Abstract
Fatherhood, as a developmental process, is both a human experience and a text that needs to be read. For developing nations like the Philippines, little is known about the process undergone by first-time fathers on their transition to fatherhood, and how nurses can play a significant role in assisting them. This grounded theory study purported to conceptualize the multifaceted process of transition from the lens of Filipino first-time fathers’ lived experiences. A total of 20 first-time fathers from Metro Manila, Philippines, were purposively selected to take part in an individual, semistructured, and in-depth interview. The Glaserian (classical) method of analysis was specifically used, and field texts were inductively analyzed using a repertory grid. Member checking and correspondence were done to validate the findings of the study. Six surfacing stages emerged relative to the process of transition. Interestingly, The B.R.I.D.G.E. Theory of First-Time Fatherhood Transition Space describes how these fathers progress from the beholding, reorganizing, inhibiting, delivering, grasping, and embracing phases toward successful transition. This emerged theoretical model can be used in framing health care programs where the needs of fathers during this period are met and addressed. Finally, it can also be used in guiding nurses in their provision of a more empathetic care for first-time fathers.
Introduction
Becoming a father is a process that entails transition (Draper, 2003; Meleis, Sawyer, Im, Messias, & Schumacher, 2000; Premberg, Carlsson, Hellström, & Berg, 2011). Transition, as defined by Genesoni and Tallandini (2009), is a staged physical, psychological, and spiritual process consisting of movement from status quo, or normal life, through a middle period of psychological reorganization and adaptation, to an incorporation of the new circumstances into one’s inner and outer world. As this is the case, transition may place additional demands on the individual and may influence him in various ways (Matthey, Barnett, Ungerer, & Waters, 2000; Nyström & Ohrling, 2004).
Background
In the past, the underemphasis of expectant fathers’ vital role in pregnancy and childbirth makes them the “forgotten parent” (Diamond, 1986) in the realm of health care. As scholarship advanced during the 21st century, there has been a growing interest in the nursing research literature on the experiences and adjustments of fathers in their transition to fatherhood (Fägerskiöld, 2008). Health care scholars assumed that men can share in their partners’ pregnancy and that first-time fathers can be the most vulnerable to various adjustments and difficulties (Condon, 2006).
Transition to fatherhood is evidently an inevitable turning point in men’s development. Several investigations have attempted to explore this area and its effects on fathers’ well-being during the periods of pregnancy, childbirth, and early postpartum (Bartlett, 2004; Buist, Morse, & Durkin, 2003; Thomas, Boner, & Hildingsson, 2011). Even though fathers in these studies positively describe their experiences as fulfilling (Eriksson, Salander, & Hamberg, 2007), some problems and difficulties are still identified. Many continue to feel that the transition to fatherhood is difficult and isolating (Draper, 2003; Jordan, 2007).
By and large, for a father to successfully undergo this transitional event, a smooth process is warranted (Jones & Prinz, 2005). Studies exploring such experience are therefore essential in guiding health care providers in developing care plans and interventions that facilitate this process (St. Jorge & Fletcher, 2011). Nurses are specifically bound to understand and to anticipate the emerging patterns of change as experienced in the transition and to prepare fathers for these (Bradley, Mackenzie, & Boath, 2004).
The Social Context of Fatherhood
It is important to note that the transition process is greatly influenced by the social context in which fathers live (Genesoni & Tallandini, 2009). In recent years, the concept of family-centered perinatal care that puts premium on the involvement of prospective fathers has gradually gained global acceptance mostly in European nations. It has been advanced that various policies and legislations to support fathers in becoming more involved in the perinatal period are closely connected to the achievement of better health outcomes (World Health Organization, 2007). In Sweden, for example, fathers are provided a 2-month paternity leave to encourage an increased participation in the perinatal period (Edhborg, Carlberg, Simon, & Lindberg, 2016). However, this generous opportunity for fathers to be more involved is not popular among several economically developing countries. In the Philippine society, current public policies and practices applicable to fatherhood remain vague and conservative in some aspects. For instance, the Paternity Leave Act of 1996 (Republic Act No. 8187) is the only existing legislation in the country that defines the leave benefits for fathers. As stipulated in this law, only married prospective fathers can take a paternity leave of 7 days while being entitled to a full pay. Such policies may certainly limit fathers to lend support to their partners during those critical periods and may have a negative impact on their transition experience as well. In light of this social context, empirical researches are therefore warranted with an end view of eventually shaping better policies on fatherhood in the Philippines.
