Chapter 1 THE PROBLEM AND ITS BACKGROUND Introduction Expectant husbands undergo a series of rapid changes during the

pregnancy of their wives. But how do they experience it? Even though they do not go through the process of conception, their mere presence and attitude have a huge impact towards their spouses pregnancy. As fatherhood becomes one of the focus for the behavioural sciences, the attention has turned to mens parenting involvement and mainly to the experiences of becoming a father and a husband during pregnancy. One factor leading to their change in behavior is when their pregnant wives enter the stage of gestational cravings (paglilihi) which is defined by

(Ciriacruz,2008) related liter. The pregnant woman would want to see, smell, touch, taste and hear specific things. Food cravings, aversions and pica are only a part of this Filipino belief. Horrendous and overflowing emotions come with it, too. Anthropologist and professor Maria Luisa Lucas Fernan says that these cravings for food is a way of involving or sharing the experience of pregnancy to the husband. The wife bears the burden, maybe, but not necessarily alone. However, do all these expectant fathers fulfil their duties and responsibilities during their wifes pregnancy? In an investigation of expectant couples, Curtis

& Blume (2007) found that mens attitude towards pregnancy were associated with their reactions to the perinatal period. These attitudes not only affected their emotional well being during the pregnancy but were also communicated to their wives through their receptiveness. Furthermore, they credited that during this time of fatherhood, the man develops the sense of nurture and caring. His visible role in the pregnancy consists primarily of providing emotional and physical support for his wife. But on the other hand, pregnancy had also been linked to negative coping behaviours. A mans lack of empathy for their spouse and their inability to cope with anxiety can be caused by these sudden burdens on their shoulder during pregnancy, added by the whims and demands of their wives during the period of gestational cravings. The transition of roles from being partners to parents take much effort and could be tremendously stressful to them since they are not used to the responsibility and diversion of their wives attention. The researchers show interest in the variety of individual and relationship factors during the womans period of gestational cravings. Moreover, the researcher aims to know the effect of these gestational cravings to the expectant fathers, since their experience of pregnancy is less obvious than the mothers. The aim of this study is to broaden and expand the knowledge and awareness concerning the experience of pregnancy and gestational cravings in the perspective of the expectant father. This study also aims to analyze the

common denominator among the experiences of the husband during the pregnancy and the period of gestational cravings.

Statement of the Problem This study aims to determine the lived experience of expectant fathers with primigravida wives going through pregnancy and gestational cravings. Specifically, the study will answer the following questions: 1. What are the physiologic effects of gestational cravings to the expectant husband? 2. What are the physiological effects of gestational cravings to the expectant husband? 3. What are the psychosocial effects of gestational cravings to the expectant husband?

Assumptions of the Study 1. Expectant fathers feel responsible during and the period of gestational cravings during his wifes pregnancy. 2. As a psychosocial effect, expectant fathers respond to their wifes cravings by satisfying their wifes craving and providing care to their wife. However, some fathers do not attend to their wifes cravings because they were unprepared towards their partners pregnancy. 3. The expectant fathers think that the most difficult part of having a craving wife is to constantly satisfy her cravings even in the wee hours of the day since they are concerned that unsatisfied cravings that can affect the baby. Other things they found difficult was the occasional aversion to food which they thought added to their burden. 4. Expectant fathers have experienced giving in to some unusual cravings of their wife as long as it would not harm their baby.

5. Expectant fathers sometimes join their wife in indulging their cravings, but this does not prove that they gained weight. 6. As a psychologic effect, by means of satisfying their partners cravings, the expectant fathers feel that even though they are not conceiving their child, they are involved in their wifes pregnancy. 7. There are some local myths about gestational cravings that the expectant partners believe in. Sometimes, it affects the wifes diet and behavior. 8. The positive effects of their wifes cravings are having more strengthened and emphatic marital relationship and evolving growth in fatherhood since in this period, they provide emotional and physical support whereas the negative effects are the additional stress and burden added to the husband. These are the physiologic and psychosocial effects to the expectant father.

