A Look At Sympathetic Pregnancy

Known more simply as “sympathetic pregnancy,” couvade syndrome describes cases where male partners of pregnant women begin to experience symptoms similar to pregnancy, explains Connie Alford, MD, a Naples-based fertility specialist at Florida’s IVFMD. She notes, however, that couvade syndrome is not a recognized physical or mental disorder—there’s not a lot of scientific research on the subject.

Regardless of whether Couvade syndrome is medically recognized or not, for those who experience it, the symptoms are more than real. Want proof? Just take a look at this Reddit thread of those who have gone through it or whose partners have.

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For Redditor u/newtothisdadthing, symptoms are a little more disruptive than you’d expect:

“My wife is having a difficult pregnancy in terms of nausea. Our OB assured us that it’s nothing to worry about and can even be a sign of healthiness. Every pregnancy is unique, etc. There’s nothing to worry about in the bigger picture, and I do everything I can to make her as comfortable as possible.

“The strange part is that I’m doing it, too. There are days that I wake up violently ill and I can’t keep anything down all morning. I don’t feel sick otherwise, just the vomiting. So much vomiting. I don’t know what’s causing it.”

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But he has a possible answer:

“Listening to it all the time might be a factor. Maybe her hormonal changes are putting out some kind of pheromone that affects me on a biological level. Maybe it’s all in my head. I had no idea.”

Is sympathetic pregnancy real?

Being named after the French verb couver, which translates to hatch or “to brood,” is pretty fitting for a phenomenon that has only recently received attention from biologists.

“There is no known physical cause of couvade syndrome, but it could be due to antepartum changes in the male hormonal profile—cortisol, testosterone, estrogen, and prolactin—that are associated with the typical symptoms,” Alford explained. She notes, however, that these changes may be “initiated by the increased anxiety associated with the upcoming change in the family unit.”

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That sounds like a reasonable explanation. Researcher Arthur Brennan takes it a step further. In his article for the Washington Post, he attributes the condition to a “man’s envy of the woman’s procreative ability.”

“The event may cause regression,” Brennan wrote. “The man’s retreat to childhood feelings and conflicts triggered by his partner’s pregnancy, such as rejection, exclusion, ambivalence and anxietywith a sense of passivity and dependency that is intensified by the developing foetus and which conflicts with the man’s need for autonomy.”

While estimates of the frequency of the syndrome are difficult to come by because of the low rate of reporting symptoms, Brennan’s 2007 study found that between 25 to 52 percent of all men whose partners were pregnant experienced the phenomenon. “It affects biological fathers particularly during the first and third trimesters of pregnancy with cessation of symptoms after birth,” Brennan and his co-authors wrote.

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“Collectively, these symptoms may signify an empathic identification with a pregnant partner and to the man’s unborn child, but the [sic] could also be a resolution of unconscious thoughts that might threaten both,” Brennan outlined in his Washington Post article.

Along similar lines, Katherine E. Wynne-Edwards, a biology professor and researcher of hormonal changes in expectant fathers, wrote of studies that suggest “men who have deep empathy toward their pregnant partner and are prone to couvade symptoms end up with strong attachments to their child. If this is the case, then the symptoms might either stimulate, or result from, underlying biological processes that are involved in social attachment.”

What exactly are these symptoms?

While Alford recognizes there isn’t a lot of scientific data available about the syndrome, she says the symptoms include “bloating … nausea, vomiting, food cravings, food aversions, musculoskeletal aches, tooth aches, and occasionally breast enlargement.”

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Another study from 1983, cited by the Washington Post, found a modest correlation between paternal-fetal involvement and attachment (such as feeling the baby kick and hearing their heartbeat) with six physical symptoms: feeling more tired, sleeping difficulties, indigestion, upset stomach, appetite changes, and constipation. Still, it’s important to note the limitations of the study, which focused primarily on a sample of white, middle-class men.

More of the psychological symptoms, according to Alford, can manifest in depression, anxiety, mood swings, poor concentration, and memory loss.

What do their partners think?

Research has shown that “when wives were asked about their husband’s experiences, a higher incidence of couvade was reported than when the husbands answered the same questions at the same time.”

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In fact, partners reporting on their husband’s symptoms is one you’ll find all over Reddit, as highlighted in this post by one Redditor:

“Couvade syndrome dude. It’s real. My husband had nausea (on and off for a couple weeks), and he gained weight. He was always the skinny guy and he never could put on weight no matter what he tried. When he was in the military they had him on a crazy diet where he had to eat all these protein bars and tons of extra calories but that didn’t work either. When I got pregnant we joked that maybe he would gain some pregnancy weight too and he ended up putting on 15lbs! It’s crazy how pregnancy can affect both parents.”

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Here’s another by Redditor ChillyAus, who likens her husband’s symptoms to a hangover (which really isn’t far off from the whole pregnancy thing):

“My hubby experienced afternoon fatigue very early in my pregnancy followed by a few days of actual nausea and generally feeling blah. It was when we he said he felt terminally hungover that I knew it was sympathetic morning sickness.”

Could stress be the hidden culprit?

