Forgotten Fathers: Why Pregnancy and birth are not just a Woman's Journey

Associate Professor Alka Kothari is a specialist in obstetrics and gynaecology and has helped thousands of women give birth over her 30-year career. She is also a passionate advocate for fathers. She is completing a PhD highlighting the need to integrate men's health into preconception care, pregnancy and birth.

For Men's Health Week, Dr Kothari answers questions about postnatal and perinatal depression and its effect on fathers.

Do men suffer from postnatal depression?

Yes absolutely. Ten per cent of men experience depression related to their partner's pregnancy, many after the baby is born (postnatal period).

When does perinatal depression start in men?

Perinatal depression may start with a pregnancy diagnosis and continue for up to 12 months or longer after birth. It affects approximately 30,000 fathers or partners in Australia. It is a significant public health problem affecting mothers, fathers, and families, with inter-generational effects. A recent report estimates the total financial burden of perinatal depression on the health care system, economy, and well-being in the first year to be $AUD 877 million.

Major depression is associated with a higher risk of suicidality, and according to national data, suicide is the leading cause of death in Australian men of childbearing age (15-44 years).

Why is a father’s mental health so important?

Fathers' mental health is critical as it affects the future of the entire family unit. Mentally unwell fathers are unable to support the vulnerable mother and newborn. Children of fathers with mental health conditions also have a significantly increased risk of behavioural problems, psychiatric problems, and suicide.

What are some of the ways perinatal depression presents itself in men?

  • Feelings of sadness and hopelessness
  • Feeling guilty
  • Reduced pleasure in usually enjoyed activities
  • Not feeling close to their baby
  • Not coping with everyday events
  • Being disconnected and withdrawn
  • Having a constant worry that does not go away
  • Feeling anxious with a racing heart, palpitations
  • Feeling irritable or angry
  • Crying
  • Struggling to eat or eating too much
  • Having trouble sleeping or staying asleep
  • Thoughts about harming themselves or others

"The whole period that she was in the hospital, I wasn't eating or drinking or sleeping much at all … I had severe anxiety for weeks." (A father who witnessed a difficult birth)

 "I mean, obviously, I went straight back [to work]. I had two days off … I had to get on with life, get out, and deal with people sort of head-on … because you got to pay the bills, you got to work, and you got to come home, you got to deal with your family and, you know, you got to try to be strong." (A father who lost a baby)

Who is more at risk of developing perinatal depression?

Young, inexperienced, and underprepared fathers may feel overwhelmed, especially when faced with complications or caring for a newborn. Some fathers may have a previous history of mental health problems, including complex trauma. Traumatic events during pregnancy and birth may act as triggers and precipitate strong emotional reactions. A lack of family and social support systems may also make the situation difficult. Fathers from culturally and linguistically diverse communities are at higher risk as they tend to lack hands-on family support.

How do men deal with perinatal depression?

Most fathers struggle with communication, receiving medical information, complex, difficult decision-making, and relationship problems. They may also have difficulties bonding with the baby. The reactions of fathers are affected by their previous life events and experiences. People deal with stress differently, and they may be reluctant to accept mental health support. Some men may try to stay strong by going to work and distracting themselves. Some may apply previously learnt strategies such as getting counselling and exercising. Others may turn to alcohol and drugs.

What can you do?

Do not ignore this feeling. It's okay to not be okay. Remember, you are not in this alone. It may be good to seek help early to support yourself and your family better. Please speak to your general practitioner, obstetrician or a trusted family member and friend.

You can reach out to these organisations that help fathers including:

  • Beyond Blue    1300 224 636
  • Lifeline            131114
  • PANDA             1300 726 306
  • Red Nose Grief and Loss 1300 308 307
  • SMS4Dads (register to begin messaging)

Read more about Associate Professor Alka Kothari.

If you would like more information on Dr Kothari’s research, please contact the UQ Medicine Advancement team on med.advancement@uq.edu.au.

If you would like to make a donation towards Dr Kothari's research, please call +61 7 3346 3920Mon-Fri 9am-4pm (AEST).

 


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