What birth does to your partner

There is a moment I have seen more often than I would like. The door of the treatment room closes, and the person who was holding her hand a second ago is standing in the corridor. Without information, without a task, without anyone explaining what is happening.

For a long time hardly anyone looked at that quarter of an hour. Now they do. And the figures are firmer than you might think.

Researcher Rebecca Webb of the University of London asked around three hundred fathers about their birth experience. Fifty-eight per cent of them thought at some point that their partner or their baby was being seriously harmed. Fifty-two per cent feared that mother or child would die.

That is about ordinary births. So more than half of partners had a moment in there when they thought: this is going wrong.

From such a moment to lasting symptoms is another step, and fortunately most people do not take it. A large review of 154 international studies arrives at around five per cent of mothers and one per cent of fathers whose symptoms fit a post-traumatic stress disorder. Among mothers with earlier traumatic experiences that rises to sixteen per cent. And ten to twenty per cent of women look back on the birth of their child as something traumatic, even without a diagnosis.

Those two figures side by side are, to me, the heart of this story. A great many partners go through something frightening. A small group is left with symptoms. And almost nobody ever asks about it.

The risk factors are known: an emergency caesarean, heavy blood loss, worry about the child. And alongside that, anxiety during pregnancy and earlier difficult experiences. Those things share one thing: powerlessness. You watch while something happens to someone you love, and in that moment there is little for you to do.

This is exactly what our work is about. Being in charge is not control over how a birth unfolds, because nobody has that. Being in charge is knowing what is happening, knowing what there is for you to do, and knowing what you are allowed to ask for. Also when things go differently than you had hoped.

The fact that the risk factors include anxiety during pregnancy and earlier experiences means there is already something to be done before the birth begins. That is where a large part of our work sits.

At PUUR Zwanger the birth partner comes along as a participant. Not as a driver, and not as someone who may watch from the back of the room. He or she learns the same techniques, practises along, breathes along, and knows by the end what there is to do when it gets intense.

There are two reasons for that. The first we already knew: a woman who has someone beside her who understands what is happening can sink and land. And that does something physical while giving birth.

The second is in the figures above. Your partner is there too. He sees things he cannot influence, he hears words he cannot place, and he comes out of it with impressions of his own. Someone who understands what is happening and who has a role stands there differently from someone who only watches. That is the difference between being powerless and being carried.

I make no promise of this, and I cannot. Researchers are careful about it themselves: good preparation helps parents to cope better, and whether it actually prevents symptoms is still unknown.

That nuance belongs here. From a course you take away an understanding of what happens in your body, ways to bring your nervous system to rest, and the language to say what you want. That is a lot, and it is not protection against everything. A birth that went differently than you hoped has not failed, and it is certainly not the fault of the woman who had prepared well.

In the Netherlands postpartum care stops after eight days or so. After that, for most parents, there is no longer a place where someone asks how they are doing, while a birth story can keep echoing for months. In Webb's study, symptoms lasted three months or longer for forty-five per cent of the fathers who had them.

Do you recognise yourself or your partner in this? Your GP is a good first step and can refer you to a specialist clinic for psychological complaints around pregnancy and birth. Since 2019 there has been a Dutch guideline for birth-related PTSD, so your care provider can fall back on it. And you may always call or email us, even if you did our course years ago.