Factors Influencing First-Time Fathers' Engagement in Prenatal Care at Hafr Al-Batin Maternity & Children Hospital, Saudi Arabia

Abstract. This study investigates the factors influencing first-time fathers’ engagement in prenatal care at Hafar Al-Batin Maternity & Children Hospital, Saudi Arabia. Guided by Attachment Theory, a quantitative, descriptive-correlational, cross-sectional design was employed to examine the relationships between demographic characteristics and paternal involvement domains—warmth and attunement, indirect control, control and process responsibility, and frustration—and overall prenatal engagement. A purposive sample of 108 first-time fathers completed an adapted 22-item Paternal Involvement with Infants Scale (PIWIS), validated by clinical experts. Findings indicate that fathers demonstrated moderate engagement, occurring “a few times a week,” with the highest involvement observed in control and process responsibility and the lowest in frustration. Educational attainment significantly influenced engagement levels, whereas age, nationality, and religion showed no substantial differences except within the warmth and attunement domain. These results underscore the combined influence of personal, cultural, and contextual factors on paternal involvement during pregnancy. The study highlights the necessity of culturally sensitive, father-inclusive prenatal care strategies and informs policy development, clinical practice improvements, and future research aimed at enhancing paternal engagement in maternal and child health within Saudi healthcare settings. Keywords: Attachment theory, Father-inclusive care, First-time fathers, Paternal involvement, Prenatal care engagement