International Father’s Mental Health Day - what an important day that is, for so many reasons.
Let me start by introducing myself. I'm Lucy, a Trainee Clinical Psychologist. For the last few years I have been researching the psychological impact of miscarriage on men, and so I wanted to use this annual event to share some of my findings, and raise awareness of the mental health of the fathers who have lost their babies.
Miscarriage, defined in the UK as a pregnancy loss up to 24 weeks, is the most common complication of pregnancy, with 1 in every 4 known pregnancies ending in a miscarriage. There is a plethora of research on the impact of miscarriage on expectant mothers, but my interest in this topic grew as whilst there is increasing awareness of men’s mental health in general, I noticed a large void in research when it comes to men’s psychological well-being following a miscarriage.
As part of my research, I shared an online questionnaire on social media over a period of 5 months and was blown away by the response, with over 500 men completing it. I also had the privilege of meeting several of these men and hearing about their experiences in more detail.
It may come as no surprise to those reading this that the results found men to experience psychological difficulties following a miscarriage. It can affect mood, anxiety and produce significant grief in men. What's more, it seemed that whilst men may experience this distress, many push their feelings to one side whilst trying to support and protect their partners through their grieving process, and as a result hide their feelings. Let us consider this IFMHD, how many dads may be feeling low in mood, anxious or grieving and not expressing how they are truly feeling for one reason or another.
Reach out to the dads you know, ask them how they are, give them space to talk.
There were a number of factors that emerged as influencing men’s psychological well-being following a miscarriage such as how far into the pregnancy the miscarriage took place, and the deep distress faced when the men’s partners had to give birth to their babies. However, this should not detract from how some men experienced earlier stage miscarriages. One of the participants I met, had experienced two miscarriages at 10 and 12 weeks and described how he was hit by feelings of depression once his wife had started to feel a little better. His loss and grief experiences were comparable to those men who had experienced later stage miscarriages.
So, reach out to the dads you know who have experienced a loss at any point, ask them how they are, give them space to talk.
Age of men also seemed to have an influence on men’s psychological wellbeing, with younger men (aged 18-24) experiencing lower mood and higher levels of anxiety and grief. This makes us question - do younger fathers need more support following a miscarriage?
Reach out to the young dads you know, ask them how they are, give them space to talk.
Thirdly, if men had children following the miscarriage, my research suggested they had lower levels of low mood, anxiety and grief than those who didn’t have subsequent children. Interestingly, the interviews highlighted that although having another child might reduce levels of distress, there are still long-lasting grief responses that remain even after a successful subsequent birth.
In addition to the long-lasting grief, the men also described experiencing high levels of anxiety associated with a subsequent pregnancy. Therefore, it shouldn’t be assumed that having a subsequent pregnancy will automatically reduce the anxiety or grief responses that men are feeling.
So reach out to those dads who may have experienced a loss years ago, who may have had subsequent children, ask them how they are, give them space to talk.
Why is it so important to reach out to dads, and why is the onus on us to do so? One of the interesting stats from my research is that only 25% of the 512 men who took part had sought support following their experience of miscarriage, yet on average the men were found to be experiencing moderate levels of anxiety and low mood. Of the three-quarters of men who hadn’t sought support, they stated that they would have liked it from family and friends or a psychological counsellor.
The support from family and friends is so often what dads need – so reach out to them, ask them how they are, give them space to talk.
We must also think about the wider societal and cultural factors in play when discussing men’s mental health and the support they need. Firstly, the taboo around discussing pregnancy loss and secondly, the fact that people feel that their loss is not acknowledged and validated within society were found to create a barrier for men seeking support after miscarriage. Therefore, the first stage of supporting men after pregnancy loss may be acknowledging that they, and their partners, have experienced a real loss which activates a real grief response and that they may require support for this.
Cultural influences may also be a barrier for seeking support following a miscarriage. One man I interviewed spoke of the role that his culture, as a South Asian Muslim, played in his grieving process. He stated that for him, he was taught that miscarriages are for women to respond to and that men’s role in this time is to support their wives emotionally and physically. He stated that he felt his culture did not emphasise the importance of the man’s emotional response of a miscarriage.
It is difficult when there are societal and cultural pressures placed on men, especially when this then acts as a barrier for men to access support. It is important for services (and friends and family) to provide culturally sensitive support whilst not imposing the grief culture from Western society.
‘Masculinity’ may also play a role in support seeking. My research suggests that the men who adhered to masculine norms (emotional control, risk taking and self-reliance) may be less likely to seek help following a difficult life event, such as a miscarriage. I could probably write a whole other blog on ‘masculinity’ and miscarriage, and I’m sure there are many blogs about ‘masculinity’ and men’s mental health, but for now all I will say is that whether we like it or not there are narratives around ‘masculinity’ in Western society. Whilst it may be difficult to re-write these narratives (although I believe that constantly questioning them will change the way society thinks about men/’masculinity’ and mental health) we do need to redefine how seeking support is seen, and use masculine norms to promote help-seeking as demonstrating men’s autonomy and strength .
With previous research discussing the inequality between men and women in relation to reproductive events, with men being seen as being on the periphery (Daniels, 2006), the current findings carry even more importance and urge for more equality in the way that men and women are treated following a miscarriage.
It feels important to note, especially on IFMHD, that some of the men that I interviewed had never spoken to anyone about how they were feeling following the loss of their baby. So, this International Fathers Mental Health Day, reach out to the dads you know, ask them how they are, give them space to talk.
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