[The forgotten gender - How do fathers experience an unforeseen caesarean section of their partner? An exploratory study].

Abstract

This exploratory case-control study investigated the psychological well-being of expectant fathers before, during, and after an emergency cesarean section. The aim was to determine whether these men are at a higher risk of post-traumatic stress compared to men undergoing a secondary cesarean section and what affective experiences they report retrospectively.Fathers (secondary cesarean [N=103] vs. emergency cesarean [N=52]) were retrospectively surveyed using a questionnaire developed by the Department of Medical Psychology and the Women's Clinic of the University Hospital of Ulm. The study focused on unplanned cesarean sections during the period from January 1, 2017, to June 30, 2019. The questionnaire consisted of two sections: Section A captured sociodemographic, biographic, medical, and psychometric characteristics. Section B focused on the experience of childbirth and afterward and integrated the "Positive and Negative Affect Schedule" (PANAS) and the Posttraumatic Stress Checklist 5 (PCL-5).During an emergency cesarean, fathers more frequently expressed fear for the life of their partner and child. The PANAS analysis showed that fathers in the emergency cesarean group significantly more often experienced negative emotions such as fear and restlessness. They also had higher PCL-5 scores, however, only three fathers from the emergency cesarean group and one father from the control group met the criteria for post-traumatic stress disorder. Fathers during an emergency cesarean felt less well cared for compared to the control group and rated the information about the possibility of an emergency cesarean as insufficient. After an emergency cesarean, psychological support was more often recommended but was not utilized. The majority of fathers desired a follow-up conversation with the treatment team. About one-fifth sought additional help after the birth, mostly from family or a midwife.The results of the retrospective study suggest that men experience higher psychological stress during an emergency cesarean compared to a secondary cesarean. Many fathers in the emergency group felt inadequately prepared. A postoperative discussion with the team is desired by the fathers and can be helpful in processing an emergency intervention.Expectant fathers should be thoroughly informed about potential complications before birth. Staff should be trained to also support the fathers during a emergency cesarean.