Exploration of fathers' mental health and well-being concerns during the transition to fatherhood, and paternal perinatal support: scoping review.

Objectives: To appraise and synthesise qualitative literature identifying: (a) fathers' concerns and challenges during the transition to fatherhood that may be impacting mental health and well-being experiences; and (b) fathers' experiences of antenatal programmes, and psychological and social support, to understand how we can better support fathers in addressing these concerns.

Design: International, qualitative evidence synthesis, scoping review.

Data sources: Six electronic databases (Medline, Embase, PsycINFO, CINAHL, Scopus, ASSIA) alongside 'grey' and supplementary searches were conducted March 2024.

Eligibility criteria: Qualitative studies and qualitative data extracted from mixed methods studies focusing on fathers' mental health within the perinatal period globally were included.

Data extraction and synthesis: The recommended Joanna Briggs Institute data extraction and critical appraisal tools were used, and an inductive thematic synthesis approach employed.

Results: 37 qualitative studies were included: UK (n=11), Europe (n=9), Australia (n=7) and Asia (n=6), USA (n=1), Canada (n=1) and the Middle East (n=2). Quality appraisal scores were moderate to high (5-10). Four analytical themes and eight subthemes were generated: (1) diminished partner relationship, (2) provider or protector? Multiplicity of fatherhood identification, (3) forgotten entity within the perinatal experience and (4) "I try to battle it myself," masculine ideals within fatherhood. The findings highlighted that fathers found the transition to be difficult, compounded by insecurity within their role as both partner and father. Fathers found a paucity of paternally focused support and antenatal programmes, not addressing fathers' needs within the transition.

Conclusions: The many concerns and challenges highlighted in the review demonstrate the importance of understanding the negative impact of the transition on fathers' mental health and well-being. There is a need for greater attention to fathers' experiences of paternal perinatal support and programmes through research and practise to inform future interventional development.

Trial registration: PROSPERO: CRD4202231381.