NICHQ Family Stories
Supporting the Whole Family: Fathers in Infant Health Outcomes
Captured by NICHQ’s Exploring State-Level Strategies to Improve Maternal Health and Birth Outcomes Initiative
Preterm birth is a leading cause of infant mortality and morbidity in the U.S. And troublingly, recent data show that U.S. preterm birth rates have risen for the fourth consecutive year. Improvement starts by identifying what programs and policies do successfully support families, understanding what makes them successful, and then using those lessons to prompt systems change in states across the country.
Cam, a father in Massachusetts, wants to lift the message that supporting the whole family is essential to child development. After becoming a father at 16, Cam connected to some community-based resources but says that more targeted efforts should be made available to fathers. Here, he shares a story that raises issues about fathers’ barriers to support and resources — and the impact of their engagement on child health outcomes.
Like many young fathers, Cam found that dating in high school wasn’t quite the experience he planned. “When we found out about the pregnancy,” he said, “I thought, ‘Oh, geez — what is the next step? How do we do this?!’ We told my parents and close friends very quickly, but we didn’t make any decisions about next steps yet.”
Throughout the pregnancy and during the first few years of Colby's life, Cam and his partner began building a support network, including WIC support leading up to and after birth. “From the very beginning, we lucked out from our support structure, which was really robust,” Cam said. But even though Cam and his partner were optimistic and had family support, not all adults in his teenage life were as supportive.
Colby was born in March 2009 — Cam’s junior year — and needless to say, his senior year of high school didn’t look like most other students’. “In high school, I wasn’t a stellar student,” Cam said. “I remember when the guidance counselor said, ‘College really isn’t an option for you anymore.’ I asked why. She said I had a lot on my plate.” Despite the challenges of young fatherhood and the eventual reality of parenting together but living apart, Cam enrolled at Cape Cod Community College with the help of his aunt, who drove him there to enroll.
Now, his parents live in different places, but early on, they were very present in Cam and Colby’s life. Looking back, Cam said Colby knew he was surrounded by a support network with his parents, family, and friends who have become an extended family. “Once when Colby was 2 or 3 years old, I told him we were heading home,” Cam said. “And he asked me, ‘Which home?’ He said, ‘‘I have my home at Mom's, Papa's, Nana's, Kathy's, and Karen's.’ Colby really has really grown up with a village, which I think is amazing.”
Finding Support Beyond the Immediate Family
Cam found out about Stronger Generations in 2013, when he moved to Boston for school. During the past five years, he had been involved “off and on” with community-based programs but reading an article about Stronger Generations piqued his interest. Stronger Generations is a new model of perinatal care at Brigham and Women’s Hospital in Boston that provides women with surrounding care in the perinatal setting and focuses on resolving racial inequities in birth outcomes. He joined the Proud 2 Parent program that focused on younger parents, hosted by the Center for Community Health and Health Equity at Brigham.
At the time, Cam had a handful of friends who had kids, but not many. He shared how later after working with the program, he realized how the support he did receive influenced his outcomes. ““My family was immensely important to my success and Colby’s,” Cam said. “I didn’t grasp how important and rare that was until I started working with Brigham.”
How to Support Fathers to Support Children
Speaking from a father’s perspective about the birth experience, Cam described an ongoing desire to be a part of a group and maintain a connection with parents, something he says could be more accessible for dads. “I feel like moms have more support groups, and it’s socially acceptable for them to ask questions,” he said. “Dads have fewer people to connect with, but I do think it’s changing slightly.”
Cam sees this lack of connection and comfortability with asking questions during the mother’s pregnancy symbolic of the struggle some fathers experience connecting with their newborns. “The emotional connection took me longer,” Cam said. “The pregnancy didn’t feel quite so real, but fatherhood really kicked in once he started to move around!”
This challenging dynamic for fathers is part of the reason why Cam stays involved in the Stronger Generations program Proud 2 Parent for teens and young parents, where they learn life skills, financial management, and how to handle emotional stress. “I was the only father in the program — I saw, maybe, one other father in the past five to six years.” Contributing a father’s perspective has widened the conversation in the group, even though many topics don’t require his input. “When the topic doesn’t apply, I respectfully step away,” Cam said.
Though he acknowledges his experience doesn’t represent all fathers, Cam would love to see more targeted efforts to support men and fathers and their role in positive children’s health outcomes. Although his co-parenting situation has been minimally impactful in the legal sense - he and Colby’s mother have never gone to court, he sympathizes with fathers who struggle to be present or obtain resources for their children. He also questioned which side should take the lead on introducing support, knowing that part of the issue is awareness.
“Do you wait for the people to ask for it, or do you set things up prior to people asking?” Cam said. “From my own experience, there are a few more hoops dads have to jump through. But kids with more support have a better chance.”
Despite the personal challenges he has overcome, Cam is committed to staying involved and he encourages other fathers to do the same, whether through attending workshops or the annual Summit for Teen Empowerment and Parenting Success (STEPS), which brings young families and community agencies together in one space, providing a safe and empowering forum for young parents to expand their knowledge and access resources to help them accomplish their goals. “It’s a great opportunity to realize there’s a community,” Cam said. “And realize that you are not alone. Sometimes all people need is a little boost in the right direction. Knowing that, ultimately, this will support your family is a huge motivator.”
Supporting Indigenous Families for Improved Health Outcomes
Indigenous mothers and birthing people, fathers, partners, caregivers, and families, can speak for themselves. So, make sure seats are available – and filled – on your projects, your teams, your boards. Many projects within the MCH field have steering committees, and all should have family representation. As I hope you’ve intuited, it’s not enough to carry a message. When I think about justice, equity, diversity, and inclusion with regard to our committees, our faculty experts, or even in our improvement advisors, I have begun to ask the question: Are there people from American Indian and Alaska Native communities here?
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