Helping Young Fathers Across the Transition to Parenthood: A Rock or a Rolling Stone?

It Takes Two

Our second “aha moment” was directly related to our recruitment strategy. Although we hadn’t set out to do research with young mothers, we decided it was prudent to include them because they were our bridge to young fathers. So, we shifted our focus to studying “co-parents,” which meant that we administered the same set of interviews and questionnaires to expectant mothers and fathers simultaneously but in separate rooms to preserve their confidentiality. We quickly discovered that young mothers could tell us a lot about their partners that they—the fathers—could not or would not tell us themselves.

Fatherhood can be a transformative process. Photo: Julie Shipman

Occasionally, these young women would tell us things that their partners had covered up, such as infidelities or illegal activities. Most of the time, however, they told us about the soft and tender sides of these young men, such as how he had taken care of her when she was sick or comforted her when she was sad. The young mothers often told us about parts of their partner’s history that were too painful for them to tell us directly, such as being abandoned or abused as a child. Hearing about these young men from their partners helped us see them more completely and compassionately.

Having both parents come to these research meetings together also allowed us to see how they treated each other. Our observations of how the young fathers talked with and listened to their partners became a vital part of how we came to understand these men and their development as fathers. Our recruitment strategy helped us see that fatherhood is an inherently interpersonal process that begins before the baby arrives (Florsheim et al., 2003). That insight—which now seems so obvious—eventually played an important role in the development of our program to help fathers stay connected. Since then, several other researchers have found that the quality of the relationship between a father and his partner is a strong predictor of how well he will manage the transition to parenthood (Carlson, McLanahan, & Brookes-Gunn, 2008).

Thanks for Asking

Our third discovery was that young fathers had more to say than anyone could have anticipated, including their partners. Typically, the expectant mother’s first interview would last for 70 or 80 minutes. Toward the end, many young women assumed their boyfriends were pacing around outside, impatiently waiting for them to finish. Almost invariably, however, the interviews with the young expectant fathers ran longer than the interviews with their partners. When these young women found out that their boyfriend was still talking, they’d often say something like, “What could he be talking about? He never talks!” It dawned on us that, given the right context, these young men were not just willing to talk but they actually enjoyed the opportunity! Many were afraid and excited by the prospect of fatherhood and wanted to unload. We were asking questions that no one had ever asked them before, and they were saying things they had never articulated. Simple questions like: “How do you feel about becoming a father?”, “What sort of father do you hope to become?”, and “What could get in the way?” opened doors they did not know were there. Once these young men realized the interview was not a test, they allowed themselves to get curious about what we were asking. The implications of this discovery— again so obvious in hindsight—was that young fathers are easily engaged when they feel listened to and appreciated.

Better Than Expected

The fourth “aha moment” took us a bit longer to grasp. Here’s how it happened: We interviewed some expectant fathers who were not functioning very well. Some were gang members who showed us their bullet wound scars, some had been recently released from jail for burglaries or selling drugs, some had been kicked out of school for fighting, and some were doing little other than smoking marijuana with their friends. After interviewing these troubled young men, we would often ask ourselves “What in the world was this young woman thinking when she hooked up with this guy?” Fast forward about 2 years. Our “aha moment” came when some of these young men, who looked like they were running headlong into serious trouble, came back for follow-up interviews and told us how they were working 50 hours a week, or back in school, or both. And then their partners reported how well these young men were doing as fathers. To be sure, some of the young men with troubled histories continued to have troubled lives, but we found ourselves surprised by how many turned their lives around, or were at least trying the make that turn.

Darnel and Cleo

Darnel, a young father from Chicago, was one of the young men who surprised us. Darnel was an 18-year-old who looked and sounded beleaguered as he recounted recent events in his life. In the months before his interview, Darnel’s father had died, he had been expelled from school for fighting, his mother had caught him selling drugs on their front porch and kicked him out, and then his girlfriend, Cleo, told him she was pregnant. As he shared all these events with us, he also seemed to be trying to make sense of his story.

Not long after this interview, Darnel went to jail for selling drugs. He got out in time to be with Cleo when she gave birth to their son, Curtis, but he was back in jail again before Curtis turned 1 year old. After he was arrested for a third time, Cleo told Darnel that she knew he could be a good father if he tried, but she needed to cut herself loose and find a different sort of boyfriend. Two years later, we were surprised to find that Darnel made a dramatic turnaround as a father and partner. He was working and staying out of trouble. More important, he and Cleo were getting along and successfully co-parenting Curtis, even though they were no longer together as a couple.

