Listening to the fathers of twins – Being sensitive to fathers’ needs in maternity and child healthcare

Father of twins walking through a poppy field, photographed from behind. The dark-haired man carries both of his two blond twin daughters on his hips, showing that he is active and committed and has a bond with each of the children.

© Unsplash/Juliane Liebermann

Currently, the number of twin births worldwide is higher than ever before. For parents, this can be challenging. So far, research has mostly focused on mothers and their experiences. However, fathers of twins also face special challenges – like establishing an early bond and interaction with both children. In addition, having more than one child of the same age also means multiplied responsibilities in childcare. Therefore, fathers of multiples must often adapt to fatherhood particularly quickly and have to be more actively involved than fathers of singletons. A qualitative research study by Kristiina Heinonen from University of Eastern Finland now concentrates on the fathers of twins. By describing their experiences, the author wants to contribute to the understanding of twin fatherhood and the needs for support.

Multiple pregnancies are particularly stressful for parents, as they are always considered high-risk and require special monitoring. Twin pregnancies are associated with significant complications during and after pregnancy and childbirth, such as preterm birth, low weight, higher stillbirth rates, and the risk of neonatal and maternal death. Parents are very aware of those risks, and, as a result, twin parents are more anxious and need more support during pregnancy. Generally, parents of multiples expect more information and support from maternity and child-health-clinic midwives and nurses for their special situation than they feel that they receive. But not only multiple pregnancy and birth are challenging – parenting can also be considered particularly demanding when there is more than one child of the same age. Accordingly, most investigations that compared the mental-health outcomes in parents of multiples versus parents of singletons found that the former show more often symptoms of depression, anxiety, and parenting stress. While the experiences of twin mothers have already been the subject of several studies, little is known about the situation of twin fathers so far. The study by Kristiina Heinonen offers a first overview.

Fathers of twins wish to be more visible

Six fathers submitted written descriptions and participated in interviews. They ranged in age from 31 to 50 years, and the pairs of twins ranged in age from 2 to almost 9 years. According to the study, being a father of twins is a complex process that develops gradually from the pregnancy onwards.

The participants were mostly very present and involved in taking care of the twins. It seems that fathers of twins have to adapt to fatherhood especially quickly and are particularly active in parenting because of the extra baby care. According to the interview, memorable moments with the twins supported this fatherhood process, were emotionally powerful and encompassed various feelings. Being particularly involved, the participants also indicated that they missed attention and support for their fatherhood from social and healthcare professionals. One father described that although the clinic provided understandable information, it tended to be directed at the mother.

The study author criticises the fact that midwives and nursing staff at maternity and paediatric clinics often focus primarily on monitoring pregnancy and the growth and development of children. In her view, it is essential that midwives show interest in and support parenthood generally, including fatherhood. Among others, fathers of multiples need comprehensive information, taking into account their special situation – for example, how to take care of twins and how to promote individuality. They also need more support in preparing for fatherhood and the changes in their relationship with their partner. Overall, the study shows that fathers of twins wish to be more visible and fully recognised as parents at the maternity and paediatric clinic.

Involving the father in infant- and family-centred developmental care

In terms of infant- and family-centred developmental care, this means that healthcare staff should seek a close professional relationship not only with the mother, but also with the father. Midwives and nursing staff should talk to fathers about how they see and experience their own fatherhood and how they can strengthen it. This can help them find their role as a parent. Actively involving fathers is often only seen as a means to help mothers cope with the challenges of multiple parenthood, e.g. by sharing the burden of childcare and household tasks. But there is much more to it: if the father is present and active, this also promotes interaction and bonding between the father and each of his children – and it can also have a positive effect on children’s development. Midwives can support this process by asking fathers to talk about their feelings and experiences and by making positive comments or asking questions. They can also help fathers to recognise each child as an individual and to talk about their observations.

It seems that an actively involved father is particularly important for twins: studies have shown that when fathers participate in childcare, it reduces the competition between the twins. To facilitate caretaking, some parents “share the twins”, i.e. assigning one parent as main guardian to one twin, thus creating a father’s twin and a mother’s twin. However, it is important that each parent also interacts and bonds with the other twin, just like spending time with both children simultaneously has proven beneficial for their development. Children who did not feel that they were clearly the children of the mother or of the father suffered the least from psychosomatic symptoms. This means that providing support for fathers also helps to promote the health and wellbeing of the entire family. Thus, the involvement of fathers should be strengthened by social and healthcare services.

Paper available at: International Journal of Environmental Research and Public Health / MDPI

Author: Kristiina Heinonen


Have a look at the European Standards of Care for Newborn Health on the topic of Infant- and family-centred developmental care