The Case of the Pregnant Seaman

Earlier this month, Holly Tucker wrote a guest post on PLoS about male pregnancy. It’s a fascinating topic–and one I’ve done a little research on myself–so I thought I’d add to the discussion.

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The doctors had already ruled out liver disease. And hepatitis. And any other obvious ailment that could explain why an otherwise healthy 33-year-old man had suddenly developed a hugely distended abdomen, why his waistline had grown five inches in six weeks. All the tests results had been normal. Finally, the doctors thought to ask the patient what he thought was wrong. “I think there is a life in my abdomen,” he said. “This may be a pregnancy.”

It had all started with a “peculiar feeling” in his belly, said the patient, a small but muscular merchant marine. He had been at sea at the time. By the time his ship came to shore, he could no longer button up his pants. He also had morning sickness and swore he could feel a baby moving around inside him. He had even started taking prenatal vitamins.

The doctors sent the seaman off to a psychiatrist, who toyed with diagnoses ranging from hysteria to paranoid schizophrenia and suggested the symptoms might be tied to the merchant marine’s ambivalence about his homosexuality. Over the course of several months of psychiatric treatment, “the delusion of being pregnant was abandoned,” the shrink reported in his write-up of the case, published in the 1960 issue of Psychosomatic Medicine. The pounds melted away and the seaman returned to his normal life.

This is a classic—albeit extreme—case of phantom pregnancy. And it’s not surprising the seaman ended up at a shrink. For years, that has been the dominant view of men who experienced even subtle signs of pregnancy. After all, they must be crazy, right?

Indeed, researchers have long known about a phenomenon called couvade syndrome. Couvade* (from the French word couver, or “to incubate, brood, or hatch eggs”), describes men who experience certain signs of pregnancy—some combination of weight gain, nausea, food cravings, backaches, insomnia, and other delights familiar to moms everywhere. Historically, couvade has been a psychosomatic curiosity or a sign of mental instability, with a list of potential causes that would please any Freudian (identification with the fetus, reverse penis envy, pseudo-sibling rivalry, and more).

Marmoset fathers participate in infant care.

Though we can’t rule on the cause of the merchant marine’s symptoms, it is now abundantly clear that not all men who experience something that seems suspiciously like pregnancy need to be rushed off to a shrink. As many as 65 percent of expectant fathers report experiencing at least one “symptom” of pregnancy, studies show; more than 20 percent of expectant dads actually sought medical care because of it.

Scientists have now shown that normal, healthy men often undergo real bodily changes when they’re expecting children. What for years we’ve considered to be a disorder of the mind is actually a natural physiological reaction to impending fatherhood.

One of the most common complaints of expectant fathers is weight gain. It’d be easy to explain this change, at least in humans, as a dutiful husband matching his wife’s increased appetite, craving for pickle-and-ice-cream craving. But a 2006 study of marmoset fathers-to-be showed that the primates gained up to 20 percent of their body weight while awaiting the birth of their offspring. (There was no evidence that the expectant dads were eating any more than usual.) Rather, their metabolism seemed to have changed. (This poppa paunch could serve an important biological function, preparing a dad for the extra energy he’ll need to bring up baby.)

The weight gain could also result from hormonal changes. Fathers-to-be have elevated levels of cortisol and prolactin, hormones that are also sky-high in mothers who are attached and responsive to their children. A father’s testosterone level also drops by about a third in the first three weeks after his child is born.

How exactly these changes come about is still up for debate. But the hormonal swings of dads-to-be closely mirror those of their pregnant partners, and researchers speculate that, while women’s hormonal changes are tied to birth, men’s are somehow linked to women’s. It seems likely that some sort of physiological signals (perhaps some sort of pheromone) are exchanged between partners living in close proximity. The changes are evident only in men who are spending lots of time with pregnant women. Which means that biological dads who aren’t living with their baby mamas don’t tend to show these hormonal fluctuations, while men who have been cuckolded—whose wives may be pregnant by another guy—do. (Other physiological changes come from actually being around babies.)

So maybe the merchant marine’s case was psychosomatic–he wasn’t around any pregnant women (or any women at all) on his ship. But today’s bloated dads-to-be need not invoke Freud to explain their strange constellation of symptoms.

* The term “couvade” initially referred to a range of rituals that dads-to-be engaged in in a variety of societies. In some cultures, for instance, certain foods may be taboo for expectant fathers; in others, it’s customary for dads-to-be to lie in bed, moaning and groaning while their wives go through delivery. These kinds of rites, which essentially create a simulated pregnancy in men, have been observed in many cultures in both ancient and modern societies. Image: Flickr/juliez_pics

Reference: JAMES A. KNIGHT (1960). False Pregnancy in a Male Psychosomatic Medicine, 22, 260-266

This entry was posted in History, Medicine, Men, Neuroscience, Parenting, Psychiatry, Psychology, Women. Bookmark the permalink.

6 Responses to The Case of the Pregnant Seaman

  1. The fancy name for imaginary pregnancy is pseudocyesis. Couvade syndrome is just a specialized form of it. There have been some surprising cases of imaginary pregnancy through the centuries. Queen Mary I for instance.

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