# Dad's Mental Health During Pregnancy Is Often Overlooked
When a new life comes into the world, all attention – and quite rightly so – focuses on the pregnant woman. Her body is undergoing enormous changes, her emotions fluctuate, her needs come first. Yet standing beside her is someone who is rarely talked about: the expectant father. A man who is also waiting, also experiencing, also afraid – and yet remains in the psychological shadow of the entire pregnancy. The psychology of expectant fathers during pregnancy is a topic that society has long overlooked, and this can have far-reaching consequences – for the couple, for the family, and for the father-to-be himself.
This is no exaggeration. Research repeatedly shows that up to one in ten men experiences symptoms of depression or anxiety during their partner's pregnancy or immediately after birth. Yet male perinatal psychology is barely discussed, and when it is, it tends to be treated as a curiosity rather than a legitimate topic deserving the attention of professionals and the public alike.
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Why aren't fathers talked about?
The roots of this neglect run deep into cultural and social norms. For centuries, the man in the context of pregnancy was seen primarily as support, a foundation, a provider – the one who holds things together while the woman goes through a physically and emotionally demanding process. This image has undergone significant transformation over the past few decades, but traces of the old thinking remain clearly visible. Men are still widely expected to be "strong," to handle their doubts and fears on their own, not to fall apart.
Yet pregnancy is truly a transformative experience for the expectant father. It brings with it fundamental life changes – a new role, new responsibilities, a reassessment of priorities, financial pressures, and questions of identity. "Who am I as a father? Can I handle this? Will I be good enough?" – these are questions that virtually every expectant father asks himself, even if he never says them aloud. And it is precisely the silence surrounding these questions that can be dangerous.
An important factor is also that pregnancy is not physically tangible for a man in the same way it is for a woman. While she feels every movement of the baby, watches the changes in her body, and is constantly reminded of the reality of new life, for a man the entire process can remain somewhat abstract for a long time. It is the first ultrasound, the first kicks, or ultimately the birth itself – these are the moments when the reality of fatherhood begins to feel real for him too. Until then, he may experience a strange sense of detachment, as if standing behind a glass wall watching something he cannot fully engage with.
Psychologist and perinatal psychology expert Mark Williams, who went through postnatal depression himself and now works in public awareness, describes it aptly: "Men are conditioned to take care of others – but who takes care of them?"
Couvade syndrome and other psychosomatic manifestations
One of the fascinating but rarely discussed phenomena is the so-called Couvade syndrome – a condition in which expectant fathers experience physical symptoms similar to those of their pregnant partner. Nausea, fatigue, weight gain, back pain, changes in appetite – all of these can affect a man whose partner is expecting a child. Estimates of the prevalence of this syndrome vary, but some studies suggest it affects, to varying degrees, as many as 11 to 65 percent of expectant fathers.
Couvade syndrome is not recognised as a formal medical diagnosis, but its existence is well documented and points to something significant: pregnancy is a shared experience for couples that affects both partners – physically and mentally. A man's body, surprising as it may sound, can respond to the proximity of a pregnant partner and to the emotional stress associated with expecting a child with very concrete physical manifestations.
Alongside this syndrome, expectant fathers commonly also experience anxiety, sleep disturbances, increased irritability, or conversely, emotional numbness. Men often minimise these symptoms or attribute them to work stress, fatigue, or other factors – anything but what is truly behind them.
Consider a real-life example: Pavel is expecting his first child with his partner Lucie. Lucie is managing the pregnancy relatively well, though she naturally has her difficult moments. Pavel, on the other hand, is performing increasingly poorly at work, sleeping badly, has stopped seeing friends, and when asked how he is, answers curtly: "Fine, just tired." Nobody – not even Pavel himself – connects his condition to what he is going through. It is only after the birth, when the symptoms deepen, that Pavel begins to seek help. It emerges that he had been suffering from prenatal anxiety that had gone unrecognised and untreated.
There are thousands of men like Pavel. And that is precisely why it is important to talk about this topic openly.
How pregnancy changes the male psyche
Pregnancy triggers a whole range of psychological processes in expectant fathers that are in their own way just as profound as those experienced by women. One of the key ones is the so-called reassessment of identity – a man ceases to be defined primarily as a son, partner, or colleague, and begins to define himself through the role of father as well. This transition is neither automatic nor easy. It requires time, space, and ideally support.
A study published in the academic journal Journal of Affective Disorders shows that men with a history of anxiety disorders or depression are significantly more vulnerable to relapse or to developing new psychological difficulties during their partner's pregnancy. Risk factors also include financial insecurity, an unstable relationship, lack of social support, or previous traumatic experiences.
At the same time, pregnancy can also be a source of profound joy, meaning, and personal growth for a man. The feeling of participating in the creation of a new life, of building a family, of his partner carrying their child – these are experiences that many fathers describe as the most powerful of their lives. The psychological reality is therefore not unambiguously negative; it is rather an intense emotional landscape full of contradictions that deserves attention and care.
An important element of the male psyche during pregnancy is also the relationship with one's own father. Many men during this period unconsciously or consciously revisit their experience of fatherhood as they themselves lived it. Those who grew up without a father, or with an absent or problematic one, may face a particular form of grief or fear of repeating patterns. Conversely, those who had a strong model of fatherhood may feel pressure to fulfil or surpass it.
This entire inner process typically unfolds without any kind of accompaniment. While pregnant women have an entire system of care available to them – regular check-ups, birth preparation, groups for expectant mothers, psychological support – a comparable infrastructure for men practically does not exist. Antenatal preparation courses generally include fathers as well, but their psychological experience tends to be, at most, a marginal topic.
The situation is slowly changing. In some countries, such as the United Kingdom and Australia, specialised support programmes for expectant and new fathers are emerging. Organisations such as the Pandas Foundation and the Australian PANDA are beginning to explicitly include men in their services and communications. In the Czech Republic, this area is still in its early stages, but awareness of male perinatal psychology is slowly growing thanks to the educational efforts of professionals and non-profit organisations.
What can help, then? Above all, open communication within the couple – and not just about practical preparations, but about genuine feelings, fears, and expectations. Research shows that couples who talk openly about their emotions during pregnancy have a more stable relationship after birth and cope better with the demands of parenthood. The point is not for a man to take on the woman's role or to compete in the intensity of his experience – it is for him to have a legitimate space for his own emotions.
Contact with other expectant or new fathers can also help. Sharing experiences in a safe environment – whether through fathers' groups, online forums, or informal gatherings of friends – can significantly reduce feelings of isolation and normalise what a man is going through. Knowing that you are not alone in your fears or doubts has a therapeutic effect in itself.
In the case of more pronounced symptoms – persistent anxiety, sadness, irritability, sleep disturbances, or loss of interest in things that previously brought pleasure – seeking professional help is appropriate. Psychotherapy, or a psychiatric consultation if needed, is not an admission of weakness; it is an expression of responsibility – towards oneself, one's partner, and the unborn child.
After all, a child needs a psychologically healthy father just as much as a psychologically healthy mother. Research in the field of developmental psychology has long confirmed that a father's emotional availability and mental wellbeing have a direct impact on a child's development, on the quality of early attachment, and on the overall atmosphere within the family. Caring for the mental health of the expectant father is therefore neither a luxury nor sentimentality – it is an investment in the future of the entire family.
Pregnancy is a journey walked by two. It is high time we began to see it that way.
