrive from informal support options. In a study conducted in Australia, the participants who accessed support services were largely satisfied; others were unaware of services and perceived that appropriate support options were lacking (Obst & Due, 2019). This experience is very similar for men here in the United States. Men may have been offered support, but the support was not in a format that spoke to their needs during their loss—mainly because they were preoccupied with caring for their partner, tending to their other children, or mentally avoiding their internal grief.

Implications

Losing a child or spouse is a profoundly traumatic event that can have long-lasting negative emotional and mental health effects. Accordingly, fathers with limited grief support resources may be at a higher risk of developing or exacerbating existing mental health conditions such as depression and anxiety. If fathers cannot receive support for their mental health and emotional needs, they are also likely to encounter difficulties in their relationships with family members and friends. Limited access to grief support may also hinder a father’s capacity to help support his surviving children through their grief process while he effectively addresses his emotional needs. When a father’s emotional needs aren’t met, it can create additional challenges for the father and the children in processing grief.

Recommendations

• Mental health professionals must engage fathers so they can access grief support services after losing a child or partner. Engaging fathers can be a delicate process that requires sensitivity and understanding.
• Public health professionals must ensure that grief support services are designed with fathers in mind. In other words, the design of grief support resources must be intentional and consider fathers’ unique experiences and needs.
• Fathers who have experienced losses of a child or partner and other dads who want to provide support can give valuable input and good information on the best ways to provide appropriate and practical grief support. Their feedback can help ensure that the services we provide are relevant, effective, and meaningful for fathers’ unique needs, acknowledging that fathers may have distinct ways of grieving and seeking support. Resources and services need to meet fathers where they are and be offered through mechanisms that they prefer to access services.
• Professionals must provide resources and services that address fathers’ concerns and help fathers cope with loss while they maintain their roles as fathers and partners.
• Professionals must educate community members, healthcare professionals, and other stakeholders about the unique grief experiences of fathers.
• A variety of platforms should be used for outreach to fathers, including social media, online forums, support groups, local community centers, health care providers, and workplaces.
• Ongoing collaboration should be established among professionals and organizations that work closely with fathers and with groups focused on fathers’ well-being. This partnership should include pediatricians, family physicians, schools, organizations, or groups providing bereavement support or mental health services. Working together creates a more comprehensive and integrated support network for fathers than working in silos.

Finally, we must recognize that fathers face practical challenges while they are grieving, such as managing household responsibilities or childcare. To alleviate some of these obligations, consider some ways the family can get assistance or referrals for support services. Fathers should be encouraged to be involved as much as possible from the beginning of their partner’s pregnancy. Hospitals, clinics, and maternal and child health services programs should acknowledge and support fathers from conception and throughout the pregnancy and early in their grief following a loss.

Resources and Support

Several organizations and agencies have developed father-friendly resources on grief and mental health. Here are some selected resources:

Centers for Disease Control and Prevention: Taking Care of Your Mental Health

The National Healthy Start Association: Infant and Maternal Loss: A Toolkit for Grieving Fathers

March of Dimes: Making a Place in Your Heart and Mind for the Memories of Your Baby

References 

• Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help-seeking. American Psychologist, 58(1), 5–14.
• Doka, K. J., & Martin T. (1998). Masculine responses to loss: Clinical implications. Journal of Family Studies, 4(2), 143–58.
• Obst, K. L., & Due, C. (2019). Australian men’s experiences of support following pregnancy loss: A qualitative study. Midwifery, 70, 1–6.
• Seidler, Z. E.D., Rice, A. J., Simon, M., Oliffe, J. L., & Dhillon, H. M. (2016). The role of masculinity in men’s help-seeking for depression: A systematic review. Clinical Psychology Review, 49, 106–118.
• Weaver-Hightower, M. B. (2012). Waltzing Matilda: An autoethnography of a father’s stillbirth. Journal of Contemporary Ethnography, 41(4),462–491.