New York State’s family planning provider community has made great strides to expand preconception care services to women in hopes of linking them to needed family planning services and improving birth outcomes among women and infants alike. Recently, in "Providing Quality Family Planning (QFP) Services", the Centers for Disease Control and Prevention (CDC) and Office of Population Affairs (OPA) set a precedent for assessing the reproductive life plan of both female and male clients, creating both a challenge and an opportunity for programs seeking to provide sexual and reproductive services to adolescent and adult males in need of education and clinical services.
An estimated 60% of males are in need of preconception care, with the greatest need identified among males aged 15 to 29 years.1 However, males’ utilization of health care services drops significantly after the age of 16.2 Males represented 8.8% of unduplicated clients served by New York State Department of Health’s (NYS DOH) network of 48 family planning providers in 2014, mirroring the national rate of just over 8%.3
As family planning providers develop innovative ways for engaging women in need of family planning services and addressing their reproductive life planning needs, it remains uncommon to ask male clients about their fatherhood intentions. In fact, a recent study found that only 8.3% of men recall being asked about their reproductive life plans at their last health care visit.4 Although males are willing to discuss various reproductive health topics with their health care providers, they often prefer such conversations be initiated by the provider.5 Approaching males of reproductive age about their fatherhood intentions consequently would require a shift in the way that many clinicians and clinical support staff offer services to male clients. It would mean engaging male clients through outreach efforts and at clinical visits to address their thoughts around fatherhood, informing them about the services that are available to them and their partners. Additionally, clinicians and clinical support staff would need to initiate a dialogue with female clients on how their male partners fit into their efforts to prevent an unintended pregnancy or plan a healthy pregnancy.
Male clients could benefit from a greater understanding of (1) the array of contraceptive options that are available to women, and (2) the importance of developing a reproductive life plan. Approaching males about their reproductive life plans also may offer an opportunity to address any concerns about infertility and to discuss the importance of nutrition, exercise, and disease prevention (which could someday impact fertility).
As family planning providers seek to get everyone at their health care delivery sites on-board with providing more integrated, comprehensive care to this “untapped” population, it is essential to consider how males fit into broader efforts to decrease the rate of unintended pregnancy and adverse birth outcomes. While contraceptive options for males are limited, family planning providers can support their male clients in exploring how fatherhood fits into their life goals and how they can best support their female partners in achieving their reproductive life plan.
1 Choiriyyah I, Sonenstein FL, Astone NM, Pleck JH, Dariotis JK, Marcell AV. Men Aged 15-44 in Need of Preconception Care.Matern Child Health J. 2015; 19(11):2358-2365. doi:10.1007/s10995-015-1753-7.
2 Marcell AV, Klein JD, Fischer I, Allan MJ, Kokotailo PK. Male adolescent use of health care services: where are the boys?J Adolesc Health Off Publ Soc Adolesc Med. 2002; 30(1):35-43.
3 Fowler, C. I., Gable, J., Wang, J., & Lasater, B. (2015, August). Family Planning Annual Report: 2014 national summary. Research Triangle Park, NC: RTI International
4 Frey KA, Engle R, Noble BB. Preconception healthcare: what do men know and believe? J Mens Health 2012; 9:25–35.
5 Same RV, Bell DL, Rosenthal SL, Marcell AV. Sexual and reproductive health care: adolescent and adult men’s willingness to talk and preferred approach.Am J Prev Med. 2014; 47(2):175-181. doi:10.1016/j.amepre.2014.03.009.