When we started studying young fathers, we made predictions about their outcomes based on the number and severity of risk factors we observed at the outset. In other words, we expected poor outcomes for fathers with a high number of risk factors (e.g., psychological problems, substance abuse, criminal history, unemployment) and positive outcomes for fathers who were at comparatively low risk. It is interesting that these predictions did not account for fathers like Darnel, who ended up doing better than we expected, based on our initial assessment of their risk status. One of the lessons we learned from fathers like Darnel is that, as clinicians, we needed be careful about prejudging fathers on the basis of their “risk profile” because, as it turns out, fatherhood can be a transformative process.

It also occurred to us that we stood to learn a lot from fathers who seemed to defy the odds. What was it about fathers like Darnel or his circumstances that could account for such a transformation? One of our most interesting findings came from a study in which we zeroed in on a group of the highest risk fathers and found that those who did “better than expected” tended to have girlfriends who scored high on a measure of interpersonal skill. Further, we found that, over time, high-risk fathers who were doing well at our follow-ups demonstrated significant improvements in their interpersonal skills, suggesting they were learning something from their partners (Ngu & Florsheim, 2011). It is important to point out that we were able to learn as much as we did from high-risk fathers, like Darnel, because we stumbled upon a strategy for finding and engaging with them. In Box 1 we summarize our approach for working with these young men, who have been widely regarded as too peripheral, too troublesome, or too disengaged to be included as partners or patients (Panter-Brick et al., 2014).

Maybe We Can Help

Our efforts to understand fathers like Darnel led us to develop a program to help young fathers make a positive transition to parenthood. Our discovery that prenatal care was a natural window of opportunity for engaging fathers was a key component of our approach because we knew that, during this time, young men were more open to receiving help if we presented that help as something that would benefit their child (Florsheim, 2014). The program, which we call the Young Parenthood Program, or YPP, draws from other relationship-focused programs, particularly those designed to help married, adult couples successfully manage the transition to parenthood (Cowan et al., 2009; Gottman, Gottman, & Shapiro, 2010). We borrowed heavily from these programs but made modifications based on what we knew about the needs and circumstances of the young expectant couples we intended to serve.

Young fathers are easily engaged when they feel listened to and appreciated. Photo: fizkes/shutterstock

First, our finding that couples with strong communication skills provide their children with more stable family environments inspired us to develop a relationship-focused program that emphasized learning to work together as parents. So, we designed YPP to help young couples listen more carefully, speak more clearly, fight more fairly, and intentionally become more supportive of each other. Some of the communication skills, which comprise the core of YPP, are outlined in Box 2. A key idea is that most couples will benefit from developing two or three selected skills to help them address the weaknesses in their relationship.

Second, knowing that many of the fathers we talked to were uncertain about their long-term commitment to their partners, we let them know that we wanted to help them develop strong communication skills so they could work well together as parents, regardless of whether or not they chose to stay together as couples. We didn’t want them to feel trapped as a “couple” by the prospect of participating in YPP.

Third, we developed YPP to be flexible because we knew that young couples approach parenthood with different strengths and weaknesses. This means that a one-size-fits-all program would be less effective and less transportable across social and cultural contexts. For this reason, we decided to deliver YPP one couple at a time and to spend the first two sessions determining each couple’s relationship goals so that we could tailor the program to address those goals.

Victor and Lara

Victor was one of the first fathers to participate in YPP. Just out of jail, Victor fell into a Romeo and Juliet romance with Lara, whose father and brothers belonged to a rival gang. Before Victor and Lara had time to get to know each other well, Lara got pregnant and decided to keep the baby. Victor was frightened by the idea of fatherhood and uncertain about whether he was up to the challenge, but he didn’t just disappear. Nonetheless, Lara distrusted Victor. Having been physically abused by her father, who had been in prison for most of her life, Lara had very real reasons to believe that most men were bad bets. Her friends were feeding her doubts by telling her that Victor was not to be trusted. Worried about how she would take care of a baby, all her anticipatory disappointment was focused on Victor, and she was quick to find fault with almost everything he did.