Qualitative investigations dealing with the process of transition to fatherhood from the context of a non-Western culture and a developing country like the Philippines have been notably sparse (Chin, Hall, & Daiches, 2011; Genesoni & Tallandini, 2009). Hence, this grounded theory study addresses the paucity of literature and purports to answer the central question: What theory explains Filipino first-time fathers’ transition to fatherhood? The period of transition, in the context of this investigation, will elucidate on Filipino first-time fathers’ lived experiences from the time of the news of pregnancy up to the first several weeks postpartum, specifically 4 to 6 weeks after childbirth (Premberg et al., 2011; St. John, Cameron, & McVeigh, 2005; Thomas et al., 2011). The early postnatal period was chosen with the consideration that participants should have had at least some time to become accustomed to fatherhood while still having a fresh memory of the pregnancy and birth experience (Premberg et al., 2011).
Method
Design
The Glaserian Grounded Theory Design was used in this study. Moving beyond merely describing a certain phenomenon, it intends to discover an explanatory theory or an abstract analytical schema of basic social processes, shaped and grounded from the views of a large number of participants, and investigated in the environments in which they take place (Glaser & Strauss, 1967).
Study Site and Participants
This study was conducted in Metro Manila, Philippines. Due to its recognition as the political, economic, social, cultural, and educational center of the country, this highly urbanized region is a home for a culturally and ethnically diverse population. This site was considered for its potential to provide a selection with richer and wider perspectives.
A total of 20 fathers were purposively recruited to participate after meeting the following inclusion criteria: (a) first-time father, (b) father to a healthy newborn, (c) resident of Metro Manila, (d) living with the mother of the infant, and (e) willing to participate. As reported (Table 1), the majority of the participants are categorized under the 20 to 40 age range, mostly not married and Roman Catholics. In terms of educational attainment, a large number has at least reached or finished tertiary level. Most of them are employed, and having a combined family monthly income of less than ₱20,000. Such amount is more or less on the borderline average of a typical Filipino family income (National Statistics Office, 2012). Additionally, it is also interesting to note that majority of these fathers reside in an extended family structure. In this study, a nuclear family consists of a man and a woman living together with their offspring (Medina, 2001); while an extended family merges family of orientation consisting of the individual, his parents, and all siblings, and family of procreation consisting of the individual, his spouse, and all his children (Medina, 2001).
Selection Characteristics (n = 20).
Instrumentation
To collect the needed narratives, the researchers devised a two-part data collection tool. The initial part focused on the pen portrait of each respondent. It is a corpus of data from where the characteristics of the selection are established. The second part is an aide memoire (Table 2) which was used openly to direct the three-staged semistructured interview. It is a written guide that serves to aid the interviewer and the interviewee during the interview process. It significantly contains “process-oriented” questions revolving on the participants’ experiences from the time they received the news of their partners’ pregnancy up to several weeks postpartum, specifically 4 to 6 weeks. It is important to note that questions within this guide were continuously formulated and developed as a product of alternating data collection and analysis. An expert group consisting of researchers and clinicians in family nursing in Metro Manila carried out the validation of the interview guide.
Aide-Memoire.
Data Collection Procedure and Ethical Consideration
After obtaining ethical clearance from the institutional review board of the hospital institution from where participants were primarily recruited, the nature and purpose of the study were discussed to eligible participants. This was accomplished in both written and verbal forms and was expressed with the use of the native Filipino language. For fathers who agreed to participate, a signed informed consent, as well as their consent to allow the researcher to audio-record the interview, was secured. Consideration was given to the privacy and confidentiality of all participants as they were advised that no identifying information would be associated with any report in any way. Furthermore, all accounts that were shared during the interviews were securely kept in a vault which is solely accessible to the researchers.
To produce accounts of sufficient depth and breadth, a three-stage interview (Seidman, 1991) was conducted. Preliminarily, rapport building, laying out the area of exploration, and trying some initial forays into the topic were the foci of the interview right after obtaining the consent and approval of potential participants while still at the hospital institution. Specifically, this initial interview was done on the first or the second day after the delivery of the newborn. Date and time during the early postnatal period (4-6 weeks) for the second interview were arranged with due consideration of the participants’ convenience. Between the first and second interview, the participants were provided time to think more deeply about the experience. Last, the third interview focused on follow-up and clarification of accounts.
