Title: Couvade: the pregnant male.
Author(s):Murphy RL
Affiliation:Maternal-Child Nursing, Barton County Community College, Great Bend,
Kansas
Source:Journal of Perinatal Education (J PERINAT EDUC), 1992; 1(2): 13-8 (33 ref)
Publication Type: journal article - review, tables/charts
Language: English
Major Subjects:Couvade
Minor Subjects:Psychological Theory; Expectant Fathers--Psychosocial Factors; Male
Journal Subset:
Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer
Reviewed; Nursing; Peer Reviewed; USA
ISSN: 1058-1243
MEDLINE Info:
NLM UID: 9301158
Publisher Info:URL: www.cinahl.com/cgi-bin/refsvc?jid=1338&accno=1997010330
Entry Date: 19970301
Revision Date:
20050414
Accession Number: 1997010330
Database:
CINAHL Plus with Full Text
COUVADE: THE PREGNANT MALE
Couvade: The Pregnant Male
Abstract
This article is an analysis of the concept of "couvade." Both ritual couvade as seen in
primitive societies and the more modern version of couvade in which mates of pregnant
women may experience pregnancy-like symptoms are reviewed from the literature.
Possible meanings and variables associated with the phenomenon are discussed. The
frequency of various symptoms reported in the literature is listed. Finally, the importance
of considering the couvade when caring for childbearing families is emphasized, so that
health needs of new and expectant fathers may be met as well as those of mothers and
babies.
A YOUNG MAN IN A REMOTE AREA of New Guinea lies on a mat in a room of his
hut, moaning, writhing, clutching at his abdomen in simulated labor pain, while his wife
quietly lies in another room, in actuality giving birth to the couple's child. On the other
side of the world, a young man in Kansas goes to his physician with complaints of
nausea, abdominal distress, backaches, and insomnia. His wife is in the eighth month of
pregnancy. Both men are evidencing characteristics of the couvade.
Health professionals working with families in the birthing cycle are not always familiar
with or well informed about the concept of "couvade." With a better understanding of the
phenomenon, health professionals can be aware of expectant fathers who are at high risk
for developing the syndrome and can help them to meet their needs as they go through
this stressful time.
Couvade, according to Webster's New International Dictionary is "a custom among
primitive peoples in many parts of the world in accordance with which when a child is
born the father takes to his bed as if he himself has suffered the pains of childbirth, cares
for the child, or submits himself to fasting, purification, or various taboos" [ 1]. Another
definition states that "couvade is the occurrence in the mate of a pregnant woman of
symptoms related to pregnancy, such as nausea, vomiting, and abdominal pain" [ 2]. The
origin of the word probably comes from the French verb "couver" which means
"brooding or hatching" [ 3].
The literature describes two main forms of the concept: ritual couvade and the modern
couvade syndrome. Ritual couvade is a practice noted in historical and anthropological
studies of numerous societies, since 60 B.C. in ancient Greece to the present in primitive
societies [ 3, 4, 5, 6]. Classical ritual couvade generally takes one of two forms:
simulations of labor in which the expectant father moans, groans, twists, and thrashes
around as though suffering the pangs of birth himself [ 7], or observances by the new
father of certain postpartum dietary and/or activity restrictions [ 5, 8, 9]. The rites of
couvade are widespread and have been present in some form on almost every continent [
6].
In many cases, as in the Ainus of northern Japan and the Witotos of South America [ 9],
the new father went to bed with the newborn infant and was fed and pampered by his
wife and friends. In some societies, however, the observances were not so pleasant for the
new father. Among the Black Carib of British Honduras in the eighteenth and nineteenth
centuries, a period of fasting and severe activity restriction was followed by purification
rites that involved pain and physical mutilation [ 7].
More contemporary examples of couvade include a continuing belief in England that the
woman's pain of childbirth is relieved in proportion to the husband's suffering [ 7]. In
Scotland, it is still a common fancy that if a husband is the first to rise on the morning
after his marriage, he will bear all the pains of childbirth when his wife's time comes [ 7].
One would suspect that Scottish bridegrooms frequently are careful to stay in bed until
the bride has arisen!
Physical Symptoms Noted in Expectant Fathers
Trethowan [ 3] first wrote in 1944 of a modern version of couvade, which he called the
"couvade syndrome," in which husbands of pregnant women suffer pregnancy-like
symptoms, such as nausea and vomiting, abdominal pain, unusual food cravings, and
toothaches. He and Conlon published a research study in 1965 in which they did a
descriptive survey comparing the incidence of a constellation of symptoms in expectant
fathers to a comparable group of men whose wives were not pregnant. They found a
significantly higher incidence of symptoms in the group of expectant fathers.
After Trethowan's initial work, other researchers began investigating the incidence and
variables associated with the modern version of couvade. It was found that pregnancylike physical symptoms were common occurrences among partners of pregnant women [
4, 10, 11, 12, 13, 14, 15, 16]. The most commonly reported symptoms in expectant
fathers are gastrointestinal in nature, with nausea and/or vomiting, abdominal pain or
cramping, and toothache heading the list. Some studies found increased appetite [ 3, 10,
12, 14, 15, 16], while others found decreased appetite [ 3, 10, 12, 14]. Headache is
another frequently reported symptom [ 3, 4, 12, 13, 14, 17, 18]. Clinton's investigation [
11] detected a significant increase in upper respiratory infections in fathers-to-be,
compared to nonexpectant men. The variety of symptoms reported in the literature is very
great (see Table 1).
