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 verbcouver, 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 rivalrythat 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.

Couvade syndrome (sympathetic pregnancy)

by Armando Molina Reviewed by the BabyCenter Medical Advisory Board

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Highlights
Hormones, love, or anxiety? Couvade syndrome elsewhere Common symptoms of couvade syndrome Treatment for couvade syndrome A pregnant woman may have to contend with mood swings, cravings, irritability, nausea, and a long list of other pregnancy ailments. If all that weren't enough to deal with, imagine if your partner started experiencing those symptoms too. Interestingly, more than a few dads-to-be go through what's commonly called "sympathetic pregnancy." It's also known as couvade syndrome (the word comes from the French wordcouver, which means "to incubate"). The symptoms tend to appear in men during the third month of their partner's pregnancy, as well as toward the final weeks before birth. A 2007 study by Arthur Brennan, a senior lecturer at St. George's, University of London, followed 282 future dads. It showed that some men whose partners were pregnant develop their own pregnancy symptoms, such as nausea, dizziness, hormonal fluctuations, back pain, cramps, irritability, and even cravings.

Hormones, love, or anxiety?

There's no clear explanation for the symptoms of couvade syndrome. Indeed, despite its prevalence, it isn't even formally recognized as a medical condition. Some studies have focused on the hormonal changes in pregnant women and compared them with the hormone levels of fathers-to-be. A 1991 study by Canadian investigators indicates that changes in a woman's hormone levels (particularly prolactin and cortisol) are also found among some men during their partner's pregnancy. The study suggests that these changes would produce pregnancy symptoms in a man, simultaneously creating an emotional connection with his pregnant wife. The findings also discovered high levels of prolactin in men during the weeks after the baby's birth. Depending on the study, the percentage of men with couvade syndrome ranges widely from 10 to 65 percent. The exact number of men who undergo these changes may never be determined because although many men develop minor pregnancy symptoms, few develop the most extreme ones, prompting only a small percentage to seek medical attention.

Couvade syndrome elsewhere

Anthropologists and other scientists have long taken an interest in the rituals surrounding birth and new parenthood in cultures around the world. According to Leopoldo Villela, a San Francisco psychologist who specializes in family therapy, "Psychological studies done in Toluca, Mexico, in the 1960s revealed that in some indigenous communities, several men would care for the expectant father by performing a ritual in which he was covered in his wife's skirts, then soothed and rocked while he behaved like a baby. The ceremony would end with a dinner, after which the man would feel cured from this illness." Villela says he has shared this information with future Latino dads who have mentioned feeling those symptoms. They claim this knowledge made them feel better and that eventually the symptoms disappeared.

Common symptoms of couvade syndrome

These are some of the physical symptoms that men who experience couvade syndrome feel early in their partner's pregnancy:

Vomiting Leg cramps Nausea Abdominal pain

These are some of the psychological symptoms that men with couvade syndrome experience:

Irritability Cravings Feelings of jealousy and anxiety Stress over the baby's future Mood swings Treatment for couvade syndrome
Doctors and psychologists agree that couples should speak frequently about their baby's future to soothe any fears men feel over becoming a parent. They encourage men to take an active role during the pregnancy. Salvadoran psychologist Melisa Villeda says, "Communication between couples is key. Each one must express how they're living the experience of becoming parents, since this will inevitably change their lives and they must learn to deal with it as well as possible. If psychological or medical help is necessary because a patient's symptoms are overwhelming, each case must be evaluated and treated with either therapy or medication to alleviate the discomfort. Experts agree that the most effective treatment is to make the man feel he is an active and vital part of the process, whether by participating in childbirth classes or providing support during delivery. It's important for couples, and especially future dads, to know that the symptoms of couvade syndrome are real and that a significant number of men whose partners are pregnant experience them. Taking the time to prepare for birth and parenthood can help them avoid feelings of anxiety and fear.