
==== Front
J Fam Nurs
J Fam Nurs
JFN
spjfn
Journal of Family Nursing
1074-8407
1552-549X
SAGE Publications Sage CA: Los Angeles, CA

39158522
10.1177/10748407241270073
10.1177_10748407241270073
Research
The Impact of the COVID-19 Pandemic on the Paternal Parenting Experience: A Scoping Review
https://orcid.org/0000-0002-8928-7647
Dol Justine PhD 1
Dennis Cindy-Lee PhD 23
Naraine Sarah BScN 2
Goyal Deepika PhD, FNP 4
1 IWK Health, Halifax, Nova Scotia, Canada
2 University of Toronto, Ontario, Canada
3 Mt Sinai Hospital, Toronto, Ontario, Canada
4 University of San Francisco, CA, USA
Justine Dol, PhD, Postdoctoral Fellow, Centre for Pediatric Pain Research, IWK Health, 5980 University Ave., Halifax, Nova Scotia B3K 6R8, Canada. Email: Justine.dol@dal.ca
19 8 2024
8 2024
30 3 199217
© The Author(s) 2024
2024
SAGE Publications
https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
The objective of this scoping review was to map the impact of the COVID-19 pandemic on the paternal parenting experience. Studies published between January 2020 and October 2021 reporting on paternal mental health, interparental relations, and child interactions were eligible. Forty studies from 17 different countries were included. Most studies included data from both mothers and fathers (83%); five studies reported data from fathers only, and three examined same-sex partners. Most commonly reported outcomes included division of childcare activities (n = 14), delegation of household tasks (n = 10), depression (n = 12), and stress (n = 9). The impact of the COVID-19 pandemic on fathers varied globally with no clear trends except for the division of childcare and household tasks, in which fathers increased their contribution to childcare and household tasks yet mothers continued to experience a higher domestic burden. Further research is recommended to advance our understanding of how fathers coped during the COVID-19 pandemic and document the long-term impact of the pandemic on families.

fathers
partners
parenting
COVID-19
IWK Health, Dalhousie University, Halifax, Nova Scotia, Canada typesetterts1
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pmcThe COVID-19 pandemic indisputably created a novel and unique challenge for families globally. Studies examining parental outcomes during the pandemic have reported increased depression and anxiety (Davenport et al., 2020), caregiving responsibilities (Calear et al., 2022), parenting stress (Taubman-Ben-Ari et al., 2021), and interparental relationship dissatisfaction (Pietromonaco & Overall, 2021). While families typically spent more time together during the pandemic due to public health recommendations to physically isolate and work-from-home, parental childcare activities also significantly increased (Calear et al., 2022). Daily routines for many children were disrupted as schools and childcare facilities closed, placing more responsibility on parents who may have already been struggling to balance the demands of work with parenting. With the addition of employment instability and decreased access to health care, poor parental mental health has also been reported (Gadermann et al., 2021).

Most research to date examining the impact of the COVID-19 pandemic on parents has focused primarily on mothers with limited attention synthesizing data on fathers and partners. The underrepresentation of this group in parenting research and clinical programming is not new (Tully et al., 2017) despite strong evidence suggesting the inclusion of fathers in programs not only has a direct beneficial effect but also has a positive impact on mothers, children, and the overall family unit (Frank et al., 2015; Plantin et al., 2011; Sarkadi et al., 2008; Wilson & Prior, 2011). To address this gap, a scoping review was undertaken to map the impact of the COVID-19 pandemic on fathers and partners in relation to their mental health, interparent relations, and father–child interactions.

Research Question

What was the impact of the COVID-19 pandemic among fathers/partners on the following outcomes:

a. Mental health (i.e., depression, stress, paternal burnout, anxiety, and social support)

b. Interparental relations (i.e., division of childcare responsibilities, division of household responsibilities, work–family conflict, co-parenting, relationship satisfaction, and family functioning)

c. Father–child interactions.

Method

This review was conducted following the PRISMA extension for Scoping Reviews (Tricco et al., 2018) and standard Joanna Briggs Institute scoping review methodology including the population, concept, and context framework (Arksey & O’Malley, 2005; Levac et al., 2010; Peters et al., 2015). A search of PROSPERO, MEDLINE, medRxiv, and Google Scholar was conducted and no current or underway systematic or scoping reviews on the topic were identified.

Population

This review considered studies that included participants who identified as a father or non-birthing partner at any stage of parenting, ranging from pregnancy (any gestation) to parent of a child up to 18 years old. While recognizing that not all families consist of a traditional mother–father dyad, this review used the term “father” to refer to all individuals who identified as the primary caregiver of a child to whom they did not give birth, thereby including heterosexual fathers and same-sex male couples. No geographical limitations were included. Studies that solely reported on maternal outcomes or parental outcomes without separating maternal/paternal data were excluded. Studies that used only maternal data reporting on paternal outcomes were also excluded (e.g., no proxy reporting was eligible).

Concept

This review sought to map the existing literature on parenting outcomes relevant to fathers in their role as a parent. Studies that reported on parents of children with specific health conditions (e.g., cancer, arthritis, learning disabilities) were excluded due to the unique challenges that may confound the pandemic’s impact on these parents.

Context

Due to the COVID-19 pandemic, there has been significant disruptions to parenting activities such as reduced access to childcare and increased social isolation. Little is known about the impact of the COVID-19 pandemic on the experience of fathers in relation to their mental health, interparental relationships, and father–child interactions. Studies that had a pre-COVID cohort and during-COVID cohort were included. Studies were excluded if they only reported on maternal outcomes, combined parental outcomes, were not published in English, or were conducted solely before January 2020.

Type of Sources

All research studies independent of design were included. Review articles identified through the search were checked for relevant primary articles but were not included in the final review.

Search Strategy

The following databases were searched on October 8, 2021: MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO. The search strategy was developed in consultation with a health science librarian and was adapted for each information source using search terms for COVID-19 and fathers and partners. The search was limited to articles published after January 1, 2020, shortly after the COVID-19 pandemic emerged. The full search strategy is available in Appendix 1.

Study Selection

All identified search citations were uploaded to Covidence where titles, abstracts, and full texts were screened by two reviewers with disagreements solved through consensus or with a third reviewer. Reasons for exclusion at the full-text stage are reported in a PRISMA-ScR flow diagram (Tricco et al., 2018).

Data Extraction and Synthesis

Data were extracted by one reviewer and verified by another and included population, study methods, and outcome details. The findings are presented in narrative form and include tables and figures as appropriate.

Results

The search identified 4,808 articles after duplicates were removed through the automation process in Covidence. During the full-text screening stage, 307 articles were reviewed and 266 were excluded for reasons outlined in the PRISMA-ScR diagram, resulting in 40 studies meeting the inclusion criteria (see Figure 1).

Figure 1 PRISMA Flow Diagram

Source. Page et al. (2021).

Characteristics of Included Studies

Among the 40 included studies, 11 (28%) were published in 2020 with the rest in 2021. As per Table 1, most of the study designs were quantitative (n = 31, 78%), with four studies utilizing mixed methods and five using a qualitative design. The majority of the quantitative studies used a cross-sectional design while the qualitative studies used a variety of approaches, including grounded theory and ethnography. Countries most represented were the United States (n = 10), Australia (n = 4), and Canada (n = 4) with a total of 17 different countries represented. Only one study included a global perspective. Most studies included data from both mothers and fathers (n = 34, 85%), while five studies reported on data from fathers only. Three studies reported on same-sex partners-two along with heterosexual couples (Craig & Churchill, 2021; Goldberg et al., 2021) and one solely on gay fathers (Carone et at., 2021). Sample sizes ranged from 3 to 4,587. Of the studies with mixed samples that provided the split between paternal and maternal respondents, the percentage of fathers ranged from 4.6% to 100% while four studies did not report the number of parental respondents separately.

