The effect of birth trauma on Dad

Men and mental health has always been a taboo area, so what happens when you add dads and mental health? It’s an even bigger taboo.

More and more men are coming forward discussing and displaying symptoms of post-traumatic stress disorder (PTSD) and you only have to look to social medial platforms to see an array of men creating accounts to support dads who speak and experience such difficulties. But what does PTSD in father look like?

PTSD is defined as a serious and debilitating disorder that can develop following exposure to a traumatic event. When parents develop PTSD, it may have an impact on their parenting role, which can include symptoms of negative alterations to an individual’s behaviour, including increased anger and reactivity, as well as social withdrawal.

The importance of this research for me comes from being a therapist and working with people diagnosed with PTSD and witnessing how it impacts their children. Trauma can be multigenerational, which may also cause children to experience subsequent psychological, social and emotional difficulties and there still appears to be a lack of a comprehensive and critical synthesis of the PTSD literature which focuses individually on parental PTSD.

Evidence suggests 3.17% of women report post-traumatic stress symptoms following childbirth. Whist the welfare and mental health of the birthing mother has been something of a wider topic, the emergence and growth in research and people taking to social media platforms to discuss how to treat a family opposed to how to just care for mum and baby has risen drastically. While research exists about the impact of birth trauma on mothers little is known about the impact on fathers.

Birth trauma is defined as physical and emotional suffering during birth resulting from either complications, physical injury or negative reactions during the birthing experience. Examples include, but are not limited to, sudden changes to the birth plan, emergency caesarean, post-birth complications and inadequate care received from staff. A feeling of lack of control around the unfolding of the birth may also increase the likelihood of it being perceived as traumatic, having an effect on anxiety, mood and perceived control.

In recent years, fathers are more likely to be present at their child’s birth than has traditionally been the case. If that birth becomes traumatic, fathers are potentially witnessing (often helplessly) the potential risk of physical harm and/or death of their partner and/or child. Current evidence tells us very little about fathers’ experiences of witnessing that trauma, the impact this may have on them and the support they receive to help them deal with such trauma.

A recent study found fathers experienced birth as a rollercoaster of emotions, characterised by ‘isolation and abandonment’. Their findings that fathers can experience trauma as a result of childbirth may arise in part due to the current maternity model, where the mother tends to be the sole focus as the patient. Participants reported feeling unjustified in their feelings and coped by avoiding discussion of the events of the birth trauma and their emotions surrounding that.

Fathers being more involved creates a paradigm within parenting research. Men are typically becoming more grounded and attentive to child needs and are more willing to stay home and care for a child when the mother goes out to work. This has come a long way since the times where man was seen to be the bread winner of the household and would work tirelessly to ensure food was on the table.

The impact of the father on child development is linked to the level of involvement, defined not only by the quantity of time spent with the infant but also by the quality and type of participation in the care and upbringing of children. It is well known that a high level of parental involvement is associated with better outcomes in all areas of development

Men will go through a transitional process when becoming a dad for the first time and this transition usually develops without major difficulties. However, for some men, the personal, unfamiliar and social demands associated with the child’s birth can be overwhelming and a source of significant distress. The lack of resources and difficulties in reconciling their expectations with those of others in relation to fatherhood, as well as with the ideas of masculinity that often reinforce the outdated idea of the father as a breadwinner, can be a source of feelings of loneliness and incapacity, usually associated with increased anxiety, decreased self-esteem and a low perception of efficacy and worth.

Similar to their maternal counterparts, men have a higher risk of developing a mental disorder during the infant’s gestation period and first year of life, with a higher risk when the mother is depressed. However, opportunities to detect these disorders and intervene are fewer because the attention in the gestational and postpartum period is usually focused on the mother and the child, and men are more reluctant to ask for support.

Adjustment to fatherhood is related to different variables at different times of the perinatal period. However, the experience can be significantly different for fathers of healthy full-term infants than for those of infants who need immediate admission to the NICU. It has been widely reported the hospitalisation of a newborn represents a major source of distress for parents. Nevertheless, studies have focused mostly on mothers, and when fathers are included, their reactions are often considered to be similar to the mother’s. Even if they are different, fathers tend to ignore their own needs and try to keep their stress hidden to protect their partner.

Fathers, particularly in the first hours and days, become the figure of reference, receiving medical information first, taking on the responsibility of caring for their partner, conveying news about the baby’s health to the mother and being the primary point of contact for the neonatal team. Therefore, they are subject to the additional stress that this new and unexpected role can trigger.

For a father, visits to the NICU, where the baby may be at high risk and remain for a long time, as well as seeing their partner potentially also at risk, constitute a source of stress and fear and can lead to a sense of impotence. Research on fathers’ experiences in the NICU shows the most common sources of distress for new fathers, in addition to the practical demands imposed by the situation, such as solving administrative procedures or taking care of other children, are the difficulties in addressing their own emotions and playing a supportive role for their partner, while also trying to establish a relationship with their infant and recognizing themselves as new fathers.