Possibly. According to Evonne Lack in an article for BabyCenter.com, men with severe couvade symptoms (more than the occasional fatigue) experience actual changes in their hormone levels, thus making their body feel out of whack.

“Stress can lower testosterone levels in men, leaving them with out-of-balance estrogen levels, creating pregnancy-like symptoms,” Lack wrote. She notes that in addition, men with extreme couvade often have too much cortisola stress-related chemical that, while effective in the face of short-term dangers, is troublesome over time.

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It’s not difficult to see why men would be stressed or anxious during their partner’s pregnancy, given that they often fall into the role of main provider for their budding family, which can take a mental toll.

Indeed, restlessness could also easily be attributed to the new financial pressure new dads face. And it’s not for nothing, but this financial stress would cause anyone to have intense cravings late at night.

Mental Health Hurdles Involved With Fatherhood

But these symptoms can also point to something more serious than mere stress. For some men, worrying about being a dad can cause depression, possibly accounting for their reduced libido, sleep problems, and changes in appetite that are associated with couvade.

And while postnatal depression in fathers is more well-documented (though relatively less known compared to postnatal depression in moms), there’s even less information on a dad’s depression prior to a baby’s birth.

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But according to one 2015 study, one in eight first-time-fathers suffer from depression while their partner is pregnant. As Deborah Da Costa, an associate professor in the Department of Medicine at McGill University, noted: “The mental health of men remains a neglected area of research and one that is not adequately addressed during the transition to parenthood.”

Similarly, Olivia Spencer, in her book Sad Dad: An Exploration of Postnatal Depression In Fathers, argued that “the true extent of the problemlike so many mental health disordersis greater than we know and that society’s approach to fatherhood needs an overhaul to address it.”

Indeed. Da Costa indicated that many depression symptoms in dads-to-be can be easily spotted. One of the biggest clues being the link between lack of sleep and depression during the pregnancy term. “We know that antenatal depression is the strongest predictor for postnatal depression. So teaching fathers and screening for this early on, can be beneficial in terms of decreasing the risk or the continuation of depression postpartum.”

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According to PANDA (Perinatal Anxiety & Depression Australia), men who feel unsupported or who lack information about what to expect with pregnancy or childbirth may be at increased risk for perinatal depression and anxiety. Here are a few signs to look for: constant tiredness or exhaustion, ongoing irritability, anger, moodiness, or emotional withdrawal from your partner.

Contributing Factors

Aside from a personal history of anxiety or depression, there are other factors that can contribute to mental health struggles in dads and dads-to-be, as outlined by PANDA:

A history of childhood trauma or family conflict. If a dad-to-be experienced a harsh upbringing, it’s likely his impending fatherhood can bring up a host of mixed feelings and difficult memories.

Relationship stress/problems. “A new mother is often very emotionally involved with or focused on the baby. It is also a physically demanding time for her and this can reduce her desire or energy for sex. Men can experience feelings of resentment or anger towards their partner or the baby as a result of these changes. They can also feel lonely and isolated.”

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Sleep deprivation. This one’s a biggie. Lack of sleep impacts a person’s family and working life.

Lack of available support. Not having a network of supportive friends or family can make a dad-to-be feel alone in his new role, without anyone to turn to for advice or guidance.

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Supporting a partner with perinatal anxiety or depression. A factor that is less addressed but shouldn’t be surprising, and which “can trigger a range of difficult emotions, including confusion, fear and helplessness. These feelings can negatively impact men’s own well-being.”

Tips for Looking After Yourself (Couvade or Not)

We get it: Being a first time dad is hard. And this applies unilaterally for men of all different walks of life. Still, there are ways of processing this tumultuous time. PANDA offers the below tips for looking after yourself:

Recognize that having a baby brings many unexpected changes. This is true for both you and your partner: In other words, give yourself time to adjust.

Life might be different, but embrace the experience. Sure, we understand this is easier said than done, but know that it will take time to come around to the idea of becoming “three.”

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Don’t try to take on everything or solve every problem. You are part of a team. And that’s a good thing.

Keep in touch with your friends and family. Having a network of supportive people in your life can help you navigate the puzzling waters of fatherhood. They don’t say it takes a village for nothing.

And most importantly: You don’t need to deal with this alone. “If you think you need some help or support, don’t be afraid or ashamed to ask. Your health and wellbeing is important to your baby.” Reach out to a therapist if your symptoms don’t improve.

Time for a Reality Check

Couvade or no-couvade: Being a dad is kind of a big deal. Meaning, the first step in seeking help for couvade symptoms is recognizing that while moms take the brunt of these biological changes, there’s no denying the mind-body connection in fathers, too.

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And while no one theory can account for the origins of the syndrome, what is known, is that “very little research has been done on male reactions to pregnancy and childbirth,” as explained by Tim Lott of The Guardian. “Instead we live with a lot of inbuilt assumptionsthat the man will be as blissful and anticipatory as the mother expects herself to be, and that when the big day comes his life, like hers, will be transformed, not without difficulty but unquestionably for the better.”

Moreover, it’s important to look at the whole picture when speaking of the phenomenon. Or as Lott puts it: “Time for a reality check. Becoming a first-time father is many thingsterrifying, joyful, nerve-racking, excitingbut unconflicted it is not.”