BIRTH 36:4 December 2009 289 A Birth Education Program for Expectant Fathers in Taiwan: Effects on Their Anxiety Hsin-Tzu Li, MS, CNM, RN, Kuan-Chia Lin, PhD, MPH, Shu-Chen Chang, MS, RN, Chien-Huei Kao, PhD, RN, Chieh-Yu Liu, PhD, and Su-Chen Kuo, PhD, CNM, RN ABSTRACT: Background: A father who does not know how to assist the mother in relieving labor pains may experience a sense of powerlessness and anxiety. The objective of this study was to evaluate how an education program for expectant fathers who attended their partners’ labor and birth affected their anxiety. Methods: In a randomized controlled trial, 87 expectant fathers who attended their pregnant partners through labor and birth at a hospital in central Taiwan were allocated by block randomization to an experimental (n = 45) and a control ( n = 42) group. The men completed their basic personal information, a childbirth expectations questionnaire, and a Trait Anxiety Inventory when they were recruited. Two hours after birth of their child, all the expectant fathers completed a State of Anxiety Inventory. Results: Our results showed no statistically significant differences between the experimental and control groups of fathers in trait anxiety and their prenatal childbirth expectations. After analysis of covariance (ANCOVA) was applied to correct for education level, sources of childbirth information, attendance at Lamaze childbirth classes, and childbirth expectations at baseline, the effect of the childbirth program was significant for the postnatal level of anxiety (F = 3.38, p = 0.001). Conclusions: The study findings justify the clinical implementation of a birth education program based on the self-efficacy theory as an effective means of reducing anxiety among expectant fathers. (BIRTH 36:4 December 2009) Key words: anxiety, childbirth education, expectant fathers, self-efficacy The birth of a first child is a unique experience for any expectant parent and is a time when many first-time fathers who attend their baby’s birth encounter more feelings of discomfort than experienced fathers. Thus, parenthood education should devote special attention to parents who are expecting their first baby (1). Neverthe- less, such a program is not implemented in Taiwan, even though the presence of expectant fathers at childbirth has become a new trend (2), arising from demands by couples and the growing concept of “family-centered care.” In addition, Taiwanese legislation now provides 3 days paternity leave (compared with 2 days in 2002), reflecting the value of men’s involvement in pregnancy, childbirth, and infant care. Many research studies demonstrate that support from partners during labor has beneficial effects, such as having a satisfying childbirth experience, reduced labor pain, less medication, and a more positive attitude toward the next pregnancy (3–5). The presence of expectant fathers during childbirth is also an important part of the Hsin-Tzu Li is a Head Nurse for the labor and delivery ward and Shu- Chen Chang is a President for the Department of Nursing, Changhua Christian Hospital, Changhua City; Kuan-Chia Lin is a Statistician and Associate Professor, Chien-Huei Kao is an Associate Professor, and Chieh-Yu Liu is an Assistant Professor of the Department of Nursing; and Su-Chen Kuo is a Professor of the Graduate Institute of Nurse- Midwifery, National Taipei College of Nursing, Taipei, Taiwan. Address correspondence to Su-Chen Kuo, PhD, CNM, RN, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, 365 Ming-TeRoad, Taipei 112, Taiwan. Accepted April 26, 2009  2009, Copyright the Authors Journal compilation  2009, Wiley Periodicals, Inc.