CoChat
Sign Up
Cited by 499Global Maternal and Child HealthMaternal Mental Health During Pregnancy and PostpartumMaternal and Perinatal Health Interventions

Male involvement and maternal health outcomes: systematic review and meta-analysis

Open access
Yargawa, Judith, Leonardi-Bee, Jo·2015·Journal of Epidemiology and Community Health
DOI 10.1136/jech-2014-204784PMC PMC4453485
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: The developing world accounts for 99% of global maternal deaths. Men in developing countries are the chief decision-makers, determining women's access to maternal health services and influencing their health outcomes. At present, it is unclear whether involving men in maternal health can improve maternal outcomes. This systematic review and meta-analysis aimed to investigate the impact of male involvement on maternal health outcomes of women in developing countries. Methods: Four electronic databases and grey literature sources were searched (up to May 2013), together with reference lists of included studies. Two reviewers independently screened and assessed the quality of studies based on prespecified criteria. Measures of effects were pooled and random effect meta-analysis was conducted, where possible. Results: Fourteen studies met the inclusion criteria. Male involvement was significantly associated with reduced odds of postpartum depression (OR=0.36, 95% CI 0.19 to 0.68 for male involvement during pregnancy; OR=0.34, 95% CI 0.19 to 0.62 for male involvement post partum), and also with improved utilisation of maternal health services (skilled birth attendance and postnatal care). Male involvement during pregnancy and at post partum appeared to have greater benefits than male involvement during delivery. Conclusions: Male involvement is associated with improved maternal health outcomes in developing countries. Contrary to reports from developed countries, there was little evidence of positive impacts of husbands’ presence in delivery rooms. However, more rigorous studies are needed to improve this area's evidence base.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/jech-2014-204784

Cites

6 of 6 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • This is the first trial of a male engagement intervention to demonstrate at least a modest impact on women's ANC attendance.

    “This is the first trial of a male engagement intervention, to our knowledge, to demonstrate at least a modest impact on women’s ANC attendance [3,28].”

    From Gender-transformative Bandebereho couples' intervention to promote male engagement in reproductive and maternal health and violence prevention in Rwanda: Findings from a randomized controlled trial (2018) · cites this paper as [28]

    The Results (Findings from studies by outcome; page unavailable) report that an earlier male-involvement study found no significant association with women’s ANC attendance. That provides context for the novelty claim, but this review does not establish that the citing authors’ trial was the first to show an impact or report that trial’s effect. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Non-trial research has found that male partner support is associated with women's antenatal attendance, birth preparedness and use of a skilled birth attendant.

    “Non-trial research has found that male partner support is associated with women’s antenatal attendance, birth preparedness and use of a skilled birth attendant [3,28].”

    From Gender-transformative Bandebereho couples' intervention to promote male engagement in reproductive and maternal health and violence prevention in Rwanda: Findings from a randomized controlled trial (2018) · cites this paper as [28]

    The Results (Findings from studies by outcome; page not provided) report a significant association between husbands’ antenatal attendance and skilled attendance at birth in a cross-sectional study. The Discussion (Interpretation; page not provided) links male involvement to birth preparation. But the reported antenatal-care finding comes from a trial and was not statistically significant, so the source does not support all three outcomes as findings of non-trial research. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 55

