• Brandon S Allport-Altillo, Anushka R Aqil, Timothy Nelson, Sara B Johnson, Alain B Labrique, Yorghos Carabas, and Arik V Marcell.
• Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, USA; Johns Hopkins Bloomberg School of Public Health, 615 Wolfe Street, Baltimore, MD 21205, USA. Electronic address: ballport@utexas.edu.
• J Natl Med Assoc. 2020 Aug 1; 112 (4): 344-361.

ObjectiveTo explore fathers' pregnancy and early infancy experiences in supporting his infant, partner, and himself, using information collected from fathers, mothers, and mother-father dyads in a low-income, urban community.BackgroundFather involvement is associated with positive child health outcomes and parental well-being. However, little information exists about low-income parents' perceived needs for father involvement during pregnancy and infancy.MethodsThis was an exploratory qualitative study of parents in low-income communities of Baltimore, Maryland. Participants were conveniently sampled via partnerships with community organizations. Eighty percent of parents were African American. Four focus groups were conducted with fathers (n = 8), 4 with mothers (n = 9), and 4 interviews with father-mother dyads (n = 8). Sessions were audio-recorded, transcribed, and analyzed using iterative, inductive open coding performed independently by two team members (interrater agreement 86%). Frequency tables were generated for identified categories for content analysis and theme development.ResultsFive themes were identified: perspectives on the father role, supporting partners, negotiating co-parenting, parenting logistics, and learning parenting skills. Participants expressed the importance of fathers to "be there" and barriers to being involved (e.g., finances, lack of role models). Fathers discussed needing to learn how to manage partner conflicts, while mothers discussed fathers' need for greater empathy. Dyads discussed the importance of co-parenting strategies (e.g., effective communication, sharing responsibilities). Logistics included direct infant care, finances, and community resources. Fathers discussed learning by trial and error rather than informational resources and relying on healthcare professionals for pregnancy information and female relatives for infant care.ConclusionParticipants discussed various needs of fathers to be effective partners and parents, and lacking informational resources tailored specifically for fathers. Research is needed to explore the best ways to tailor and disseminate information to fathers, especially prenatally.ImplicationsStudy findings have significant implications for improving the ways in which maternity care, community-based programs, and pediatric providers support father involvement.Copyright © 2020 National Medical Association. Published by Elsevier Inc. All rights reserved.

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