March of Dimes’ Big Miss

Very good news was just released about the United States’ preterm birthrate: in 2011, for the fifth consecutive year, it decreased. The rate now stands at a 10-year low of 11.7%.

This news was rightfully celebrated by the organization that is probably the single biggest advocate for maternal and infant health in the U.S., March of Dimes. That admirable organization has set a goal of a 9.6% rate by 2020.

We sincerely hope and pray that the goal is met.

However (you knew a “however” was coming), we at National Fatherhood Initiative believe that March of Dimes is missing an enormous opportunity to reach and surpass the goal they have set. As far as we can see, they are doing little to nothing to acknowledge or encourage the role that involved fathers play in maternal and child health.

Before I say more, I will take this opportunity to inundate you with data, because there is so much research out there that shows, unequivocally, that father involvement matters to maternal and child health.

In a landmark study conducted by the University of South Florida and published in the Journal of Community and Family Health in 2010, researchers examined the records of all births in Florida from 1998 to 2005 – more than 1.39 million live births. They found the following:

• Infants with absent fathers were more likely to be born with lower birth weights, to be preterm and small for gestational age.
• Regardless of race or ethnicity, the neonatal death rate of father-absent infants was nearly four times that of their counterparts with involved fathers.
• The risk of poor birth outcomes was highest for infants born to black women whose babies’ fathers were absent during their pregnancies. Even after adjusting for socioeconomic differences, these babies were seven times more likely to die in infancy than babies born to Hispanic and white women in the same situation.
• Obstetric complications contributing to premature births, such as anemia, chronic high blood pressure, eclampsia and placental abruption, were more prevalent among women whose babies’ fathers were absent during pregnancy.
• Expectant mothers in the father-absent group tended to be younger, more educated, more likely to never have given birth, more likely to be black, and had a higher percentage of risk factors like smoking and inadequate prenatal care than mothers in the father-involved group.

If that data is not enough to convince you that March of Dimes should do more to engage fathers, here’s more:

• Infant mortality rates are 1.8 times higher for infants of unmarried mothers than for married mothers. ¹
• High-quality interaction by any type of father predicts better infant health.²
• Children living with their married biological or adoptive parents have better access to health care than children living in any other family type.³
• Premature infants who have increased visits from their fathers during hospitalization have improved weight gain and score higher on developmental tests.⁴
• When fathers are involved during the pregnancy, babies have fewer complications at birth.⁵
• Babies with a father’s name on the birth certificate are 4 times more likely to live past 1 year of age.⁶
• Twenty-three percent of unmarried mothers in large U.S. cities reported cigarette use during their pregnancy. Seventy-one percent were on Medicare.⁷

Given the powerful case that the research makes, it is critical that every entity working to improve maternal and child health invests in increasing father involvement. All indications are that March of Dimes is not doing this in any noticeable or significant way.

A legitimate question at this point is, “How do you increase father involvement in maternal and child health?” There are three broad categories:

• Awareness – The first step is to ensure that the public is aware of the data that we provided above. Do you think most people understand the central role fathers play in this area? March of Dimes is positioned better than any other organization in the country to make a big deal out of how important dads are to maternal and child health. By simply listing this sort of research on their website and talking about father involvement as a factor in determining the preterm birthrate, they can have a great deal of influence. In the USA Today article from 11/13/12 in which I found out about this news, March of Dimes spokespeople cited things like access to prenatal care and reduced smoking during pregnancy as critical to preventing premature births, but nothing about involved dads.
• Research – Given what we know from the above research, and given the continued emphasis on research into why preterm births happen, more research dollars should be dedicated to understanding why fathers play such an important role, and then, how we can get them more involved from the start. Based on their website, it appears that none of March of Dimes’ research grant recipients are studying father involvement.
• Skill-building – Finally, every entity that interacts with pregnant moms (hospitals, birthing centers, Lamaze classes, nurse home visits, etc.) should be encouraged and equipped to provide fathers with inspiration and education about the importance of their role. Many fathers are afraid to get involved in pregnancy and infants’ lives because they fear that their lack of parenting skills will hurt more than help. We need to collectively disavow fathers of this notion by providing them with high quality skill-building materials to increase their health literacy and get them in the game. Again, it does not appear March of Dimes is doing anything on this front.

There is a concept called the “tipping point” that can be described as follows: “that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire.”⁸ We believe that for reductions in the preterm birthrate to reach a tipping point, increasing father involvement needs to become an important part of the noble efforts currently underway. Otherwise, there is a very strong possibility of the reductions plateauing and lots of very smart people wringing their hands about why they can’t get the needle to shift further.

Let’s work together to encourage March of Dimes to pay more attention to the father factor in maternal and child health Here’s how. Contact March of Dimes to praise them for their great work, but to also encourage them to take the next step by acknowledging, celebrating, and encouraging the central role that fathers play in determining the preterm birthrate.

• Ask them a question about their research here. For example, you can ask “What are you doing to investigate the role that father involvement plays in reducing preterm births?”
• Comment on their Facebook wall. For example, you can say, “Research shows that father involvement is a key to reducing the preterm birthrate. What is March of Dimes doing to encourage father involvement?” Share with them the research we provide in this post, and tell them that father involvement during the prenatal period is key to reaching a tipping point in their effort. Encourage them to work with NFI.
• Tweet about the father factor in maternal and child health and tag March of Dimes. For example, you can tweet, “There's a father factor in preterm birthrate. Data here: http://bit.ly/nfiblogdimes112612. What is @MarchofDimes doing to encourage father involvement?”

Collectively, we can help a great organization reach a very important goal by speaking up for dads and the important role they play in nurturing healthy moms and babies.

Endnotes:
1. Matthews, T.J., Sally C. Curtin, and Marian F. MacDorman. Infant Mortality Statistics from the 1998 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports, Vol. 48, No. 12. Hyattsville, MD: National Center for Health Statistics, 2000.
2. Carr, D. & Springer, K. W. Advances in families and health research in the 21st century. Journal of Marriage and Family, 72, 743-761 (2010).
3. Gorman, B. G., & Braverman, K. Family structure differences in health care utilization among U.S. children. Social Science and Medicine, 67, 1766–1775 (2008).
4. Coleman WL, Garfield CF, and the Committee on Psychosocial Aspects of Child and Family Health. “Fathers and Pediatricians: Enhancing Men’s Roles in the Care and Development of their Children”. American Academy of Pediatrics Policy Statement, Pediatrics, May, 2004.
5. Alio, A.P., Mbah, A.K., Kornosky, J.L., Marty, P.J. & Salihu, H.M. "The Impact of Paternal Involvement on Feto-Infant Morbidity among Whites, Blacks, and Hispanics". Matern Child Health J. 2010; 14(5): 735-41.
6. Ibid.
7. McLanahan, Sara. The Fragile Families and Child Well-being Study: Baseline National Report. Table 7. Princeton, NJ: Center for Research on Child Well-being, 2003: 16.
8. http://www.amazon.com/Tipping-Point-Little-Things-Difference/dp/0316346624

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photo credit: Martin Gommel via photopin cc