Couvade Syndrome

Definition

Couvade syndrome, which is also known as sympathetic pregnancy, male pregnancy experience, or "pregnant dad syndrome," refers to a condition in which a father-to-be experiences some of the physical symptoms of pregnancy prior to the baby s birth. The term couvade comes from the French verb couver, which means "to brood," in the sense of a bird protecting its eggs before they hatch.

Description

The term couvade was first used by the anthropologist E. B. Tylor in 1865 to describe certain father-hood rituals performed by husbands while their wives were giving birth. These rituals were found in many different historical periods as well as various cultures around the world, ranging from ancient Greece and parts of the Roman Empire to Chinese Turkestan, the Basque regions of northern Spain, China, Thailand, Borneo, parts of Russia, and many Indian tribes in North as well as South America. In some cultures the expectant father avoids eating certain foods or handling knives or other sharp tools while the mother is in labor. In Papua New Guinea the father builds a hut apart from the rest of the village and goes to bed when his wife s childbirth begins. He then stays in bed and imitates the pains of childbirth until the baby is born. A similar custom is observed among the Basques. Couvade rituals are thought to have a number of possible purposes, depending on the specific culture:

• To draw the attention of evil spirits away from the mother to the father instead.
• To strengthen the emotional bond between father and child.
• To show that the man is the child's biological father.
• To relieve the father's anxiety while the mother is in labor.
• To strengthen the father's relationship with supernatural beings so that he can guide the child into the world.

Ritual couvade is no longer observed in most developed countries, but the term couvade syndrome has been applied to the physical symptoms that many men in these countries experience during a wife's pregnancy, ranging from mild nausea or backaches to weight gain or toothache. One group of Italian researchers reported that the number of men who experience couvade syndrome ranges between 11 and 65 percent, while others estimate that as many as 80 percent of expectant fathers develop these symptoms. It is thought that more men in Western societies experience couvade syndrome in the early 2000s than was the case with previous generations of fathers, due in part to changes in men s involvement with the birthing process. Some doctors think that the participation of fathers in the delivery room as "coaches" or comforters is one reason for the increased number of men who develop pregnancy symptoms.

Causes and symptoms

Causes

Several different types of explanation have been proposed for couvade syndrome:

• It is a psychiatric disorder. This type of explanation is more common among European than American physicians. Some attribute the symptoms of couvade syndrome to jealousy of the woman s ability to give birth, while others maintain that they result from male guilt over impregnating the woman or to sibling rivalry—that is, the husband regards the wife as a competitor that he must try to outperform.
• It results from real biological changes in the expectant father s body. A team of Canadian researchers reported that their sample of expectant fathers had higher levels of estradiol (a female hormone) and lower levels of testosterone (a male sex hormone) in their blood and saliva than a control group of childless men. The researchers have cautioned, however, that their findings should be checked by studying groups of men from other cultures.
• It is a reaction to a changed social role; that is, the syndrome is one way that some men "work through" their feelings about assuming the social expectations and responsibilities associated with fatherhood.
• It is a set of psychosomatic symptoms that is within the range of normal experience and does not indicate mental illness. Psychosomatic refers to physical symptoms that are caused or influenced by emotional factors, such as stress headaches or "butterflies in the stomach" before an examination.

Symptoms

Expectant fathers may experience one or more of the following:

• weight gain
• nausea and vomiting
• stomach cramps
• constipation or diarrhea
• loss of appetite
• sleep disturbances
• food cravings
• headaches
• toothache
• nosebleeds
• itchy skin

Only a few men, however, develop the more dramatic symptoms. Some studies report that couvade syndrome is most severe during the third or fourth month of the wife s pregnancy and again just before birth. Some researchers report that the syndrome is more common in first-time fathers, while others have found that it is equally likely to develop in men who already have children.

Diagnosis

Couvade syndrome is not listed as a diagnostic category in the most recent editions of the American Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (2000) or the World Health Organization's International Classification of Diseases, version 10 (1993). In addition, it is not described or discussed in most medical textbooks, although a few handbooks for doctors in family practice mention it in passing as a condition of unknown origin. Since most men with couvade syndrome have only mild symptoms, they are unlikely to consult a doctor about the condition by itself.

Treatment

There is no standard mainstream treatment recommended for couvade syndrome because it is not usually mentioned in medical textbooks. Anecdotal evidence, however, indicates that most fathers-to-be are helped by a simple explanation of the syndrome and reassurance that it is not uncommon among American and Canadian men.

Alternative treatment

Some expectant fathers report that meditation or such movement therapies as yoga and t'ai chi are calming and relaxing. Peppermint tea or ginger are herbal remedies that help to relieve nausea.

KEY TERMS

Anthropology— The study of the origins, biological characteristics, beliefs, and social customs of human beings.

Psychosomatic— Referring to physical symptoms that are caused or significantly influenced by emotional factors. Some doctors regard couvade syndrome as a psychosomatic condition.

Syndrome— A set of symptoms that occur together.

Prognosis

Couvade syndrome almost always goes away after the baby is born. While a few instances of the syndrome developing into full-blown psychosis (loss of contact with reality) have been reported in European medical journals, such cases are extremely rare.

Prevention

There is no known way to prevent couvade syndrome as of the early 2000s, as doctors do not yet understand why some men develop it and others do not.

Resources

BOOKS

Reed, Richard K. Birthing Fathers: The Transformation of Men in American Rites of Birth. Piscataway, NJ: Rutgers University Press, 2005.

PERIODICALS

Budur, K., and M. Mathews. "Couvade Syndrome Equivalent?" Psychosomatics 46 (January 2005): 71-72.

Mason, C., and R. Elwood. "Is There a Physiological Basis for the Couvade and Onset of Paternal Care?" International Journal of Nursing Studies 32 (April 1995): 137-148.

Masoni, S., A. Maio, G. Trimarchi, et al. "The Couvade Syndrome." Journal of Psychosomatic Obstetrics and Gynecology 15 (September 1994): 125-131.

Mayer, C., and H. P. Kapfhammer. "Couvade Syndrome, A Psychogenic Illness in the Transition to Fatherhood." [in German] Fortschritte der Neurologie-Psychiatrie 61 (October 1993): 354-360.

Reed, Richard. "Birthing Fathers." Mothering, no. 78 (Spring 1996).

Tenyi, T., M. Trixler, and F. Jadi. "Psychotic Couvade: 2 Case Reports." Psychopathology 29 (1996): 252-254.

ORGANIZATIONS

American Academy of Family Physicians (AAFP). 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. 〈http://www.aafp.org〉.

OTHER

Polinski, Michael. "Feeling Her Pain: The Male Pregnancy Experience." Pregnancy Today, 〈http://www.pregnancytoday.com/reference/articles/malepg.htm〉.