Keeping the family together and bonding: a father’s role in a perinatal mental health unit

Objective: This study explores fathers’ paternal roles and relationships when their partner and baby were admitted to a Perinatal Mental Health Unit. It contributes to an understudied and important area of perinatal mental health. Background: The importance of establishing a secure attachment in the first months of life is widely accepted to be critical to the development of good infant mental health. Parental mental ill-health and parent–infant separation can negatively impact parental and infant attachment. Additionally, maternal postnatal mental health is known to affect the father’s well-being and this can impact on his parenting. Methods: Grounded theory methodology was used. Eight fathers were recruited from two Perinatal Mental Health Units. Transcripts were analysed and compared by researchers. Results: Fathers described a difficult experience of trying to create and maintain family bonds. Long admissions with infrequent visits were most difficult. Fathers wanted to bond and had concerns about bonding, but prioritised the mother–baby bond. Couple relationships were strained and fathers relied on external family supports. Fathers experienced anxiety about their partner’s illness and felt relief when their partner was admitted. Fathers were uncertain about treatment and prognosis and desired improved communication with professionals. Conclusion: Severe maternal postnatal mental illness and inpatient admission affected fathers. They were aware of not being consistently available to their baby and were concerned about the impact of this on bonding, attachment, and the infant’s well-being. Fathers would benefit from increased staff awareness of their needs, increased involvement in their partner’s care planning, and additional support to promote infant-father attachment.