SIGNIFICANCE OF THE STUDY This study was designed to explore emotional stress and effects of gestational cravings and determine the different reactions of expectant fathers with wives going through pregnancy. In conducting this research, people with have a deeper understanding regarding the effects of pregnancy and gestational cravings to expectant fathers. Expectant Fathers. The study will help the expectant fathers to develop maore effective marital relationship with their pregnant wife by anticipating and preparing for the changes ahead of them and their childs birth, it will also help him to be more aware of the factors that influences their coping skills and attitude towards pregnancy. Future Fathers. The study will help the future fathers gather more knowledge about their wifes pregnancy to be able to prepare themselves all throughout the period of gestation. It will also help them be a better support system to their pregnant wife and to be more empathic regarding the difficulties their wife experiences during pregnancy.

Future Pregnant Mothers. The study will help the future mothers understand that their husband significancy. It will also increase their awakeness that their behaviors, demands and whims can trigger their husbands anxiety, and that their role transition from being a husband to a parent is not uncomplicated. And through this study they will be able to produce an effective and symbiotic relationship with thier husbands during their pregnancy. Health Care Proffesionel. This study will help the Health Care Proffesionel guide not only yhe pregnant mothers but also their husbands throughout the pregnancy. Through this, they can help the expectant fathes prepare themselves through the changes that will occur during the whole period of conception, and to be able to teach what the husband should do during pregnancy and the period of gestational cravings. Nursing Students. This study will help us nursing students increase our knowledge and awareness to the effects of gestational cravings to the husband of primigravida mothers. This study will help us understand what kind of changes occur to the expectant fathers, and how does its awareness help us with our health teachings in the community area. Future Researchers. This study will help future researchers broaden the scope of the pregnancy and gestational cravings effects to the wife of the pregnant mother. Throughout this research, they can formulate new ideas regarding the husbands changes of attitude during his wifes pregnancy. Scope and Delimitation The awareness of every health care professional about the effects of pregnancy and gestational craving to expectant fathers is very important preparing them to the new challenges of pregnancy and fatherhood. The study covers those expectant fathers who have pregnant primigravida wives experiencing gestational cravings but is not limited to the

respondents age and civil status. Furthermore, the study is limited to expectant fathers with pregnant primigravida wife seeking prenatal check-ups in Novaliches Health Center. The transcripts of interview from us researchers were coded to identify common categories, which in turn generated the themes of emotional deregulation and understanding the effects to the expectant fathers in the situation.

Definition of Terms For further understanding of the study, the following terms are defined operationally. Expectant father- a father expecting the birth of their child. Gestational Cravings- the changes in the first trimester of pregnancy where the women senses is buffeted by all sort of yearnings. The pregnant woman would want to see, smell, touch, taste and hear specific things. Food Aversion- a psychological repulsion to some foods caused by emotions associated with the food rather than by any chemical properties within the food. Primi gravida- refers to a woman who is pregnant for the first time. Physiologic effect- the effects which pertains to normal functioning of the body.

Psychological effect- the effect on mental processes and the drives or motives that regulate human behaviors. Psychosocial effect- the effects which pertains to relationship between a person and how he/she relates to others in a social setting. Pica- Unusual condition where patients develop cravings for nonnutritive substances that can cause significant health risks. Marital Relationship- the relationship between wife and husband. Stress- a negative condition that can have an impact on an organisms mental and physical well-being. Support- its a boost of someone to one side in times of mishap and troubles.

