Couvade Syndrome Makes Some Men Get Pregnancy Symptoms

Pregnancy comes with its share of side effects. There’s a litany of unpleasant symptoms that might come with the territory including nausea, heartburn, abdominal pain, bloating, toothaches, fluctuating appetite, trouble breathing, leg cramps, backaches, and genital irritation. Then there’s the mental stuff: anxiety, depression, reduced libido, restlessness, trouble sleeping. These are all well-known common symptoms for moms-to-be. Pregnant people are likely to run into a handful of the above. Less well known is that a quarter to, by some estimates, half, of fathers-to-be also experience a handful of the above. Many dads feel, act, and, if we’re being honest here, look a bit pregnant — all because of a weird and surprisingly common thing called Couvade syndrome, in which men get pregnancy symptoms too.

Couvade syndrome isn’t a recognized disease. As such, it’s unclear whether the physical symptoms felt are psychologically influenced or honest-to-god physical symptoms. What we do know is that Couvade syndrome is a form of extreme male empathy for pregnancy, and it’s common around the world. What it looks like exactly, it seems, is highly dependent on geography and culture.

One study of Polish dads, for instance, found just four symptoms prevalent among Couvade syndrome sufferers: sympathetic weight gain, flatulence, fluctuating appetite, and personal distress. Another study of first time dads in Bengalaru in southern India found a much much wider array of symptoms: changes in appetite, flatulence, constipation, indigestion, fatigue, nausea, vomiting, food cravings, diarrhea, abdominal pain, headache, fainting, toothache, weight loss, weight gain, back pain, leg cramps, skin problems, insomnia, mood swings, irritability, crying, nightmares, loneliness, helpless, guilt, and resentfulness. The difference between the two studies is stark, but the root of the symptoms appear to be the same: These dads-to-be were experiencing onset fatherhood through the eyes of their wives.

Although the personal physical symptoms seen here are a relatively recent historical phenomenon, Couvade syndrome has cultural precedence that dates back for millennia. “Couvade is any kind of cultural behavior that draws attention to the male to the responsibilities of caring for the infant’s survival,” explains Frank L’Engle Williams, Ph.D., an anthropologist at Georgia State University and author of Fathers and their Children in the First Three Years of Life. “The one thing they all have in common is it brings a father from their activities to the mother and the child. It tells society that that child belongs to the father and the father belongs to the child.”

For example, hunter-gatherers on the Trobriand Islands, who live just off the east coast of Papua New Guinea, use a ritual to pass responsibility for a pregnancy over to a father figure. Because it’s a known “free-love” society, a Couvade ritual is enacted in part to designate the father-to-be (biological or not). This dad performs a multi-day simulation of birth pains during the mother’s pregnancy to show his connection to the laborer. This is both empathetic to the pregnancy and necessary — a showing to the group that this would be the father and caretaker of the child.

Such performative rituals can still be found around the world, but in modern times, it’s a somewhat rare rite, occurring in small parts of the Caribbean, Africa, and Asia. “In our Western society, a father is simply given a cigar,” says Williams. “But it’s a huge responsibility to have an infant and deserving of a multi-day cultural experience. In the age of deadbeat dads, it makes you wonder if the ritual was invented to avoid that.”

It also might make you wonder if our reaction to not having an outlet for ritualistic fatherhood is to feel — truly feel, down to nausea and swollen feet — the mother’s pain. Couvade syndrome, after all, is far less performative than the cultural Couvade. It’s personal, physical, potentially even biological. This strange twist, Williams argues, might have evolutionary roots.

Men undergo a hormonal transformation at the moment of birth. Prolactin spikes, testosterone drops, and oxytocin increases. “There’s a lot of biology in fatherhood that’s invisible to the eye,” says Williams. “And it’s something which might stick with them for the rest of their lives.”

Studies have shown that lower testosterone levels in modern dads may foster less risk-taking and better child-rearing, and this is something that evolved in men over the past five to six million years. Men whose testosterone lowered were more successful in raising infants, and their genes were passed along. It’s a well-studied phenomenon (and a fine reason to embrace the low-T dad life). It’s also information that makes physical symptoms of child-rearing sound a little less crazy. Could this be the sign of that pre-prolactin spike that dads are about to experience?

More research is needed. While the science catches up, however, there is an obvious lesson surrounding Couvade: Extreme empathy of pregnancy in any form makes for better-prepared dads.

“You suddenly see yourself differently,” says Williams. “I think when there is a lot of bonding with the spouse, this takes the form of a Couvade.” What’s a little weight gain and back pain when you have that?