INTRODUCTION:

Sympathetic pregnancy (Couvade syndrome) describes a situation in which an otherwise healthy man — whose partner is expecting a baby — experiences pregnancy-related symptoms^1-2. While some research suggests that Couvade syndrome might be common, it isn't a recognized mental illness or disease. The Journal of Reproductive and Infant Psychology states that the symptoms may be "a consequence of the man's envy of the woman's procreative ability. Couvade symptoms follow a chronological pattern, beginning in the first trimester of pregnancy, before temporarily disappearing in the second and then re-appearing in the final trimester. They can even extend into the period after the baby is born^1-3.

DEFINITION:

The term couvade comes from the French verb couver, which means "to brood," in the sense of a bird protecting its eggs before they hatch¹.

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 birth²

INCIDENCE:

Several studies have found an incidence of between 25-52% of all men with a pregnant partner in the US; 20% in Sweden, and an estimated 61% in Thailand, though this includes mild to extreme symptoms such as the physical ones above. The incidence in the UK is unknown, but estimates in the 1970s put it between 11%-50%^3-4.

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 outperform⁴.

· 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^4-5.

· 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 fatherhood⁶.

· 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 examination⁷.

· Attachment: the man’s closeness to the foetus gives rise to the syndrome. In a seminal study published in 1983, a sample of white middle-class, first-time expectant men found a modest correlation between more paternal-foetal involvement and attachment (feeling and hearing the unborn child kicking, confirmation through the woman’s pregnancy symptoms and the ultrasound scan) with the incidence of six physical symptoms of the syndrome. These included feeling more tired (34%), sleeping difficulties (33%), indigestion (14%), stomach upsets (12%), appetite changes (8%) and constipation (6%). The investigators concluded men’s symptoms were a reflection of their level of attachment to the unborn child and involvement in the pregnancy⁵.

SYMPTOMS^1,2,5:

Physical symptoms. These symptoms might include

· Nausea,

· Heartburn,

· Abdominal pain,

· Bloating,

· Appetite changes,

· Respiratory problems,

· Toothaches,

· Leg cramps,

· Backaches, and

· Urinary or genital irritations.

Psychological symptoms These symptoms might include

· Changes in sleeping patterns,

· Anxiety, depression,

· Reduced libido and

· Restlessness.

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 itself⁸.

How to Cure Couvade Syndrome:

How is the syndrome resolved? Birth - by the mother - will definitely do it, but for the most part there's no need to go so far. Most of the time the symptoms simply dissipate before birth. Although studies indicate that men with Couvade tend to take more medication during the pregnancy, that medication is meant to control the symptoms, not treat the Couvade syndrome itself. The syndrome is a medical curiosity, but never seems to have been real problem. Occasionally, men will experience sympathetic pains during birth, and will be medicated for them, but there have been no cases of Couvade ever endangering anyone^9-10.

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 men¹¹.

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 nausea¹².

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 rare¹³.

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 not¹⁴.

REFERENCE:

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

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

3. 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.

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

5. 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.

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

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

8. Nippoldt, Todd B. (January 15, 2014). "What can you tell me about Couvade syndrome? Can men really experience sympathetic pregnancy symptoms?". Mayo Foundation for Medical Education and Research.

9. Trethowan, W. H.; Conlon, M. F. (1965). "The Couvade Syndrome". The British Journal of Psychiatry111 (470): 57–66. doi:10.1192/bjp.111.470.57. PMID 14261730.

10. Lipkin, Mack; Lamb, G. S. (1982). "The Couvade Syndrome: An Epidemiologic Study". Annals of Internal Medicine96 (4): 509–11. doi:10.7326/0003-4819-96-4-509. PMID 7199885.

11. Trethowan, W.H. (1968). "The couvade syndrome—some further observations". Journal of Psychosomatic Research12 (1): 107–15. doi:10.1016/0022-3999(68)90016-0. PMID 5663941.

12. Khanobdee, Chantima; Sukratanachaiyakul, Varunee; Gay, Janice Templeton (1993). "Couvade syndrome in expectant Thai fathers". International Journal of Nursing Studies30 (2): 125–31. doi:10.1016/0020-7489(93)90062-Y. PMID 8496024.

13. Masoni, S.; Maio, A.; Trimarchi, G.; De Punzio, C.; Fioretti, P. (1994). "The couvade syndrome". Journal of Psychosomatic Obstetrics & Gynecology15 (3): 125–31. doi:10.3109/01674829409025637. PMID 8000469.

14. Bogren, L. Y. (1984). "The couvade syndrome: Background variables". ActaPsychiatricaScandinavica70 (4): 316–20. doi:10.1111/j.1600-0447.1984.tb01215.x. PMID 6496155.

Received on 28.05.2015 Modified on 26.06.2015

Int. J. Nur. Edu. and Research 3(3):July-Sept., 2015; Page 330-332

DOI: 10.5958/2454-2660.2015.00017.4