Table 1. Summary of Included Studies.

Author (Year)	Country of study	Methodology	Objective	Population (sample size)	Inclusion criteria	Authors’ conclusions	
Aguiar et al. (2021)	Portugal	Quantitative—Cross sectional	To analyze parental burnout levels, comparing levels of burnout reported by mothers and fathers before lockdown to levels reported by a second group during lockdown.	Mothers and fathers (n = 995)
315 (31.7%) fathers
680 (68.3%) mothers	Portuguese fathers and mothers, living with at least one child under the age 18 years.	Although parental burnout levels remain higher for mothers across the two waves, the growth in burnout was greater for fathers than for mothers.	
Ahorsu et al. (2022)	Iran	Quantitative—Cross sectional	To examine the actor-partner interdependence effect of fear of COVID-19 among Iranian pregnant women and their husbands and its association with their mental health and preventive behaviors during the first wave of the COVID-19 pandemic in 2020.	Mothers and fathers (n = 580)
290 (50%) fathers
290 (50%) mothers	Mothers and fathers were at least 18 years old, able to speak and understand Persian, and enrolled in the Integrated Health System.	The findings demonstrated significant dyadic relationships between husbands and their pregnant wives’ fear of COVID-19 and mental health.	
Baral (2021)	Uganda	Qualitative—Ethnography	To explore the experiences of Ugandan men who became unable to provide under the national lockdown.	Mothers and fathers (n = 14)
9 (64.3%) fathers
5 (35.7%) mothers.	Based on prior relationships established by the first author.	Men being at home progressively shifted from an unwanted obligation to a welcomed responsibility. Men explored different ways of validating themselves in the crisis.	
Bastiaansen et al. (2021)	Multiple	Quantitative—Cross sectional	To examine the extent to which co-parenting has a mitigating effect on the association between state-imposed lockdown measures and parental burnout levels, and how this effect might be different between men and women.	Mothers and fathers
(n = 4,587)
1,183 (25.8%) fathers
3,404 (74.2%) mothers	Two-parent families who had at least one child still living at home, regardless of age.	The relationship between COVID-19 lockdown measures and levels of parental burnout was not significantly affected by co-parenting.	
Ben-Yaakov & Ben-Ari (2022)	Israel	Quantitative—Cross sectional	To explore the level of COVID-19-related anxieties and parenting stress of Israeli parents in their first year of parenthood.	Mothers and fathers
(n = 606)
137 (22.6%) fathers
469 (77.4%) mothers	First-time parents of infants aged 3–12 months and could complete questionnaires in Hebrew.	Mothers reported higher levels of anxiety than fathers for all aspects of the pandemic except for economic damage, whereas fathers reported higher levels of two dimensions of parenting stress: dysfunctional interaction with the infant and perception of the infant as difficult.	
Carlson et al. (2021)	United States	Quantitative—Cross sectional	To provide a descriptive overview of how parents’ time in, and division of, domestic labor has changed since the beginning of the pandemic.	Mothers and fathers
(n = 1,025)
523 (51%) fathers
502 (49%) mothers	Parents in the United States who resided with a partner and a biological child. Excluded respondents who identified as a gender other than male/female and who reported being in a same-sex relationship.	Mothers and fathers disagreed substantially on the degree of equality achieved. Fathers report sharing housework and childcare equally in most families, while mothers report retaining responsibility for domestic labor in the vast majority of families despite increases in fathers’ domestic contributions.	
Carone et al. (2021)	Italy	Quantitative—Cross-sectional case-control	To gather data on the implications of the COVID-19 pandemic for father–child bonding and the mental health of Italian same-sex fathers who were having or had a child through cross-border surrogacy during March–July 2020, when US and Canadian borders were closed and/or the process of obtaining the child’s birth certificate and passport took much longer.	Same-sex partners (all fathers; n = 80)	Fathers that self-identified as both cisgender and gay; resided in Italy at the time of the COVID-19 pandemic; and were having or had a child through cross-border surrogacy in a planned gay father family between March and July 2020.	The findings call for the development of international guidelines for cross-border surrogacy and underline the need for tailored and ongoing psychological and legal support for intended gay fathers to ease their strain and anxiety related to having a child through cross-border surrogacy during the COVID-19 pandemic.	
Carroll et al. (2020)	Canada	Mixed method—Thematic analysis, cohort	To identify how health behaviors, level of stress, financial and food security have been impacted by the pandemic among Canadian families with young children.	Mothers and fathers (n = 361)
126 (35%) fathers
235 (65%) mothers	Families had at least one child between 18 months and 5 years of age at the time of registration for the study, lived within the Guelph-Wellington area in Ontario, Canada and English-speaking.	Key factors influencing family stress include balancing work with childcare/homeschooling and financial instability. While some unhealthful behaviors appeared to have been exacerbated, other more healthful behaviors also emerged since COVID-19.	
Chung et al. (2021)	United Kingdom	Quantitative—Cross sectional	To examine the role flexible working has for gender equality during the pandemic.	Mothers and fathers (n = 1,384)
692 (50%) fathers
692 (50%) mothers	Heterosexual cohabitating parents of children under 18 years, where both partners were working before the COVID-19 pandemic.	The sharp rise in number of workers working from home, especially that of fathers, may have enabled a more equitable distribution of unpaid work among heterosexual dual-earning couples.	
Cooper et al. (2021)	United States	Quantitative—Cross sectional	To examine how Black American fathers’ COVID-19 perceived work risk was associated with their individual well-being, COVID-19 diagnosis, depressive and anxiety symptoms, sleep disturbance, sleep quality, as well as spill-over into family contexts.	Fathers only (n = 466)	Unemployed and retired participants were excluded.	Black fathers working in higher risk contexts may be at risk for COVID-19 exposure and infection. This study indicates that these effects extend to their own well-being, including mental and sleep health as well as increased family stress.	
Craig & Churchill (2021b)	Australia	Mixed method	Focuses on how lesbian, gay, and bisexual mothers and fathers in couples and single mothers subjectively experienced unpaid work and care during lockdown compared with heterosexual mothers and fathers in couples, and with partnered mothers.	Mothers, fathers and same-sex partners (n = 2,722)
Number and percentage of mothers and fathers not reported separately.	Not reported.	During the pandemic, non-heterosexual fathers’ subjective reports were less negative than those of their heterosexual counterparts.	
Craig & Churchill (2021a)	Australia	Quantitative—Cross sectional	To determine how COVID-19 affected paid work, domestic work, and care in Australian households; also investigated how gender differences in objective time spent on these activities, and in subjective feelings about it, changed due to the pandemic.	Mothers and fathers (n = 1,536)
Number and percentage of mothers and fathers not reported separately.	Employed, partnered men and women with children under the age of 17.	More fathers reported high levels of subjective time stress, unfairness, and dissatisfaction with actively juggling (too much) paid work and unpaid domestic labor and care. Compared to before COVID-19, the increases in childcare (though not housework/ household management) were proportionally higher for fathers.	
DesRoches et al. (2021)	Canada	Quantitative—Cross sectional	To examine the impacts of COVID-19 mandated homeschooling on work–family conflict and alcohol use in romantic couples and their possible moderation by gender.	Mothers, fathers, and same-sex partners (n = 1,516)
711 heterosexual couples (mothers/fathers)
