CLINICAL ISSUES Male and female involvement in the birth and child-rearing process Gracia Maroto-Navarro, Guadalupe Pastor-Moreno, Ricardo Oca~ na-Riola, Vivian Benıtez-Hidalgo, Marıa del Mar Garcıa-Calvente, Marıa del Pilar Gutierrez-Cuadra, Marıa T Gijon-Sanchez, Marıa del Rıo-Lozano and Jorge Marcos-Marcos Aims and objectives. To know the male involvement during pregnancy and childbirth, with special attention to their partici- pation in public services of perinatal health and the impact that this participation has on their subsequent involvement in child-rearing, to compare the male and female involvement in child-rearing and to identify the factors associated with a greater male involvement. Background. Most of the research on male involvement in birth and child-rearing comes from Anglo-Saxon and Scandina- vian countries. These studies show a lower involvement of men in relation to women, even in countries with instruments to promote gender shared responsibility. The Spanish Ministry of Health has developed strategies to improve the male involve- ment in the public services of perinatal health to advance in gender equality. This is a suitable context to contribute to the lack of information about fatherhood and the gender inequalities in the Spanish context. Design. Transversal design. Methods. A questionnaire was administered to 150 fathers and 157 mothers residing in Granada, with at least one biological child aged 2 months to 3 years. Results. A minority of the men attended the childbirth education whereas most of them attended pregnancy check-ups and were present at birth. Women spent more time with their children and took charge of tasks of child-rearing to a larger extent. The profile of an involved father is a man with a higher level of education, not married, his partner has a full-time employment, born in Spain and attended to the childbirth education classes. Conclusion. This study shows gender inequalities in the reproductive field beyond the biological conditions. Relevance to clinical practice. The challenge of the health services is to promote social change and identify areas for improvement to include the father figure in public services of perinatal health. Key words: gender perspective, health promotion, inequalities in health, parenting, perinatal care, reproductive health Accepted for publication: 24 October 2012 Introduction At the Cairo Conference (United Nations 1995), for the first time and from a bio-psycho-social approach, men were designated as reinforcing agents of the reproductive health of women, and the role they played in the achievement of gender equality when they take part in the household responsibilities and family care was recognised. It was also Authors: Gracia Maroto-Navarro, ScD, Lecturer, Andalusian School of Public Health, Granada and CIBER de Epidemiologıa y Salud Publica (CIBERSP), Madrid, Spain; Guadalupe Pastor-Moreno, ScD, Research Specialist, Andalusian School of Public Health, Granada; Ricardo Oca~ na-Riola, PhD, Lecturer, Andalusian School of Public Health, Granada; Vivian Benıtez-Hidalgo, ScD, Research Specialist, Andalusian School of Public Health, Granada; Marıa del Mar Garcıa-Calvente, PhD, MD, Lecturer, Andalusian School of Public Health, Granada; Marıa del Pilar Gutierrez-Cuadra, ScD, System Information Director, Virgen de las Nieves Hospital, Granada; Marıa T Gijon-Sanchez, PhD, Lecturer, University of Malaga, Malaga; Marıa del Rıo-Lozano, ScD, Research Specialist, Andalusian School of Public Health, Granada; Jorge Marcos-Marcos, ScD, Research Specialist, Institute for Women’s and Gender Stud- ies, University of Granada, Granada, Spain Correspondence: Gracia Maroto Navarro, Lecturer, Cuesta del Observatorio s/n, 18080, Granada, Spain. Telephone: + 34 958 027400. E-mail: gracia.maroto.easp@juntadeandalucia.es © 2013 John Wiley & Sons Ltd Journal of Clinical Nursing, 22, 3071–3083, doi: 10.1111/jocn.12153 3071