Study uncovers overlooked crisis of paternal deaths after childbirth

It took the better part of a century for maternal mortality to be recognized, forgotten and finally recognized again as an urgent public health crisis in the United States. In contrast, research shows fathers - particularly men in their 20s through early 40s - die disproportionately from preventable causes such as suicide, overdose, homicide and accidental injury. Yet paternal mortality is rarely examined in connection to the transition to parenthood.

Northwestern University scientists are trying to change that.

A new Northwestern study examined all 130,267 babies born in Georgia in 2017 and tracked whether their fathers died at any point during the following five years, through 2022. Of those fathers who died within five years (796), 60% of the deaths were preventable, which the study authors call a "huge, missed opportunity." These deaths resulted from homicide (143), accidental injury (142), suicide (102) or overdose (93), while 296 fathers died of natural causes.

The findings echo what maternal mortality research has long shown: Deaths around the transition to parenthood are shaped less by biology than by social vulnerability, and many are preventable - even as paternal deaths remain largely uncounted and unaddressed. Prior research has shown that paternal involvement is linked to better child and family health outcomes, while paternal absence is associated with a range of adverse outcomes for children.

Still, fatherhood appears to be protective

After age 20, the death rate for fathers is consistently lower compared to men who are not fathers. For example, among those aged 30 to 34, the death rate for Georgia fathers was 120 deaths per 100,000 men compared to Georgia non-fathers, whose death rate was 231 deaths per 100,000 men.

"Being a father appears to be protective in this particular group of men," Garfield said. "We were surprised to see reduced mortality among men who are fathers. Whether that is due to changes in lifestyle or a new purpose or new roles and responsibilities, we don't know, but it is certainly worth further study."

More about the study

The scientists examined all births in Georgia between 2017 and 2022 and linked them to death records for fathers listed on birth certificates. They analyzed causes of death, overall mortality rates and whether fatherhood, itself, appeared to affect men's risk of death.

Non‑natural deaths occurred more frequently among younger fathers. Medicaid‑paid births and unmarried status were linked to higher homicide risk. Fathers who died were more likely to have been older, non‑Hispanic Black, unmarried, living in rural areas and to have had Medicaid‑paid births. Higher education, Hispanic ethnicity and Tricare‑paid births were associated with fewer deaths.

Experiences in the hospital inspired the work

As a pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago, Garfield said he has encountered many situations in which mothers in the neonatal intensive care unit were coping with the death of their partner - whether from a shooting, a car accident or another sudden cause.

"In my experience, that happens more often than mothers dying," Garfield said. "The death of any parent has enormous consequences for a child, and as a pediatrician, I care most about how a parent's death impacts the child, especially in the early years."

Despite publishing dozens of papers on fathers' mental and physical health, Garfield said he could find little research examining fathers' deaths in the years immediately following a child's birth.

Why Georgia?

"If we don't measure it, we can't change it," Garfield said. "That affects thousands of children."

Other Northwestern co‑authors include Clarissa D. Simon and Katy Bedjeti.

Source:

Northwestern University

Journal reference:

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2848572