A perilous journey from delivery room to bedroom - NYTimes
A perilous journey from delivery room to bedroom
By KEITH ABLOW, M.D.
Published: August 23, 2005
Josh was a man in his 40's I'd been treating for depression. His wife had given birth to their first child, a girl, three days before.
"Congratulations," I said.
"She's beautiful. A miracle," he responded.
"Amazing, isn't it?" I agreed, remembering the first time I held my own daughter.
"Just incredible." He shrugged, shook his head. His foot started tapping. "You were ... there?" he asked me, tentatively. "I mean, for the delivery?"
There. I could hear the other questions coming. I have heard them many times from men whose wives had given birth days or weeks before our sessions.
Even when I had been treating these men for a year or more, they always seemed uncharacteristically hesitant to broach this topic.
"I was," I said. I waited.
He nodded. "Incredible, isn't it?"
"It's a lot of things," I said, giving him permission to say more.
He relaxed a bit. The tapping of his foot slowed. "Where were you? The head of the bed?"
That was almost always the next question. "Just about the whole time," I said.
He winced. "I probably should have stayed up there, too."
"You know," he said with a smile.
He couldn't bear to say it. "You saw more than you wanted to?" I asked.
The smile left his face. "I just can't get it out of my mind."
"What about it?"
"I mean," he went on, "how are you supposed to go from seeing that to wanting to be with ... ?" He stopped, but his eyes kept asking the question.
"Right," I said. "It gets easier with time, for just about everyone."
Although no one seems to talk publicly about the problem, Josh is only one of dozens of men who have confided to me that witnessing the births of their children has made it difficult for them to be attracted to their wives, at least in the short run.
They seem to have trouble seeing them as sexual beings after seeing them make babies, trouble reverting to a mind-set in which their wives' sexual anatomy is just that - not associated with images of new life emerging through the birth canal.
In the age of the "new man," very little consideration is given to the potentially negative side effects of togetherness in the delivery room. Every man I have spoken with over the past few years knows he is expected to be with his wife when his child comes into the world.
How can anyone explain sitting out such a life-changing moment in the waiting room?
The trouble is that the moment turns out to be both intensely beautiful and potentially traumatic.
It is miraculous to see a baby's head emerge, and it can also be shocking. It is riveting to see an umbilical cord connecting mother and baby, but it can also be very disturbing. It is exciting to be asked by a doctor to cut that umbilical cord, but also potentially very frightening, even for otherwise rather fearless men.
And not every man gets over it. Several men have confessed to me that they never regained the same romantic view of their wives that they had before seeing them deliver children.
"They ended up having to cut her open to get the baby," one patient told me. "I saw it. I mean, how am I supposed to get that out of my head? Every time I look at the scar, it's like I'm seeing it again."
In the most striking cases, the symptoms that men experience come close to post-traumatic stress disorder, with its roots in the witnessing of an event that involves a threat to the physical integrity of self or others and responding with intense fear, helplessness or horror.
The symptoms, as my patients have reported, include recurrent and intrusive distressing recollections of the event and efforts to avoid recalling it.
I do not believe that most men suffer these symptoms. But some do. And predicting which men will be vulnerable to them is nearly impossible in a social climate in which men who admit reticence about being present in the delivery room risk being labeled throwbacks.
The fact that the subject is taboo also means that a man who is traumatized by the experience may be retraumatized again and again, with each child born to him.
"Honestly," one man, married for 12 years, told me, "I think one of the main reasons I don't feel attracted to my wife is that I saw her give birth three times. It's like I know too much about that part of her."
The mystery is gone. And while there are other contributing factors to the loss of passion in the man's marriage, one of them does seem to be his presence in the delivery room, three times.
And I'm not sure that the delivery is the only cause of men's psychological struggles during their partners' pregnancies.
I myself recall feeling as if the clinical focus on childbirth during prenatal classes, including the detailed descriptions of the placenta and the meconium, took away from the wonder of the process, rather than adding to it.
I don't know what is gained by showing the cross-sectional anatomy of a woman's torso to her lover.
Whether the father is present in the delivery room is a couple's personal decision, of course.
But it is a decision that involves potential gains and potential losses, and too few couples realize that fact or are willing to talk about it.
Women may want to consider the risks as they invite their partners to watch them bring new life into the world. For some of the passion that binds them together may leave their lives at the very same time.