Psychologic Symptoms in Expectant Fathers
Several studies [ 3, 4, 10, 11, 15, 16, 19, 20] found psychologic symptoms such as
anxiety, depression, and insomnia. These are felt to be related to the developmental crisis
of impending fatherhood (see Table 2).
Occurrence of Couvade Symptoms
A number of variables have been investigated in relation to the occurrence of couvade
symptoms. Lower income and social status have been found to correlate with higher
incidence of symptoms by several researchers [ 4, 10, 16], while lower educational levels
were found in symptomatic men by others [ 10, 14, 16]. Strickland [ 16] and Clinton [ 4]
found a higher incidence of symptoms in expectant fathers of ethnic minority and black
race. Unplanned pregnancy increased symptomatology in a study by Strickland [ 16].
Dissatisfaction with the support provided by his partner and social networks was
associated with higher levels of symptoms in Brown's work [ 21].
In contrast, Clinton [ 4] found that men who had greater affectional involvement in the
pregnancy had more symptoms, and Longobucco and Freston [ 22] detected a positive
association between symptoms and greater paternal-role preparation.
A study by Quill, Lipkin, and Lamb [ 23] looked at comparable groups of nonexpectant
men and discovered lower rates of visits to physicians for symptoms in the expectant
group. This study looked at mostly white, married, working, middle-class members of an
HMO who, according to the above studies, may be expected to have lower incidence of
couvade symptoms. It is apparent that questions about the significance and meaning
behind the phenomenon remain.
The Meaning of Couvade
There are several theories concerning the meaning and etiology of couvade. One idea is
that ritual couvade is due to "feminine tyranny and henpecking" [ 7]. Another
explanation is that primitive couvade is seen as a rite of adoption by the father as society
moves from maternal to paternal ties of parentage [ 7].
Tylor [ 6] believed that couvade owed its origin to "sympathetic magic" in which
primitive men believed there existed a physical bond between the father and infant. What
was done to one directly affected the other. Prescribed activities and taboos then carried
a protective element for the vulnerable newborn.
The psychodynamic theory advances the idea that ambivalence of the father toward the
mother and baby is behind the couvade. According to this theory, conscious trouble is
taken to ease the woman's pain in order to counter the unconscious, concealed hostility
against the mother. The dietary couvade may be protective in nature and is intended to
set up an effective barrier against the father's impulse to do harm to the infant [ 24].
According to psychoanalytic theory, couvade is the husband's envying his wife's ability to
produce a child [ 17, 25, 26]. It is also proposed that societies with low male salience in
early childhood often exhibit couvade [ 18, 26, 27, 28, 29]. Walton's research [ 20] did
not support this theory, as early father absence did not increase incidence of symptoms.
Several writers assert that pregnancy is a time of crisis for the expectant father and that
symptoms at this time are a sign of ineffective coping and a plea for assistance in dealing
with the crisis [ 19, 30, 31, 32, 33]. Others assert that couvade symptoms in husbands of
pregnant women are associated with identification of the man with the woman and are
correlated with "feeling fatherly" and actively participating in parenting activities [ 22,
33]. From this perspective, couvade is viewed as a positive response to pregnancy.
Implications for Practice
At this time, there is not a consensus of opinion as to whether couvade is a positive,
adaptive behavior in expectant fathers or a maladaptive one. It may be a socially
acceptable way for the father to act out involvement in pregnancy and birth and may
result in increased closeness as the husband identifies with the wife. On the other hand, it
could cause a strain in family relationships if the husband is more concerned with his
own somatic and psychologic symptoms than in providing support for his wife.
There is general agreement, however, that expectant fatherhood is a significant event for
men. Pregnancy is a crucial period for fathers-to-be as well as their mates, a time when
physical symptoms may occur as an expression of deep psychological stress as they
anticipate the births of their children. Frequently, little attention is given to expectant
fathers and inadequate concern is shown for relieving their anxieties and physical
symptoms. By becoming familiar with the characteristics, possible underlying meanings,
and variables with which couvade is associated, nurses can more effectively anticipate
needs and problems of expectant fathers and assist them in working through this
challenging time.
Specifically, health care providers need to assess men's status in relation to childbearing
when they enter the health care system. The literature indicates that this assessment is
seldom done [ 14], but it is important to discover possible relationships between
impending fatherhood and health problems men are having.
It may be helpful to provide information about the couvade syndrome to expectant
fathers. Men are not as likely as women to compare and share feelings and symptoms
with other expectant fathers, and a man experiencing "morning sickness" during his
wife's pregnancy may think he is the only one to have such signs. He may also be too
embarrassed to mention his problems. With information about possible couvade
symptoms, he may feel more comfortable voicing his concerns and getting his needs met.
When caring for childbearing families, it is important that health professionals focus on
the physical and psychological well-being of expectant and new fathers, as well as those
of mothers and infants. After assessing fathers' needs, perinatal educators should suggest
interventions to promote wellness. Armed with an understanding of the variety of
responses normally experienced by men during their mates' pregnancies, health
professionals will be better able to provide education and support necessary for fathers
to work through this challenging growth process and to make a real contribution to the
health and well-being of new fathers and their families.
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Article copyright Lamaze International, Inc.
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By Roma Lee Murphy