Individual, semistructured, and in-depth interviews were held in Filipino language. Cognizant of the fact that the basic social process of fathering takes place in the home, the primary researcher observed and conducted the interviews particularly in the residences of the participants. The entire tape-recorded interview, most specifically in the second stage, took at least an hour on the average. Whenever there is researcher–participant contact during the entire data collection period, refreshments were provided to the whole family of the participant as a form of expressing gratitude for participating in this study.
Data Explicitation
The tape-recorded interviews were transcribed verbatim in the native language by the researchers. Subsequently, the transcriptions were carefully translated into English to come up with the field text with due consideration of keeping the emic side of the language. This was successfully done with the assistance of a professional translation firm. Through repertory gridding, gathered accounts were then subjected to the four major stages of the Glaserian (classical) grounded theory process of analysis (Glaser, 1992), which include (a) open coding and comparing incidents, (b) integrating categories and properties, (c) selective coding and sorting memos, and (d) writing the theory.
Notably, data collection was done consistently in a “zigzag” manner through a series of gathering information, then analysis of data, and back to gathering more information, then analysis, and so forth (Creswell, 2013). Said process, called constant comparative method of analysis (Glaser, 1992), is carried out until categories of information became saturated and the evolving theory was elaborated in all its complexity. In this investigation, saturation has been achieved tremendously with the 20 recruited participants. Hence, no further gathering of information was necessary.
Member-checking procedure (Long & Johnson, 2000) and correspondence (de Guzman & Guillermo, 2007) were observed to ensure the reflexivity, reliability, trustworthiness, and truthfulness of the emerged theory. The primary researcher undertook these checks with the participants by asking if the themes developed from the codes were accurately describing their statements. Asking the participants to read the definition and explanation of the themes generated from the data in order to assess their accuracy facilitated this process.
Findings
Analyzing from the depth and breadth of the participants’ individual verbalizations, a novel process emerged by which transition to first-time fatherhood is accomplished by a select group of Filipino first-time fathers. Interestingly, The B.R.I.D.G.E. Theory of First-Time Fatherhood Transition Space (Figure 1) depicts the process by which first-time fathers transit to the beginning of a new chapter in their lives. Said transition surfaced six distinct themes, namely: the beholding, reorganizing, inhibiting, delivering, grasping, and embracing phases.
The B.R.I.D.G.E. Theory of First-Time Fatherhood Transition Space.
Similar to the structural design of a truss bridge, the journey of first-time fathers as emerged from their lived experience is characterized by ups and downs; hence, the ebb and flow toward a successful transition. In like manner that trusses of a bridge are subjected to tension and compression in response to dynamic loads, fathers are also bound to be resilient to the challenges and difficulties of this journey, without overshadowing the boundless joys and intangible rewards it brings. As represented, the emerged phases of transition are embedded on the trusses and are threaded from start to end to establish their gradual but sequential interconnection.
Beholding Phase
In this study, the transition journey of first-time fathers begins with the beholding phase where they start to comprehend the news of pregnancy and to entertain a space characterized by variety of emotions. Initially, it is not unexpected that these fathers feel surprised on receipt of the news. As one participant shared, “At that point, I was numbed for a while. It’s like everything came to a halt, and everything tossed on me” (R3). For some of them, it even took some time for this unexpected blessing to sink in their minds. One father verbalized, “It took a while before it really sank in. But of course, I was totally happy knowing that I will be having my kid soon” (R16). Notably, they were filled with shock in the early stages of learning the news. Gradually, as these fathers came to their senses, questions start to hover in their minds, as exemplified in this verbalization: “I didn’t think about anything else other than having a kid soon. I kept asking myself, ‘Am I ready for this? Am I mature enough for this? Can I handle it? Am I tough enough?’” (R3). While some may have entertained questions, some others have already acknowledged a feeling of unpreparedness to the situation as reflected in this statement: “It felt like I was splashed with cold water. I was aghast because I was thinking my focus was more on myself only” (R1).
As the reality of the situation starts dawning on them, these fathers also expressed mixed emotions ranging from happiness, excitement, gratefulness, and even initial fears. Most of them pictured this moment as indescribable in a single emotion. One stated: “I was surprised and happy yet sad, like that. My emotions were mixed” (R2).