92 same-sex couples (gender not specified)	Involved in romantic relationship of at least 3 months with a partner also willing and available to participate. Both partners had to be at least 19 years old, living in Canada, cohabiting together during April 2020, and following COVID-19-related stay-at-home advisories in their jurisdiction during April 2020. Essential workers excluded.	Gender differences found in FIW (family interferes with work) but not WIF (work interferes with family) conflicts.	
Farley et al. (2021)	South Africa	Mixed method—Thematic analysis, cross-sectional	To explore and describe the birth and new parenting experiences in South Africa during the COVID-19 pandemic, the impact of COVID-19 and the lockdown on these experiences, and the association between birth experiences and postpartum depressive symptoms.	Mothers and fathers (n = 520)
24 (4.6%) fathers
296 (95.4%) mothers	Aged 18 years or older, living in South Africa at the time of the baby’s birth and had a baby born between January 1, 2020, until October 10, 2020.	Lockdown exacerbated many birth and parenting challenges including mental health and health care access.	
Giannotti et al. (2021)	Italy	Quantitative—Cross sectional	To investigate psychological adjustment to COVID-19 restrictions in Italian families considering parental stress, co-parenting, and child externalizing behaviors, in order to capture the process of family adjustment during home confinement at different levels.	Mothers and fathers (n = 602)
76 (12.6%) fathers
526 (87.4%) mothers	Parents older than 18 years with at least one child between 3 and 17 years old, without physical or intellectual disabilities as well as neurotypical development.	Mothers reported higher levels of parental stress than fathers both prior and during the lockdown. No significant differences before and during the lockdown on quality of co-parenting in both mothers and fathers.	
Goldberg et al. (2021)	United States	Mixed method—Thematic analysis using content analysis, cross-sectional	To examine adoptive parents’ worries and concerns, work–family arrangements, and mental, physical, and relational health in the context of the pandemic and associated quarantine.	Mothers, fathers, and same-sex partners (n = 89)
26 partnered (6 unpartnered) lesbian respondents, 21 partnered (0 unpartnered) gay male respondents, and 32 partnered (3 unpartnered) heterosexual respondents. 1 participant did not provide data on relationship status.	Parents were required to be adopting their first child, and both parents needed to be becoming parents for the first time. Only one parent per couple was encouraged to participate.	Parenting during a pandemic places undue burdens on parents, particularly on those working from home with limited help, highlighting parenting, relationships, and personal challenges due to the COVID-19 pandemic.	
Graham et al. (2021)	Australia	Quantitative—Cross sectional	To examine the impact of working at home on general health, pain, stress, and work–family and family–work conflict, and differences based on gender and parental responsibilities.	Mothers and fathers (n = 219)
64 (9.7%) fathers
155 (23.6%) mothers	Aged 18 years or more, working from home at least 2 days per week during the period following the declaration of the COVID-19 pandemic in Australia, and currently living in Victoria, Australia.	Satisfaction with the division of household tasks appears to play a substantial role in alleviating stress, and work–family and family–work conflict suggesting the way in which household tasks are divided can either negatively or positively impact physical and mental health.	
Hazarika & Das (2021)	India	Qualitative—Thematic analysis	To examine the experiences of men and women (parents) in sharing household responsibilities and its impact on their careers during the lockdown imposed due to the COVID-19 pandemic	Mothers and fathers (n = 40)
20 (50%) fathers
20 (50%) mothers	Not reported.	Fathers and mothers mostly concurred that they were overworked and overburdened during the lockdown. Mothers were overburdened due to household chores, child-rearing, and home-schooling duties; and fathers due to “work from home” with poor Internet and phone facilities.	
Hipp & Bünning (2021)	Germany	Quantitative—Cross sectional, longitudinal	To explore the social and economic implications of the pandemic for gender inequality in Germany, by examining changes in paid and unpaid work and in subjective well-being in response to the nationwide lockdown.	Mothers and fathers (n = 2,269)
Number and percentage of mothers and fathers not reported separately.	Respondents aged 25 to 54 who participated in all three survey waves; in this review, only reported on parent data.	Analyses suggest an increase rather than a reduction in gender inequalities in Germany during the pandemic. Despite slight changes in how parents divided the additional childcare, mothers still did considerably more unpaid work during the lockdown than fathers.	
Hupkau & Petrongolo (2020)	United Kingdom	Quantitative—Cross sectional	To explore the effects of the COVID-19 crisis and the associated restrictions to economic activity on paid and unpaid work for men and women in the United Kingdom.	Mothers and fathers (n = 3,384)
Number and percentage of mothers and fathers not reported separately.	Individuals aged 16–64 who participated in at least one of the COVID-19 waves and who had previously participated in Understanding Society longitudinal study wave nine. Restricted to those who report being employed as of January 2020. For the analysis of childcare, individuals with children aged 15 and younger across the two waves of the COVID-19 study.	Within the household, women provided on average a larger share of increased childcare needs, but in an important share of household’s fathers became the primary childcare providers.	
Iztayeva (2021)	United States	Qualitative—Grounded theory	To examine the differences between work and caregiving responsibilities of custodial single fathers prior to and during the COVID-19 pandemic.	Fathers only (n = 30)	Single, custodial fathers with a full-time job.	Fathers in the low-wage labor market experienced a significant intensification of work–family conflict and deterioration of mental health and emotional well-being.	
Kerr et al. (2021)	United States	Quantitative—Cross sectional	To describe parenting experiences at the beginning of the COVID-19 pandemic and examines differences across parent gender and family income level.	Mothers and fathers (n = 1,009)
109 (11%) fathers
896 (89%) mothers	Participants who identified as men or women were included. Must have been parents with a child under 13 years of age.	Parents reported high levels of anxiety and depression symptoms, and a majority reported at least one symptom of parental burnout.	
Kreyenfeld & Zinn (2021)	Germany	Quantitative—Cross sectional	To identify the effect of the COVID-19 crisis on fathers’ time spent on childcare tasks, examining difference between 2019 and period of first lockdown in Spring 2020.	Mothers and fathers (n = 925)
322 (35%) fathers
603 (65%) mothers	Households with a valid phone number, women and men aged 20–59 at the time of the first interview, and a child between 0 and 11 at the time of first interview in 2019. Excluded if no valid phone, single parents, childless couples, or divorced since the first interview.	Both parents reported spending more time with their children during the crisis than they did in the previous year. Although the absolute increase was a bit larger for the mothers, fathers spent, on average, 2.5 more hours per day with their children.	
Lucassen et al. (2021)	Netherlands	Quantitative—Cross sectional	To examine whether and how changes in parental stress of mothers and fathers from the Pre-COVID-19 period into the height of the first lockdown in the Netherlands were linked to changes in coercive parenting of mothers and fathers and to changes in co-parenting quality.	Mothers and fathers (n = 208)
104 fathers (50%)
104 (50%) mothers	Having a 3-year-old child, being a residential family in which one or more children were raised by a mother and a father, and having a Dutch native background (mother and father of both parents were born in the Netherlands).	Changes in parental stress may affect changes in co-parenting quality, indicating the importance of a family systems perspective in prevention and intervention programs.	
Manja et al. (2020)	Malaysia	Quantitative—Cross sectional	To examine the effect of lockdown order on parental burnout, parental neglect, and parental violence.	Mothers and fathers (n = 158)
38 (24.1%) fathers
