Preconception health is not a man’s business : A formative qualitative study on men’s roles in preconception health preparation
Abstract
Background: Issues related to preconception health are always associated with women, whereas men’s involvement in maternal and child health services is crucial to prevent maternal and infant mortality and morbidity. Despite its importance, research related to the involvement and role of men in the preconception period is still very limited.
Objectives: The purpose of this study is to explore men’s roles in preconception health preparation.
Methods: This formative qualitative research was conducted from October 2023 to July 2024. Participants consisted of 26 premarital couples and staff from three Community Health Centers, a Village Office, the National Population and Family Planning Agency, a Religious Affairs Office, and the Health Office in Bantul Regency, Yogyakarta, Indonesia. Purposive sampling was used to recruit individuals who had direct experience with, or relevant responsibilities in, premarital health services and intersectoral coordination. Data were collected from nine focus group discussions (FGDs) and 15 in-depth interviews, which were then transcribed and analyzed using thematic content analysis.
Results: The role of men in preconception health preparation was low due to a lack of awareness of its importance. Furthermore, men were not directly involved in the existing government’s preconception health program. Although men encouraged their partners to prepare for pregnancy, they lacked the awareness regarding the importance of improving their own preconception health, such as through doing exercise, eating a nutritious and balanced diet, and avoiding unhealthy lifestyles. Their preparation tended to focus more on economic and social readiness, while mental preparation was given less attention.
Conclusions: Increasing the role of men in preconception health can be conducted by involving men in preconception care.
References
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29. Grieger JA, Grzeskowiak LE, Wood LG, Clifton VL. Asthma control in pregnancy is associated with pre-conception dietary patterns. Public Health Nutr [Internet]. 2016 Feb 1 [cited 2021 Dec 23];19(2):332–8. Available from: https://pubmed.ncbi.nlm.nih.gov/25908413/
30. Alipour Z, Kheirabadi GR, Kazemi A, Fooladi M. The most important risk factors affecting mental health during pregnancy: a systematic review. Eastern Mediterranean Health Journal. 2018 Jun 1;24(6):549–59.
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35. Priani IF, Afiyanti Y, Kurniawati W. Preparing pregnancy through Preconception Education Training. Enferm Clin. 2019 Sep 1;29:304–9.
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2. Mason E, Chandra-Mouli V, Baltag V, Christiansen C, Lassi ZS, Bhutta ZA. Preconception care: advancing from “important to do and can be done†to “is being done and is making a difference.†Reprod Health [Internet]. 2014;11. Available from: https://www.proquest.com/scholarly-journals/preconception-care-advancing-important-do-can-be/docview/1565876465/se-2
3. Anbesu EW, Aychiluhm SB, Kahsay ZH. Male involvement in family planning use and its determinants in Ethiopia: a systematic review and meta-analysis protocol. Syst Rev [Internet]. 2022 Dec 1 [cited 2024 Mar 15];11(1). Available from: /pmc/articles/PMC8805394/
4. Apriyanti. Infokes. 2019 [cited 2021 Jul 2]. Mampukah Program Kesehatan Reproduksi Bagi Calon Pengantin (Catin) Menurunkan Angka Kematian Ibu ? Available from: https://infokes.dinus.ac.id/2019/11/14/mampukah-program-kesehatan-reproduksi-bagi-calon-pengantin-catin-menurunkan-angka-kematian-ibu/
5. Widiantari NKN, Suariyani NLP, Karmaya INM. Hubungan Karakteristik Sosio Demografi dan Dukungan Sosial Suami dengan Partisipasi Ibu Mengikuti Kelas Ibu Hamil. Public Health and Preventive Medicine Archive (PHPMA). 2016 Jul 1;4(1):54–9.
6. Kululanga LI, Sundby J, Malata A, Chirwa E. Male Involvement in Maternity Health Care in Malawi. Afr J Reprod Health. 2012 Mar;16(1):145–57.