It is certainly during this stage when fathers verbalized the fulfillment of something they were wishing for and dreaming of. One participant shared, “We knew right then that she was pregnant. It was really our dream to have a baby. And there, I was happy at the same time excited” (R19). Such is the case, they subsequently expressed their extreme happiness and gratefulness while acknowledging this valuable, priceless, and God-given gift, as evidenced in this verbalization: “I was excited, at the same time very thankful because I was really praying to God to have one. It’s a mix of many emotions. It is given by God” (R13).
Reorganizing Phase
The reorganizing phase of transition describes first-time fathers’ entry to a realm of subsequent changes brought about by fatherhood. For the sake of beginning a new chapter in their lives, fathers start to undertake several changes in perspectives as they verbalize their eagerness to modify their former ways of life and to change for the better. As the days count, one aspect of change has become evident as these fathers start to see their ideal self, and their willingness to persevere more, as verbalized: Of course, before, you were only thinking about yourself, now it’s like you have to think about the future of your family. During that time when I learned that I was going to be a daddy soon, I thought that I have to change . . . that it’s not enough anymore that I am just a graduate. So, it has become one of my goals to find job in the government as an employee. And I also strived hard for me to pass the licensure examination, to get eligibility for government work, and to get the job I wanted. (R15)
This aspect is also complemented with a change in mind-set among these fathers as evidenced by their conceived change of priorities. One father said, “My priorities have really changed too. By then, my priority was my baby because I was already certain that the baby was there yet” (R18).
As their mind-sets changed, these fathers also shared about an unnoticeably surpassed change in their lifestyle, which includes but not limited to modifying usual habits and eradicating vices. One father boldly verbalized, “Since the time my partner was pregnant, it’s like I have personally changed too. I got rid of women, alcohol, all vices, sir, they were totally gone” (R16). This aspect is likewise concretized in this statement: I think the only change in me is the kind of life I had before. I would spend hours in the computer; sleep at dawn, then would wake up, eat then sleep again, play basketball afterwards. As simple as that, my life was comfortable before. (R5)
In the course of their transition journey, fathers were also bound to face the most challenging adjustment. For them, economic adjustment in the form of saving up for short-term and long-term needs has been the toughest responsibility, as one father shared: Perhaps one big challenge for me before was my responsibility for my baby. Of course, you need to save for his future. When he grows up, he will definitely go to school. And so during those times, I have already put in my mind that I needed income, and I needed to earn. (R11)
Toward the end of this phase, fathers are situated in a space where they are also bound to adapt to the physical, social, and spiritual changes brought about by fatherhood. Each day that passed, they observed certain bodily changes and the most notable is gaining weight since fathers did not anymore find time to exercise. One father admitted: Seeing myself then, I really gained weight. Before, I regularly go to the gym, and then I also play physical games. I can say at some point that I was physically fit. But since the time I learned about my wife’s pregnancy, I needed to attend to her almost every time and so I found no time for those activities I used to do. But for me it doesn’t matter! (R1)
Fatherhood has also brought about two distinct social changes. On one hand, there has been a notable positive change in partner relationship such that these fathers started to value and to love their partners even more. One father affirmed, “When my partner was already pregnant, I felt like my partnership with her was more valuable” (R3). On the other hand, there have been slight changes in relating to their peers because of putting much of their attention to the pregnancy. One participant shared, “Socially, my meet-ups with friends, night out, basketball games, birthday parties, all social gatherings . . . all these were lessened. Everything was limited since I needed to take care of my wife” (R9). And finally, fathers mostly described another positive change in their spiritual lives characterized by a heightened spirituality. One of their significant articulations was: A noticeable change is that before, I was praying for my career, and for my day to day living. But then, I had some other things to pray for, and that was for the good health of my baby and my partner. It’s totally different then, what you were asking, what you were thanking for. (R1)
Inhibiting Phase
While the foregoing first segment of transition deals with the experiences of awaiting fathers during pregnancy, the second segment of transition narrates their experiences at childbirth. As fathers entered this period, they initially worried and feared about what to come and about other aspects that relate to the welfare of both the mother and the baby, dubbed as the inhibiting phase. Whether or not these fathers were present in the birthroom, they all exemplified extreme uneasiness, worry, nervousness, and feeling of discomfort while waiting because of not knowing what is happening inside the delivery room. One expressed, “I was outside the room that time, I was worried because I couldn’t see what was happening to them, especially when I was hearing that she’s screaming, that it was painful” (R6).