120 (75.9%) mothers	Mothers or fathers in Malaysia that had (at least) one child still living at home.	The level of parental burnout during lockdown in Malaysia was between average and high, but there was no difference between mothers and fathers.	
Marchetti et al. (2020)	Italy	Quantitative—Cross sectional	To examine the prevalence of parenting-related exhaustion—and to identify its risk and protective factors—4 weeks into the COVID-19 lockdown.	Mothers and fathers (n = 1,226)
131 (11%) fathers
1,095 (89%) mothers	18 years of age or older, the parent to at least one child aged 0–13 years who was living with them during the lockdown.	Mothers showed significantly higher psychological distress and more parenting-related exhaustion than fathers.	
Mousavi (2020)	Iran	Quantitative—Cross sectional	To investigate the effect of home quarantine on psychological well-being and marital and parental outcomes in families living in Iran.	Mothers and fathers (n = 213)
73 (34.3%) fathers
140 (65.7%) mothers	All married fathers and mothers living in cities of Iran who have at least one child who needs care at home (without age limit), are literate, and have consented to participate in the study.	Fathers had higher scores in martial satisfaction and psychological well-being and lower parental burnout than mothers.	
Recto & Lesser (2021)	United States	Qualitative—Descriptive, content analysis using participatory action research	To examine how young Hispanic fathers are coping with the effects of COVID-19 pandemic.	Fathers only (n = 7)	Hispanic fathers who were part of a community-based fatherhood program.	The stress from the uncertainty of the pandemic and its potential threat to their livelihood resulted in a persistent state of worry among the participants.	
Ruppanner et al. (2021)	Australia	Quantitative—Cross sectional	To identify traditional gender roles for U.S. and Australian parents and the effect of COVID on well-being during the first few months of the pandemic.	Mothers and fathers (n = 1,375)
672 (48.9%) fathers
703 (51.1%) mothers	Parents with childcare responsibilities.	The pandemic took different tolls on mothers and fathers in Australia and the United States. U.S. parents’ time spent in paid work, housework, and childcare served to reinforce hegemonic masculinity, while Australian parents reshuffled gender roles.	
Russell et al. (2020)	United States	Quantitative—Cross sectional	To examine concurrent patterns of parents’ experience from a national sample during the early months of the U.S. COVID-19 pandemic.	Mothers and fathers (n = 420)
218 (52%) fathers
202 (48%) mothers	Adults 18 years or older, living in the United States who speak English, and were caring for a child under the age of 18 years old in their home.	Fathers report higher rates of burden overall than mothers.	
Russell et al. (2021)	United States	Quantitative—Cross sectional, longitudinal	To explore the associations between resilience, mental health and stress indicators, and parenting outcomes (caregiver burden and parent–child relationship qualities) over a 30-day period during the COVID-19 pandemic.	Mothers and fathers (n = 271)
147 (54.2%) fathers
124 (45.8%) mothers	Individuals who were 18 years or older, living in the United States, who speak English and were caring for a child under 18 years old in their home were eligible to participate.	Fathers’ depression symptoms and associated spill-over to perceived child stress produced stronger effects on their parenting experiences than effects reported by mothers.	
Shafer et al. (2020)	Canada	Quantitative—Cross sectional	To examine the perceived changes in the division of household labor in the months immediately following the beginning of the pandemic in Canada.	Mothers and fathers (n = 1,234)
613 (49.7%) fathers
621 (50.3%) mothers	Canadian parents, in a residential romantic relationship, 18 or older, have at least one residential child under the age of 18, English or French language proficiency, and have the ability to access an online survey.	There were small shifts toward a more equal division of labor in the early “lockdown” months, with increased participation in housework and childcare by fathers.	
Sun et al. (2021)	China	Quantitative—Cross sectional	To investigate the prevalence of paternal perinatal depression among the fathers exposed to the COVID-19 pandemic and to determine relevant risk factors.	Fathers only (n = 1,187)	Men with hospitalized partners at >28 weeks gestational age or within 7 days after delivery.	Declining risk of postpartum depression observed over the early period of the COVID-19 pandemic.	
Taubman-Ben-Ari & Ben-Yaakov (2020)	Israel	Quantitative—Cross sectional	To examine parental distress and apprehension about raising an infant during the COVID-19 pandemic among new parents, comparing mothers and fathers and exploring the role of personal resources.	Mothers and fathers (n = 606)
137 (22.6%) fathers
469 (77.4%) mothers	First-time parents of babies up to 1 year old had to read Hebrew.	New parents may experience parental distress and concerns about raising a child during the crisis, but there were no significant differences between mothers and fathers.	
Taubman-Ben-Ari et al. (2021)	Israel	Quantitative—Cross sectional	To compare the parenting stress of new parents during the COVID-19 pandemic with the level of stress reported in the previous year, relating to both mothers and fathers.	Mothers and fathers (n = 1,591)
422 (26.5%) fathers
1,169 (73.5%) mothers	First-time Israeli parents of infants 3–12 months old and could complete questionnaires in Hebrew.	The findings highlight the vulnerability of new parents of young infants to parenting stress during the crisis, and the special attention which should be paid to fathers.	
Waddell et al. (2021)	New Zealand	Quantitative—Cross sectional, longitudinal	To examine the presence and implications of gender differences in the division of labor during COVID-19 lockdowns.	Mothers and fathers (n = 314)
157 (50%) fathers
157 (50%) mothers	Couples who had been cohabiting for at least 1 year, spoke fluent English, and who had a child between 4 and 5 years old who had not been formally diagnosed with a social or cognitive impairment.	Women who were unfairly doing a greater share of housework and parenting, and having less personal time, experienced residual increases in relationship problems and residual decreases in satisfaction.	
(Wissö & Bäck-Wiklund, 2021)	Sweden	Qualitative—Ethnography	To explore fathering practices among Syrian refugee families in Sweden.	Fathers only (n = 3)	Being a cohabiting partner with at least one child in the age group 3–18 who had lived in Sweden for at least 3 years.	Provided insight into how fathering and family are shaped in the interaction between family members.	
Xue & McMunn (2021)	United Kingdom	Quantitative—Cross sectional	To describe gender divisions of unpaid care work during the height of the COVID-19 lockdown in the United Kingdom and its associations with psychological distress.	Mothers and fathers (n = 3,282)
1,641 (50%) fathers
1,641 (50%) mothers	Working, coupled parents.	There are continued gender inequalities in divisions of unpaid care work.	
Yerkes et al. (2020)	Netherlands	Quantitative—Cross sectional	To investigate gender differences in (a) paid work (work location, working days and times, perceived work pressure); (b) the division of childcare/household tasks; and (c) quality of life (leisure, work–life balance, relationship dynamics) among Dutch mothers and fathers during the COVID lockdown.	Mothers and fathers (n = 852)
375 (44%) fathers
477 (56%) mothers	Dutch household, at least one member in paid employment, at least one child age of 18 or younger living at home.	The impact of the first COVID-19 lockdown measures on Dutch parents was gendered, with some existing gender inequalities increasing.	
Zamarro & Prados (2021)	United States	Quantitative—Cross sectional	To study the impact of the pandemic on gender equity within households in the United States and to understand gender differences, how fathers and mothers are coping in terms of childcare provision, employment, working arrangements, and psychological distress levels.	Mothers and fathers (n = 3,980)
1,950 (49%) fathers
2,030 (51%) mothers	All adults 18–65, married, or partnered. For the childcare analysis, only participants with school age children were included.	The unprecedented school closures, social distancing measures, and stay-at-home orders to contain the COVID-19 pandemic had the potential to drastically magnify gender differences in terms of both childcare arrangements.	

