Paternal Perinatal Mental Health

Abstract
Perinatal mental health problems occur from pregnancy up to the infant’s first year. Existing practice recommendations focus almost exclusively on maternal emotional wellbeing, assuming mental health deterioration is primarily linked to the physical nature of pregnancy and birth. Consequently, evidence regarding the dyadic relationship between maternal and paternal mental health remains limited, and few studies examine midwives’ experiences providing paternal care.
This thesis addresses these gaps across three chapters: a scoping review, a secondary quantitative analysis of a longitudinal cohort study examining paternal mental health prevalence and inter-parental dyadic relationships, and a qualitative interview study with seventeen midwives exploring perceptions of paternal care.
Findings indicate that paternal depression prevalence may be an enduring condition, following an upward trajectory across the first postpartum year. A significant dyadic relationship was identified between maternal and paternal wellbeing, suggesting at-risk fathers can be identified early. However, midwives reported that lack of specialised training, inadequate infrastructure, and absent referral pathways prevent effective paternal support.
These findings demonstrate that maternal-centric care fails to address the inter-parental nature of perinatal mental health. To move beyond a "visitor" model, policy and NHS practice must transition to a family-centered framework, incorporating integrated electronic health records, specialised training, and routine clinical pathways for fathers. Future research should prioritise standardising screening tools, distinguishing between paternal "stress" and "mental illness," and exploring inter-parental experiences within under-represented populations.