Sympathetic_Pregnancy

Men with Sympathetic Pregnancies: The Strange Cravings, the Phantom Labor Pains and the Stomach-Turning Morning Sickness

Is Couvade Syndrome a testament to male empathy, or simply a case of womb envy?

When men prepare themselves for impending fatherhood, it mostly means getting ready for life after the baby while mom-to-be gestates: assembling the crib, painting the nursery, stocking the diapers and preparing for sleeplessness. Less expected and rarely warned about: That while mom is gently expanding, getting wicked heartburn and wretched morning sickness, that dad might experience pregnancy symptoms himself, too.

It happened to Darren, a Canadian father of two who tells me that during his wife’s first pregnancy, he packed on 28 pounds. He similarly experienced strong food aversions, no longer able to stomach the beloved sushi he’d once consumed multiple times per week. The most notable event, though, was when his wife called him from work concerned that her water had broken. “I rushed to pick her up, and my body had a physical reaction to the distress she was in,” he writes via email. “During the five-mile drive to the hospital, my entire body broke out into a sweat where I soaked through a T-shirt. Part nerves for sure, but it was a sweat from psychological stress I’d never experienced before.” Basically, his water had kind of broke, too.

Called Couvade Syndrome, or Sympathetic Male Pregnancy, it’s generally defined as pregnancy-like symptoms in otherwise healthy men whose partners are pregnant, ranging from abdominal pain, bloating, nausea, heartburn and backaches, to in some cases, even swelling breasts. A man could have only one of those symptoms and still call it Couvade, as there’s no rigorous checklist to meet a certain criteria for diagnosis, because it’s not a recognized medical disorder, nor does it appear in the most recent Diagnostic Statistical Manual of Mental Disorders, or DSM-V.

It also inhabits a strange purgatory where experts aren’t sure which comes first: The physical symptoms or the psychological ones. “I don’t think people understand the nature of the disorder,” Arthur Brennan, a leading researcher on the condition, told The Guardian recently. “It sort of straddles the boundaries between a mental disorder and a physical disorder. It doesn’t fit tidily into one or the other category.”

It happens globally, but the prevalence fluctuates depending upon where you look. In Poland, it can affect up to 72 percent of expectant fathers. In the U.S., it’s closer to 52 percent. Meanwhile, psychiatrists in Turkey detailed a case of a 32-year-old man with a newly pregnant wife who checked into a psychiatric outpatient clinic last year complaining of five months of “weight gain, gastritic symptoms, food cravings, nausea and vomiting, palpitation, insomnia, anxiety, irritability and headache.” 

CNN’s Sanjay Gupta once said 90 percent of men will experience one symptom during a partner’s pregnancy. But some experts think that’s exaggerated, mostly because it’s unclear what really constitutes Couvade, especially when many of the alleged symptoms could be explained by proximity alone. After all, being around a vomiting person easily causes nausea — no disorder required. The same with weight gain. Partners who live together and eat together are likely to up the caloric intake together. And if your pregnant partner tosses and turns during the night, you will wake up often and lose sleep, too.

Plus, not all men’s symptoms actually mirror their partner’s. Darren gained 28 pounds during his wife’s pregnancy and felt no nausea, but she lost 40 due to hyperemesis gravidarum, extreme morning sickness that led to such frequent vomiting that she returned to the hospital every 72 hours to receive an IV to avoid dehydration.

It’s also not restricted to heterosexual men, either: Back in 2012, a gay man wrote about his own sympathetic pregnancy pains during the surrogacy process: “I’ve had nausea so bad that I cannot sleep despite being unreasonably fatigued. Even without the nausea I’m suffering from insomnia, watching the clock tick past midnight and 1 a.m. and 2 a.m. most nights before I finally get taken away to sleepland. My appetite has been up and down, mostly down. Even so, my weight has reached an all-time high of 166 pounds, despite substituting a Slim Fast shake for my normal breakfast cereal while maintaining or even upping my normal excessive exercising habits. I’m having back pain and some never-before knee joint pain. Headaches are making me grouchy. I’m over-the-top excited in one moment, and then down in the dumps the next. What’s going on?”

In another case noted by The Guardian, a woman experienced pregnancy symptoms when her dog was pregnant. Further, women sometimes report that their own mothers experience pregnancy symptoms as they go through pregnancy themselves. 

Back to men, though: The most widely cited reasons men experience Couvade are stress about the pregnancy and empathy for the pregnant partner’s experience. Some research found that men are more likely to experience a sympathetic pregnancy when they participate in birthing classes with their pregnant partner. Along those same lines, it seems to be common in couples who have sought infertility treatments together, such as when the male partner gives his partner daily hormone injections. These are largely explained by the hormones themselves, such as lowered testosterone and higher prolactin, which in combination may explain depression, weight gain and greater emotional support and mood swings. 

But there are deeper psychological and psychoanalytic theories, too, which is where things get interesting. Some researchers think Couvade is a result of how fathers are marginalized in the pregnancy experience and relatively ignored beyond providing sperm. Another theory suggests Couvade is explained by men being jealous of women’s reproductive capacity, or womb envy. The counter to Freud’s theory that women experience penis envy, womb envy is Freud student Karen Horney’s theory that men’s drive for success is spurred by their inability to create, carry and nurture life. Womb envy explains everything from Couvade to reproductive control of women’s bodies, as well as men demanding their surname be given to the child and wife, a way of taking credit for the womb’s work.

A third theory posits that men have fetal envy, too. That is, they’re jealous of the newly focused attention on the growing baby — and the lack of attention on them — and mimicking pregnancy is their way of glomming onto the experience and getting attention for themselves.

Others, however, take a more generous view of the condition, suggesting that Couvade men aren’t jealous drama queens stealing a woman’s pregnancy thunder, just more sensitive, attuned and empathic than other men. “My wife and I were really close and got pregnant three months after our wedding,” Darren explains. “My best guess and the very real situation for us would be that the more emotionally close and connected you are, the better the chance of some sympathetic symptoms are.”

Also, in spite of his own symptoms, it didn’t prevent Darren from tending to his wife throughout her pregnancy. “It wasn’t difficult to care for her or empathize,” he says. “It was completely necessary for me to be her caregiver and full support system as she was so sick. She required help with almost everything from preparing something as simple as toast to just getting dressed and into doctor’s appointments.”

In a way, he adds, it allowed them to experience the version of pregnancy they’d expected all along. “It was just something we joked about — how I was having the pregnancy she wished she had.”