  1. [3]United Nations Department of Public Information. International Conference on Population and Development, ICPD ‘94: Summary of the programme of action 1995 http://www.un.org/ecosocdev/geninfo/populatin/icpd.htm (accessed 5 Feb 2013).
  2. [5]Dudgeon MR, Inhorn MC Men's influences on women's reproductive health: medical anthropological perspectives. Soc Sci Med 2004; 59: 1379– 95. 15246168
  3. [6]Gharoro EP, Igbafe AA Antenatal care: some characteristics of the booking visit in a major teaching hospital in the developing world. Med Sci Monit 2000; 6: 519– 22. 11208364
  4. [7]Bhalerao V, Galwankar M, Kowli S, et al Contribution of the education of the prospective fathers to the success of maternal health care programme. J Postgraudate Med 1984; 30: 10– 2. 6716302
  5. [8]Beenhakker BC The impact of male involvement in antenatal care in Kathmandu, Nepal. Proquest Dissertations and Theses: Doctor of Philosophy Dissertation. Johns Hopkins University, 2005.
  6. [9]Banos JP, Banos C, Moumouni Z Constraints faced by hospitalized maternity patients in Niamey, Niger. Sante 1996; 6: 345– 51. 9053101
  7. [11]Schaffer MA, Lia-Hoagberg B Effects of social support on prenatal care and health behaviors of low-income women. J Obstet Gynecol Neonatal Nurs 1997; 26: 433– 40. 9252891
  8. [12]Martin LT, McNamara MJ, Milot AS, et al The effects of father involvement during pregnancy on receipt of prenatal care and maternal smoking. Matern Child Health J 2007; 11: 595– 602. 17557201
  9. [13]Kiernan K, Pickett KE Marital status disparities in maternal smoking during pregnancy, breastfeeding and maternal depression. Soc Sci Med 2006; 2: 335– 46. 16472900
  10. [14]Bielinski-Blattmann D, Lemola S, Jaussi C, et al Postpartum depressive symptoms in the first 17 months after childbirth: the impact of an emotionally supportive partnership. Int J Public Health 2009; 54: 333– 9. 19636511
  11. [15]O'Hara MW Social support, life events, and depression during pregnancy and the puerperium. Arch Gen Psychiatry 1986; 43: 569– 73. 3707289
  12. [16]Plantin L, Olukoya AA, Ny P Positive health outcomes of fathers’ involvement in pregnancy and childbirth paternal support: a scope study literature review. Fathering 2011; 9: 87– 102.
  13. [17]Dennis CL, Ross L Women's perceptions of partner support and conflict in the development of postpartum depressive symptoms. J Adv Nurs 2006; 56: 588– 99. 17118038
  14. [18]Gremigni P, Mariani L, Marracino V, et al Partner support and postpartum depressive symptoms. J Psychosom Obstet Gynaecol 2011; 32: 135– 40. 21774735
  15. [19]Grube M Inpatient treatment of women with postpartum psychiatric disorders—the role of the male partners. Arch Womens Ment Health 2005; 8: 163– 70. 15959625
  16. [20]Al Dallal FH, Grant IN Postnatal depression among Bahraini women: prevalence of symptoms and psychosocial risk factors. East Mediterr Health J 2012; 18: 432– 8. 22764429
  17. [21]Lee D Partner support reduced depressive symptoms in postpartum depression. Evid Based Ment Health 2001; 4: 51.
  18. [22]Reid H, Power M, Cheshire K Factors influencing antenatal depression, anxiety and stress. Br J Midwifery 2009; 17: 501– 8.
  19. [23]Stapleton LR, Schetter CD, Westling E, et al Perceived partner support in pregnancy predicts lower maternal and infant distress. J Fam Psychol 2012; 26: 453– 63. 22662772 PMC3992993
  20. [24]Mekonnen W, Worku A Determinants of low family planning use and high unmet need in Butajira District, South Central Ethiopia. Reprod Health 2011; 8: 1– 8. 22151888 PMC3248357
  21. [25]Yue K, O'Donnell C, Sparks PL The effect of spousal communication on contraceptive use in Central Terai, Nepal. Patient Educ Couns 2010; 81: 402– 8. 20719462
  22. [26]D'Aliesio L, Vellone E, Amato E, et al The positive effects of father's attendance to labour and delivery: a quasi experimental study. Int Nurs Perspect 2009; 9: 5– 10.
  23. [27]Block CR, Norr KL, Meyering S, et al Husband gatekeeping in childbirth. Fam Relations 1981; 30: 197– 204.
  24. [28]Guthrie K, Taylor DJ, Defriend D Maternal hypnosis induced by husbands during childbirth. J Obstet Gynaecol 1984; 5: 93– 5.
  25. [29]Henneborn WJ, Cogan R The effect of husband participation on reported pain and probability of medication during labour and birth. J Psychosom Res 1975; 19: 215– 22. 1104819
  26. [30]Helzner JF Men's involvement in family planning. Reprod Health Matters 1996; 7: 146– 54.
  27. [32]Sarkadi A, Kristiansson R, Oberklaid F, et al Fathers’ involvement and children's developmental outcomes: a systematic review of longitudinal studies. Acta paediatrica 2008; 97: 153– 8. 18052995
  28. [33]Alio AP, Salihu HM, Kornosky JL, et al Feto-infant health and survival: does paternal involvement matter? Matern Child Health J 2010; 14: 931– 7. 19826935
  29. [34]Morfaw F, Mbuagbaw L, Thabane L, et al Male involvement in prevention programs of mother to child transmission of HIV: a systematic review to identify barriers and facilitators. Syst Rev 2013; 2: 5. 23320454 PMC3599633
