Ben had been prepared for sleepless nights, in his first month of becoming a dad – but not like these. Nearly every night, even when baby Alex was sleeping soundly, Ben woke sweating, sometimes screaming, jolted awake by the memory of his wife Becca in labour. The rise and fall of the gas and air machine, the penetrating snip of the scissors. All the blood.
Ben was in the army. He wasn’t fazed by blood, and kept his head in high-pressure situations. He had never had these night terrors before.
But the experience of having had to stand by, powerless to help, as Becca’s life seemed in danger had shaken something loose in Ben, and he relived it in his dreams. On average, Ben was getting three hours of sleep a night.
He started getting up in the night and going down to the garage, where, earlier in the pandemic, he had assembled a makeshift gym. Working out felt productive, like he was making the most of these small hours. If Alex wouldn’t settle, Ben would take him to the garage too, training alongside the baby in his pram while, back in the house, Becca slept. After all, Ben thought, she’d actually given birth – the least he could do was to let her rest.
Exercise cleared Ben’s head. It allowed him, like nothing else, to exist only in the present moment; to see through the descending fog. He started doing two workouts at his home gym every day, and going for runs. His habit grew.
In one 24-hour period, four weeks after Alex was born, Ben did a CrossFit circuit with a friend; a five-mile run that morning, and a shorter one in the afternoon; and two sessions in the garage at night.
The next morning, a Saturday, Ben woke up at 3am, shaking as though he was ill. He was still shaking when Becca woke up five hours later. They assumed he had Covid, but the test was negative.
That Sunday, Ben met a close friend from the army, and he told him what was going on. The friend had a boy a year older than Alex. He listened, then told Ben that he wasn’t sick – he was exhausted.
“He’s not one to mince his words,” says Ben, now. “He said: ‘If you carry on doing this, you’re going to kill yourself.’ That was when I knew something was wrong.”
Postnatal depression (PND) in men may strike many as an oxymoron. In Fleabag it’s a punchline, skewering Fleabag’s ex for putting himself at the centre of his partner’s difficult birth.
In fact “postnatal depression” refers to depression in any parent – birthing, non-birthing, adoptive – in the first year of having a child. It is thought to affect as many as 10-15 per cent of mothers worldwide; recent research suggests that it may be even higher. PND in men is both less studied and underreported, with no routine screening. Even so, it is thought to affect 8-10 per cent of new dads.
Whether it is sufficiently distinct from depression to warrant a separate diagnosis is the subject of ongoing debate, but there is no question that all parents are susceptible.
Scientific understanding is increasing of the biological changes that occur in all primary caregivers, whether they give birth or not. Men even go through hormonal changes that may contribute to their risk of PND. But the lack of awareness of PND in fathers and partners means suffering often goes undiagnosed, taking a huge toll on the family, and even children’s development.
As approaches to family and parenting continue to evolve, the uneven attention on parents’ mental health is a challenge not just for public health, but for gender equality.
“Years ago, men were mainly the breadwinners, they had little to do with child-rearing. Now, things are very different,” says Dr Sharin Baldwin, one of the few academics to have studied PND in fathers. “We have stay-at-home dads, we have same-sex couples – the role of the father has changed a lot. But when it comes to looking at fathers’ mental health and wellbeing, there’s very little research… and very little support.”
As a nurse and health visitor working in an NHS trust, Baldwin has extensive experience of new families and perinatal (meaning inclusive of pregnancy) mental health. But she found “a huge gap” in attention on dads. “I was supposed to be working with families, but in practice it was mainly mums and babies,” says Baldwin. “I wanted to find out more about men’s experience of becoming a father.”
In her three-part New Dad Study, carried out since 2018, Baldwin assessed the existing research on first-time fathers, and conducted her own. Her first surprise was the ease with which she recruited dads willing to speak about their experience. (All 21 were cisgender and heterosexual, but from varying ethnic backgrounds.)
The accepted wisdom was that “men wouldn’t want to talk about their mental health, or to be asked questions about it,” says Baldwin – but what her study participants told her was that they were rarely given the opportunity.
Baldwin’s subjects described experiencing a “rollercoaster of feelings” upon becoming fathers – by no means all negative. But some felt ill-prepared – for the stress of labour, the lack of sleep, the impact on day-to-day life – and grappled with the change in their relationship and identity.
