An Amazing Fatherhood Program’s Impact on Birth Outcomes

The United States is arguably the world’s most financially wealthy country. Unfortunately, we haven’t parlayed that wealth into improving two connected stains on our nation: our dead-last ranking among wealthy countries in maternal mortality and our nearly dead-last ranking among wealthy countries in infant mortality.

These crises have hit Blacks and Hispanics particularly hard. As I noted in a previous blog article on the maternal mortality crisis, the situation for Black women is dire with their death rate two and one-half times the rate for White women and three times the rate for Hispanic women. Regarding infant mortality, the rate of death for Black and Hispanic babies is nearly twice that of White babies.

In my previous article, I encouraged fatherhood practitioners to address the maternal mortality crisis with the dads they serve and suggested ways to do so. That’s why I was pleased to learn recently about Dads2Be, the fatherhood program of the Urban Family Development Center in Columbus, Ohio that’s taking these crises head on and seeing amazing results.

I recently had the pleasure of interviewing David Fluellen, the CEO and founder of the center. I was enthralled by David’s passion for serving dads, the laser-focused program-delivery model of Dads2Be, and the results they’ve seen. Rather than summarize what I learned—as I typically do when sharing success stories in this blog—I decided instead to share a slightly edited transcript of our conversation. (Let me know what you think of this approach. Email me at cbrown@fatherhood.org.)

Chris: Please describe Dads2Be. How does it serve dads?

David: Dads2Be offers prenatal education to new and expectant dads in Columbus that live predominantly in high-risk areas for infant death. We help dads fully understand how they can support moms throughout the pregnancy to be as healthy as possible. We know that when dads are involved during this time, it increases the likelihood of positive birth outcomes for moms and children.

Chris: In doing background research to prepare for our interview, I noticed that you started Urban Family Development Center in 2013. Is that when you started Dads2Be?

David: No. I started the center to offer skills-trade training. Before starting the center, I worked for nonprofits that helped former inmates reenter society. I discovered that the issue for ex-offenders wasn’t getting a job, it was getting a good-paying job. I knew that skills-trade training was ideal for ex-offenders because it didn’t require a degree to get into. I got a call after a couple of years doing this work from a consultant working with the Columbus Urban League. He was trying to help them get a fatherhood program off the ground but struggling with it, and he thought we could help. He said the Urban League wanted to work with dads to reduce infant mortality. So, I committed to helping it get started.

We started a pilot by partnering with the Wexner Medical Center at Ohio State University and their Moms2Be program, which focuses on prenatal education for moms. They had four sites in high-risk infant mortality areas. They had moms showing up who would often bring dads, but the program didn’t offer anything for the dads to do. They had reached out to the Ohio Commission on Fatherhood for help serving these dads, and the Ohio Commission reached out to the Urban League. We started a pilot to provide that education to the dads.

We did a lot of research to find other programs around the country focused on prenatal education for dads. But we found nothing—no templates, no model, and no curriculum for dads on prenatal education. So, we structured Dads2Be like Moms2Be and created a curriculum—a toolkit for dads to support moms. We worked alongside Moms2Be. We showed up to their sessions, and we worked with the dads. We eventually disconnected from the Urban League and took the program on fully, which is when we created the name and did the branding for the program. This was in 2017.

Chris: How do you describe the dads you serve?

David: Dads in low-income, urban communities at high risk of infant mortality. These can be biological dads and father figures. About 70% are Black, 10% White, and the rest a mix of races and ethnicities, including a good number of Somalis. Dads come in at different periods during mom’s pregnancy and stay with us until the child turns 1. We show up at hospitals at the time of birth and give dads their own bag with items just for them that they can carry while out with their baby. We celebrate births including when there’s a healthy birth outcome. We promote births on social media.

Chris: Do you have data on numbers of dads you’ve served?

David: Oh, yes! About a year in, we started to collect data on who we served and how many served. Now, we also track birth outcomes, such as whether a baby is full-term, the baby’s weight, whether mom breastfeeds, and whether dad and mom are using safe sleep practices with their baby. Since the program’s inception, we’ve served 912 dads and documented 412 healthy birth outcomes.

