29.06.2026
There is an abundance of public health messaging advising women to prepare for pregnancy, whether about taking folate supplements, stopping smoking, or managing chronic conditions.
However, as I have recently described with an international team of collaborators, a growing body of evidence also indicates that men’s health and life experiences before conception can also influence fertility, pregnancy, maternal wellbeing, and children’s health – both through biological pathways (including sperm), and through how partners support mothers during the perinatal period.
Yet, policy and practice still often neglect the biological and social relevance of fathers until a baby arrives. With our rapidly deepening understanding of fathers’ contributions, this oversight is no longer tenable.
Fathers matter before pregnancy, biologically
For decades, it was commonly believed that because sperm are quickly replenished, its health is influenced only by very recent exposures.
Research now suggests a more complex picture: sperm can in fact carry molecular signals shaped by nutrition, toxins, stress, and other exposures across the life course, with potential downstream effects after conception. Some of the best-known signals are ‘epigenetic’ tags or small RNA molecules that influence gene activity without changing the DNA.
Several paternal factors have been associated with birth and child outcomes in large human studies. For example, preconception alcohol use has been linked with higher odds of birth defects; advanced paternal age has been associated with risks including stillbirth and neurodevelopmental outcomes; and paternal mental health problems are associated with elevated risks of depression in offspring.
Fathers matter during pregnancy as partners
Biology is only part of the story, though. Partners directly shape maternal health behaviours and stress levels at precisely the time that fetal development is most sensitive. Supportive partners are associated with positive outcomes including greater antenatal care attendance, reduced maternal smoking and alcohol use, and higher breastfeeding rates.
Just as importantly, relationship quality is closely linked to maternal mental health. When women perceive strong partner support, rates of perinatal depression and anxiety are lower, while avoidant or hostile coping styles are associated with worse maternal mental health.
Poor perinatal mental health matters not only for mothers’ own wellbeing, but also because maternal depression and anxiety are associated with measurable impacts on children’s cognitive and socioemotional development – which, in turn, can have lifelong consequences.
Men’s early-life experiences shape their future role as partner and father
To ensure mothers are well supported by engaged, committed partners during pregnancy, intervention cannot start at the antenatal clinic.
Men’s executive functioning and coping skills, which are central to being a supportive partner, are shaped early in life and are undermined by adverse childhood experiences (ACEs) including poverty, maltreatment and poor household dynamics.
This indicates that addressing childhood adversity can have much longer-term benefits that extend well beyond than the child themselves, through future maternal, child and family/whānau wellbeing.
Sadly, ACEs are common in Aotearoa New Zealand, with surveys showing nearly nine in ten children reporting at least one ACE, and alarmingly about 16% – or one in six children – experiencing four or more ACEs.
This is also an equity issue
A narrow focus on mothers has other consequences.
First, women are burdened with responsibility for outcomes that are often shaped by a couple’s shared circumstances and by structural conditions.
When preconception care and public messaging focus mainly on women, adverse outcomes are more readily framed as maternal “failure,” even though paternal factors can considerably influence pregnancy and child outcomes.
Indeed, research shows that men typically wish to participate in planning and preparation for pregnancy and parenthood once they understand the extent of their influence on pregnancy and child outcomes. Yet guidelines and services tend to provide limited practical preconception guidance for men, and research suggests New Zealand men face communication barriers in engaging in conversations about preconception matters.
Second, maternal-focused policy settings can subtly discourage paternal involvement, especially for lower-income families. For example, in New Zealand, partner’s leave is typically unpaid, and many fathers take less leave than desired due to financial pressures.
Third, in te ao Māori, child wellbeing is inherently relational and intergenerational, with pēpi and tamariki embedded in whakapapa and cared for by whānau, hapū, and iwi. Approaches that treat men as peripheral individuals can therefore systematically disrupt their roles in families and community.
Furthermore, historical processes including land dispossession and cultural disruption have weakened protective structures supporting hauora, contributing to persistent intergenerational health and social inequities.
These dynamics are starkly laid out in statistics showing disproportionate rates of Māori experiencing ACEs and imprisonment. Imprisonment removes men from partners and children, increases economic stress, and can compound trauma – all of which makes healthy conception, safe relationships, and stable parenting harder.
Bringing fathers back into the fold
To achieve the best possible maternal and child wellbeing, fathers cannot remain a policy afterthought. Fortunately, there are many opportunities to address this.
The first is to make preconception a couple’s (and whānau) agenda. This means clinical guidance and public messaging should routinely include men. This should cover aspects beyond just fertility, including mental health, substance use, medications, and chronic conditions.
The second is to start initiatives early in life, though schools and youth programmes that build health literacy and coping skills for boys and young men, serving as long-term investments in family health.
Finally, structural barriers should be treated as a health issue. Incarceration, poverty, and structural discrimination are upstream determinants that shape whether fathers can be present, supportive and safe, and should be recognised as being inseparable from pregnancy and child outcomes.
The core message is simple: better maternal and child wellbeing requires a more holistic model of how families work, and that means taking into account men’s health, histories, and social conditions – well before a pregnancy test turns positive.