Studies reported on a variety of outcomes. Within the mental health category, depression was the most widely reported outcome in 12 studies, followed by stress (n = 9), parental burnout (n = 8), anxiety (n = 7), and a lack of social support (n = 2). For interparental relationships, the most frequently reported outcome included division of childcare responsibilities (n = 15) and delegation of household tasks (n = 10), followed by work–family conflict (n = 5), co-parenting activities (n = 4), relationship satisfaction (n = 3), and family functioning (n = 1). Four studies reported on father–child interactions. Table 2 provides a summary of study outcomes. A summary of measures used to assess mental health outcomes are available in Appendix 2 and those used to assess interparental relationships are available in Appendix 3.

Table 2. Summary of Outcomes of Interest.

Outcome/study	Mental health	Interparental relationship	Parent–child bonding	
Parental burnout	Depression	Anxiety	Social support	Stress	Work–family conflict	Co-parenting	Relationship satisfaction	Family functioning	Childcare responsibilities	Household tasks	
Aguiar et al. (2021)	X												
Ahorsu et al. (2022)		X	X										
Baral (2021)												X	
Bastiaansen et al. (2021)	X						X						
Ben-Yaakov & Ben-Ari (2022)			X		X								
Carlson et al. (2021)										X	X		
Carone et al. (2021)		X	X	X								X	
Carroll et al. (2020)					X								
Chung et al. (2021)										X	X		
Cooper et al. (2021)		X	X			X							
Craig & Churchill (2021b)											X		
Craig & Churchill (2021a)										X	X		
DesRoches et al. (2021)						X							
Farley et al. (2021)		X											
Giannotti et al. (2021)					X		X						
Goldberg et al. (2021)		X	X					X			X		
Graham et al. (2021)					X	X							
Hazarika & Das (2021)										X	X		
Hipp & Bünning (2021)										X	X		
Hupkau & Petrongolo (2020)										X			
Iztayeva (2021)		X				X	X						
Kerr et al. (2021)	X	X	X							X			
Kreyenfeld & Zinn (2021)										X			
Lucassen et al. (2021)					X		X						
Manja et al. (2020)	X												
Marchetti et al. (2020)	X	X											
Mousavi (2020)	X	X						X					
Recto & Lesser (2021)					X								
Ruppanner et al. (2021)										X			
Russell et al. (2020)	X	X	X									X	
Russell et al. (2021)	X	X			X							X	
Shafer et al. (2020)										X	X		
Sun et al. (2021)		X											
Taubman-Ben-Ari & Ben-Yaakov (2020)					X								
Taubman-Ben-Ari et al. (2021)					X								
Waddell et al. (2021)								X		X	X		
(Wissö & Bäck-Wiklund, 2021)				X					X	X			
Xue & McMunn (2021)										X			
Yerkes et al. (2020)						X				X	X		
Zamarro & Prados (2021)										X			

Mental Health

Depression

Twelve studies reported on depression, of which, seven were conducted in the United States or Canada, two in Iran, and one each in South Africa, Italy, and China. Two studies conducted in Italy and Iran found maternal depression symptoms were higher than those reported by fathers (Marchetti et al., 2020; Mousavi, 2020), while two studies in the U.S. reported fathers had greater symptomatology than mothers (Russell et al., 2020, 2021) and one U.S. study found no difference (Kerr et al., 2021). In terms of prevalence, Sun et al. (2021) found rates of postpartum depression to be 13.8% among Chinese fathers while Farley et al. (2021) reported 29% of South African fathers had minor depressive symptoms and 25% had probable depression. Thirty-nine percent of same-sex male couples with children in a U.S. study indicated their mental health worsen during the COVID-19 pandemic and that they currently were still experiencing heightened levels of depression, anxiety, and stress than before the pandemic (Goldberg et al., 2021).

Fathers working in high-risk settings (e.g., essential, frontline) had more depression symptoms than those working in low-risk settings (Cooper et al., 2021), and COVID-19-related fear was also associated with higher rates of depression among men with pregnant partners (Ahorsu et al., 2022). Same-sex fathers who were having or had a child during the COVID-19 pandemic reported more severe depression compared with same-sex fathers who had a child prior to the pandemic, although both groups scored below the clinical cut-off (Carone et al., 2021). In the only qualitative study with custodial single fathers, blurred boundaries between work and family life, social isolation, economic strain, fear of contracting COVID-19, and overall future uncertainty together negatively affected paternal mental health (Iztayeva, 2021).

Parenting Stress

Nine studies reported on parenting stress. While one Israeli study found no significant difference in perceived parenting stress between mothers and fathers (Taubman-Ben-Ari & Ben-Yaakov, 2020), another Israeli study reported fathers had significantly higher levels of parenting stress than mothers (Taubman-Ben-Ari et al., 2021), and a third Israeli study found fathers of older infants (7–12 months) had higher levels of parenting stress than mothers, but no differences were found among those with younger infants (0–6 months; Ben-Yaakov & Ben-Ari, 2022). Looking more globally, a Canadian study reported moderately high levels of parenting stress among both parents (Carroll et al., 2020), three studies from Italy, Australia, and the U.S. reported fathers had lower parenting stress than mothers (Giannotti et al., 2021; Graham et al., 2021; Russell et al., 2021), and one study from the Netherlands reported that both mothers and fathers experienced an increase in parenting stress from before the pandemic to during the pandemic (Lucassen et al., 2021). In two qualitative studies, Canadian and American fathers noted an increase in stress and isolation related to the pandemic (Carroll et al., 2020; Recto & Lesser, 2021).

Parental Burnout

Eight studies reported on parental burnout, of which five reported fathers had lower parenting-related burnout than mothers, with similar findings from Portugal, the U.S., Italy, Iran, and a global survey (Aguiar et al., 2021; Bastiaansen et al., 2021; Kerr et al., 2021; Marchetti et al., 2020; Mousavi, 2020). Conversely, one U.S. study found fathers had higher parenting-related burnout scores than mothers (Russell et al., 2020) and two studies from the U.S. and Malaysia found no significant differences between parents (Manja et al., 2020; Russell et al., 2021).

Anxiety

Seven studies reported on anxiety, five of which were conducted in North America. When comparing differences between parents, two studies found Israeli and American fathers had lower anxiety than mothers (Ben-Yaakov & Ben-Ari, 2022; Kerr et al., 2021) and one U.S. study found no differences (Russell et al., 2020). American fathers working in high-risk settings (e.g., essential, frontlines) had greater anxiety than those employed in low-risk settings (Cooper et al., 2021), and one Iranian study found COVID-19-related fear was associated with higher anxiety among men with pregnant partners (Ahorsu et al., 2022). Fathers in same-sex relationships who were having or had a child during the COVID-19 pandemic reported more severe anxiety compared with gay fathers who had a child prior to the pandemic (Carone et al., 2021). Furthermore, same-sex parents interviewed in a qualitative study indicated that they were worried about their mental health and reported high generalized anxiety about the uncertainty of their future due to the pandemic (Goldberg et al., 2021).

Social Support

Two studies reported on social support. One study found no differences in perceived social support among gay fathers in the U.S. and Canada before and during the pandemic (Carone et al., 2021). A qualitative study with Syrian refugee fathers found the supportive networks they were used to in Syria no longer existed for them in Sweden, which had an overall negative effect on them (Wissö & Bäck-Wiklund, 2021).

