In the realm of pregnancy, the traditional focus has predominantly centered on mothers as the primary seekers and bearers of knowledge [1]. However, contemporary perspectives increasingly emphasize the integral role of fathers in the journey to parenthood [2]. Fathers’ participation in maternal-fetal health care offers profound benefits; for example, it is associated with a reduction in birth-related risks [3] and improved cognitive outcomes in infants [4]. Consequently, the Cairo Initiative [5] and recommendations from the World Health Organization [6] advocate for the promotion of a father’s engagement during pregnancy. The Cairo Initiative emphasized the importance of reproductive health and the shared responsibilities of men and women in family planning and health-related decisions while promoting men’s involvement in pregnancy to support maternal health and ensure better pregnancy outcomes.

Fathers have emerged as active participants in the pursuit of pregnancy-related information [7,8]. This is one of the many ways fathers become involved in the pregnancy journey, which involves obtaining information about pregnancy to improve their knowledge [2]. Fathers navigate the vast landscape of the internet and engage with specialized app, websites, blogs, and online support groups [9-12]. This digital terrain resonates particularly with millennial fathers, who readily turn to internet-based resources for guidance and support [13]. While fathers’ information-seeking practices have garnered significant attention, it is crucial to acknowledge that the dynamics of this journey transcend mere information acquisition and extend to the pivotal aspect of information sharing. This is because fathers also actively engage with others to exchange information, experiences, insights, and support throughout the pregnancy journey [14].

Information sharing is a multifaceted aspect of human communication, driven by various motivations and yielding both advantages and disadvantages. People engage in sharing to disseminate knowledge, experiences, and insights, fostering collaborative and interactive communication [15,16]. The process is influenced by key variables, such as trust, risk assessment, perceived rewards, and the dynamics of relationships [17,18]. A rapid review study by Naeem et al [18] also emphasizes privacy concerns and the sensitivity of information as the multifactorial nature of an individual’s willingness to share health information. Trust plays a pivotal role, as individuals are more inclined to share sensitive information when there is trust in the audience [18]. Assessing the risk associated with sharing and anticipating potential rewards, such as support or advice, further motivates information-sharing behaviors [15,17]. The advantages of sharing include the creation of a supportive community, the exchange of diverse perspectives, and the building of relationships [19]. Sharing can enhance one’s understanding, contribute to a collective pool of knowledge, and provide emotional and practical support [10,19]. However, sharing also comes with disadvantages. Individuals may face the risk of judgment or misunderstanding [20] and the potential harm of information misuse or misinterpretation [21]. Striking a balance between the benefits and drawbacks of sharing is a nuanced consideration in various contexts, influencing individuals’ decisions to engage in information-sharing behaviors.

In the domain of pregnancy information sharing, results of a research study demonstrate that fathers exhibit a willingness to share information acquired about pregnancy and fatherhood [11]. Fathers actively engage in both online and offline practices [22]. In the context of online information sharing, fathers contribute to discussions and seek advice within their digital communities [11]. They share relevant articles or seek guidance on parenting forums [10]. Some fathers disseminate their knowledge through online forums, while others opt to articulate their experiences via blogs [10]. Within these online forums, fathers recount their journey and provide mutual support [23]. In addition, fathers frequently indicate their participation in online support groups tailored to discussing various aspects of the pregnancy and fatherhood experience [24]. Furthermore, fathers have embraced social media apps as platforms for expressing their emotions and recounting their pregnancy journeys [9]. In these internet-based spaces, fathers actively share pregnancy-related information, fostering their involvement, bolstering their confidence, and encouraging their peers [25,26]. Conversely, offline information sharing predominantly takes place through face-to-face conversations. This emphasizes the significance of interpersonal relationships in the dissemination of information [27]. Fathers engage in discussions about pregnancy-related experiences during casual hangouts or directly seek advice from family members and friends [28]. This practice is driven by the desire to connect, collaborate, and contribute to collective knowledge [19].