Expectant fathers want to become good fathers and partners, and they are open to getting help for themselves for the sake of their baby. Photo: LightField Studios/shutterstock

Victor tried to win Lara’s trust. He said he wanted to find a job, to be a good father, to stay out of trouble, but he seemed to be clueless about how to make any of that happen. He was still hanging out with his gang friends and hadn’t really looked for a job. Victor wasn’t lying about wanting to step up to the plate, but he lacked the confidence and the competence to make good on his intentions. And like many young expectant couples, neither Lara nor Victor knew how to offer each other the sort of understanding and support they both needed.

When we invited Victor and Lara to participate in YPP, they were both skeptical but agreed. Over the course of a few months, with help from Sophia, one of our YPP counselors, they learned to express themselves more openly, listen to each other more carefully, and solve problems together rather than blame and criticize. Feeling more motivated, Victor found a job, and when the baby arrived, he asked Lara to move into the basement apartment in his parents’ house. This move was challenging because it required a dramatic leap of faith during a highly emotional moment in their lives. But with their new skills, they worked through the stress of taking care of a new baby and the difficulty of learning to depend on each other.

Two years later, when we met with Victor for a follow-up interview, he was proud to report that he was doing well as a parent and that he and Lara were making it work. Lara was still giving Victor a hard time for not doing everything she expected, but she privately she told us he was doing great. Despite his inauspicious circumstances, Victor’s story illustrates the value of helping fathers who need assistance adjusting to parenthood and learning to work things out with their partners. Our work with young men like Victor has convinced us that it is possible to help even the most unlikely young fathers successfully adjust to fatherhood.

Father-Inclusive Prenatal Care

The research we’ve done with YPP has yielded promising results (Florsheim et al., 2012; Florsheim, Chojnacki, Hesse, & Luna, 2019). Most notably, we have found that couples who participate in YPP are less likely to engage in interpartner violence and that fathers who participate in YPP are more nurturing with their children and at lower risk for child maltreatment compared to fathers in the control group. Nonetheless, we know that more work is needed to increase the effectiveness of co-parenting programs designed to help at-risk families. Based on our experience with young fathers, we have also come to appreciate the need to expand the range of services beyond co-parenting counseling. For example, some of the fathers we’ve worked with have needed substance abuse treatment or individual psychotherapy for their depression or trauma. And some have needed help with self-management problems that prevent them from finding or keeping jobs.

Young men were more open to receiving help if we presented that help as something that would benefit their child. Photo: Anita Patterson Peppers/shutterstock

In 1960, 1 in 20 babies was born to unmarried parents under the age of 25. In 2018, the rate for babies born to unwed parents less than 25 years old was closer to 7 out of 10 (Hamilton, Martin, Osterman, & Rossen, 2019). The upshot of this dramatic change in family composition is that young parents in 2020 receive less institutional support to ensure family stability than did parents in previous generations. More to the point, if the institution of marriage, which once helped keep fathers connected to their families, has become less adhesive over time, then we—as a society—need to identify other institutions to support that bond. A key premise of father-inclusive prenatal health care (FIPH) is that prenatal care can play an important role by helping young couples solidify their co-parenting bond—regardless of their relationship status—and help fathers ready themselves for the challenge of parenthood.

There are several good reasons for targeting prenatal care for father inclusion (Garfield, 2015). As we have noted above, the prenatal period is characteristically a time of hopefulness and anxiety. Expectant fathers want to become good fathers and partners, and they are open to getting help for themselves for the sake of their baby. It is prudent and strategic to make use of this period of high motivation. Second, it’s easier and more effective to administer mental health and relationship-focused interventions early, before problems become more complicated and entrenched. Indeed, prenatal mental health services for fathers may help diminish the intergenerational transmission of social and psychological problems. Third, prenatal care providers are well positioned to refer young fathers and mothers for psychological services because of their unique role in the lives of young expectant couples. If psychological services are integrated into the prenatal care settings, men will be more willing to attend if they see their attendance as relevant to the health of their child.

What does FIPH look like? To be successful, it needs to be worked into routine health care. Rather than only permitting fathers to participate in prenatal care if they are inclined, clinicians might expect that fathers will meet with a health educator or behavioral health specialist who can collaboratively assess what a father needs to prepare for fatherhood (Fletcher, Vimpani, Russell, & Sibbritt, 2008). This conversation begins with the expectant mother’s prenatal provider asking if she wants the father to be involved in raising their child (as depicted in Box 3).

