Men’s health ‘secondary consideration’ in pregnancy planning

The health and wellbeing of men and male partners remain ‘secondary considerations’ when it comes to research, practice and policy for preconception and antenatal care, according to a new international review.
 
One RACGP expert says the review highlights how GPs can play a major part in improving ‘shared responsibility’ for pregnancy and parenting outcomes.
 
The review of biological and behavioural analyses found ‘siloed research’ across fields ranging from sperm health to post-natal parenting had exacerbated men’s often secondary role in preconception health.
 
‘Boys and young men are an important but persistently under-appreciated population for preconception interventions to improve intergenerational health,’ wrote the researchers.
 
‘Across biological and behavioural research, young men’s early life course experiences have been shown to shape their own and their partner’s preconception physical, emotional, and behavioural health.
 
‘Moreover, focusing on men’s preconception health offers a corrective for legacies of sexism, which place responsibility for intergenerational health solely on the birthing parent, and of racism and colonialism, which have disproportionately disrupted the familial and societal roles of Black and Brown men.’
 
Dr Ka-Kiu Cheung, Chair of RACGP Specific Interests Antenatal and Postnatal Care, agrees that the weight of responsibility for contraception and preconception health is ‘disproportionately’ placed on women, but that GPs are well placed to help address the imbalance.
 
‘There is an opportunity both for GPs and the public to raise expectations that men are included in conversations about reproductive intentions, contraception, and preconception care, and supporting a shift towards shared responsibility for pregnancy planning and outcomes,’ she told newsGP.
 
Dr Cheung said with around 40% of pregnancies in Australia being unplanned, the opportunity for meaningful preconception planning is often missed, with women left to carry the load.
 
‘Many people enter pregnancy without the opportunity to optimise their health, with care and messaging still largely focused on women,’ she said.
 
‘This is mirrored in discussions around contraception and pregnancy planning disproportionately positioned as a woman’s responsibility.’
 
The researchers said identifying both direct (sperm epigenome and paternal parenting) and indirect (via maternal health and behaviours, for example) paternal influences could provide more opportunities for preconception intervention. 
 
‘Paternal factors more commonly studied in mothers may have similar (or potentially larger) effects,’ they wrote.
 
As an example, they cited a study of more than 500,000 Chinese couples, which found a 35% higher chance of birth defects in babies born to fathers that reported pre-conception alcohol consumption, while numerous studies have associated advanced paternal age with autism spectrum disorder, still birth, birth defects and schizophrenia.
 
Dr Cheung said the study ‘reinforces that male preconception health also matters’.
 
‘Sperm health is influenced by modifiable factors such as smoking, alcohol, weight, medications and environmental exposures — all of which align with good general health advice,’ she said.
 
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intergenerational health male fertility parenting preconception health sexism sperm health