A common theme among Baldwin’s new fathers was they felt “the need to cope alone.” “They didn’t want to burden their partners, so they didn’t talk about it,” she says.
Others feared being perceived as weak, or failing to provide for their families. This was exacerbated by a lack of external support, and a sense of being excluded by health professionals. Baldwin’s study found that most men were never asked about their mental health or wellbeing during the perinatal period; check-ins with midwives and health visitors, routine for mums, did not consistently cover dads. “They felt it was just something they had to deal with,” Baldwin says. “They felt totally helpless.”
Ben’s stress levels had been mounting for some time. They learned that Becca was pregnant just as they had been about to go on their honeymoon in Normandy, in February 2020.
The following month, most of the armed forces were stood down due to the pandemic, but Ben was put on standby and given extra duties. In May he returned to his usual job. Two weeks later, his stepfather died from Covid-19.
Restrictions prevented Ben from attending the funeral. “That hit quite hard,” he says. He worried about Becca catching the virus during her pregnancy. His mother was also vulnerable and unwell. Ben spoke to her on a video call, the day his stepdad died. “She said, ‘I don’t care what I have to do, I am making it out of here to meet my grandson’ – I remember just crying, talking to her – and she kept her word.”
Then, in August, Ben was told that he was being promoted – and that he would have to upend his life in Somerset and relocate to Hampshire just before Becca’s due date.
Ben knew that the timing wasn’t right for a move, but he didn’t feel able to refuse or even to voice the mounting pressure he felt under. When it came to Alex’s birth, in October 2020, it was primed to come to a head.
Becca went into hospital for an induction, but it failed. After three days in hospital, she spent a further 23 hours in labour, and needed an epidural and an episiotomy.
“I pushed for hours and hours, and he wasn’t coming: his head got stuck,” Becca says. That’s Ben’s side of the family, she adds, smiling. “They have big heads – so I had to have help.” She glances at her husband. “And all this impacted Ben a lot.”
Ben clears his throat, abashed. “Listen – I’m in the army. I’ve dealt with some pretty nasty things in the past. Seeing Becca in this state, when I couldn’t do anything for her… all I’m seeing is red stuff pouring out and I’m thinking, ‘She’s hemorrhaging. Why aren’t they doing anything?’”
Becca was not in danger, but that wasn’t communicated to Ben. “I had no idea what was going on.”
Meanwhile, Becca had been misidentified by hospital staff as a second-time mother, meaning she was not shown how to breastfeed. She was still paralysed from the epidural when Ben was sent home.
He grows emotional recalling it. “Watching the love of my life go through this really traumatic experience, and then I couldn’t stay with her… I drove home that night thinking ‘OK, I’m a dad, but…’ I left her in such a state.”
Becca and Alex returned home the next day – but Ben found that he could not move on from the harrowing experience in the hospital, in particular the episiotomy. “I woke up every night to the sound of Becca being cut.”
A health visitor the couple trusted referred Ben to the PANDAS Foundation, a non-profit supporting parents through mental illness. Ben joined their Facebook group for dads, and later their weekly Zoom call. “It flipped from banter, and taking the mick out of each other, to ‘How are you doing, mate?’... I told them everything.”
They say that being a parent is the hardest job in the world. Amid a reported “epidemic of loneliness”, a growing global mental health crisis, and intersecting crises around living costs and housing – it isn’t getting any easier.
Indeed, you could go so far as to say that some decline in mental health is an inevitable (and natural) response to becoming a parent. But, whether you are a man or a woman, there are some factors that put you at greater risk of developing PND. First-time parents are more susceptible, as are those aged 25 or younger, and those with past experience of mental illness. But PND has also been linked to money worries, relationship troubles, socioeconomic deprivation, a lack of support from friends or family, recent adverse life events or previous trauma.
When Oliver learned that his partner Beth was pregnant, he admits, “I had a bit of a panic attack.” He was 20 years old at the time, with a history of anxiety and mild depression. From there, the strain only increased. Beth was found to have immune thrombocytopenia (ITP), a blood disorder causing a low platelet count, meaning that she was in and out of hospital with excessive sickness and bleeding. Several times their baby stopped moving, prompting fears that he had stopped growing, or worse.