 

There is a small group of expectant mothers who feel threatened by their ex-partner and may not want him involved. For these cases, the conversation would end there. But if it makes sense to continue the conversation, the second step in this process involves a motivational interviewing approach to talking with fathers about their goals and needs. This is a strategy we have used to increase the enlistment of fathers who are skeptical of any services. If done well, the experience of talking with the person doing the “family readiness check” will whet a father’s appetite for more help. If fathers are given the chance to say what concerns them, they are more likely to be receptive to participating in programs that can address those concerns. Some fathers may want to take a father-oriented class on infant care and child development, some might be interested in a program like YPP to help them fight less with their partner. Some may want to talk with a counselor about coping with psychological traumas that could get in the way of being a good father.

The third step in this process is a warm hand-off to a behavioral health provider who is trained to work with the father or the young couple. This step, of course, requires that such training is available through social work, counseling, and family health educator programs so that prenatal clinics have access to fatherhood-trained providers. We think this is a manageable workforce development goal. In order to feed this new workforce, we’d need to ensure that father-focused prenatal services are reimbursable through health insurance. Early childhood advocates have worked with Medicaid to cover the cost of parenting programs based on evidence that such prevention-oriented approaches promote healthy families and reduce risks for children (Normile, VanLandeghem, & King, 2017; Smith, Granja, Nguyen, & Rajani, 2018). Our conversations with Medicaid and health systems administrators give us confidence that coverage for father-inclusive prenatal care is possible, although that hypothesis has not yet been tested. In the recommendations for health care administrators, outlined in Box 4, we put this funding issue at the top of our list.

In considering the feasibility of FIPH, we look to the history of women’s prenatal care for inspiration. In the early 20th century, most women in the United States did not have access to prenatal care or medically assisted childbirth. Since 1900, as more women received these services, the rates of maternal and infant mortality declined by about 90% and 99%, respectively (Centers for Disease Control and Prevention, 1999). When advocates for women’s and children’s health first proposed to train midwives to provide these services to poor urban and rural women, the proposal was initially rejected, primarily because the American Medical Association was concerned about protecting its professional territory, and legislators thought it sounded too socialist (Kotelchuck, 2007). After a persistent campaign by a few hardcore advocates—both men and women—coverage for universal prenatal care was eventually codified into law. The rate of maternal and infant mortality plummeted and now universal access to prenatal care is assumed. We think the same story could also be true for fathers, with a wide range of good effects for mothers and babies. All that is needed is the will and determination to make it happen.

Author Bios

Paul Florsheim, PhD, is a clinical psychologist and professor in the Joseph Zilber School of Public Health at the University of Wisconsin Milwaukee. He and David Moore recently published Lost and Found: Young Fathers in the Age of Unwed Parenthood (Oxford, 2020) which is written for a general audience. Dr. Florsheim’s research focuses primarily on young parents and the development of programs to help young fathers and their partners become effective co-parents. In addition, Dr. Florsheim conducts research on the implementation of child maltreatment prevention programs and on access to mental health services for children and adolescents.

David Moore, PhD, is a clinical psychologist and a Distinguished Professor of Psychology at the University of Puget Sound in Tacoma, Washington. He has authored multiple publications in the areas of teen parenting, adolescent and adult development, and romantic relationships. In addition to teaching and conducting research, Dr. Moore maintains a private clinical practice specializing in psychotherapy with individuals as well as both married and unmarried couples.

Jason Burrow-Sánchez, PhD, is a professor of counseling psychology and the chair of the Department of Educational Psychology at the University of Utah. He is also the director of the Mountain Plains Region 8 Prevention Technology Transfer Center funded by the Substance Abuse and Mental Health Services Administration at the University of Utah. His research interests include the prevention and treatment of substance use for adolescents in school and community settings. His research has been funded at the local, state, and national levels, and he has published numerous articles, chapters, and books. He is also a licensed psychologist in Utah.

Suggested Citation

Florsheim, P., Moore, D., & Burrow-Sánchez, J. (2020). Helping young fathers across the transition to parenthood: A rock or a rolling stone? ZERO TO THREE Journal, 40(6), 12–19.

References

Blankenhorn, D. (1995). *Fatherless America: Confronting our most urgent social problem. New York, NY: Harper Collins.

Carlson, M. J., McLanahan, S. S., & Brooks-Gunn, J. (2008). Coparenting and nonresident fathers’ involvement with young children after a nonmarital birth. Demography, 45(2), 461–488.