While certain fathers actively share information about pregnancy with others [9,11,23], results of other studies suggest that some fathers may refrain from sharing pregnancy-related information [20,29]. First-time fathers, in particular, may seldom share personal experiences about the pregnancy journey, often due to feelings of unfamiliarity with the topic [29]. In addition, they may choose to keep pregnancy matters confidential, adhering to local cultural norms that discourage fathers from discussing such matters with others [29]. As seen in a previous study by Esmaeilzadeh [30], privacy concerns often influence the extent to which individuals are willing to share sensitive information, particularly in online environments like social media. A study by Nash [20] also reveals that, even though fathers share health information about pregnancy, they may withhold their feelings related to pregnancy or fatherhood due to concerns about judgment from other men, indicating a thoughtful risk assessment before sharing the information. These findings illuminate various reasons why fathers may opt not to share information, thereby limiting their potential benefits from engaging in this practice [31].

Studies on fathers’ information-sharing behavior in the context of pregnancy information in high-income countries are well-researched [11,23,26]. However, there is a noticeable gap in research studies addressing pregnancy-related information-sharing practices in low- and middle-income countries, particularly in the Southeast Asian context. Southeast Asia is characterized by its diverse cultural norms, traditions, and varying degrees of digital literacy [32-34], providing a unique backdrop for examining how fathers participate in the sharing of pregnancy-related information. In the Southeast Asian context, cultural norms of privacy and reserved communications may impact fathers’ information-sharing behaviors [30], influencing whether sharing is performed, what information fathers share, and with whom they share pregnancy-related information [35]. The cultural emphasis on societal expectations within Southeast Asian cultures further directs fathers toward traditional channels, such as consulting with extended family members or seeking advice from older people [36,37].

Adding to this landscape, Southeast Asia exhibits varying levels of digital proficiency, impacting how fathers share information and engage in online information sharing [38]. Specifically, this study was conducted in Indonesia, the most populous nation in Southeast Asia. Indonesia, being part of Southeast Asia, embodies a rich tapestry of diverse cultural norms, traditions, and varying levels of health and digital literacy [38-40]. The country’s internal diversity provides a nuanced backdrop for exploring how first-time expectant fathers engage in sharing pregnancy-related information. Indonesia’s cultural, linguistic, and contextual elements mirror the broader diversity within Southeast Asia [34,41,42]. The shared cultural threads and regional commonalities offer insights that may extend to other Southeast Asian countries [39,43].

Southeast Asia is a region with various ethnicities, religions, and languages [34]. These differences may impact the information-sharing behaviors of first-time expectant fathers. For example, fathers from Malay, Chinese, or Indigenous communities may have distinct traditions and customs related to pregnancy [36]. These differences may influence their communication patterns and the type of information they prioritize to search and share (or not to share). In addition, religious practices related to Islam, Christianity, Buddhism, and Hinduism may guide the behavior and decision-making process of fathers during pregnancy [44,45]. Finally, linguistic diversity may shape how fathers search for and share pregnancy-related information using their preferred language. Results of a research exploring cross-language information-seeking behavior showed participants implement different strategies and tactics when completing the search process depending on the language they used [44]. Therefore, fathers might have different strategies and approaches when searching and sharing, depending on the language used during the process.

An exploration of information-sharing practices in these contexts contributes valuable insights to our understanding of how these nuances shape fathers’ behavior in the pregnancy journey, as it is likely to be different from the results of research studies conducted in high-income countries. Therefore, this study embarks on an exploration of information-sharing practices of pregnancy information among first-time fathers in Indonesia, a Southeast Asian low- and middle-income country, where cultural traditions and social networks intersect and may shape fathers’ behaviors [45]. Our research question and follow-up questions are outlined as follows: Do first-time expectant fathers engage in information sharing about pregnancy? The follow up questions were as follows: (1) If information is shared, with whom is it shared? (2) Through what means the information is shared? (3) Why is the information shared? and (4) If not shared, what are the underlying reasons? This exploration is particularly salient within the temporal confines of the antenatal phase, a pivotal juncture in the transition to fatherhood [46]. Here, we draw a clear distinction between first-time fathers and those with prior parenting experience. The rationale is that first-time fathers bring a unique perspective as they prepare for fatherhood [29]. Furthermore, first-time fathers display heightened sensitivity to their new situation, leading to more pronounced information needs and interaction compared to fathers with prior experience [47]. The results of this study aim to enhance domain knowledge by providing answers to the research questions stipulated earlier.

