A critical review of the Couvade syndrome: the pregnant male

Abstract

The Couvade syndrome is a global phenomenon occurring in industrialised countries around the world and has a wide international variance. It affects biological fathers particularly during the first and third trimesters of pregnancy with cessation of symptoms upon birth or shortly within the postpartum period. It does not appear in the nosology of the Diagnostic Statistical Manual of Mental Disorders: DSM—Version 4 (American Psychiatric Association, 2000) on the ICD—Version 10 (WHO, 1993). Nevertheless, early accounts tended to medicalise it as a psychosomatic disorder. Its relationship with socio‐demographic factors is inconsistent, with the exception of ethnicity. International studies reveal some contradictory findings in the type of symptoms. This may reflect methodological problems in the syndrome's definition or criteria and type of measurement across studies. A plethora of theories has been put forward to account for the origins of the syndrome. Psychoanalytical theories contend that it is a consequence of the man's envy of the woman's procreative ability or foetal rivalry. Psychosocial theories propose that it occurs due to the marginalisation of fatherhood and as part of a transitional crisis to parenthood. Paternal theories suggest a connection between the man's involvement in pregnancy, role preparation and the syndrome. However, some of these theories have not been thoroughly investigated. Those which have reveal inconsistent findings. It is recommended that future investigators use qualitative approaches to further illuminate the syndrome's characteristics, definition and perceptions as seen by male partners. This should be followed by quantitative approaches of large heterogeneous samples to investigate the type, incidence, severity and distress of symptoms of the syndrome and its relationship with socio‐demographic factors.