How Does Perinatal Loss Affect Fathers' Mental Health?

What you need to know

Fathers can experience elevated levels of depression and post-traumatic stress symptoms after losing a baby during pregnancy or shortly after birth.
While mothers generally report higher levels of symptoms, fathers may also be at increased risk of developing depression or PTSD following perinatal loss.
Depressive and post-traumatic stress symptoms in fathers tend to decrease over time, especially after the birth of a subsequent healthy child.

The impact of perinatal loss on fathers’ mental health

Losing a baby during pregnancy or shortly after birth can be a devastating experience for parents. While there has been more research on how mothers are affected by perinatal loss, less is known about the psychological impact on fathers. This systematic review examined existing studies to better understand how perinatal loss may affect fathers’ risk of developing depression or post-traumatic stress disorder (PTSD).

What is perinatal loss?

For this review, perinatal loss was defined as:

Intrauterine death occurring at 20 weeks of pregnancy or later
Stillbirth
Death of a newborn within the first month after birth

It’s important to note that the terminology and definitions for perinatal loss can vary across different studies and contexts. This review focused specifically on later pregnancy losses and early infant deaths.

Depression symptoms in fathers after perinatal loss

Several studies found that fathers who experienced perinatal loss showed elevated levels of depression symptoms compared to fathers who had not gone through this experience:

One study measured depression symptoms an average of 2.2 years after the loss and found 18.1% of fathers in the loss group had depression, compared to 6.7% in a control group.
Another study at 2 months after the loss found depression in 14.2% of fathers in the loss group versus 2.7% in a control group.
Additional studies also found significantly higher depression scores in fathers after perinatal loss compared to control groups.

However, not all studies showed significant differences between fathers who had experienced loss and those who had not. The results were somewhat mixed across different studies.

PTSD symptoms in fathers after perinatal loss

Fewer studies looked specifically at PTSD symptoms, but there was some evidence of elevated risk:

One study found 12.3% of fathers met criteria for probable PTSD diagnosis and 5.7% for subclinical PTSD between 1.2 months to 18 years after the loss (average 3.4 years).
Another study measured symptoms 12-24 hours after the loss and found fathers had scores suggesting higher risk for PTSD.
High levels of post-traumatic stress symptoms were also reported in fathers during a subsequent pregnancy after a previous loss.

Changes in symptoms over time

Some key findings on how symptoms changed over time:

Depression and PTSD symptoms in fathers tended to decrease as more time passed after the loss.
Symptoms often declined after the birth of a subsequent healthy child.
However, one study found that intrusive thoughts actually increased over time in fathers, even as overall stress symptoms decreased.

Comparing mothers and fathers

Most studies that compared mothers and fathers found that mothers generally reported higher levels of depression and PTSD symptoms after perinatal loss. However, the differences were not always statistically significant.

Some studies also noted differences in how symptoms manifested:

Fathers tended to score higher on avoidance-related symptoms of PTSD.
Mothers tended to score higher on intrusion-related symptoms.

Impact during subsequent pregnancy

Several studies looked at mental health during pregnancy after a previous perinatal loss:

Fathers with a prior loss often had higher depression and stress symptoms during a subsequent pregnancy compared to first-time expectant fathers.
However, symptoms typically decreased after the birth of a healthy baby in the subsequent pregnancy.

Limitations and gaps in the research

While this review provides valuable insights, there are some important limitations to keep in mind:

Many of the studies had small sample sizes.
Most research was conducted in high-income Western countries, with limited data from other regions.
Studies used a variety of different measurement tools, making direct comparisons difficult.
Most focused on heterosexual couples - there is little data on same-sex couples or single fathers.
Many studies combined different types of perinatal loss rather than examining them separately.
Time points for measuring symptoms varied widely across studies.

The authors note that more consistent, high-quality research is needed to draw firmer conclusions about how perinatal loss impacts fathers’ mental health.

Implications for supporting fathers

Despite the limitations, this review suggests that many fathers do experience significant psychological distress after perinatal loss. Some key implications for providing support:

Healthcare providers should be aware that fathers, not just mothers, may be at risk for depression and PTSD after perinatal loss.
Screening and support services should be offered to both parents.
Support may need to be tailored differently for fathers vs mothers.
Attention should be paid to fathers’ mental health during subsequent pregnancies after a loss.
More research is needed on effective interventions specifically for bereaved fathers.

The grief and trauma of perinatal loss can have long-lasting effects on parents. With greater awareness and appropriate support, the psychological impact on both mothers and fathers can potentially be reduced.

Conclusions

Perinatal loss appears to increase the risk of depression and PTSD symptoms in many fathers, though more research is needed.
Symptoms tend to decrease over time for most fathers, especially after a subsequent healthy birth.
Fathers may experience grief and trauma differently than mothers, possibly with more avoidance-type symptoms.
Healthcare providers should assess and support fathers’ mental health after perinatal loss, not just mothers’.