JaKobi Burton remembers the work that started months before the birth: he attended every medical appointment with his wife, Crystal Wilmot-Burton, and joined classes with Dads to Doulas, a program created by Dear Fathers that teaches Black fathers-to-be how to provide physical, mental and spiritual support before and after childbirth. In Indianapolis, Burton now cradles his newborn daughter, describing his role as active from the beginning rather than something reserved for a day of delivery.
Health professionals and advocates say the effort reflects both a practical and a cultural gap in maternity care. They point to federal health data showing that Black women are almost 3.5 times more likely than white women to die around the time of childbirth, and they argue that fathers’ involvement can help counter some of those risks by improving support during pregnancy, labor and postpartum. Organizers also describe a shift in attitudes among some Black men, with more openly discussing fears and insecurities connected to pregnancy and birth.
Advocates link the disparities to racism in medical institutions and to unequal access to prenatal care. The National Center for Health Statistics has cited health disparities, racism and equal access to prenatal care as contributing factors for maternal mortality differences across races. The gap is also reflected in the CDC’s maternal mortality statistics for 2023, which show 50.3 deaths per 100,000 live births for Black women, compared with 14.5 for white women; Hispanic and Asian women faced 12.4 and 10.7, respectively.
The push for fathers comes through multiple organizations. The National Healthy Start Association, created in 1998 to help improve infant and maternal mortality rates, has “fatherhood practitioners” at its 116 project sites. Along with case managers, those practitioners offer men support that includes webinars, a texting service and cooking lessons, and organizers say these services are designed to make paternal involvement part of the structure of care rather than an afterthought.
Kenneth Scarborough, who has served as the NHSA’s fatherhood and men’s health consultant for 10 years, said the organization has seen a noticeable shift toward including male partners in efforts to preserve pregnant women’s health. He said that while more research aims to “change those narratives,” the remaining challenge is persuading institutions to understand the value of ensuring “Dad is there and he is at the table.”
Doctors, advocates say, have often left Black fathers “on the fringes of the conversation,” while society can encode those fathers as “scary and rough.” Dr. Ndidiamaka Amutah-Onukagha, founder and director of the Center of Black Maternal Health and Reproductive Justice at Tufts University, said in interviews that she has heard “countless anecdotes” of fathers being ignored in the exam room despite evidence that paternal involvement is “directly correlated with better outcomes.”
For Wilmot-Burton, the search for attentive care included choosing an obstetrician-gynecologist who she thought would listen. She said she “thought maybe she would be more caring, be more willing to listen to my issues,” and that the doctor was. However, the story also points to structural barriers: Black doctors make up a small share of OB-GYNs nationwide, and the article cited 2023 figures indicating that among an estimated 43,700 practicing OB-GYNs, 7.5% are Black women and 2.3% are Black men.
Deborah Frazier, the CEO of National Healthy Start, said medical organizations must drop stigma about paternal involvement, noting that Black and brown fathers still face stereotypes of absenteeism. She said NHSA has “data and interviews with fathers,” including accounts from fathers who “told us that they wanted to be there with their partners” and “wanted be present for their births.”
The effort to reshape how fathers show up at medical appointments is also reflected in advocacy shaped by lived experience. Charles Johnson IV founded 4Kira4Moms in 2017 after his wife, Kira, bled to death during a cesarean section at Cedars-Sinai hospital in Los Angeles, according to the article, and he sued the hospital in 2022 alleging her death was tied to a culture of racism. The group’s executive director, Gabrielle Albert, said fathers should be able to walk the line between assertive and aggressive while still being “a force in the room,” and she described using role-play conversations to help men practice pushing back against a doctor.
That training approach appears in the Dads to Doulas workshops Burton attended. In August—two months before Wilmot-Burton gave birth—Burton was among prospective dads holding a Black baby doll during a session led by facilitator Kyra Betts Patton. Patton told the group that studies show present fathers-to-be can lower the chances of premature births and said the “largest time frame for maternal mortality” is “43 to 100 days after you’ve had a baby,” when partners may be the only ones immediately present.
Burton said the classes gave him the confidence to advocate throughout the pregnancy, and that he took a checklist of questions from the class to each appointment. He described pushing hard to make sure their birth plan was followed, adding that while it was not completely followed, “she still turned out great and was delivered successfully.” He also took classes with the Indiana Breastfeeding Coalition.
Wilmot-Burton credited her husband for taking on the workshops while working and attending grad school, and she said his presence was especially important when she felt unwell or nervous. She told others to encourage their partners to attend classes or read books, and she said they should “definitely go to as many appointments as they can.”