What About Fathers When Their Partner Suffers From Peripartum Cardiomyopathy?

Background: Peripartum cardiomyopathy (PPCM) is a life threatening condition and defined as: An idiopathic cardiomyopathy presenting with heart failure (HF) secondary to left ventricle systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of HF is found. The left ventricle may not be dilated but the ejection fraction is nearly always reduced below 45% [1]. The diagnosis of PPCM in women can be a transition trigger for fathers, exacerbating the disruptions created in transition to fatherhood. In Sweden, policy enables fathers to take paternal leave, with an allowance, instead of the mother [2]. Such policy practices clearly provide a supportive structure for fathers’ transition to a new role, and have been advocated in the international arena. The World Health Organization (WHO) [3] calls for a broader understanding from healthcare professionals of paternity and men's needs and perspectives related to perinatal care. A meta-synthesis, with data from different continents showed that fathers wish to be included during labour and birth, to support their partner in an adequate manner [4]. Despite this, there appears to be a lack of awareness and recognition by health professionals of the benefits of effective paternal involvement in maternity care [5]. Although structured support systems are developed, these systems tend to be based on the healthcare providers’ perceptions and focus mainly on mothers’ care. Fathers’ vital role in supporting their partners has been advocated in previous research. However, the impact of PPCM on the male partners of women is less understood. This is the first qualitative study about men’s experiences of healthcare while their partner is suffering from PPCM.

Aim: To explore the experiences of healthcare in fathers whose partner was suffering from Peripartum cardiomyopathy.

Methods: The data from interviews with fourteen fathers were analyzed using inductive content analysis.

Results: Being prepared and receiving clear information were essential elements of a positive experience that would support fathers to help their partner in the best way. The birth of the child was an exciting experience, but a feeling of helplessness was central, related to seeing their partner suffering. The negative experiences were related mainly to feelings of being at the periphery due to lack of attention paid by professionals. Lack of timely information did not allow fathers to understand their partner´s distress, and plan for the future. Because the fathers did not directly understand the situation, frustrations arose related to uncertainty and insecurity. An overarching category “The professionals could have made a difference” was identified from the data, characterized by the sub-categories: ‘To be informed/not informed,’‘To feel secure/insecure,’‘To feel visible/invisible’ and ‘Wish that it had been different’ [6].

Conclusion: The fathers are not patient nor visitor, and are in between somewhere, acting as a carer and protector for the woman and their children. Professionals, by being attentive to fathers’ need may increase fathers’ self-confidence and help in developing strategies to handle the actual transition. When men, as partners of women with PPCM, get adequate information of their partner´s condition, they gain a sense of security and control that gives them strength to handle their personal and emotional life situation during the transition of becoming a father, along with taking care of an ill partner with PPCM. Hence, maternity professionals should also focus on fathers’ particular needs to help them fulfil their roles.

Keywords: Peripartum cardiomyopathy, Fathers´s experiences, Pregnancy, Heart failure, Qualitative study, Information, Care