Concurrently, these fathers also expressed their intense fear about the possible unlikeable outcomes of pregnancy and childbirth. Potential death of mother or the baby due to complications of birthing process, along with possible disabilities and deformities of the baby, was the dreadful thought these fathers were having. It was shared: She was having a lengthy labor period. What I have been feeling was a mixture of fear, happiness, something like that. I was fearful for both their safety and welfare. You know sometimes it’s an inevitable thing, that when the baby is out, he is dead, or it’s the mother who was not saved. I was also thinking, what if my baby has physical deformities. I’ve been tried that moment. (R6)
But amid all these worries and fears, the participants have completely submitted themselves to God and impressively turned to prayer. During this inhibiting period, prayers have been their steady armor, as reflected by this verbalization: I was really scared, and I kept on praying and praying during that time. I was praying that everything will be fine and that there will be no complications on the baby and my partner. Actually, during that time, I was at a fieldwork. So I was really fearful since I did not know what was happening. I was not there. But at the same time, I lifted everything to God. (R15)
Delivering Phase
As soon as the birthing process concludes, fathers abruptly transit to the next phase called the delivering phase. This period is characterized by fathers’ sense of emancipation on hearing about the safe and healthy birthing process, as well as their acknowledgement of the arrival of the baby. Fathers, on seeing their child for the first time, entered a realm where a sense of relief and freedom from all the worries and fears are felt. One father expressed, “While I was waiting outside, I was also waiting to hear the first cry of my baby. And when I heard a baby cry, it’s like I was unloaded of a heavy burden I was carrying on my chest” (R10). As these fathers unloaded, they also verbalized their gratefulness and expressed an unexplainable joy for the positive outcomes of delivery, as described: Of course, I was very happy when I learned that it was a normal delivery and my wife was safe. I was really thankful to God for finally my baby got delivered healthily and safely, and that my wife was okay during the whole pregnancy. I felt relieved. (R9)
It is also interesting to note that as early as this period, they express a sense of ownership of the child by explicating an almost indescribable father–baby connection. One father claimed: When I rushed into the hospital to see them, I saw a baby beside my wife. I really can’t explain but it’s like there was a connection . . . I knew by then she was my baby . . . she really was!” (R15)
Eventually, fathers also verbalize their claim of facial resemblance with the newborn, as supported by this statement: I was very happy. I mean, he looks like me. When he was already out, you would see he really looked like me. My siblings were even saying that our child did not get any resemblance from his mother. It’s incomparable happiness. (R11)
Grasping Phase
The grasping phase of transition comes in immediately after childbirth where fathers are situated in a space with much uncertainty of what to do. Described as a first-time and a firsthand situation, this phase is primarily depicted with fear and hesitation in caring for the baby. For these fathers, not knowing the hows of caring skills makes them fearful and hesitant in providing fatherly care, as mentioned, “I called for help, because at that time I really did not know how to do it, I was unskilled of doing it yet” (R13). Another participant elaborated without reservation: While I was carrying the baby, she cried. That was the first time I heard her cry. I really panicked because it was my first time in such situation. And this is my own child, how will I be able to calm her, I was asking myself. I really did not know how. (R1)
Such hesitation and fear of fathers are also attributed to their acknowledgement of the fragility of the baby, as reflected in this verbalization: “His body was so soft. I just held him for like ten seconds, and then I passed him back because I was really afraid I might cause him harm” (R6).
Consequently, this situation prompts these fathers to collect pieces of advice, opinions, and tips about things they need to know and skills they need to perform from their own fathers, both parents, siblings who are fathers themselves, some peers, and even online resources. One participant acknowledged, “I know my mother and my father are more knowledgeable so I sought their help on how would I do things” (R13). Another participant validated, “From then, I started to seek advice, of course, from my father. It’s like . . . he has been there, he experienced what I was experiencing by then. I openly received his opinions and pieces of advice” (R14).