CHAPTER 2 REVIEW OF RELATED LITERATURE Related Foreign Literature Cravings for food or aversions to certain foods during pregnancy are so common that they are considered a normal part of adaptation to pregnancy. It was formerly considered that these strange desires for food reflected a womans need to call attention to a pregnancy or were a reaction to her imposed dependent state. However, cravings are actually more likely the result of a physiologic need for more carbohydrates or particular vitamins and minerals such as iron. (Pillitteri, 2010). In the first trimester, Pillitteri (2010), presented that the first task of a woman and partner is to accept the reality of pregnancy. It is recognized that all partners are important and should be encouraged to play an emotional role in the pregnancy. It means that if a woman adapts to pregnancy, her partner may go through some of the same psychological changes. It also concluded that for an expectant father, accepting the pregnancy means not only accepting the certainty of the pregnancy and the reality of a child to come but also accepting the wife in her changed state. Expectant fathers may vary feelings regarding the pregnancy. Related Local Literature Balisnomo, (2003) credited that people surrounding a pregnant couple tend to see the part played mostly by the pregnant mother and a little of what the fathers perform. As witnessed by the researcher, fathers were denied access

to the labor and delivery rooms of most institutions or during home deliveries, and that there is a wall that separates the birthing mother and the expectant father. It deprives the father of his participation in the special event of the couples life. It also stated that crisis and stress are interrelated, for stress is an aftermath of crisis and vice versa that arises in a single entity such as the family. Pregnancy is a psychologically stressful time for the-would-be father because he too, faces the transition from non-parent to parent, or from a parent of one to a parent of two or more children. An expectant father

experiences many of the same feelings and conflicts as that of an expectant mother when the pregnancy has been confirmed. Related Foreign Study Mens experience during pregnancy has emphasized fathers positive and negative coping behaviour. It is demonstrated that pregnancy has been associated with fathers increase in outside activities, extramarital affairs, and job changes. It is also stressed the extent to which parenthood contributes to emotional and maturity. Presented evidence for this study, mens attitudes towards pregnancy and childbirth were associated with their reactions to the perinatal period. The expectant fathers, are not only their emotional well-being that is affected during the pregnancy but also their communication to their wives through their responsiveness. Those individuals who are able to take into account the viewpoint of another may be viewed more positively and be perceived as showing a greater concern for the needs, interest, and desires of others. The couples should, therefore, support each others experiences in to

place heavy demands on their perspective taking ability as parents. The role of an expectant father in pregnancy consist primarily in providing emotional and physical support for the mother as he attempts to redefine himself and to anticipate the further changes that will follow birth (Curtis., et al, 2007). Lassally (2011), stated during pregnancy there is a transition from man to being a father. Most mens feelings of anxiety and distress occur at six to eight weeks. Though men cant bear a child, they had their biological bond and intense feeling of happiness and love thru their wifes pregnancy. On the physiological light in this study, Wilkinson (2010) states that men experienced gaining weight during their wifes pregnancy. If a pregnant woman experienced cravings for random kinds of food that they eat, their husbands may crave and indulged as well. Stress and anxiety may contribute in gaining weight in first time fathers. Related Local Study In the ethnographic study of Rolda (1997), the urban poor women of Bagbag, Novaliches, has their own cultural beliefs, practices and rituals observed during pregnancy and childbirth. The findings show that the women of Bagbag, Novaliches have no reproductive rights, such being the prerogative of the husbands. Men are supportive to and solicitous of their wives during pregnancy like assisting in household chores. They take over their wives responsibilities until postpartum period. The period of gestational cravings does not focus only on food. The pregnant woman would crave for specific things, as her senses are buffeted by

all sorts of yearnings. Even taste, touch, smell, see and hear specific things. Furthermore, pregnancy has its way of involving the people around the conceiving mother especially with a closely-tied culture like ours. This gestational craving is a way of including and partaking the experience of pregnancy; with the husband, the other members of the family, community and kin groups (Ciriacruz, 2008) We Filipinos have attributed various beliefs and folklore to the things that happen during a pregnant mothers conception. Ciriacruz (2008) cited anthropologist and professor Maria Lucas Fernan who stated that according to folklore, the types of food craved also makes an impact on the baby that is forming, that they would have an influence on the physical characteristics of the child. However, Ciriacruz (2008) also credited Dr. Nida Gloria D. Villanueva, an obstetrician and gynaecologist who said that scientifically, there is no basis in the belief that the child will reflect the food the mother craves during pregnancy.

