Phantom Pregnancies Happen. Why Don’t We Talk About Them?

This article originally appeared on VICE Arabia.

During his wife’s pregnancy, 45-year-old Egyptian photographer Ezzat started feeling a strange pain in his chest – pain not dissimilar to what his pregnant partner was also experiencing at the time. Ezzat discreetly consulted a gynaecologist who told him about a medical condition that can affect cis men during a partner’s pregnancy. The specialist told him to relax and assured him that this phantom pain would pass.

The opposite happened: Whenever his wife experienced a new symptom related to her pregnancy, like severe back pain or an increased need to pee, so did he. “All of them,” he says, “vanished after my wife gave birth.”

It’s likely that Ezzat had Couvade syndrome, a condition better known as sympathetic or phantom pregnancy, in which cis men experience some of the psychological and physical symptoms of pregnancy. The disorder largely occurs during the first and third trimesters of pregnancy, and reported rates of those experiencing some form of couvade differ around the world.

The term was coined in 1865 by British anthropologist Edward Burnett Taylor, but historical documents and more contemporary research show that couvade is a global phenomenon stretching back in time. It would seem that for as long as there have been pregnancies, there have those who end up adopting the suffering of pregnancies as their own. 

Physical symptoms include nausea, heartburn, abdominal and back pain, bloating, loss of appetite and weight gain. Psychological symptoms may include changes in sleep patterns, anxiety, depression, and decreased sexual desire.

Despite it being an ongoing concern, professionals are keen to stress that, even today, couvade remains difficult to define from a medical and scientific perspective. London-based lecturer Arthur Brennan, one of the world’s leading experts on the topic, argues that “this disorder is on the borderline between mental and physical distress, and clearly does not fit into one category or another”.

There are several theories floating around as to why couvade happens. Some professionals believe it is the result of similar hormonal changes to those women undergo during pregnancy. Others are more interested in examining the condition as one that results from a heightened sense of empathy.

There is also a theory that says that when a cis man feels marginalised during a woman’s pregnancy, he experiences these symptoms until he feels that he is in the forefront again. Put bluntly, the men feel envious and jealous and will do what they can to reaffirm their position in the relationship. 

Though there is an understanding that the condition isn’t necessarily a cut and dry affair, some medical professionals take a more hardline stance on the topic. One of those professionals is Dr Mahmoud Ghallab, a Cairo-based psychologist who specialises in family issues. “I firmly believe that the condition is entirely psychological,” he says. “It appears in some cis men as a result of their sympathy with their wives and in other cases to attract attention as a result of everyone’s focus on the pregnant wife.”

There are possible physical explanations for this syndrome, too. What we do know from the admittedly very few studies done so far is that men's hormone levels change dramatically during the prenatal period. A team of Canadian researchers discovered that fathers-to-be showed higher than average levels of estradiol (a female hormone) and lower levels of testosterone (a male hormone) in their blood and saliva than a group of childless cis men. Research indicates that the more time fathers spend participating in childcare, the lower their testosterone levels, too.

Although phantom pregnancies are a longstanding concern, people aren’t always comfortable discussing them. In some cases, like that of 38-year-old Syrian lawyer Dawoud, who was advised not to speak about his problem. Having experienced dizziness, fatigue, abdominal pain and a loss of appetite during his wife’s pregnancy, he sought help from his brother, who works as a nurse. “After I explained to my brother what was happening,” Dawoud says, “he told me not to tell anyone else because it was too strange.” 

He says that his brother went on to prescribe him a medicine which did nothing to solve the problem. He doesn’t know what the medicine was. Like Ezzat, Dawoud’s symptoms resolved themselves shortly after his wife gave birth. But this isn’t always the case. On occasion, the effects linger and even change in the aftermath of childbirth, and there is evidence to suggest that some cis men with Couvade experience postnatal depression.

Male reticence to discuss the topic openly occasionally comes from a place of empathy. Ezzat says he only mentioned the symptoms he’d experienced to his wife after she’d given birth. “I didn’t want the focus to be on me. She was the one who was actually pregnant and needed care.”

While he thinks that society at large isn’t quite ready to talk openly about phantom pregnancies, he does believe that going through one dispels the idea that pregnancy is “easy” in any way. Some men, he feels, “underestimate the pain their partners go through and accuse them of being spoiled or prone to exaggeration”.

Just like Ezzat and Dawoud, Mohammed, a 41-year-old teacher from Yemen, took on some of his wife’s symptoms while she was expecting. “She was constantly nauseous,” he recalls. “My sympathy and sadness turned into the same feelings she was experiencing. I was tired, nauseous and in pain.” Unlike the other men, Mohammed spoke up about it at the time. Unfortunately, his pain wasn’t exactly met with sympathy – he says that friends and family alike made fun of him when he voiced his concerns about what he was going through.

While the explanations behind phantom pregnancies remain the source of debate, we know that many men around the world report experiencing these psychological and physical symptoms. We also know that many men don’t feel comfortable talking about it: The people we spoke to for this article declined to provide their full names for fear of ridicule. What we’re less sure about is when society will finally allow them to talk openly to friends, family members, and actual medical professionals about their condition.