The effect of father-sensitive birth education on antenatal paternal attachment: a single-blind randomized controlled trial

Antenatal paternal attachment supports fathers’ wellbeing and child development, yet childbirth education programs rarely address fathers’ needs. This single-blind, randomized controlled trial in Mersin, Türkiye (February–October 2024) examined the effect of a Father-Sensitive Childbirth Preparation Program (FS-CPP) on prenatal paternal attachment. 99 first-time expectant fathers, whose partners were experiencing their first pregnancy at 20–32 gestational weeks, were randomized to FS-CPP ( n = 50) or a Standard Childbirth Preparation Program (S-CPP, n = 49); both received four weekly three-hour sessions. Attachment was assessed with the Paternal Antenatal Attachment Scale (PAAS) before and after the intervention. PAAS scores increased in both groups (FS-CPP: t = 8.992; S-CPP: t = 4.189; both p < 0.001), with greater improvement in the FS-CPP group (70.52 ± 4.96 vs. 61.96 ± 5.65, t = 8.021, p < 0.001). Baseline scores differed between groups; moderation analysis showed the effect was strongest among fathers with lower baseline attachment and remained significant for most of the sample. Regression confirmed FS-CPP participation as the strongest predictor of posttest attachment (B = 9.36, Beta = 0.70, p < 0.001, R 2 = 0.39). FS-CPP enhanced prenatal paternal attachment; father-sensitive content in childbirth education may strengthen paternal engagement and support family-centered midwifery care. Trial registration : The clinical trial registration number is NCT06953544 (https//clinicaltrials.gov/study/NCT06953544). Date of registration 04/23/2025 (registered retrospectively).