Oliver felt helpless – but deeply worried for Beth. “All that she was going through, just to bring a baby into the world… it was great seeing the scans, but there’s not a lot of bonding that a dad can do through the pregnancy process,” he says. “Just seeing Beth in that state really screwed with me.”
Their son Henry was eventually born by Caesarean, following a failed attempt to induce. The couple and their newborn moved in with Beth’s parents, hoping to ride out the pandemic and save for a house deposit – but, in such close quarters, the pressure continued to build.
“It was not an easy situation,” says Oliver. “You couldn’t get any privacy anywhere.” Eventually, they abandoned their dream of home ownership and moved out to a rental.
Oliver felt like he had failed his young family, “like I hadn’t provided,” he says. “I still do it a bit now: I worry about my skills as a dad, if I do right by them.”
In those early days of being a father, he tried to put his depressive thoughts aside, wanting to shield Beth from his worsening state of mind. “I didn’t want Beth to worry about me, she’s got enough going on – if I can deal with things in my own way, then I will.”
But, exacerbated by sleepless nights, it affected his mood. Oliver became irritable, inclined to shout. He winces: “Beth, unfortunately, got the brunt of that.”
Beth was understanding, which made Oliver feel even more guilty. At least if she had snapped back – so went his warped logic – they would be even. As it was, “I knew I was being awful,” he says. “We’re in this together, we’re meant to be supporting each other – and Beth’s nursing a baby, and supporting me.”
It was while he was on paternity leave with Aidan, their second child, that Oliver discovered PANDAS’ Facebook group. He is now a trained volunteer for the organisation, hosting regular Zoom calls for dads seeking to let off steam or a sympathetic ear outside their family.
A spokeswoman for PANDAS says demand for its services has been growing steadily, including a 13 per cent increase in the past year; it now has a group of some 800 fathers offering peer-to-peer support. For many fathers, PANDAS might be their only outlet, says Oliver. Especially in those first months after the birth, “there’s a lot of ‘How’s Mum? How’s baby?’ ‘Yeah, they’re fine’ – end of conversation,” he says. “Even if I wouldn’t give a truthful answer, it’s still nice to be asked.”
When fathers are routinely sidelined in their children’s care, it can become a self-fulfilling prophecy. In her research on first-time father’s experience, Dr Baldwin found that fathers often felt shut out of resources billed as being for “mums and babies”, or not taken seriously by health professionals. One father told Baldwin of being praised for simply dressing his baby, and “joining in”. “He said it was patronising: ‘I’m his father’.”
This dismissiveness of dads is insidious, across every aspect of parenting, and is also reflected in the lack of help and understanding for their struggles with mental health. Gags like the one in Fleabag about men with PND reinforce the assumption that they are less affected by the transition to parenthood than women, and are of secondary importance in their children’s lives.
Adoptive parents may even be at a higher risk of PND, says Baldwin: “They are less likely to admit it if they are struggling, because they don’t want to come across as a failure.”
This was “exactly” the case for Stu Oakley, co-author (with Lotte Jeffs) of The Queer Parent. “I felt like we’d chosen this, that we’d gone through this process and had just got to stick it out.”
Stu and his husband John brought home their son and daughter – full siblings, aged seven months and two-and-a-half – in 2018, after a year-long process. Both then took eight months’ parental leave, together, over the summer: time to solidify their new family. Stu remembers it as “bliss”.
Then, in October 2019, they got an email from their social worker with the subject line “News”: there was a third sibling, a five-month-old boy.
There was no question of not bringing him home, says Stu. “The moment we heard about him, it felt like he was a part of our family.”
But the swiftness of their son’s arrival, just five weeks after that email, coincided with Stu having just taken voluntary redundancy from a job he loved. “My identity was suddenly completely changed – I didn’t know who I was.”
Stu loved his son; but the circumstances were different to his first experience of becoming a father. Lockdown escalated the situation. “I was more irritable with him than I’d been with the other two… it was that feeling that I was out of control,” says Stu.
John suffered the worst of it. “I was vile to my husband,” Stu admits. “It was like I wanted him to be a therapist to me – but that’s not his role.”
But Stu resisted seeking professional help. “I thought that if I picked up the phone to the doctor and said ‘I think I’m suffering from depression’, that would be on my record.” He imagined it being used against them, should they want to adopt again, or even in finalising this adoption.
He felt especially vulnerable as a queer parent: “If a straight couple adopted, and they had trouble, their sexuality wouldn’t come into it.”