7. Almeling R, Waggoner MR. MORE AND LESS THAN EQUAL: How Men Factor in the Reproductive Equation. Gend Soc [Internet]. 2013 Nov 11 [cited 2024 Mar 15];27(6):821–42. Available from: /pmc/articles/PMC3856903/
8. CDC. Centers for Disease Control and Prevention. 2020. Information for Man. Available from: https://www.cdc.gov/preconception/men.html
9. DirjenKesmas. Kesehatan Reproduksi dan Seksual Bagi Calon Pengantin. Jakarta: Kementerian Kesehatan Republik Indonesian; 2018.
10. Atashi V, Kohan S, Salehi Z, Salehi K. Maternal-fetal emotional relationship during pregnancy, its related factors and outcomes in Iranian pregnant women: a panel study protocol. Reprod Health [Internet]. 2018 Oct 17 [cited 2024 Mar 15];15(1). Available from: /pmc/articles/PMC6192301/
11. Czeizel AE, Czeizel B, Vereczkey A. The participation of prospective fathers in preconception care. Clin Med Insights Reprod Health [Internet]. 2013 Jan [cited 2021 Dec 12];7:CMRH.S10930. Available from: https://pubmed.ncbi.nlm.nih.gov/24453513/
12. Kotelchuck M, Lu M. Father’s Role in Preconception Health. Matern Child Health J [Internet]. 2017 Nov 1 [cited 2024 Mar 15];21(11):2025–39. Available from: https://pubmed.ncbi.nlm.nih.gov/28983715/
13. Agustina SA, Zolekhah D, Barokah L. Perbedaan Pengetahuan Calon Pengantin Laki-laki dan Perempuan tentang Kesehatan Prakonsepsi. PREPOTIF Jurnal Kesehatan Masyarakat. 2022 Dec;6(3):1890–5.
14. Nitert MD, Foxcroft KF, Lust K, Fagermo N, Lawlor DA, O’Callaghan M, et al. Overweight and obesity knowledge prior to pregnancy: a survey study. BMC Pregnancy Childbirth [Internet]. 2011 Nov 21 [cited 2021 Dec 12];11. Available from: https://pubmed.ncbi.nlm.nih.gov/22103736/
15. Lang AY, Bartlett R, Robinson T, Boyle JA. Perspectives on preconception health among migrant women in Australia: A qualitative study. Women Birth [Internet]. 2020 Jul 1 [cited 2021 Dec 12];33(4):334–42. Available from: https://pubmed.ncbi.nlm.nih.gov/31280974/
16. Yulivantina EV, Gunarmi G, Maimunah S. Urgensi Preconception Care sebagai Persiapan Kesehatan Sebelum Hamil: Sistematik Review. In: Prosiding Seminar Informasi Kesehatan Nasional (SIKesNas). Surakarta: Fakultas Ilmu Kesehatan Universitas Duta Bangsa Surakarta; 2022. p. 31–9.
17. CDC. Centers for Disease Control and Prevention (CDC). 2023 [cited 2024 Jun 9]. About Planning for pregnancy. Available from: https://www.cdc.gov/pregnancy/about/index.html
18. Shawee J, Steegers EA, Verbiest S. Preconception Health and Care: A Life Course Approach. USA: Springer; 2020.
19. Dieny AR, Rahadiyanti A, Kurniawati DM. Gizi Prakonsepsi. Jakarta: Bumi Medika; 2019.
20. Hayes L, Mcparlin C, Kinnunen TI, Poston L, Robson SC, Bell R. Change in level of physical activity during pregnancy in obese women: findings from the UPBEAT pilot trial. BMC Pregnancy Childbirth [Internet]. 2015;15 CC-:52. Available from: https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01178462/full
21. Xiang M, Zhang J, Liang H, Zhang Z, Konishi M, Hu H, et al. Physical activity and dietary intake among Chinese pregnant women: an observational study. BMC Pregnancy Childbirth [Internet]. 2019 Aug 14 [cited 2021 Dec 12];19(1). Available from: https://pubmed.ncbi.nlm.nih.gov/31412799/
22. Aune D, Saugstad OD, Henriksen T, Tonstad S. Physical activity and the risk of preeclampsia: a systematic review and meta-analysis. Epidemiology [Internet]. 2014 [cited 2021 Dec 10];25(3):331–43. Available from: https://pubmed.ncbi.nlm.nih.gov/24713878/
23. Tobias DK, Zhang C, Van Dam RM, Bowers K, Hu FB. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care [Internet]. 2011 Jan [cited 2021 Dec 12];34(1):223–9. Available from: https://pubmed.ncbi.nlm.nih.gov/20876206/
24. Jesus MCP de, Silva MH da, Cordeiro SM, Kortchmar E, Zampier VS de B, Merighi MAB. Understanding unsuccessful attempts to quit smoking: a social phenomenology approach. Revista da Escola de Enfermagem da USP. 2016 Feb;50(1):71–8.