Theoretical Framework Psychiatrist Harry Stack Sullivan is the creator of interpersonal relations theory. The theory emphasized that the essence of being human is the capacity to live effectively in relationship with others. IPR is a relationship between two or more persons that result in a mutual or reciprocal action or influence. In his interpersonal theory, Sullivan believed that such a relationship has the power to transform an immature preadolescent in top a psychologically healthy individual. All personal growth, personal damage and regression are a result of our relationship with others. Failures to develop IPRs are responsible for mental disorders and ineffective coping. This theory points out that personality development depends on the IPR one individual has with another. Sullivan spells out the sequence of interpersonal situations to which the person is exposed in passing from infancy to adulthood, and the ways in which this situation contribute to the formation of personality. The period of late adolescence constitutes a rather prolonged initiation in to the privileges, duties, satisfactions and responsibilities of social living and citizenship. The full compliments of interpersonal relations gradually take form and there is a growth of experience in the syntaxic mode that permits a widening of symbolic horizons. The self system becomes stabilized, more effective sublimation of tensions are learned, and stronger security measures against anxiety are instituted.

IPR develops through some phases between patient and nurse when they come together in the health care environment. Hildegard E. Peplau was the first person in the field of nursing who did a significant work on IPR. She published a book on Interpersonal relationship in nursing in 1952 and proposed a theory of IPR in nursing. In her book, she discussed the four phases of IPR and she mentioned that nursing is a significant, therapeutic interpersonal process because it involves interaction between two or more individuals (nurse and patient) with a common goal. In connection to this study, the theory of interpersonal relationship is applied by the expectant father to his wife. When there is an effective reciprocal relationship between them during pregnancy, the expectant father will likely be able to have a personal growth and a smooth role transition from becoming a partner to a parent. When there is a mutual fulfillment of needs between them, there exists coping and a successful relationship. The full complement of interpersonal relations gradually takes form and there is a growth of experience that permits a widening of their perspectives. The self system becomes stabilized, more effective sublimation of tensions are learned, and stronger security measures against anxiety are instituted. The same process goes to the nurse-patient relationship. The nurse and the expectant father develop interpersonal relationship for the nurse to help and support the father with his responsibilities and actions to understand the father with regards to his stress. If he is appreciated for his performance of his

roles that are ideal, expected and accomplished. If there is a satisfaction on the roles and practices of the father because of an effective interpersonal relationship with the nurse, this leads to paternal role actualization where the father develops role transition and growth as a father. However, if there is no interpersonal relationship, it results to paternal role frustration where the father remains in crisis and is unable to cope with stress.

Fig. 1 Conceptual Framework

CONCEPTUAL FRAMEWORK During pregnancy, the exact roles, responsibilities behaviors and attitudes of the expectant father are still not distinguished by many. Until now, health workers lack health teachings to the expectant fathers during the anticipation of a child, leaving them clueless to what their responsibilities are to become an empathic husband. Beside to the emotional burden of having a pregnant wife, gestational cravings also add to the load of difficulties a father experiences during pregnancy. Depending on the fathers coping capabilities, different positive and negative effects can transpire.

Simulacrum

coping behaviors

PREGNANCY & PAGLILIHI

Crisis

Stress /Anxiety

Effective Marital Interaction

Failure of Husband to provide symbiotic relationship.

Hypotheses/Assumptions: H1(+) Presence of Gestational Cravings can cause more stress to the husband. H2(+) High levels of stress leads to presence of anxiety to the husband. H3(+) High levels of Anxiety leads to dynamic failure of the husband to provide symbiotic relationship H4(-) Presence of anxiety leads to less positive coping behaviors. H5(+) Better positive coping behaviors leads to an effective marital interaction.

