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 pregnancy-like 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.
References
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