  30. [35]Brusamento S, Ghanotakis E, Car LT, et al Male involvement for increasing the effectiveness of prevention of mother-to-child HIV transmission (PMTCT) programmes (review). Cochrane Database Cyst Rev 2012; 10: 1– 18. PMC6718228 23076959
  31. [36]Ditekemena J, Koole O, Engmann C, et al Determinants of male involvement in maternal and child health services in sub-Saharan Africa: a review. Reprod Health 2012; 9: 32. 23171709 PMC3573948
  32. [43]Dersimonian R, Laird N Meta-analysis in clinical trials. Controlled Clin Trials 1986; 7: 177– 88. 3802833
  33. [46]Chattopadhyay A Men in maternal care: evidence from India. J Biosoc Sci 2012; 44: 129– 53. 22004658
  34. [47]Gausia K, Fisher C, Ali M, et al Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study. Arch Womens Ment Health 2009; 12: 351– 8. 19468825
  35. [48]Gausia K, Fisher C, Ali M, et al Magnitude and contributory factors of postnatal depression: a community-based cohort study from a rural subdistrict of Bangladesh. Psychol Med 2009; 39: 999– 1007. 18812008
  36. [49]Mullany BC, Becker S, Hindin MJ The impact of including husbands in antenatal health education services on maternal health practices in urban Nepal: results from a randomized controlled trial. Health Educ Res 2007; 22: 166– 76. 16855015
  37. [50]Sapkota S, Kobayashi T, Kakehashi M, et al In the Nepalese context, can a husband's attendance during childbirth help his wife feel more in control of labour? BMC Pregnancy Childbirth 2012; 12: 1– 10. 22698006 PMC3464724
  38. [51]Sreelekshmi F, Sharika S, Vidyakrishna V, et al Risk factors of postpartum depression among married mothers attending SAT Hospital, Trivandrum. Aust Med J 2010; 3: 222.
  39. [52]Wasti D, Lim A, Pathak RS Influence of husband domestic support on maternal morbidity in rural Nepal. Southeast Asian J Trop Med Public Health 2012; 43: 1009– 17. 23077825
  40. [53]Ip WY Chinese husbands’ presence during labour: a preliminary study in Hong Kong. Int J Nurs Pract 2000; 6: 89– 96. 11111493
  41. [54]Wan EY, Moyer CA, Harlow SD, et al Postpartum depression and traditional postpartum care in China: role of zuoyuezi. Int J Gynaecol Obstet 2009; 104: 209– 13. 19036364
  42. [55]Xie RH, Yang J, Liao S, et al Prenatal family support, postnatal family support and postpartum depression. Aust N Z J Obstet Gynaecol 2010; 50: 340– 5. 20716261
  43. [56]Aydin N, Inandi T, Karabulut N Depression and associated factors among women within their first postnatal year in Erzurum province in eastern Turkey. Women Health 2005; 41: 1– 12. 16219584
  44. [57]Senturk V, Abas M, Berksun O, et al Social support and antenatal depression in extended and nuclear family environments in Turkey: a cross-sectional survey. BMC Psychiatry 2011; 11: 48. 21435209 PMC3073894
  45. [58]Andersson N, Omer K, Caldwell D, et al Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states. BMC Health Serv Res 2011; 11 (Suppl 2): 1– 11. 22375828 PMC3332566
  46. [59]Lteif Y, Kesrouani A, Richa S Depressive syndromes during pregnancy: prevalence and risk factors. J Gynecol Obstet Biol Reprod (Paris) 2005; 34 (3 Pt 1): 262– 9. 16012387
  47. [60]Sexton MB, Flynn HA, Lancaster C, et al Predictors of recovery from prenatal depressive symptoms from pregnancy through postpartum. J Womens Health (Larchmt) 2012; 21: 43– 9. 22060255 PMC3256560
  48. [61]Stewart DE, Robertson E, Dennis CL, et al Postpartum depression: literature review of risk factors and interventions. Univ Health Netw Womens Health Program 2003.
  49. [62]Tweheyo R, Konde-Lule J, Tumwesigye NM, et al Male partner attendance of skilled antenatal care in peri-urban Gulu district, Northern Uganda. BMC Pregnancy Childbirth 2010; 10: 53. 20846369 PMC2946269
  50. [63]Ahmed A, Hossain SAS, Quaiyum A, et al Husbands’ knowledge on maternal health care in rural Bangladesh: an untapped resource? Trop Med Int Health 2011; 16: 291.
  51. [64]Ali M, Rizwan H, Ushijima H Men and reproductive health in rural Pakistan: the case for increased male participation. Eur J Contracept Reprod Health Care 2004; 9: 260– 6. 15799183
  52. [65]Kakaire O, Kaye DK, Osinde MO Male involvement in birth preparedness and complication readiness for emergency obstetric referrals in rural Uganda. Reprod Health 2011; 8: 12. 21548976 PMC3118172
  53. [66]Bhatta DN Involvement of males in antenatal care, birth preparedness, exclusive breast feeding and immunizations for children in Kathmandu, Nepal. BMC Pregnancy Childbirth 2013; 13: 14. 23324410 PMC3558464
  54. [67]Shefner-Rogers CL, Sood S Involving husbands in safe motherhood: effects of the SUAMI SIAGA campaign in Indonesia. J Health Commun 2004; 9: 233– 58. In: Davis J, Luchters S, Holmes W. Men and maternal and newborn health: Benefits, harms, challenges and potential strategies for engaging men. 2012. 15360036
  55. [68]Betran AP, Say L, Gulmezoglu AM, et al Effectiveness of different databases in identifying studies for systematic reviews: Experience from the WHO systematic review of maternal morbidity and mortality. BMC Med Res Methodol 2005; 5: 1– 5. 15679886 PMC548692

