The Health Problems of Young Fathers

August 7, 2015 by Robert Franklin, Esq, Member, National Board of Directors, National Parents Organization

The latest scare about fathers and fatherhood comes here (Telegraph, 8/4/15) and here (Philadelphia Inquirer, 8/5/15). A study out of Finland found that men who became first-time fathers before the age of 25 have an increased chance of dying in middle age. (The Telegraph article includes references to other studies.) Importantly, the lead researcher of the Finnish study said “The findings of our study suggest that the association between young fatherhood and mid life mortality is likely to be causal.”

The researchers wanted to understand better why other studies have shown similar patterns. Using census data, they drew a sample of 10 percent of Finnish men born between 1940 and 1950. Those who had at least one child were tracked between the ages of 45 and 54. The researchers then limited the study to more than 11,700 brothers.

Narrowing the study further to 1,124 siblings, the researchers found that men who had their first child before age 22 were 73 percent more likely to die in their late 40s and early 50s than their brothers who first became fathers at ages 25 and 26. And those who became parents when they were 22 to 24 years of age were 63 percent more likely to die in middle age.

Overall, 5 percent of the fathers — or one in 20 — died in their late 40s and early 50s. The most common causes of death were heart disease (21 percent) and alcohol-related illnesses such as alcohol poisoning (16 percent).

So the much ballyhooed finding — that early fatherhood increased the chances of dying in mid-life by 73% — obscured the fact that, even for those fathers, the chance of premature death was a very low 5%. Still, an increase of 2.9% for fathers generally versus 5% for young fathers is significant.

Moreover, the lead researcher, Elina Einio, of the University of Helsinki, said the results are likely applicable to western countries generally.

"We believe that our results can be quite safely generalized to men born in the 1940s and 1950s in other Western countries," Einio said. "For these men, marriage was relatively universal and childlessness relatively uncommon."

So the question arises of why early fatherhood increases a man’s chances of dying in middle age. (I assume the researchers corrected for factors like selection bias. For example, a man who becomes a father early in life might be a man who engages in behavior that’s more risky than others and so is more likely to die early.) Unsurprisingly, it seems that the stress of early fatherhood when the man may not be ready to take on that much responsibility may be the key.

A new study reports that Finnish men who became fathers before age 25 were more likely to die in middle age. The findings raise questions about whether the stress of early parenthood had an especially strong impact on these men.

Younger men were less likely to have planned for children and needed to become breadwinners quickly to support their new families, said study lead author Elina Einio, a postdoctoral researcher at the University of Helsinki in Finland. "Suddenly taking on the combined role of father and breadwinner may have caused considerable psychological and economic stress for a young man not ready for his new role," he said.

To their credit, both the Inquirer and the Telegraph pieces use the research to argue for greater social support for young fathers. After all, previous studies have found much higher levels of stress and mental health issues like depression in new fathers. That should surprise no one. The fairly extreme hormonal changes fathers undergo during their partner’s pregnancy and after the birth of their child can wreak havoc on a father’s emotional state just as it can a mother’s. And of course the hormone cortisol — the stress hormone — plays an active role in getting parents ready for their new baby.

So yes, high stress likely plays a part as does the precipitous drop in testosterone levels in new fathers.

From the Telegraph article:

It is not only men’s physical health that can be affected when they become fathers. In June, the National Childbirth Trust (NCT) published research which found that one in three (38 per cent) of new fathers were concerned about their mental health.

Dr Sarah McMullen, head of research at the NCT, said: “We recognise the huge impact having a baby can have on dads as well as mums. Perinatal mental health issues can affect men or women so raising awareness of the specific concerns and questions that dads-to-be or new dads have is crucial…

In May, an Oxford University study found that pressure to be a modern, hands-on father, balancing a career with a more active role in family life, is driving growing numbers of men to depression.

Dr Anna Machin, of Oxford’s Department of Experimental Psychology, who led the research, said "The reality is that as a society I don’t think we are ready for [the idea of involved fatherhood] — we don’t support the fathers in doing that, we pay lip service to it but we haven’t put in place systems which are fit for purpose.

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There is also increasing evidence that men are prone to post-natal depression. As far back as 2010, researchers at University College London found that depression hits one in five men after they become fathers, with the highest risk being in the first year after birth.

Meanwhile in 2014, a study at the University of Notre Dame found that the transition to fatherhood caused men’s testosterone to decline by almost a third over a five-year period, and that a drop in testosterone levels was more severe in more hands-on fathers. Low testosterone has been linked to depression, tiredness, joint pain, weight gain and low sex drive.

In her 2014 book Sad Dad: An Exploration of Postnatal Depression In Fathers, Olivia Spencer warned that the true extent of depression in fathers could be much greater than has been reported.

She said that "The NHS is focused on the mother and child during pregnancy and birth; It ignores the dad’s mental wellbeing. This has a huge impact on the family as a whole.”

All of that is worthwhile information that policy-makers and funders of research should be paying attention to. Body chemistry and social pressures combine to cause stress in fathers and those can prove fatal later on for particularly young dads.

But what neither the studies nor the articles think to ask is why those young fathers came to be surprised by fatherhood.

From the Inquirer:

Whatever the case, "it is important for young men to wait until they are sure they are ready for the responsibilities of fatherhood," Einio said. "Some young men can be pretty mature at an early age and others not at all. Young men who decide to have children should be supported in their choice."

That’s good advice, but it assumes these fathers wanted to have children. Maybe they didn’t. Maybe their partner’s pregnancy was a “surprise” to them. Recall, for example, the study conducted at two community colleges in Washington State that found that a whopping 33% of young women polled had already stopped taking their contraceptive medication without telling their partner in the hopes of becoming pregnant.

Surely a man who’s surprised by his partner’s pregnancy and isn’t ready to be a dad will experience greater stress about the matter than one of the same age who agrees to have a child and pursues that outcome with full awareness of the consequences.

So one thing all these studies argue for is the availability of safe, effective contraception for men. A man’s ability to control his fertility looks to be important not only for his emotional health, but for his very life.

They also argue for a man’s right to opt out of responsibility for a pregnancy. Women choose to abjure legal responsibility for a pregnancy; they can take a morning-after pill or terminate the pregnancy by abortion. Should they choose to carry the child to term, there are Baby Moses laws in every state with which she can absolve herself of continuing responsibility for the child. And of course, she can place the child for adoption.

Generally speaking, those options aren’t available to men involved in a pregnancy.

When the Guttmacher Institute asked women about their reasons for having an abortion, essentially all of them listed the practical problems of raising a child. They said they weren’t financially able to care for a child, hadn’t completed their education, didn’t have a good enough relationship with the father, etc.

Obviously, those are all equally applicable to fathers and forcing young men into fatherhood when they’re not ready financially, haven’t completed their education or don’t have a good relationship with the mother, among others, will certainly ramp up their stress levels. So men should have the right to opt out of a child’s life by signing, sometime before the child is born, a form relinquishing all rights and obligations to the child.

Men’s mental and emotional health, and maybe their very lives depend on increasing the options for them, first to prevent pregnancy and second to be able to opt out of fatherhood should an unwanted pregnancy occur.

#men’shealth, #earlyfatherhood, #prematuremortality, #pregnancy, #abortion

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