In this study, a grounded theory approach [48] was used to investigate the information-sharing practices of first-time expectant fathers concerning pregnancy-related information. Grounded theory enables the development of theories derived directly from empirical data and provides a neutral perspective on human actions within a social context [49]. The grounded theory approach was used for this study due to the limited knowledge regarding the information-sharing practices of first-time fathers in the context of pregnancy-related information in Southeast Asia. This methodology facilitates the discovery of patterns, capturing lived experiences, exploring the themes, and systematically developing theories grounded in the data itself [50]. This methodological choice is particularly valuable in the context of this study as it allows for the in-depth exploration of the nuanced and context-specific behaviors of first-time fathers beyond surface-level observations. To enhance interpretive validity and intercoder reliability, personal reflexivity practices were implemented [51].

Recruitment notices were placed in health care facilities in Indonesia, community centers, and online social media portals. Participants were required to meet specific inclusion or exclusion criteria. Participants must be aged ≥21 years, first-time fathers, and have sought pregnancy-related information in the past 9 months. Importantly, participants must not be working in or have a formal qualification or be in the process of achieving an academic qualification in the health care or allied health care sectors to eliminate the possibility of health expertise and literacy influencing results.

Data collection involved the use of questionnaires and semistructured interviews. The questionnaire serves to capture information on sociodemographic, digital and health literacy levels, family situations, and pregnancy-related details. This is to provide an overview of the participants of this study and will not be used for analysis. The sociodemographic section encompasses details about participants’ social and demographic characteristics. Digital literacy levels are self-assessed to gauge participants’ proficiency and comfort with digital technologies. Similarly, health literacy levels are self-assessed to understand participants’ capacity to comprehend health-related information effectively. These self-assessments provide insights into fathers’ perceived literacy levels related to health and digital matters. Family situations are explored to uncover contextual factors that may influence information-sharing behaviors, considering the role of familial connections in the pregnancy journey. Finally, pregnancy-related details are gathered to gain insights into specific aspects of participants’ experiences.

Semistructured interviews were used to collect data, enabling in-depth exploration of participants’ thoughts and experiences [52]. The interviews were designed to be open-ended and revolved around the research questions outlined in this study. Participants were queried about their engagement in the sharing or nonsharing of pregnancy-related information. Participants who shared information were asked follow-up questions: (1) with whom the information is shared, (2) through what means the information is shared, and (3) why the information is shared. Participants who did not share pregnancy-related information were asked to elaborate on the reasons for this decision. Participants were allowed to choose whether the interview will be conducted in Bahasa Indonesia or English. An option was provided, as using the mother tongue in interviews can lead to more reliable and valid data [53]. The researcher is Indonesian, so the interview and translation were conducted by the researcher if the participants chose the interview to be conducted in Bahasa Indonesia. If the interview was conducted in Bahasa Indonesia, transcribing was done in Bahasa Indonesia to prevent the loss of meaning of the answers and collect as much culturally localized information as possible [54]. Thereafter, the interviews were translated into the English language [53]. All interviews were recorded and transcribed verbatim, ensuring a robust connection between the data and the researcher [55].

Open coding technique was used with the grounded theory approach [56]. This method was used to examine participants’ responses regarding their information-sharing practices [57]. Initially, a master list of codes was generated through inductive reasoning, with ongoing revisions after every third interview [58]. Subsequently, these codes were condensed into overarching themes using the constant comparative method, which entailed a systematic review of each response to identify prominent patterns and key themes [58,59]. Data analysis commenced immediately following each interview and continued until the study’s completion [50]. This method of content analysis provided a comprehensive understanding of fathers’ information-sharing practices about pregnancy and the underlying reasons for their behavior [50]. To ensure interpretive validity and intercoder reliability, personal reflexivity practice was undertaken [51].

Before recruitment, ethics approval was obtained from the University of Canterbury, New Zealand (HREC 2022/66). Informed consent was obtained from all participants before their involvement in the study. Participants were provided with a detailed information sheet consisting of the study’s objectives, procedures, potential risks, and benefits. They were also informed of their right to withdraw from the study at any time without any penalty. Their consent was recorded electronically. All identifiable information was anonymized, and unique codes were assigned to each participant. Participants were informed about how their data would be stored and used, which is based on the university’s regulations. Data were stored securely on password-protected devices to prevent unauthorized access. There was no compensation for participants.