Cited by

Sorted by citations

Authors
Yargawa, J., & Leonardi-Bee, J.
Affiliations
  • University of Nottingham (GB)
  • Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Nottingham, UK
ORCID
Yargawa, Judith
Venue
Journal of Epidemiology and Community Health
Publisher
BMJ
Published
2015-02-19
Volume
69
Issue
6
Pages
604-612
ISSN
  • 0141-7681 (ISSN-L)
  • 0143-005X
  • 1470-2738
DOI
10.1136/jech-2014-204784
PMC
PMC4453485
OpenAlex
W2147202147
Cited by
499
References
6
Citations by year
2026: 42 · 2025: 42 · 2024: 62 · 2023: 53 · 2022: 62 · 2021: 67 · 2020: 62 · 2019: 31 · 2018: 45 · 2017: 17 · 2016: 15 · 2015: 1
FWCI
3.96
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Journal of Epidemiology & Community Health (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Repository@Nottingham (University of Nottingham) (publishedVersion, other-oa)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by-nc)
  • Nottingham ePrints (University of Nottingham) (submittedVersion, cc-by-nc)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by-nc)
Funders
University of Nottingham
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
male involvement, paternal involvement in pregnancy, maternal outcomes, postpartum depression, skilled birth attendance, postpartum care, maternal health service utilization, developing countries, maternal mortality
MeSH terms
Maternal Health, Decision Making, Developing Countries, Female, Humans, Male, Maternal Health Services, Pregnancy, Pregnancy Outcome, Social Support, Spouses, Postpartum Period

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review