25. Reskiaddin LO, Supriyati S. Proses Perubahan Perilaku Berhenti Merokok: Studi Kualitatif Mengenai Motif, Dukungan Sosial dan Mekanisme Coping. Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior. 2021 Jun 30;3(1):58.
26. Louis GMB, Sapra KJ, Schisterman EF, Lynch CD, Maisog JM, Grantz KL, et al. Lifestyle and pregnancy loss in a contemporary cohort of women recruited before conception: The LIFE Study. Fertil Steril. 2016 Jul;106(1):180–8.
27. Barker M, Dombrowski SU, Colbourn T, Fall CHD, Kriznik NM, Lawrence WT, et al. Intervention strategies to improve nutrition and health behaviours before conception. Lancet [Internet]. 2018 May 5 [cited 2021 Dec 12];391(10132):1853–64. Available from: https://pubmed.ncbi.nlm.nih.gov/29673875/
28. Anggraeny O, Ariestiningsih AD. Gizi Prakonsepsi, Kehamilan, dan Menyusui. Malang: Universitas Brawijaya Press; 2017.
29. Grieger JA, Grzeskowiak LE, Wood LG, Clifton VL. Asthma control in pregnancy is associated with pre-conception dietary patterns. Public Health Nutr [Internet]. 2016 Feb 1 [cited 2021 Dec 23];19(2):332–8. Available from: https://pubmed.ncbi.nlm.nih.gov/25908413/
30. Alipour Z, Kheirabadi GR, Kazemi A, Fooladi M. The most important risk factors affecting mental health during pregnancy: a systematic review. Eastern Mediterranean Health Journal. 2018 Jun 1;24(6):549–59.
31. Bedaso A, Adams J, Peng W, Xu F, Sibbritt D. An examination of the association between marital status and prenatal mental disorders using linked health administrative data. BMC Pregnancy Childbirth. 2022 Oct 1;22(1):735.
32. Welshman H, Dombrowski S, Grant A, Swanson V, Goudreau A, Currie S. Preconception knowledge, beliefs and behaviours among people of reproductive age: A systematic review of qualitative studies. Prev Med (Baltim). 2023 Oct;175:107707.
33. Kurniawati W, Afiyanti Y. “Establishing healthy family and offspring on prospective bridegroomâ€: A qualitative analysis. Enferm Clin. 2019 Sep;29:855–61.
34. Rahmah N, Kurniawati W. Relationship between Marriage Readiness and Pregnancy Planning among Prospective Brides. J Public Health Res. 2021 May 16;10(1_suppl):jphr.2021.2405.
35. Priani IF, Afiyanti Y, Kurniawati W. Preparing pregnancy through Preconception Education Training. Enferm Clin. 2019 Sep 1;29:304–9.
36. Shukla S, Abejirinde IOO, Meyer SR, Shenderovich Y, Steinert JI. Mechanisms behind gender transformative approaches targeting adolescent pregnancy in low- and middle-income countries: a realist synthesis protocol. Syst Rev. 2024 Mar 23;13(1):95.
37. UNFPA. Gender Transformative Approaches to Achieve Gender Equality and Sexual and Reproductive Health and Rights. United Nations Population Fund (UNFPA). 2023 Mar 8;
38. Nizamani S, Agarwal CRK, Somerset S, McFarlane RA. Together we win! Narratives of couples pursuing a healthy diet and physical activity: A qualitative study. Health Sci Rep. 2024 Sep 28;7(9).
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