Interparental Relations

Division of Childcare Responsibilities

Fifteen studies reported on division of childcare responsibilities, with all except one (India) conducted in high-income countries (e.g., the U.S., the Netherlands, Australia, the United Kingdom). While three studies found parental sharing of childcare responsibilities increased toward equality during the pandemic (Carlson et al., 2021; Craig & Churchill, 2021a; Shafer et al., 2020), eight studies reported mothers continued to spend more time on childcare than fathers (Kerr et al., 2021; Waddell et al., 2021; Xue & McMunn, 2021; Zamarro & Prados, 2021), even if paternal time spent on childcare increased (Hupkau & Petrongolo, 2020; Kreyenfeld & Zinn, 2021; Yerkes et al., 2020). Two German studies found equal sharing of childcare was more likely early in the pandemic and decreased with time (Hipp & Bünning, 2021; Ruppanner et al., 2021). When fathers worked from home, they tended to spend more time on childcare than pre-pandemic, but if they worked out of the home, mothers were more likely to do most of the childcare activities (Chung et al., 2021). Fathers were also less likely to reduce their working hours or patterns due to childcare activities than mothers (Xue & McMunn, 2021).

In a qualitative study conducted in India, mothers felt overworked and overburdened with childcare due to the pandemic while fathers felt the pandemic positively affected them as it allowed additional time with their children (Hazarika & Das, 2021). However, this additional time did not alleviate maternal perceptions of burden. In another qualitative study with Syrian refugee fathers in Sweden, the findings were more mixed where some fathers took on more childcare responsibilities and enjoyed it, while others experienced no change due to continuing to work outside the home (Wissö & Bäck-Wiklund, 2021).

Division of Household Responsibilities

Ten studies reported on the division of household responsibilities, all of which were conducted in high-income countries with the exception of one study from India. Similar to the division of childcare responsibilities, studies primarily found that while fathers increased their contribution to household tasks during the pandemic, mothers still had significantly more domestic burden than fathers (Carlson et al., 2021; Chung et al., 2021; Craig & Churchill, 2021a; Waddell et al., 2021; Yerkes et al., 2020). One German study found no change in the unequal pre-pandemic distribution of household tasks (Hipp & Bünning, 2021) while a Canadian study found that the sharing of household responsibilities increased toward equality during the pandemic between mothers and fathers (Shafer et al., 2020). There were also differences in the amount of time spent completing tasks recognized by the partner and what was self-reported as well as disagreements on the amount of equality achieved when comparing maternal and paternal responses (Carlson et al., 2021; Shafer et al., 2020; Waddell et al., 2021) as well as same-sex couple responses (Craig & Churchill, 2021).

In a qualitative study, mothers in India indicated no change in paternal contributions to household tasks, which further burdened them and negatively affected their career, which was not reported by the fathers (Hazarika & Das, 2021). In a qualitative study with same-sex couples, many discussed household task division in neutral terms, although often one partner felt overburdened (Goldberg et al., 2021).

Work–Family Conflict

Five studies reported on work–family conflict, all using different measures (Appendix 2). Graham et al. (2021) found that Australian fathers reported less family–work conflict than mothers, which was alleviated after controlling for workplace location and satisfaction with the division of household tasks. DesRoches et al. (2021) found Canadian fathers experienced less family-interfering-with-work conflict than mothers, but no differences were found in terms of work-interfering-with-family conflict. Yerkes et al. (2020) found no differences in partner disagreements due to workload division between parents living in the Netherlands. Cooper et al. (2021) found Black American fathers who worked in high-risk settings at greater risk for contracting COVID-19 reported more family conflict than those working in low-risk settings. Finally, in a qualitative study with custodial single fathers living in the United States, Iztayeva (2021) found that fathers often experienced work–family conflict due to employers expecting uninterrupted work commitment, particularly among those working essential jobs outside the household, which created childcare challenges.

Co-parenting

Four studies reported on co-parenting outcomes. While one Italian study found no significant differences in co-parenting quality before and during the lockdown (Giannotti et al., 2021), a study with parents in the Netherlands found co-parenting decreased during the COVID-19 pandemic (Lucassen et al., 2021). Bastiaansen et al. (2021) found co-parenting mitigated the effect of COVID-19 lockdown measures on parental burnout for fathers but not for mothers. In a qualitative study with single custodial fathers from the U.S., the pandemic added stress to the co-parenting relationship due to the need to negotiate and communicate more with former spouses (Iztayeva, 2021).

Relationship Satisfaction

Three studies reported on relationship satisfaction. In an Iranian study, fathers reported more marital satisfaction than mothers during the pandemic (Mousavi, 2020). In a New Zealand study, both parents had high relationship satisfaction prior to and during the lockdown (Waddell et al., 2021). Finally, in a qualitative study with adoptive parents in the U.S., most parents (61%) said there were no major changes in their relationship quality during the pandemic, with only 10% reporting a decline and 18% indicating an improvement (Goldberg et al., 2021).

Family Functioning

Only one qualitative study reported on family functioning among Syrian refugee fathers in Sweden. Results suggest the pandemic intensified family life, with increased paternal participation in parenting experience (Wissö & Bäck-Wiklund, 2021). The three fathers interviewed reported spending more time at home with their children and greater participation in fathering, influencing the family functioning dynamic (Wissö & Bäck-Wiklund, 2021).

Father–Child Interactions

Four studies reported on father–child interactions, of which two studies found that fathers had significantly more positive changes in their perspective of their child–parent relationship than mothers (Russell et al., 2020, 2021). One study found that gay fathers who were having or had a child during the COVID-19 pandemic using cross-border surrogacy had a lower quality of father–child bonding compared with gay fathers who had a child prior to the pandemic (Carone et al., 2021). In an ethnographic qualitative study with Ugandan fathers, the shift toward being home more initially caused discomfort and feeling overwhelmed, which transformed with time to caring and affective connections with their children (Baral, 2021).

Discussion

This scoping review sought to map the existing literature regarding the impact of the COVID-19 pandemic on paternal mental health, interparental relations, and father–child interactions. Findings regarding the impact of the COVID-19 pandemic on paternal mental health outcomes were mixed, with slightly more studies suggesting fathers had lower parenting-related burnout and anxiety compared with mothers. All other mental health outcomes, including depression, social support, and stress, were mixed in terms of trends. The strongest trends that emerged with this review were related to the interparental relationship. Interestingly, despite fathers’ increased contribution to childcare and household tasks during the pandemic, mothers still maintained a significantly higher domestic burden than fathers. Findings related to work–family conflict, co-parenting, and relationship satisfaction were mixed, and there was no clear trend in the impact of the COVID-19 pandemic on father–child interactions.

Findings of the studies that examined the impact of COVID-19 pandemic on paternal mental health were diverse. These findings are in direct contrast to those among mothers, which noted increased depression and anxiety associated with the COVID-19 pandemic, particularly during the perinatal period (Hessami et al., 2020; Iyengar et al., 2021; Kotlar et al., 2021). In a systematic review of mothers with infants under 5 years of age, higher clinically elevated depression and anxiety symptoms were noted during the COVID-19 pandemic compared with pre-pandemic rates (Racine et al., 2022). While Racine et al. (2022) focused on mothers, findings suggest the impact on parental mental health was not limited to the perinatal period and may extend throughout the parenting experience. Similarly, mental health distress among adults living in the United Kingdom increased during the first lockdown when compared with pre-pandemic rates (Pierce et al., 2020). Early evidence strongly suggests that the mental health impact on individuals during the pandemic is an important issue, which may in part be due to the increase in social isolation due to physical distancing recommendations and repeated lockdowns (Galea et al., 2020). Further research is needed to better understand the role that the pandemic has had on fathers in relation to their mental health and how it affected their parenting cognitions and behaviors to assist in the development of partner-included interventions to prevent mental health deterioration.