Embracing Phase
After surpassing every uphill and downhill of early fatherhood, the participants progressively moved on to the terminal point of this theory, termed as embracing phase, which brings them into a space of total acceptance of their new role. In this phase, they become much aware of the psychic rewards of fatherhood which include realizing the intangible and self-actualizing aspects. For them, becoming a father is a fulfilling and a priceless endeavor, as one claimed: There were indeed many adjustments. I personally accepted them instead of considering them as stressors. I was really telling myself . . . they’re already there; I had nothing left to do than to face them with responsibility. In fact, if you don’t accept them as early as possible, it will be more difficult later on. After all, it is so fulfilling to become a father. It’s priceless! (R14)
Along the way, these fathers continue to adjust to a more demanding life. But amid all the hardships faced, they continue to possess a happy disposition, as evidenced by this statement: Even if I get tired and get challenged at most times, seeing my baby relieves me from everything heavy. Yes, it’s true. For instance, whenever I get home, just by merely looking at him and seeing him smile, or even cry, make me feel all right. (R12)
While developing a positive attitude, the participants’ readiness to embark on a new responsibility was evidenced by their tendency to acknowledge the place of learning the rope. Accordingly, one shared, “I think it is learning in progress—that is something that you learn every day. I mean you can never be perfect and it is something I’ve learned to do every day” (R3).
Finally, these realizations enable fathers to also start defining their goals for their own families. Tellingly, most of them look straightforward to the direction of providing only the best life for their families by being a good provider and a role model, as this father wrapped up, “I told myself, ‘I am already on a different stage of my life, and I am no longer a gentleman.’ You really need to plan ahead. You also need to set direction for your family” (R14).
Discussion
While it is true that transition to fatherhood experiences in the context of developing nations remains a blind spot in nursing research literature, this qualitative study provides a novel insight into how Filipino first-time fathers narrativize their own experiences. Journeying toward fatherhood is clearly a process and not just a single event in a man’s life (Jordan, 2007; Pollock, Quinton, & Golding, 2002). Filipino first-time fathers who participated in this study describe their transition in a similar way, one which is complex and further typified by a variety of emotions felt, challenges faced, and rewards received. The beholding phase, for instance, signals the starting point of their journey. Fathers entertain in here a space characterized by mixed feelings as they begin to comprehend the news of their partners’ pregnancy. Findings from previous studies mirror similar feelings of fathers on receipt of the news (Jordan, 2007; Meleis et al., 2000; Schumacher, Zubaran, & White, 2008). Earlier, Lemmer (1987) reviewed the literature and one of the identified common themes is fathers’ ambivalence during the early period of their partners’ pregnancy. While this event mainly evoked a sense of euphoria and pride for some, a feeling of anxiety may also take its place primarily because of these fathers’ anticipation of expanded responsibilities among others (Edward, Castle, Mills, Davis, & Casey, 2015).
It is interesting to note that as fathers descend from the heights of their emotions, their perspectives and mind-sets also changed gradually. The reorganizing phase then starts as they enter a realm of eagerness to modify their former ways of life and change for the better. Becoming a father seems to be a powerful motivating force for these participants to improve themselves through changing how they have been or are currently living their lives (Greenhalgh, Slade, & Spiby, 2000; Lemay, Cashman, Elfenbein, & Felice, 2010). Particularly, expectant fathers modify daily behavior throughout the pregnancy period which may include but not limited to increasing their level of responsibility in the family, saving and economizing, and decreasing or eradicating vices (Sansiriphun, Kantaruksa, Klunklin, Baosuang, & Jordan, 2010). While literature points out that childbirth is the most stressful time for fathers, present studies noted pregnancy as being the most stressful because of psychological reorganization during this period (Condon, Boyce, & Corkindale, 2004). On a lighter note, Fägerskiöld (2008) emphasized that however unpredictable these fathers’ changing life was, it was mostly connected to positive feelings. These findings, on the whole, are evidently in substantial agreement with the transformative perspective of the effects of fatherhood (Knoester & Eggebeen, 2006). As days unfold during the pregnancy period, fathers were also inevitably bound to adapt physical, social, and spiritual changes. First, gaining weight, the most notable physical change, may be attributed as consequential to changes in these men’s commitments and priorities, which in turn lessened their time to engage in sports, exercise, and other physical activities. Sympathy eating with the expectant mother could also account for this physical change. In addition, fatherhood may also encourage fathers to modify their social relationships, prompting them to spend lesser time with associates and friends (Knoester & Eggebeen, 2006) as they become more partner focused. Such is the case, fathers in this study reported a more loving and a more valuable relationship with their partners. This observation affirms that changing partner relationship, usually resulting to a more closely united one, is common even at the stage of pregnancy (Fägerskiöld, 2008). Last, most of the participants in this study described also a positive change in their spiritual lives. Filipino fathers see their children as a gift and a grace from God, and this view may possibly, in turn, have encouraged and motivated them to become more spiritual. Indeed, fatherhood’s association with increased levels of religiosity is noted (Eggebeen & Knoester, 2001).