Stu’s anger and frustration came to weigh heavily on his relationship. “It almost broke us,” he says. He started shouting at the children, then hating himself for shouting. “John just got to this point where he said: ‘I can’t do this any more; I need you to see somebody.’”
After a tearful phone conversation with his doctor, Stu was prescribed the antidepressant sertraline and cognitive behavioural therapy. The improvement was immediate.
Now, Stu says, he can see how the pressure he felt to be a perfect parent added to his struggle. Some of it was self-imposed. “But I do think there is greater pressure on you when you are a queer parent,” he adds.
“You also have people telling you all the time that you’re wonderful: ‘Aren’t you amazing’, ‘It’s great you’re doing this’. Why? We’re just wanting to be parents.”
Implicit to the praise is the low expectations of straight fathers to be involved in their children’s care.
“People talk about equal parenting, and the fact that we need to strive for that – but the problem is, everything is so geared towards motherhood in language… if men are never able to feel free in these spaces, like they can be there, then it’s never going to change.”
Enshrining mums and dads as equal in healthcare policy would be a step towards improving the experience of parenting across-the-board, says Baldwin. Health visitors have KPIs for assessing mothers and babies, but not for fathers, who are excluded from routine mental health screening and may not necessarily be seen with their family at the appointment at all.
Resourcing, of course, is an issue; but, Baldwin argues, it is important to take dads’ wellbeing seriously – not to divert resources or attention from mums, but to strengthen their family unit and sources of support.
Evidence shows that, if one parent is struggling with PND, it is likely that the other will be too. “If a father has depression, we know that it can affect the child’s emotional development, cognitive, social, behavioural – it has a huge impact,” Baldwin says. “It can affect intimate relationships as well. Therefore I think it’s a huge public health issue, and it needs to be tackled at the same time as mothers – instead of just mothers.”
Ben was not alone in struggling. A month after he was diagnosed with PND, Becca sought help as well – for postpartum rage.
As a nursery worker with a degree in Early Childhood, Becca had felt more prepared than most new mums. But, after Alex arrived, she felt overwhelmed. “I have no idea what I’m doing,” she told Ben. “None of what I’ve learned is helping me right now.” She found herself exploding at the tiniest provocation.
Getting help – which included getting prescribed Sertraline – made Becca more open to Ben’s problems. “It could have been quite easy for me to be like, ‘I’m the one who gave birth, you didn’t experience what I went through, so you don’t have a right to feel like you do.’” Instead, Ben says, “She told me: ‘We’re in this together. You matter as much as I do’ – which has been the main driving force for getting myself help, to be honest.”
In December 2021, the couple learned that Becca was pregnant again. They were determined to make sure that they had a better experience. But when the day came and Becca went into labour, as soon as the episiotomy scissors were produced – “my body just shut down”, Ben remembers, wincing.
He stole the sick bowl off Becca’s belly and collapsed in the chair next to her, rocking and rubbing his head. Over the gas and air machine, he heard Becca’s voice, asking the staff to check on him. “I think he’s got PTSD from the first one.”
Soon afterwards, Ellie arrived. “That’s when I forgot about all the things that were bothering me,” says Ben. “I was just looking at Becca, thinking: ‘You’re incredible.”
The PTSD diagnosis has not been confirmed, but it tallies with what Ben understands from his experience of being in the army. Recently, he spoke as a representative of PANDAS about PND before an audience of Royal Marines. He talked about how, compared to them, he felt like a fraud. “I might have PTSD just from watching my wife have a child,” he told the room.
Two Marines, “these tough guys”, called him out on it. Ben chuckles at the memory. “It doesn’t have to be an explosion,” they told him. “You don’t choose how it affects you. That’s not how it works.”
In a few weeks, the family will be going ahead with the long-delayed relocation to Hampshire. The timing is finally right, says Ben, with eight-month-old Ellie splayed on his chest. Two years ago, “I don’t think we would have survived… whereas, now, we’re happy.”
If there’s one thing Ben’s learned, that he tells new dads all the time, it’s that fathers can’t care for their families without also looking out for themselves.
“We always say that we should put our partners and our kids first. In fact they should come a very, very close second – because you, as a dad, need to be right to help them.”
See more from the Modern Lovers series here.
Illustration by LilyLK.