Chris: What’s the name of the curriculum you use?

David: We’re still developing it. The Nurturing Fathers curriculum is the foundation. We added an “Infant Vitality Toolkit” for dads that we deliver while mom is still pregnant. We also have what we call a “Kickback” where dads from all of our sites come together periodically to listen to a topic-based expert, such as on financial planning.

Chris: What’s in the toolkit?

David: Four things. First, breastfeeding support, such as its importance and benefits, physiology of the breast, and how milk is formed. Second, safe spacing of births, such as it takes two years for mom’s body to fully heal after birth and birth control options to prevent pregnancy in that two-year period, what’s happening with mom’s body when she comes home from the hospital, and when you can have sex again. Third, safe sleep practices for the baby, such as how to create a safe sleep environment and dad’s role in safe sleep). Fourth, smoking cessation, such as the importance of quitting because of the effects of second-hand smoke on the baby.

Chris: Do you have other staff?

David: Yes. We have a coordinator who goes out to all of our sites and conducts four in-person and one virtual session each week at sites provided by Ohio State University that deliver Moms2Be. He facilitates a session with dads during that two-hour. We also have a community health worker who assists our coordinator to come up with Family Improvement Plans and connect dads and moms to our Family First Program. In that way, we support both dad and mom.

Chris: Do you have partners that bring additional resources to the dads you serve?

David: Yes. We have a good relationship with the local health department that gives our dads and moms who enroll in their smoking-cessation program free diapers for the baby’s first year. We have a partnership that helps dads and moms with nutrition information for infants and helps when breastfeeding is a challenge. We partner with a mental health expert ready to help dads, especially with paternal postpartum depression.

Chris: Do you engage dads only in groups or also one-on-one?

David: Both. The sessions are group sessions, but we meet with dads one-on-one throughout the week. We meet one-on-one starting with enrollment into Dads2Be and then meet weekly in “Touch Base Sessions” that take place over the phone or in person, such as at their home, a coffee shop, or wherever it’s convenient for them. The one-on-one contact helps us keep dads accountable for following through on their Family Improvement Plan, which is, basically, a case management component.  

Chris: How do you recruit dads?

David: Through Moms2Be. Plus, we are the only organization in Franklin County focused on working with dads to reduce infant mortality. As a result, we have relationships and referrals from programs serving pregnant moms. We also market via social media and host a session once a week for any dad who wants help in this area and isn’t connected to Moms2Be.

Chris: How do you retain dads’ participation?

David: The Touch Base Sessions, of course, which is a reflection of retention through the relationship we create with them. Our work with them is relationship-based. It creates a safe environment where they can be transparent about what they need, and it’s culturally relevant, genuine.

Chris: Where does your funding come from?

David: The Ohio Commission on Fatherhood, the City of Columbus, and Ohio State University.

Chris: What’s the biggest strength of the program?

David: Our ability to educate dad on his role during the pregnancy. If we can empower dad via education before birth, the chance that dad sticks around is higher and reduces the risk of having issues around child support, custody, etc. that result from father absence. This keeps dad in the home and strengthens community.

Chris: What’s the biggest challenge for the program?

David: There are two primary challenges. First, we’re working against a system that keeps dad out of the picture, especially the medical community during the prenatal period. Second, getting other organizations on board to partner, especially those working on reducing infant mortality. All of their marketing materials focus on moms.

Chris: To wrap up our interview, I’d like to ask you a question that provides a nice takeaway for others who want to learn from successful programs like yours. If you were speaking at a conference about your program and were asked for three pieces of advice in serving dads during the prenatal and postnatal periods, what would you say?

David: The most important advice is to build trust with dads because you can’t get down to what they need if they don’t trust you. Second, do what you say you’ll do—follow through. Third, hold dads accountable, not to beat them over the head but in terms of motivating them to be involved and always reminding them we’re here to help.

Do you serve dads during the prenatal and postnatal periods?

If not, what’s keeping you from reaching dads during that critical time?