Symptoms may appear unexpectedly. Nausea, severe fatigue, numbness in the arms, tenderness in the skin of the arms and chest, or an overall feeling of discomfort or strangeness. It’s a list that many pregnant women will recognize.
However, these symptoms are also experienced by future parents or members of the couple who are not pregnant while waiting for a baby, even if they are not the ones carrying the baby. What is it due to? To a little-known condition called Couvade syndrome.
“The best way to describe it is empathy pregnancy,” says Catherine Caponero, an obstetrician-gynecologist at the Cleveland Clinic in Ohio, who has seen some cases.
“Basically, it occurs when one of the members of the couple experiences symptoms of pregnancy despite not being biologically pregnant.”
A growing body of research reveals that the syndrome is more common than previously thought, and some scientists wonder whether its strange symptoms warrant a reconsideration of how pregnancy affects both parents.
Widespread but unclassified
sCouvade syndrome can affect future parents, same-sex couples and even future grandmothers who live with the pregnant person and actively participate in their care, according to Caponero.
Symptoms range from nausea and fatigue to back and dental pain, mood swings, cravings and weight gain. Its onset resembles that of a physical pregnancy and usually peaks during the first and third trimester, before disappearing postpartum.
Because Couvade syndrome can manifest in many ways and has an imprecise definition, estimates of its prevalence vary dramatically. One study, for example, found that up to 52% of American fathers reported experiencing some symptoms of the syndrome during their wives’ pregnancy, with similar numbers in Jordan (59%) and Thailand (61%).
Other studies have found higher numbers in Poland and China, where seven in ten expectant parents reported experiencing Couvade symptoms. Other research indicates that the prevalence may be lower in Sweden (20%) and Russia (35%).
Although this research indicates that it is quite common, Couvade syndrome is not officially classified as a medical disorder, says Ronald Levant, professor emeritus of psychology at the University of Akron in Ohio.
Neither the International Classification of Diseases nor the United States Diagnostic and Statistical Manual of Mental Disorders, 2 reference tools used by clinicians around the world, recognize Couvade syndrome. Few medical textbooks mention it.
“I think I learned a phrase about that.” [en la facultad de medicina]”says Caponero. “Even among our resources as clinicians, there is not a lot of information.”
Today, much of this understudied syndrome remains a mystery. “Its mechanism is not well understood,” says Daniel Singley, psychologist and director of the Center for Men’s Excellence in San Diego, USA. “Maybe it’s a way of trying to sublimate and deal with emotional problems, maybe there’s a neurobiological nasty thing. I don’t think it’s known.”
However, most researchers agree that Couvade syndrome is “multifactorial,” involving both biological and psychological components, Levant says.
Rituals
The word “couvade” derives from the French verb “couver,” which means to incubate or breed. The English anthropologist Edward Burnett Tylor popularized the term in 1865 to describe an unusual scene he witnessed during a trip through the Basque Country: peasants lying in bed with their newborns.
According to Richard Powis, a medical anthropologist at the University of South Florida, the derogatory expression was intended to ridicule men. “It’s about the widespread notion that men behave like women,” explains Powis.
However, the origin of the practice of “couvade” dates back to 50 BC, when expectant parents in Corsica, Cyprus and Iberia would lie in bed and express labor pains or imitate aspects of childbirth, sometimes wearing their partner’s clothing.
Anthropologists later described similar rituals practiced by groups around the world, in the West Indies, South America, and East Asia.
These rites were performed as adoption ceremonies, Tylor wrote in 1889, noting that “among certain tribes, the Couvade is the valid form by which the father recognizes a child as his.” In other cases, it was believed to divert the attention of evil spirits from the mother to the father.
In that sense, Powis explains, Couvade abilities were seen by scholars of the time, mostly wealthy, Victorian elite men, as an intentional set of rituals practiced by new parents in “exotic locations” to keep their pregnant partner and fetus in good health and spirits.
But when the perspective shifted to their own industrialized Western societies in the mid- and late 20th century, Couvade began to take on a different nuance, “like a psychological pathology,” Powis says: an involuntary experience of pregnancy syndromes with biological and psychosomatic bases.
For example, Sigmund Freud, anthropologist Mary Douglas, and others proposed various psychoanalytic theories. “One held that men imitated pregnancy on purpose to steal their partner’s attention,” says Powis, or that Couvade symptoms had their origin in subconscious envy, and that future fathers perceived the fetus as a rival for their partner’s attention.
