Dad’s Mental Health Week 2020 – Termination for Medical Reasons vs Continuing a High Risk Pregnancy

If you are reading this because you have lost a baby, I’m so sorry for your loss – I’m sorry too because I know it hurts, even if you’ve been pretending you’re fine.

Can ACT and CFT help dads who are faced with termination of pregnancy for medical reasons, miscarriage, still-birth or a baby born with known congenital problems?

Brief Research Summary

A Swedish study by Carlsson and Mattsson (2018) interviewed twelve men about their thoughts and feelings when presented with 20 week scan results that showed a congenital heart abnormality and faced with the question of whether to terminate or continue the pregnancy. The men reported an intense emotional shock, but putting their feelings to the side to support their partner. They emphasised the importance of reaching a joint decision about whether to continue or end the pregnancy. When they chose to end the pregnancy they experienced loss of a child they had wanted and an emotionally intense termination procedure yet also reported that their mental health needs were neglected by professionals. They also described worries about the risk of the same thing happening again in future pregnancies. When they chose to continue, the men reported aiming to stay positive during the pregnancy but worry about how things would be after the birth. The authors conclude the findings show the importance of including dads in ante-natal care and follow up appointments particularly after a pre-natal diagnosis.

Kecir and Ligier (2020) interviewed eight dads the day after their partner went through termination of pregnancy due to foetal abnormality. The men talked about experiencing intense emotional strain, a fear of losing their partner, feelings of anger, loneliness and exclusion. The dads described trying to cope by minimising their experiences and trying to avoid their feelings by distracting themselves. The authors also noted the importance of follow up with professionals in the months following the procedure, as there could be a delay of mental health problems for the dads emerging.

What both these studies highlight is that the “stiff upper lip” approach of pushing feelings away and trying to avoid them to meet the stereotype of the “strong” man actually makes men really vulnerable to lasting mental health difficulties like depression and anxiety as well as likely putting an unintended strain on the couple’s relationship due to all the thoughts unsaid, misunderstandings, mind-reading, tension and resentment that might be likely to emerge. The studies also highlight that currently the male approach of avoiding feelings to support a partner may lead to professionals not detecting mental health problems in men and therefore not offering much needed support. Since for women as well as men there can be patchy mental health service provision after baby loss, men are particularly disadvantaged where they are less likely to speak up.

Where ACT and CFT come in

What the research tells us is that avoiding your thoughts and feelings doesn’t work – it’s toxic for your mental health, and for your close relationships. Yes, there may be moments when it is helpful to put your partner first – but not all the time or for too long.

So, in case you’re reading this as a man ready to entertain dropping the avoidance tactics, here’s a rough guesstimate cost and benefit analysis you can fine tune for your own stuff –

benefits of experiential avoidance – What do you gain by avoiding acknowledging your feelings? If you think you’re conforming to a traditional “strong” man expectation, you might feel good about yourself.

How do you manage it – keeping busy with work? exercise? socialising? being glued to a screen? Are there pay offs for you from doing this?

In the short term, your partner or others you hide negative feelings from might enjoy your company and your support – in any close relationship though, most people will be unsatisfied with a lack of intimacy and sharing feelings after a while and start craving a more genuine connection which requires sharing both the ups and downs, because life brings everyone both.

costs of experiential avoidance – How many times have you said “I’m fine” lately? How much of the time has “fine” been true?

Does your partner really believe you’re “fine” or are they perhaps wondering what your real thoughts and feelings are? Do you feel connected to your partner emotionally? Do you think they feel connected to you? Is it possible your partner might feel alone in their own emotions or guilty or bad about how they feel if you model that feelings should be avoided? If you think that last one could be true, then you’re unlikely to be doing your partner’s mental health or your relationship any favours by avoiding your own feelings. A long-term imbalance of give and take in a relationship is also unhealthy, and a partner who doesn’t get the chance to offer support is dis-empowered.

Just consider for a moment that it takes a lot of courage to show self-compassion, and – I would argue – more than it does to hide your true feelings away. And if you allow yourself some self-compassion, that could unlock more loving capacity you can then channel back into your relationship, supporting your partner and any current or future children in your life so much more effectively.

So what’s your conclusion – are you ready to consider learning more about self-compassion and acceptance and commitment therapy? If so, you’ve come to the right place. On the home page, choose what you’d like to start learning about with a commitment to start caring for your own mental health today. It doesn’t really matter where you start, as long as you make that big leap of deciding to try self-care. So, what appeals? Compassion? Mindfulness? A beer and an honest chat with your partner? The choice is yours.

Recommended Compassion Focussed Resources

Here’s a TED talk by Steven Hayes about how bringing compassion or love to yourself even when it’s hard can be liberating and allow you to bring more love into the world. In a miscarriage context, if you can be more loving with yourself, it may free you up to be more compassionate to your partner and to open up to your feelings of love and loss for this pregnancy. Going through that process will set you free to move forwards when you are ready –

Sometimes when we’re grieving we go through a stage of feeling intensely angry, whether at ourselves, other people or the world. Russell Kolts has done a TED talk which you can watch on YouTube if you want to which is on the topic of finding the strength to be self-compassionate when you’re angry and hurting. “Anger, Compassion and what it means to be strong” –

The book “Get out of your mind and into your life” by Steven Hayes might also be worth a look as its a general ACT self help guide and you can use it to help you manage any sort of psychological distress.

Finally, don’t hesitate to seek talking therapy via your GP after reading this if you need it. There are also phone lines available such as Breathing Space on 0800 838587 if you need to talk right away, and support organisations such as SANDS – Stillbirth And Neonatal Death Charity – which you can also approach for counselling.

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