In recent decades, global health researchers and policy makers have advocated for men’s increased involvement in pregnancy and childbirth with the goal of improving maternal health outcomes. However, such approaches often fail to account for the culturally valid and gendered ways in which men already are involved in supporting women’s reproductive health. This study is based on participant observation, semi-structured interviews, and life histories conducted among 106 fathers in eastern Sierra Leone over the course of 2013-2016.