While the pregnancy period is mainly characterized by a more psychological transition, childbirth is described as the biological aspect (Draper, 2003). It is during this period when fathers entered the inhibiting phase or the stage where they all exemplified extreme uneasiness coupled with their intense fear of the possible outcomes of pregnancy and other aspects that relate to the welfare of both the mother and the child. Similarly, this theme echoes the results of previous studies reviewed which narrativized men’s experiences during labor and delivery wherein they felt ill-prepared (Bartlett, 2004; Draper, 2003), helpless, useless, and anxious (Greenhalgh et al., 2000), as well as uncertain, powerless, and lonely (Ekström, Arvidsson, Falkenström, & Thorstensson, 2013). Clearly, these symptoms felt suggest that this phase is a critical turning point in their transition experience. If fathers were provided advanced information, these feelings would have been partly avoided. Fägerskiöld (2008) asserted that stressful events such as childbirth, coupled with fathers’ feeling of insecurity during this period, do not facilitate a positive transition experience. It is therefore imperative for health care providers to recognize these fathers’ intense feelings of helplessness and anxiety since inattention may negatively contribute to their experiences. It is assumed that when fathers’ experiences are more positive, their capacity to support their partners will likely increase too. This, in turn, may contribute positively to both their experiences of childbirth.
No matter how stressful the initial part of childbirth for them, fathers gradually proceeded to the delivering phase of their transition where they, on seeing their child for the first time, entered a realm of freedom from worries and fears. This phase of the theory, as described congruently in the literature (Ekström et al., 2013; Poh, Koh, Seow, & He, 2014; Premberg et al., 2011) pictured fathers expressing feelings of relief after childbirth when their fears for their partners’ and babies’ health dissipated. Notably, the participants of this study also manifested a sense of ownership of the child. Jordan (2007) supported this observation when she pointed out that fathers seek to “claim” their child by identifying paternal or familial features.
Meanwhile, it is in the grasping phase, which proximately proceeds after childbirth that fathers are situated in a vacuum with much uncertainty of what to do. In this phase, the literature describes fathers’ frustrations of not being involved and their perceptions of not being skilled in caregiving (Buist et al., 2003; de Montigny & Lacharite, 2004). Evidently, the acquisition of the said skill is vital for these fathers during this period. By acquiring the necessary caregiving skills, such as recognizing baby’s needs, feeding the infant, learning to change diapers, among others, fathers may be able to take control of the new situation (de Montigny & Lacharite, 2004; St. John et al., 2005). Social support may then, in part, play an essential role in this phase of transition since the arrival of the newborn is not only considered as a major developmental challenge but also a critical period of learning the rope for these first-time fathers. Similar to recent studies (Fenwick, Bayes, & Johnson, 2012; Forsyth, Skouteris, Wertheim, Paxton, & Milgrom, 2011; Poh et al., 2014), fathers in this study received help and support in all forms from multiple sources such as both parents, their own fathers, friends who are fathers, and even Internet resources, thereby giving them later a feeling of reassurance. Evidently, support coming from the health care group during this period was considerably unacknowledged.
Finally, after the participant succeeds in overcoming the initial challenges and difficulties of being a first-time father, he enters the terminal point of this theory, the embracing phase, which brings him into a space of total acceptance of his new role while enabling him to define his goals for his family. Reports from earlier qualitative studies pointed out that postpartum experience of fatherhood, particularly during the first several weeks, can be challenging especially for first-time fathers (Bartlett, 2004) since it may demand adjustment to a completely new life situation (Premberg, Hellström, & Berg, 2008). It is however noteworthy how the participants in this study were able to embrace their new life as first-time fathers. Resilience, as one of the notable Filipino traits, may in part contributed to this successful transition. Interestingly, this phase also describes how the couple relationship begins to be much outshone by the presence of the child, hence gradually transforming the former dual relationship into a triadic one (Genesoni & Tallandini, 2009). Such is the case, part of fathers’ mind-set has changed to include the child in their commitments and priorities in life. It is evident in this study that to provide for their family, as well as to become role models, is the most common goal of these fathers. As providing is central to a father’s identity (Christiansen & Palkovitz, 2001; Williams, 2008), the provider role should be a focus of attention too.
