Arthur Brennan

A critical review of the Couvade syndrome: the pregnant male

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 syndromes 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 mans envy of the womans 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 mans 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 syndromes 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.

A qualitative exploration of the Couvade syndrome in expectant fathers

The aim of this qualitative study is to explore the nature and duration of male partners somatic and psychological symptoms, across gestation and parturition, collectively called the Couvade syndrome. Fourteen men with expectant partners aged 19–48 years from diverse social and ethnic backgrounds were interviewed. The data was processed using qualitative analytical software WinMAX Professional and the emerging themes and sub‐categories identified and analysed. The first was ‘Emotional Diversity in Response to Pregnancy’, which varied with time and other factors and also included mixed and polarised feelings such as excitement, pride, elation, worries, fears, shock and reluctance. The second was ‘Nature, Management and Duration of Symptoms’, which revealed the types and duration of physical and psychological symptoms experienced by men. Attempts at managing these were influenced by social and cultural factors. Physical symptoms were more common than psychological ones, and their time course demonstrated trends similar to those reported for the Couvade syndrome. Although the former were reported to their GPs, no definitive diagnosis was made despite medical investigations being performed. The third theme, ‘Explanatory Attempts for Symptoms’ was influenced by cultural beliefs and conventions like religion, alternative medical beliefs or through the enlightenment by healthcare professionals in the process. Some participants were unable to find explanations for symptoms but some perceived that they were related in some way to the altered physiology of their female partners during pregnancy. These findings highlight the need for further research to acquire deeper insight into mens experiences of, and responses to, pregnancy as a way of explaining the syndrome.

Prevention and early detection of cervical cancer in the UK

This literature review explores the prevention and early detection of cervical cancer in the UK. Current findings indicate that there is a risk for women under the age of 25 years, who may develop cervical cancer. There appears to be a gap in UK policy that may overlook these women, who are beneath the age for initial screening but exceed the age for vaccination. Despite the inextricable link between sexual activity and cervical cancer, cervical screening and sexual health promotion still appear to be disjointed, and the role of a sexually transmitted infection leading to the development of cervical cancer has not been emphasised enough in public health messages. Further training should be provided and its impact monitored, designed to address this anomaly in health promotion. There are many barriers to health promotion including, those of a societal, cultural and religious nature. Additional research is required to ascertain the types of educational and awareness interventions that would be most effective in promoting and encouraging positive sexual behaviours among young people, and to explore how these might be successfully implemented.