In this section, we begin with a brief overview of the sociodemographic details of the participants. Following this, we delve into participants’ information-sharing behaviors, categorized into those who shared information and those who did not. Information-sharing activities among first-time fathers who shared information are further explored, considering the audience, communication channels used for sharing information, and underlying reasons for sharing. In addition, further examination of first-time fathers who chose not to share information will be provided, revealing their underlying reasons behind this decision.

There were 40 participants in this study. Data saturation [60] for this study was achieved with 75% (30/40) participants. The data saturation point is generally reached in 15 interviews, with one-third of the number of interviews being added [61]. Similarly, a study showed that thematic saturation from the conducted interviews will be achieved by completing 30 interviews [62]. Furthermore, other studies exploring information-seeking behavior recruited 40 participants for the interviews to reach data saturation [63,64]. Therefore, in this study, after data saturation was achieved with 30 participants, the researcher added another one-third of the number of interviews, bringing the total to 40 participants.

Most participants fell within the age group of 26 to 30 years, constituting 68% (27/40) of the sample. Urban residency was predominant, with the majority residing in cities (21/40, 52%), while others living in suburbs (10/40, 25%) and rural areas (9/40, 22%). Educational backgrounds were diverse, with 65% (26/40) holding bachelor's degrees, followed by master’s degrees (7/40, 18%), and high school qualifications (7/40, 18%). Language preferences for online searches indicated that most used the national language (Bahasa Indonesia; 25/40, 62%), rather than the local languages or dialects (ie, Javanese, Sundanese, Balinese, and Betawi). A national language is a language that is officially recognized and used formally at the country level. By contrast, local languages or dialects are specific to certain communities or regions with specific cultural markers. Most (24/40, 60%) participants worked in the private sector, followed by entrepreneurs (8/40, 20%). Monthly household income varied, with 45% (18/40) falling within the IDR 2-4.99 million (US $120-300) range, followed by the IDR 5-9.99 million (US $325-650) range (14/40, 35%).

In terms of social and familial aspects, 88% (35/40) identified with the Islamic faith. Furthermore, 62% (25/40) of participants perceived their family social systems as equal, including roles and responsibilities between husband and wife. Most (36/40, 90%) participants lived together with their partners. Most participants’ partners were in the third trimester (20/40, 50%), followed by the first and second trimesters equally (10/40, 25%). Health and digital literacy levels varied, with 60% (24/40) of participants having moderate health literacy and 28% (11/40) having high health literacy. In terms of digital literacy, 50% (20/40) demonstrated high digital literacy, while 40% (16/40) exhibited moderate digital literacy.

Results indicated that 90% (36/40) of the participants shared information, while 10% (4/40) of the participants did not share information with anyone. Within the 36 participants, 55% (22/40) participants only shared information with their partners. Furthermore, 20% (8/40) of the participants shared information solely with their partners, extended family, and the physicians. Results indicated that most (36/40, 90%) first-time fathers were “sharers” of pregnancy information.

A small number of participants, specifically 10% (4/40) of the participants, did not share pregnancy-related information with anyone (Table 5). In total, 2 themes emerged; these themes were partners’ health qualifications (2/40, 5%) and work environment (2/40, 5%). Under the partner health qualification theme, the reason for not sharing information was because of the partner’s professional qualifications in the health care field (eg, physician or midwife). This led first-time fathers to perceive their partners as possessing superior knowledge about pregnancy. Consequently, they deemed it unnecessary to gain information about pregnancy intensively, including sharing any pregnancy-related information. Another factor influencing nonsharing was the demanding work environment of the respondent, such as military service, which was perceived as a hindrance to engaging in discussions about pregnancy. Furthermore, they lived apart from their partners daily, so they were not involved in their partners’ pregnancies. Despite not sharing information, these fathers still searched for pregnancy-related information, mainly driven by personal curiosity and preparation for the baby’s delivery.

This study reveals that most (36/40, 90%) first-time Southeast Asian fathers share information with others. Most (22/40, 55%) first-time fathers share information only with their partners, while the remaining (14/40, 35%) extend this to a small circle, including physicians, extended family, and friends. The most popular communication method for sharing information is face-to-face (36/40, 90%), followed by online messaging apps (26/40, 65%). Social media sharing is less common, with 35% (14/40) of the participants engaging in private sharing and only 5% (2/40) sharing information publicly. First-time fathers’ motivations for sharing information include validating information (14/40, 35%) and compassion for others (13/40, 32%), with a smaller group aiming to enhance their understanding by adding others’ perspectives (9/40, 22%).