Summarily, nurses have a key interventional role in the transition process as these fathers seek and need health care guidance. In the beholding and reorganizing stages, the role of the nurse is primarily educative. They are bound to involve fathers in the antenatal education and to assess their individual learning needs in order to alleviate their frustrations and their sense of unpreparedness. In the inhibiting and delivering stages, the role of the nurse is basically supportive. They are just bound to listen, to acknowledge, and to empathize with these fathers who are in their extremes of emotions. And last, in the grasping and embracing phases, the role of the nurse is essentially facilitative. They are bound to guide and to engage fathers toward the achievement of their goals for their families. Overall, this study echoes the claim about the centrality of transitions in the nursing discipline (Meleis et al., 2000) in which nurses provide interventions aimed at assisting client toward a healthful transition.
Limitations of the Study
However interesting the emerged theoretical model is, several limitations of this qualitative investigation should be the foci of future researches. These parameters stem largely from the demographic characteristics of the participants. Previous studies have advanced that father’s involvement in the childbearing and child-rearing periods may be influenced by a number of contextual features such as sociodemographics (Doherty, Kouneski, & Erickson, 1998; Goldscheider, Hofferth, Spearin, & Curtin, 2009; Summers, Boller, Schiffman, & Raikes, 2006). First, although most of the first-time fathers in this study are employed and have finished tertiary level of education, they were largely coming from the context of lower income families. Coming from such background, it is assumed that they are likely to face more challenges and difficulties related to limited resources as they prepare and face the transition process. On the contrary, higher income fathers may exhibit a different and a unique pattern of transition to first-time fatherhood. Second, most of the participants of the study are not married to their partners. Such status may possibly be relative to the extent of commitment and involvement of these fathers during the period of transition. Third, the participants’ age bracket could be another limitation as there were no participants who were older than 40 years old. It can possibly be assumed that the experiences and views of older fathers may significantly differ from those who participated in this study. Fourth, majority of the participants reside in an extended family structure. As this is the case, the provision of social support from the significant others may partly have facilitated these participants’ transition experience. And last, the participants are fathers to a healthy newborn. Since this inclusion criterion was set, the emerged theory describes first-time fathers’ successful transition to fatherhood. Hence, this theory did not account for those fathers who may have not qualified relative to this criterion.
It is likewise noteworthy that the locus of this investigation is an urbanized region in the Philippines. A question may be raised whether fathers from the rural areas of the country will manifest similar experiences. Future studies should also seek to explore on possible variations of the theory from both local and global contexts. It would also be interesting to explore on how various policies and legislations influence the experience. Further theorizing about first-time fatherhood is therefore warranted with consideration on how these given points affect the transition process.
Conclusion
This qualitative inquiry purported to conceptualize the process of transition to fatherhood among Filipino first-time fathers. From the in-depth individual interviews conducted with the participants, six distinct themes emerged, namely, the beholding, reorganizing, inhibiting, delivering, grasping, and embracing phases. Said stages provide a panoramic understanding of how the participants go through the transition experience, from the moment they learned about their partners’ pregnancy until the first several weeks postpartum.
As it turns out in this study, transition journey to fatherhood can be extremely difficult and challenging, but this is particularly true when first-time fathers are not provided with the necessary and practical guidance for them to successfully cross the process. Hence, The B.R.I.D.G.E. Theory of First-Time Fatherhood Transition Space may serve as a springboard from which to frame health education strategies and contents for the benefit of these first-time fathers. In nursing research, its relevance is acknowledged by serving as a comprehensive theoretical model from which to base and to generate future studies in the field. In a similar way, nurse practitioners and student-nurses may also greatly benefit from this study since it provides them a valuable and a concrete guide in identifying and addressing needs of these fathers at each specific phase in the transition space. With a much greater understanding of what specific support is best at a particular time, nurses will be able to provide a more empathetic care for these fathers.
This investigation contributes to the continually expanding literature about transition to fatherhood experiences of fathers. It is just one of the very few qualitative studies which investigated the said layer of human experience from the lens of a non-Western culture and a developing country. This study therefore invites future exploration from a cross-cultural perspective so as to identify points of convergence and divergence in regard to the emerged theoretical model.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.