Given the significant impact the COVID-19 pandemic has had on childcare responsibilities and household work, the outcome that has the best evidence available is interparental relations. Despite fathers increasing their actual amount of time spent on household and caregiving activities during the pandemic, trends suggest that mothers were still experiencing a higher burden of care. In general, the family unit was highly affected during the COVID-19 pandemic, not only by shifting childcare and household responsibilities but also by external stressors such as financial hardships and uncertainty around health and safety (Pietromonaco & Overall, 2021). It is not surprising that there has been a varied impact of the pandemic on work–-family conflict, co-parenting, and relationship satisfaction, given the experience is unique to each family and their circumstances. It is important to consider both internal and external factors when identifying strategies to improve and/or maintain positive interparental relations during stressful times (Pietromonaco & Overall, 2021).

While only four studies examined father–child interactions, overall, it appears the pandemic had a negative effect initially. Becoming a parent to a child during the pandemic brought unique stressors. For example, fathers in same-sex relationships who were having or who had a child during the pandemic reported a lower quality of father–child interactions in comparison to same-sex fathers who already had a child and a relationship established (Carone et al., 2021). In another study, higher rates of child–parent relationship conflict were reported by fathers and lower rates of child–parent closeness were reported by mothers (Russell et al., 2020). Some families adjusted to the increased time that fathers were spending at home due to the pandemic. After fathers performed more practical acts of care and connected with their children, more positive father–child interactions were reported (Baral, 2021). Despite this increase in paternal time, mothers still shouldered much of the caregiver burden.

Most of the current literature focused on differences between mothers and fathers, with only three studies reporting on gay or same-sex couples. In this limited literature, evidence suggests that gay fathers had more anxiety and depression during the pandemic, experiencing stress due to the uncertainty of their future (Carone, et al., 2021; Goldberg et al., 2021) with non-heterosexual fathers experiencing less negative perceptions of the division of household responsibilities than their heterosexual counterparts (Craig & Churchill, 2021). In a non-parenting context, a study found that having a pre-existing mental health condition was associated with poorer mental health in LGBTQ+ individuals during the COVID-19 pandemic (Slemon et al., 2022). However, there is limited literature exploring parenting outcomes in the context of the COVID-19 pandemic that specifically target LGBTQ+ parents. Further work is needed to explore the impact of the COVID-19 pandemic on LGBTQ+ families.

Overall, the findings have important implications for family nursing and nursing practice. Given the mixed findings, it is important to take a personalized approach to identifying parenting challenges that fathers may be experiencing due to the COVID-19 pandemic. In a family practice setting, nurses and other health care providers who have been delivering care to families before the pandemic may be the first to identify mental health issues. With the increase in virtual health care during the pandemic, knowledge that fathers’ mental health, interparental relations, and father–child interactions may be negatively affected suggests the important role that health care providers can play in assessing issues early on. However, it is important to note that not all fathers experience parenting challenges and further research is needed to understand risk and protective factors. In addition, given the mixed findings on most outcomes, further research on fathers from all family types is warranted to better understand the impact of the COVID-19 pandemic to identify preventive strategies that could be provided to all families moving forward.

To our knowledge, this is the first scoping review to synthesize evidence on the impact of the COVID-19 pandemic on fathers in terms of their mental health, interparental relations, and father–child interactions. Nevertheless, there are some limitations. First, studies were limited to those in English, which may have biased the findings given the pandemic is global. However, this review does have representation from 17 different countries, reflecting a wide variety of experiences. Second, we did not search preprint databases, which may have missed some emergent literature that had not yet been published due to the time delay with the peer review process. However, since this is a scoping review and no critical appraisal was undertaken, to ensure a baseline level of quality, the inclusion of preprint literature was not feasible.

Conclusion

The impact of the COVID-19 pandemic on fathers varied considerably, with limited trends except for the division of childcare and household tasks. Further work is warranted to understand how fathers and LGBTQ+ parents are adjusting during the COVID-19 pandemic, in order to identify protective and preventive factors that could be implemented with all families during stressful times.

Author Biographies

Justine Dol, PhD, is a postdoctoral fellow in Centre for Pediatric Pain Research, IWK Health, Halifax, Nova Scotia, Canada. Her research focuses on perinatal mental health and using mHealth technology to improve parental and newborn outcomes, both in Canada and internationally. Recent publications include “Impact of COVID-19 restrictions on the postpartum experience of women living in Eastern Canada during the early pandemic period: A cross-sectional study” in Journal of Nursing Scholarship (2023, with B. Hughes, M. Aston, D. McMillan, G. Tomblin Murphy, & M. Campbell-Yeo), “Canadian women’s experience of postnatal care: A mixed method study” in Canadian Journal of Nursing Research (2022, with B. Hughes, G. Tomblin Murphy, M. Aston, D. McMillan, & M. Campbell-Yeo), and “The role of parity and age of newborn on self-efficacy, social support, postpartum anxiety, and postpartum depression in the first six months postpartum in the Maritime Provinces” in Birth (2021, with B. Richardson et al.).

Cindy-Lee Dennis, PhD, is a professor in the Lawrence S. Bloomberg Faculty of Nursing and the Faculty of Medicine, Department of Psychiatry at the University of Toronto. She is a senior scientist at Lunenfeld-Tannenbaum Research Institute at Mt Sinai Hospital. She is currently the principal investigator of several large, multi-site studies and is a co-investigator on many other research projects concerning maternal, paternal, and infant health outcomes with a particular focus on perinatal mental health, breastfeeding, and e-health interventions. Recent publications include “Culturally sensitive psychotherapy for perinatal women: A mixed methods study” in Journal of Consulting and Clinical Psychology (2022, with D. R. Singla et al.), “Preconception risk factors and health care needs of pregnancy-planning women and men with a lifetime history or current mental illness: A nationwide survey” in PLOS ONE (2022, with H. K. Brown et al.), and “Paternal prevalence and risk factors for comorbid depression and anxiety across the first 2 years postpartum: A nationwide Canadian cohort study” in Depression & Anxiety (2022, with F. Marini, J. Dol, S. N. Vigod, S. Grigoriadis, & H. K. Brown).

Sarah Naraine, BScN, RN, is a master of nursing student in the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto in Ontario, Canada. She is a registered nurse in pediatric critical care, with research and clinical interests in pediatric and maternal health. Recent publications include “Scoping review of racial and ethnic representation of participants in maternal mental health research conducted during the COVID-19 pandemic” in Journal of Obstetric, Gynecologic & Neonatal Nursing (2023, with D. Goyal et al.).

Deepika Goyal, PhD, FNP-C, is a professor in the School of Nursing and Health Professions at the University of San Francisco, California and maintains a clinical practice as a nurse practitioner in the OB/GYN department at Santa Clara Valley Medical Center. Her research interests include perinatal depression and risk factors among diverse and underserved populations, in particular, women of Asian descent. More recently, her research has focused on the impact of COVID-19 on the mental health of diverse birthing persons. Recent publications include “Unmet prenatal expectations during the COVID-19 pandemic” in MCN: The American Journal of Maternal Child Nursing (2022, with L. De La Rosa, C. Liu, L. Mittal, & C. Erdei), “Postpartum depressive symptoms and experiences during COVID-19” in MCN: The American Journal of Maternal Child Nursing (2022, with C. Beck, R. Webb, & S. Ayers), and “Patient satisfaction with virtual-based prenatal care: Implications after the COVID-19 pandemic” in Maternal and Child Health Journal (2021, with C. Liu, L. Mittal, & C. Erdei).

