The "V" Ps of Male Involvement in Title V
By Michael Hayes
Deputy for Family Initiatives, Texas Attorney General’s Office
Program Specialist for Family Initiatives, Texas Attorney General’s Office
Michael’s wife teaches a class called Women’s Reproductive Health at a university here in Austin, and each semester he has the honor of delivering a guest lecture titled “Men as Partners in Women’s Reproductive Health.” And, each semester, he’s initially met with more than a few quizzical looks from students who (like you, perhaps) seem to be thinking, Wait, this is supposed to be about women’s health. Why are we talking about men?
Why are we talking about men? In 600 words or less, we’re going to answer that question with what we’re calling The “V” Ps of Male Involvement in Title V.
- Prevention — whether it’s intimate partner violence, unintended pregnancy, low-weight births, or child abuse and neglect — men aren’t just a part of these problems, they are an integral part of the solution. Just one example: The last 10 years have seen a decline in contraceptive use among American women and a corresponding increase in unintended and non-marital births. Facing similar trends, international family planning programs have taken serious steps to develop male outreach, and they are beginning to see positive outcomes. One study found that women whose partners received counseling on contraceptive methods were twice as likely to be using their method one year later, when compared to women whose partners weren’t included in counseling. Title V family planning efforts would be enhanced by adding significant attention to male partner education and outreach.
- Preconception — when does a man start planning to become a father, and what information does he need as he makes that decision? For too many men, the process only begins when his partner tells him she thinks she’s pregnant, and he’s filled with that initial mixture of doubt, dread, and excitement. To address this issue, Texas has implemented an educational program: p.a.p.a. — Parenting and Paternity Awareness . p.a.p.a. focuses on the rights and responsibilities of both parents, and guides high school students to seriously consider when and what kind of parent they want to be. It highlights a sequence — finish education, start a career, get married/enter a committed relationship, then have a child — and builds skills that increase the likelihood that the teen will be able to father/mother in the way they want for themselves and their future child(ren). Title V programs could provide similar information through population–based education efforts.
- Prenatal — the single biggest predictor of whether a woman will get early and adequate prenatal care is the support of her male partner . Men are in the ideal emotional state to grow and learn when their partner is pregnant. Unfortunately, the healthcare system generally responds with, “We’ll call you when the baby’s born.” This misses an opportunity to prepare dad for all that mom will go through physically and emotionally which, according to our friends in the family violence prevention field, is a critical first step in reducing the upturn in family violence that accompanies pregnancy. In addition, healthcare professionals should provide guidance on how dad can support mom and baby’s health based on the overwhelming amount of research on dad’s impact on nutrition, smoking cessation and drug use/non-use. They should also address dad’s fears and concerns which are, quite often, about how he’s going to support this baby. One of the key findings from a conference we held back in 2007 — The First Nine Months of Fatherhood: Paternal Contributions to Maternal and Child Health — is that the more a program can help the father imagine and understand his partner’s prenatal experience, the more prepared he is to be a responsible father. Title V prenatal programs may be the optimal providers for this type of outreach.
- Paternity — four out of 10 children in the United States are born to unmarried mothers and, until paternity is established, those children have only one legally recognized parent. The good news is that the vast majority of unmarried parents (more than 80% of unmarried mothers and fathers) want the father’s name on the birth certificate and plan for the father to be involved in their child’s life . New research has shown that paternity establishment has positive ripple effects on long term emotional and financial support . But, for most unmarried couples, the first time they hear about paternity establishment is at the hospital right after the baby is born — when they are suffering from emotional and physical fatigue and drowning in information–overload. Ideally, unmarried couples should hear about paternity establishment at multiple stops along their journey into parenthood, and Title V programs are perfectly situated to offer that education.
- Pediatric — several years ago, the American Academy of Pediatrics published a clinical report titled “Fathers and Pediatricians: Enhancing Men’s Roles in the Care and Development of Their Children. ” In it they make the case for seeing the father as a unique and indispensable resource for improving the health and well-being of children. The article makes numerous suggestions for pediatricians that Title V clinics could easily adopt — everything from making the clinic’s practice more father friendly to engaging and informing the father directly about the importance of his involvement, both for his child’s health and his partner’s well-being.
 Terefe, Am J Public Health 1993;83(11).
 Schaffer MA, et al., Effects of Social Support on Prenatal Care and Health Behaviors of Low-Income Women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 1997 Jul-Aug; 26 (4):433-40.
 Le Menestral, Suzanne. “What Do Fathers Contribute to Children’s Well-Being?” Child Trends Research Brief (May 1999), http://www.childtrends.org/Files//Child_Trends-1999_05_01_RB_FatherContribute.pdf.
 you can download the full report of the findings from the The First Nine Months of Fatherhood Conference here: https://www.oag.state.tx.us/AG_Publications/pdfs/first9months.pdf
 Bendheim Thoman Center for Research on Child Wellbeing. “Dispelling Myths about Unmarried Fathers,” Fragile Families Research Brief, no.1 (May 2000). http://www.fragilefamilies.princeton.edu/briefs/researchbrief1.pdf
 Bendheim Thoman Center for Research on Child Wellbeing. “In-Hospital Paternity Establishment and Father Involvement in Fragile Families,” Fragile Families Research Brief, no.30 (February 2005). http://www.fragilefamilies.princeton.edu/briefs/ResearchBrief30.pdf
 Coleman, William L., Garfield, Craig, Committee on Psychosocial Aspects of Child and Family Health, “Fathers and Pediatricians: Enhancing Men's Roles in the Care and Development of Their Children,” Pediatrics, 2004 113: 1406-1411. http://aappolicy.aappublications.org/cgi/reprint/pediatrics;113/5/1406.pdf