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Fathers, cultural norms and childbearing - Samuel Cumber wants to explore African fathers' involvement in pregnancy and childbirth

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Dr. Samuel Nambile Cumber has received a postdoc grant from the Anna Ahrenberg Foundation for the next two years to research the participation of African fathers during pregnancy, childbirth and the neonatal period.

Samuel Cumber is originally from Cameroon and holds a PhD in Public Health from South Africa. Since 2017, he has been employed as a senior lecturer at the University of Gothenburg in the subject of Social medicine and Epidemiology. His postdoc project will include studies of African men living both in Cameroon and in Gothenburg, Sweden.

Previous research has shown that men's involvement during pregnancy and childbirth is low in African countries. Many African women prefer to bring a sister or mother to the delivery ward, in Sweden as well.

- In Sweden, we promote that the father is active and present in the maternal care and delivery room but when it comes to African couples, our experience is that the fathers are usually not involved at all during pregnancy and childbirth. There are probably lessons to be learned from how things work in Africa that can be transferred to Swedish settings. Perhaps there are cultural norms that are playing part here and maybe we can get answers to what can be done to create more commitment, says Helen Elden, associate professor, midwife and research group leader in childbirth.

Malin Bogren, who is also an associate professor and midwife, continues:

- It is a very exciting area of ​​research! It is interesting to lift the male perspective and truly enriching to have a man in the research group. We are always keen to emphasize that it is the whole family that is offered health care during pregnancy and childbirth and that childbearing is not just about women. It is also valuable that Samuel has a different background than the rest of us in the research group.

Fatherhood and cultural differences

We talk to Samuel Cumber on an unsteady video link from Cameroon, where he is currently spending time while working on the literature review that will form the basis for the planned studies.

- In this project, I wanted to do something different, Samuel explains. In my doctoral project, I worked with street children and my research interest has been focused on studying vulnerable populations. This time, I wanted to study something related to my life both in Cameroon and in Sweden. Therefore, I decided that I wanted to study men's involvement in women's pregnancy, childbirth and aftercare. Men in Sweden and in Africa have such different backgrounds and we interpret things so differently. I also have my own experiences of this as an African man.

- When I was expecting my first child in Sweden, I was told that I was expected to be on site at the midwife clinic and in the delivery room. I told my wife straight away that it will not happen! Then I called my mother and told her that I was expected to attend the birth and she just sighed and asked if I didn’t have anything more important to do. It is interesting because now when I look back on this, I clearly see how different I interpreted and looked at childbirth then.

- Therefore, I think it will be an interesting study, just to look at how African men in particular, relate to, and interpret the involvement around childbirth. It's not that African men do not want to get involved, but it's some kind of cultural phenomenon where we come from, our background. We usually say that the woman can call us when the child is out, says Samuel and laughs.

Early commitment from fathers strengthens the family

Why is it important to examine fatherhood in a cultural context?

- Fathers play a big role in the family. The traditional African family father has a huge role in the family's decision making. During pregnancy and childbirth, however, there are many challenges and difficulties for the mother that most African men are not aware of. It is important for the whole family to know when the woman needs support or help. That is why I think it is very important for men to have a high degree of involvement. During my education and by living in Sweden, I have learned that sometimes you just have to listen to the words and needs of your family members, but men in more traditional, African settings, who may lack education, make all decisions concerning the family unanimously. In order for men to become more involved in childbirth, we must familiarize ourselves with their perspective.

- The concept of involvement can mean many different things depending on what background you have, Samuel continues. Exactly what is meant by involvement can be very varied. When reading previous research in an African context, it is described that the men consider themselves involved, but this may mean that they feel that they are fully involved when they support the family.

- It is important to capture the essence of this, emphasizes Helen Elden. You probably need to do more of an anthropological field study to get deeper and take the role of an informal observer. Samuel has access to a more personal sphere because he is who he is, Helen continues. As Swedish female midwives, we could never have access to an honest, informal conversation if we studied African men.

The goal is change

Your previous publications have revolved around reproductive health, how come you're interested in this field of study?

- Actually, I have always been interested in children's health. I have devoted a lot of time to vulnerable children, so for me it was natural to also study family formation. I also became interested in what is the right level when it comes to the father's involvement because it benefits the child's health. However, my main purpose is to find out what we can do to provide good support for pregnant women and come up with interventions and recommendations to promote women during pregnancy, childbirth and even the health of newborns. It is about seeing the different perspectives but also how we can challenge norms and incorporate other perspectives.

What are the challenges in a project like this?

- There are of course a number of challenges. One of them is the possibility of biases in the interviews. It may be difficult to get honest answers. One can imagine that there may be a tendency for the interviewees to say what they think is "right" in Sweden rather than the truth. I’m afraid they may think they have to be careful with what they say. That is why I want to talk to them in more informal contexts so that they will hopefully be more transparent. More of a field study really. If we do not get honest interviews, we cannot give adequate suggestions on what can be done for men to increase their involvement and be a good support during childbirth.

Motivated by own experiences

How has your own fatherhood been? Have you been involved?

-It is a very challenging question, Samuel says and laughs. I am a father of four children and I would say that I am more like an involved Swedish father rather than a traditional African father. But it is more because of coincidences and circumstances. My wife had a serious accident when she was pregnant with our second child and has since been hospitalized a lot. So I took care of my oldest son on my own. Since I was new in Gothenburg at this point and didn’t know anyone, I was mostly alone with him for a long time. This led to a very solid bond between us that really strengthened my fatherhood. When we had more children, I was with them myself for long periods of time when my wife needed healthcare and rehabilitation. As a consequence, I am very close to my children because I have spent so much time alone with them and it is difficult for me to know how my involvement would have been otherwise because I had no other choice. But I'm very happy about that, because before all this I was very busy working and that's what many African men prioritize.

-Sometimes when I talk to my African friends, they have the same attitude as I had when I first came to Sweden. I ask them if they really don’t want to be more present and offer support? They usually respond by saying that they support their family best by working and providing. So we look at things in different ways and that is really the core of my motivation. I really look forward to presenting the results!

The Anna Ahrenberg Foundation

Ingvar Dahlberg is secretary of the board of Anna Ahrenberg's foundation that finances Samuel Cumber's project.

- The foundation collaborates with different parts of the University of Gothenburg and we are happy to have the opportunity to collaborate with the Faculty of Health Sciences this time. The education at the Sahlgrenska Academy has an important role in society, which the past year has shown very clearly. The breadth of research at Sahlgrenska is impressive and we are pleased to contribute to a researcher to get an opportunity to establish himself within the academy.

Why is it important for the foundation to promote research?

- That is our mission. The donor, Anna Ahrenberg,  was a wealthy Gothenburg woman with an interest in the arts, music, science and charity. She started two foundations, of which the Anna Ahrenberg Foundation for scientific and other purposes was given a focus on scientific research and education at the University of Gothenburg and Chalmers university of technology. This is evident from both the statutes and the activities during Anna Ahrenberg's many years of presidency.

Previous grants have gone to predominantly humanities and art, how come you have granted grants for health care research in your postdoctoral call 2020?

- Also in this respect, we fulfill the donor's intentions. When the board decided to set up a postdoctoral grant, it deemed it important that the funds became available for different fields of research. 

Do you think the donor Anna Ahrenberg would have found this project interesting?  

It is always difficult to interpret the opinion of a donor about an activity, which is financed through her donation but at a different time. However I think that Anna Ahrenberg would probably be pleased with the translation of knowledge, thoughts and ideas as well as the attitudes and method improvements that may follow from the postdoctoral work. With her social commitment she would probably appreciate the purpose of increasing fathers' involvement.