Complex emotions
Today, most experts agree that Couvade syndrome has a psychological component and that the symptoms probably arise due to the stress experienced when becoming a parent, even if you are not pregnant.
“Having a baby is one of the most important developmental milestones in adult life,” says clinical psychologist Kevin Gruenberg, founder of the nonprofit Like, Dad in California. “Sometimes it can be very stressful and overwhelming, so Couvade syndrome could be a way to reflect this great transformation.”
The postpartum period introduces new stresses for both parents, such as lack of sleep and the constant demands of caring for a newborn. “There are also different aspects related to sexual identity, physical intimacy or family logistics,” adds Singley.
About one in ten new fathers develop prenatal or postpartum depression, while up to 18% of men report high levels of anxiety during that period, and 7% exhibit symptoms of post-traumatic stress disorder (PTSD). Studies show that if a new mother suffers from postpartum depression, her partner is at least twice as likely to develop it as well.
Some of these psychological changes could have a Freudian background. “I see many parents who come to consultation and talk about aspects of their experience, such as jealousy of a newborn, grieving for the life they had before or having to share their partner,” says Singley.
Show of support
Some experts suggest that expectant parents involuntarily experience pregnancy-like symptoms as a deep, subconscious form of empathy toward their pregnant partners. It is a reflection of “the deep emotional involvement and identification with the pregnant couple,” says Levant.
In fact, it is often accompanied by intentional supportive actions. If an expectant mother develops a sudden aversion to the sight and smell of meat, her partner might choose to become a vegetarian as a show of support. If the pregnant woman reduces her physical activity to spend more time resting on the couch, her partner could do the same to keep her company.
Powis, for example, compares it to the Couvade rituals that were historically practiced. “My definition of Couvade is when someone does something during pregnancy or postpartum to contribute to the support of pregnant women,” explains Powis. “When we call it a syndrome, we pathologize it. But there’s nothing wrong with it or particularly unique. It’s just human empathy.
“Ultimately, what we talk about is how people take care of each other and what happens when they do.”
Hormonal changes
However, evidence also suggests that Couvade syndrome may have a biological undertone that drives subsequent psychological and intentional factors. In a series of experiments, some of the most extensive research to date, Robin Edelstein, a psychologist at the University of Michigan, examined how the hormone levels of first-time couples, both heterosexual and homosexual, changed during pregnancy.
While pregnant women showed large prenatal increases in cortisol, progesterone, estradiol and testosterone, men experienced notable decreases in the latter two hormones. This is not surprising, says Edelstein. “Decreased testosterone is thought to orient men toward caring for the baby and investing in the family, rather than seeking new partners or being aggressive. And lower levels of estradiol may make caregiving easier,” explains Edelstein.
When surveyed three and six months after giving birth, fathers who showed greater prenatal declines reported contributing more to both housework and baby care, which was confirmed by their partners when consulted separately. “Hormonal changes seem to come first, which predicts greater investment [en la atención posparto]”says Edelstein.
Therefore, hormonal changes could explain some symptoms of Couvade syndrome, says Edelstein. For example, low levels of testosterone and estradiol are associated with weight gain in men, while the latter has been linked to depression. However, it is unknown what triggers these changes.
This coincides with numerous neurological studies that show that parents’ brains change after the birth of a child. A 2024 study, for example, revealed that gray matter volume is reduced in fathers after childbirth, as well as in mothers, as a form of synaptic pruning, boosting brain areas relevant to interpreting baby signals, bonding, and caregiving.
Men with greater reductions reported spending more time with their newborns and experiencing greater bonding, reflecting successful adjustment to fatherhood.
Given all the factors involved, Singley rejects the common notion that Couvade syndrome is simply a reflection, conscious or subconscious, of the pregnant couple’s symptoms. “It’s a pretty traditional way of looking at the parenting experience,” Singley says. The couple, he explains, “is also going through various psychological, social, neurological, endocrine and interpersonal adjustments, because they are an independent person.”
For fathers-to-be, it may be more difficult to accept, given societal expectations about how men should behave. “Men may think, ‘I’m a tough guy, I can’t or be depressed; No, that’s weak. I’m a father, I have to be on top of my game and provide for my family,’” says Singley.
Instead, he argues that we should allow them to say, “I may have a migraine, I may have muscle tension, I may have gastrointestinal problems. I may feel like I’m carrying a lot of responsibility.”
*This article was published on BBC Family Tree. Click right here to see the usual version (in English).
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