Centers for Disease Control and Prevention. (1999). Achievements in public health, 1900–1999: Healthier mothers and babies. Morbidity and Mortality Weekly Report, 48(38), 849–858.

Cowan, P. A., Cowan, C. P., Pruett, M. K., Pruett, K., & Wong, J. J. (2009). Promoting fathers’ engagement with children: Preventive interventions for low-income families. Journal of Marriage and Family, 71(3), 663–679.

Fletcher, R., Vimpani, G., Russell, G., & Sibbritt, D. (2008). Psychosocial assessment of expectant fathers. Archives of Women’s Mental Health, 11(1), 27–32.

Florsheim, P. (2014). The Young Parenthood Program: A guide to helping young mothers and fathers become effective co-parents. New York, NY: Oxford University Press, USA.

Florsheim, P., Burrow-Sánchez, J. J., Minami, T., McArthur, L., Heavin, S., & Hudak, C. (2012). The Young Parenthood Program: Supporting positive paternal engagement through coparenting counseling. American Journal of Public Health, 102(10), 1886–1892.

Florsheim, P., Chojnacki, D., Hesse, D., & Luna, I. (2019). Relationship problems associated with pregnancy/childbirth complications among young disadvantaged mothers and fathers: Does co-parenting counseling help? Journal of Adolescent Health, 64(2), S112–S113.

Florsheim, P., Sumida, E., McCann, C., Winstanley, M., Fukui, R., Seefeldt, T., & Moore, D. (2003). The transition to parenthood among young African American and Latino couples: Relational predictors of risk for parental dysfunction. Journal of Family Psychology, 175–79.

Garfield, C. F. (2015). Supporting fatherhood before and after it happens. Pediatrics, 135(2), e528–e530.

Gottman, J., Gottman, J., & Shapiro, A. (2010). A new couples approach to interventions for the transition to parenthood. In M. S. Schulz, M. K. Pruett, P. K. Kerig, & R. D. Parke (Eds.), Decade of behavior (science conference). Strengthening couple relationships for optimal child development: Lessons from research and intervention (pp. 165–179). Washington, DC: American Psychological Association. doi.org/10.1037/12058-011

Hamilton, B. E., Martin, J. A., Osterman, M. J., & Rossen, L. M. (May, 2019). Births: Provisional data for 2018. Hyattsville, MD: National Center for Health Statistics, Division of Vital Statistics.

Kotelchuck, M. (2007). Safe mothers, healthy babies: Reproductive health in the twentieth century. In J. W. Ward & C. Warren (Eds). Silent victories: The history and practice of public health in twentieth-century America (pp. 105–134). New York, NY: Oxford University Press.

Lamb, M. E. (2010). The role of the father in child development (5th ed.). Hoboken, NJ: John Wiley & Sons.

Lamb, M. E., Pleck, J. H., & Levine, J. A. (1985). The role of the father in child development. In B. B. Lahey, & A. E. Kazdin (Eds), Advances in clinical child psychology, Vol 8 (pp. 229–266). New York, NY: Springer.

McLanahan, S., & Sandefur, G. (1994). Growing up with a single parent: What hurts, what helps. Cambridge, MA: Harvard University Press.

Murray, C. A. (1999). The underclass revisited. Washington, DC: American Enterprise Institute.

Ngu, L., & Florsheim, P. (2011). The development of relational competence among young high-risk fathers scross the transition to parenthood. Family Process, 50(2), 184–202.

Normile, B., VanLandeghem, K., & King, A. (August, 2017). Medicaid financing of home visiting services for women, children, and their families. Washington, DC: National Academy for State Health Policy.

Panter-Brick, C., Burgess, A., Eggerman, M., McAllister, F., Pruett, K., & Leckman, J. F. (2014). Practitioner review: Engaging fathers–recommendations for a game change in parenting interventions based on a systematic review of the global evidence. Journal of Child Psychology and Psychiatry, 55(11), 1187–1212.

Parke, R. D. (1996). Fatherhood (Vol. 33). Cambridge, MA: Harvard University Press.

Smith, S., Granja, M. R., Nguyen, U. S., & Rajani, K. (2018). How states use Medicaid to cover key infant and early childhood mental health services: Results of a 50-state survey. New York, NY: National Center for Children in Poverty.

Wilson, W. J. (1996). When work disappears. New York, NY: Knopf.