Fatherlessness Begins Prenatally: A Scoping Review

October 1, 2022
Edition: Fall 2022
Volume: 32
Issue: 2
Article: Verbatim

Table of Contents


Objective: Clinicians should encourage and promote paternal involvement even in prenatal care, as this early engagement has far-reaching, positive implications on a child’s life.

Summary: Men are not superfluous to the abortion process. In fact, a father’s roles and responsibilities start before the act leading to conception and continue through the pregnancy, birth, and through their children’s lives. This paper seeks to review evidence that these roles play an important part in a child’s overall development. Additionally, this paper seeks to suggest direct approaches physicians may take to encourage constructive engagement and responsibility in fathers.

Key Words: paternal involvement, fatherlessness, prenatal, abortion


Studies are increasingly showing that involved fathers are important to a child’s well-being over the course of their life. From the beginning of conception, fatherlessness negatively impacts development, educational achievement, relational efficacy, and socioeconomic success. Children without involved fathers tend to have higher risks of alcohol and substance abuse, antisocial behavior, delinquency, and incarceration.1 Up to 15 percent of U.S. men will father children with more than one woman. Of this group, 61 percent have a history of incarceration, compared to 28 percent of men without a history of incarceration.2 The number of children living in homes without fathers has risen sharply, with up to 48 percent of children living without fathers in the black community.3

This systemic problem spans all levels of society. Women from all educational backgrounds are having more children out of wedlock than ever before. This trend has grown most quickly among white and Hispanic women.4 The shift to fatherlessness has largely impacted society. Between 30 and 44 percent of fathers have no ongoing relationship with their children.5 Additionally, in many families, fathers are no longer providing adequate financial support.10 The rise of the uninvolved father has occurred in tandem with the rising acceptance of high-risk sexual behavior, both in the media and in reality. According to prenatal care providers’ anecdotal observations, fatherlessness begins before birth. This paper aims to identify the role men play in the decision for an elective abortion. Additionally, this paper seeks to describe approaches physicians may take with the fathers of unborn children, and to discuss importance of paternal-infant and paternal-mother bond to unborn children.

Men and Abortion

Men’s lack of support begins before birth. Approximately 14 percent of women report that their sexual partner pressured them to have an elective abortion in 2004, while 48 percent of this population reported that they did not want to be a single mother or to have relationship problems.6 Another study separately questioned 30 Canadian women and their partners about the decision-making process leading up to a scheduled abortion.8  Although 83 percent of this sample reported “seeking advice” from their partner, 50 percent had already decided to have an abortion before informing their partners. Pro-choice advocates strongly emphasize a woman’s right to choose to have an abortion. However, many women also choose to have sexual intercourse that can lead to an unintended pregnancy, with 80 percent of individuals reporting non-use of contraception in the couples’ study mentioned.8 In this article, only 27 percent of women and only one-third of men reported broaching the topic of unintended pregnancy before the pregnancy occurred. Almost all the women (97 percent) were ‘happy’ with the discussion that occurred before abortion. However, only 70 percent of men were pleased with the discussion that took place.  According to the study, 27 percent thought the decision was mostly that of the woman, 68 percent thought there was some joint decision making, and only 5 percent thought the decision to have an abortion was mostly that of the male partner. Nelson and colleagues9 asked college students about men’s role in an abortion decision.  In this cohort, men clearly thought they should have more input than woman thought they should have.  In another study of men whose partners had an abortion, 42 percent encouraged their partner to do so, and 31 percent gave no advice in either direction.3 Due to lack of research, the insight into why men suggest that their partners get an abortion is limited. One survey lists a few reasons for abortion referral, including a lack of readiness to be a father (39 percent) and not expecting a relationship with that woman to be long-term (24 percent).7 The debate surrounding abortion rarely focuses on the material advantages or secondary gain for men, instead focusing on how the procedure can affect women. However, men cite avoidance of child support, avoidance of paying for another child, ability to break up with their partner, and other reasons as possible reasons for supporting their partner’s abortion.7 Other darker possibilities for men supporting an abortion could include anger at a female partner, perhaps for failing to prevent pregnancy. This line of reasoning clearly contradicts the female empowerment agenda often found intertwined in pro-abortion messaging. Regardless of the motivation, fathers often have agency in abortion decision-making. Clinicians who wish to oppose fatherlessness can start in their own offices. By encouraging paternal involvement, establishing fatherhood with ultrasound, and by using pro-life word choices, medical professionals can empower men to be supportive fathers. Once involved, fathers should be continually included in clinics, schools, and other social arenas. Physicians can also extend this advocacy into school boards, local medical associations, schools, healthcare training programs, and social media. Further, physicians can create alliances with like-minded groups that support paternal involvement, even groups with which they may not agree on other issues.


Traditionally, some of the roles encompassed in fatherhood have included protecting, providing, educating, encouraging, disciplining, and modeling relationship skills for one’s children. Physicians can support fathers in these roles even in the prenatal stage. Evidence demonstrates that fathers have involvement before birth, whether it is supportive of life, or supportive of abortion. A consistent pro-life ethic promotes a father’s involvement. The presence of a father will benefit a child, not only before birth, but throughout the child’s entire life.


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About the Authors

Affiliation: Nemours Children’s Health, Dept of Gastroenterology