Among those who did not share information beyond their partners, the reasons included a preference for asking questions rather than sharing information (12/40, 30%), self-situation awareness (5/40, 12%), lack of relevant audiences (5/40, 12%), concerns about privacy (3/40, 8%), and physician-specific constraints (11/40, 28%). A small group of first-time fathers (4/40, 10%) did not share information with anyone, mostly due to their partner’s professional health qualification (2/40, 5%) or demanding work environments (2/40, 5%). However, these first-time fathers remained engaged in information seeking, driven by personal curiosity and preparation for the baby’s arrival.

Several limitations should be acknowledged while interpreting the findings of this study. First, the study primarily relies on self-reported data from an interview, which introduces the possibility of social desirability bias and recall inaccuracies. In addition, the nature of the research design restricts the ability to capture the dynamic nature of information-sharing behaviors over time. Furthermore, the study’s focus on Southeast Asian cultural contexts may limit the applicability of the findings to other cultural settings.

Despite efforts to ensure diversity, the study’s geographical concentration in Indonesia might not fully capture the regional variations within the country. Finally, the rapidly evolving digital landscape introduces a temporal dimension to the study, and the information-sharing behaviors observed may evolve with technological advancements. These limitations should be considered when interpreting the findings, and they underscore the need for future research to address these constraints and further refine our understanding of first-time expectant fathers’ information-sharing practices.

A potential avenue for further exploration related to this topic is delving into the impact of cultural variations within low- and middle-income countries on fathers’ information-sharing behaviors during pregnancy. This could involve comparative studies across different regions or cultural subgroups within Southeast Asian countries, offering nuanced insights into how cultural diversity influences communication patterns. In addition, future research could investigate the role of digital literacy and access in shaping information-sharing practices among expectant fathers. Understanding how varying levels of digital literacy impact the use of online platforms for sharing pregnancy-related information could provide valuable insights for designing targeted interventions or support systems. Furthermore, longitudinal studies tracking fathers’ information-sharing behaviors throughout different phases of pregnancy and early parenthood could uncover how these practices evolve over time. Exploring how fathers’ roles and information-sharing dynamics shift from pregnancy to post partum could also contribute to a more comprehensive understanding of their evolving roles within the extended family unit. Finally, as demographic factors were not included in the analysis for this research study, exploring the relationship between sociodemographic aspects and information-sharing behavior could provide deeper insights into the dynamics of paternal involvement during pregnancy.

In conclusion, the results of this study provide an understanding of the intricate interplay of factors that influence information-sharing practices among first-time expectant fathers in low- and middle-income countries. The existing gap in research on this subject prompted this study’s exploration, recognizing the unique cultural, digital, and contextual nuances within Indonesia. The country’s diversity in cultural norms and varying degrees of digital literacy serve as a rich backdrop for comprehending how fathers engage in the sharing of pregnancy-related information. By focusing specifically on Indonesia, with its diverse cultural landscape and regional commonalities, this study contributes essential insights that might be extrapolated to other Southeast Asian countries. In doing so, it addresses the existing research gap and enriches the global understanding of fathers’ roles in the intricate journey of pregnancy. This not only increases our knowledge of paternal engagement but also emphasizes the importance of nuanced approaches that take cultural variation into account in future theoretical discussions.

On a practical level, this study offers valuable insights with implications for policy makers, health care providers, and support organizations. On the basis of this study’s findings, physicians and midwives in Indonesia might need to allocate additional time and diversify communication channels during antenatal care to enhance paternal involvement. Developers can leverage these insights to create dedicated online forums tailored for fathers. For governmental intervention programs, the study suggests initiating awareness campaigns, workshops, and support groups to encourage fathers’ active participation in pregnancy discussions. In the workplace, employers can foster an inclusive environment through programs addressing the unique needs of expectant fathers, creating designated spaces for open discussions, and implementing awareness campaigns to destigmatize pregnancy conversations. These contributions aim to promote paternal involvement, enhance support networks, and foster a collaborative sharing environment. The extrapolation of findings to other Southeast Asian countries provides actionable knowledge for those working in the region that guides the development of culturally tailored strategies to promote paternal involvement during pregnancy. Overall, the study bridges the gap between theoretical advancements and practical applications in the context of paternal involvement in low- and middle-income countries.