Presence of pregnancy and gestational cravings can cause stress or anxiety to the expectant father. If the father can manage it, he will be able to cope. But if he cannot handle stress or anxiety, that would lead to crisis where the father would fail to provide symbiotic relationship with his wife.

Chapter III RESEARCH METHODOLOGY This research chapter process contains the used conceptual structure and description of the methodology, research design, research setting, sampling technique and data gathering procedure. This includes the collection of the data through questionnaires, textual analysis and synthesis of data to determine the lived experience of the respondents in the study. Research Design The researchers will utilize the phenomenologic design in this study. This is the best research design for this study since it aims to know the meaning of ones lived experience. Being a person is self -interpreting; therefore the only reliable source of information to answer this question is the

person(Mapp,2008). Using this design facilitates, our understanding to the behavior or experience of the expectant fathers without making attempts to manipulate or control the variables.

LOCALE AND POPULATION The researchers will conduct the study at Novaliches Proper Health Center, or commonly known as Arsenia De Jesus Maximo Health Center, located in Quirino highway, Novaliches Quezon City. It has been chosen by the researchers as the setting of this study since it is one of the highest and most advanced health centers within the area. They offer many health care services like routine medical and dental care, promoting and rendering EPI, prenatal care and other services. Since the concern of the researchers is on the

husbands of primigravida women, the researchers deem that Novaliches Proper Health Center is the best locale for the study. Research Subjects The chosen subjects of the researchers are the expectant husbands of primigravida women seeking prenatal care and checkups in Novaliches Proper Health Center regardless of their age. Husband of multigravida and nulligravida women will not be included as respondents. Researchers believe that first time fathers are fit for the study that they are excited to their upcoming first baby hence more sensitive to the needs of their wives. Sampling Technique The researchers will choose their respondents by using purposeful or judgmental sampling technique since the people must pass the criterion first for them to be considered as participants or subject of the study. It is form of

non-probability sampling in which decisions concerning the individuals to be included in the sample are taken by the researcher based upon a variety of criteria(Burns & Groves,2013) In this study the researchers will search who will passed the standards of the required subjects. They must be partners of primigravida women regardless of their age and marital status. The researcher will conduct the interview by questioning those will have the time for their interrogation. Research Instruments The research instruments used in this study will be based on the related literature and studies for data gathering. Hence, it should adhere to certain validations prior to its administration to the respondents. The content of every question in the instrument is relevant and pertinent to the subject matter. The interview questionnaire consists of queries pertaining to the different experiences, reactions and behaviors of the expectant father during his wifes pregnancy and gestational craving. Validation of the Instrument The research instrument will undergo validation through external and internal validity. Revision of the instrument will be done through consultation and advice from the OB Gynecologist, the Obstetrics professor, Community Health Professor and the Research Adviser.

The pilot study will be conducted at Novaliches Proper Health Center or commonly known as Arsenia De Jesus Maximo Health Center in Novaliches Bayan, Quirino Highway, Quezon City where the respondents will be ask to answer the interview questionnaire. Additional advice and further instructions will be given to the researchers.

Data Gathering Procedure Before the collection of the data, a letter of consent will be used to get permission from the Health Centers Chief Officer, where the target population is situated. Researchers requested permission to identify primigravida women and interview their husbands. Later on, the interview questionnaires will be given to each respondent in the setting. The survey will be done with the guidance of the researchers to ensure proper understanding of the questions, making their answers more reliable. Each respondent will be expected to answer the questionnaires no more than twenty minutes since the time of both respondents and the researchers is taken into consideration. All answers and questionnaires will be retrieve after they finish answering. After the retrieval, the researchers will organize the data for presentation, analysis and interpretation.

Ethical Consideration To protect the rights of this studys respondents, ethical considerations must be implemented. The patients rights to privacy and confidentiality are