Appendix 1: Search Strategy

Medline

Searched October 8, 2021, Retrieved 2,687

(AB=(COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus) OR TI=(COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus) OR COVID-19.sh) AND (paternal or father* or spouse* or dad* or coparent* or co-parent* or parent* or same-sex).ab,ti. OR (Fathers or spouses).ab,sh,ti.

Web of Science

Searched October 8, 2021, Retrieved 2,357 Results

(AB=(COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus) OR TI=(COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus)) AND (TI=(paternal or father* or dad* or coparent* or co-parent* or parent* or same-sex) OR AB =(paternal or father* or dad* or coparent* or co-parent* or parent* or same-sex))

EMBASE

Searched October 8, 2021, Retrieved 2,754 Results

(“coronavirus disease 2019”/exp OR “covid 19”:ti,ab,kw OR “sars cov 2”:ti,ab,kw OR covid19*:ti,ab,kw OR covid:ti,ab,kw OR “sarscov 2”:ti,ab,kw OR “sars cov2”:ti,ab,kw OR sarscov2: ti,ab,kw OR coronavirus:ti,ab,kw) AND (paternal:ti,ab,kw OR father*:ti,ab,kw OR dad*:ti,ab,kw OR coparent*:ti, ab,kw OR “co parent*”:ti,ab,kw OR parent*:ti,ab,kw OR  “same sex”:ti,ab,kw OR spouse*:ti,ab,kw OR “father”/exp OR “spouse”/exp)

CINAHL

Searched October 8, 2021, Retrieved 1,034 Results

((MH “SARS-CoV-2”) OR (MH “COVID-19”) OR (MH “COVID-19 Pandemic”)) OR TI (COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus) OR AB (COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus) AND MH (fathers OR spouses) OR TI (paternal or father* or dad* or coparent* or co-parent* or parent* or same-sex or spouse*) OR AB (paternal or father* or dad* or coparent* or co-parent* or parent* or same-sex or spouse*)

PsycINFO

Searched October 8, 2021, Retrieved 606 Results

(TI (COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus) OR AB (COVID-19 OR SARS-CoV-2 OR COVID19* OR COVID OR SARSCOV-2 OR SARS-COV2 OR SARSCOV2 OR coronavirus) OR MA covid-19) AND (AB (paternal or father* or dad* or coparent* or co-parent* or parent* or same-sex or spouse*) OR TI (paternal or father* or dad* or coparent* or co-parent* or parent* or same-sex or spouse*) OR MA (fathers OR Spouses))

Appendix 2. Measurements for Outcomes of Interest for Mental Health Outcomes.

Outcome/study	Mental health	
Parental burnout	Depression	Anxiety	Social support	Stress	
Aguiar et al. (2021)	Parental Burnout Assessment					
Ahorsu et al. (2022)		Patient Health Questionnaire
Hospital Anxiety and Depression Scale	Hospital Anxiety and Depression Scale			
Bastiaansen et al. (2021)	Parental Burnout Assessment					
Ben-Yaakov & Ben-Ari (2022)			Study-Specific Questionnaire		Parenting Stress Index-Short Form	
Carone et al. (2021)		Patient Health Questionnaire	Generalized anxiety disorder	Multidimensional scale of perceived social support		
Carroll et al. (2020)					Study-specific questionnaire	
Cooper et al. (2021)		Short form PROMIS	Short form PROMIS			
Farley et al. (2021)		Edinburgh Postnatal Depression Scale				
Giannotti et al. (2021)					Modified Parental Stress Scale	
Goldberg et al. (2021)		Study-specific questionnaire	Study-specific questionnaire			
Graham et al. (2021)					Copenhagen Psychosocial Questionnaire (COPSOQ)	
Iztayeva (2021)		Qualitative Interview Guide				
Kerr et al. (2021)	Parental Burnout Assessment	Patient Health Questionnaire	Generalized Anxiety Disorder			
Lucassen et al. (2021)					Parental Stress Scale (PSS)	
Manja et al. (2020)	Parental Burnout Inventory					
Marchetti et al. (2020)	Parental Burnout Inventory	General Health Questionnaire				
Mousavi (2020)	Parental Burnout Assessment	5-item well-being World Health Organization				
Recto & Lesser (2021)					Qualitative Interview	
Russell et al. (2020)	Burden Scale for Family Caregivers—Short form	Major Depression Inventory	Generalized Anxiety Disorder			
Russell et al. (2021)	Burden Scale for Family Caregivers—Short form	Major Depression Inventory			Perceived Stress Scale–Adult Form	
Sun et al. (2021)		Edinburgh Postnatal Depression Scale				
Taubman-Ben-Ari & Ben-Yaakov (2020)					Parenting Stress Index–Short Form	
Taubman-Ben-Ari et al. (2021)					Parenting Stress Index–Short Form	
(Wissö & Bäck-Wiklund, 2021)				Study-specific questionnaire		

Appendix 3. Measurements for Outcomes of Interest for Interparental Relationship.

Outcome/study	Interparental relationship	
Work–family conflict	Co-parenting	Relationship satisfaction	Family functioning	Childcare responsibilities	Household tasks	
Bastiaansen et al. (2021)		Co-parenting inventory for parents and adolescents					
Carlson et al. (2021)					Study-specific questionnaire	Study-specific questionnaire	
Chung et al. (2021)					Study-specific questionnaire	Study-specific questionnaire	
Cooper et al. (2021)	Coronavirus Impact Scale						
Craig & Churchill (2021b)						Study-specific questionnaire	
Craig & Churchill (2021a)					Study-specific questionnaire	Study-specific questionnaire	
DesRoches et al. (2021)	General Social Use survey – 2 items						
Giannotti et al. (2021)		Coparenting Relationship Scale-Brief					
Goldberg et al. (2021)			Qualitative Interview			Study-specific questionnaire	
Graham et al. (2021)	10-item work–family conflict and family–work conflict scales						
Hazarika & Das (2021)					Qualitative Interview	Study-specific questionnaire	
Hipp & Bünning (2021)					Study-specific questionnaire	Study-specific questionnaire	
Hupkau & Petrongolo (2020)					Study-specific questionnaire		
Iztayeva (2021)	Qualitative Interview	Qualitative Interview					
Kerr et al. (2021)					Study-specific questionnaire		
Kreyenfeld & Zinn (2021)					Study-specific questionnaire		
Lucassen et al. (2021)		Parental Teamwork subscale—Parenting and Family Adjustment Scale					
Mousavi (2020)			Kansas Marital Satisfaction Scale				
Ruppanner et al. (2021)					Study-specific questionnaire		
Shafer et al. (2020)					Study-specific questionnaire	Study-specific questionnaire	
Waddell et al. (2021)			Investment Scale		Study-specific questionnaire	Study-specific questionnaire	
(Wissö & Bäck-Wiklund, 2021)				Qualitative Interview	Qualitative Interview		
Xue & McMunn (2021)					Study-specific questionnaire		
Yerkes et al. (2020)	Study-specific questionnaire				Study-specific questionnaire	Study-specific questionnaire	
Zamarro & Prados (2021)					Study-specific questionnaire		

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD: Justine Dol https://orcid.org/0000-0002-8928-7647
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