Transition to fatherhood

5In a historical approach, Senécal, Saucier and Garon (2013) published a literature review on the transition to fatherhood and the important psychic rearrangements of the future fathers. These authors underline that the study of fathers is a new field and, mostly, that the concept of fatherhood is largely under-explored in its specificities.

6First of all, it seems like the desire of men to have children finds its roots in what Ross (1977) names the “epigenesis of the father identity” (Senécal et al. 2013, p. 168). Thus, men’s desire to conceive a child is notably related to his œdipal desires and conflicts, in order to realize himself, to create a child, or, in a perspective of reparation, to offer this child to his own parents (Senécal et al. 2013).

7The passage to fatherhood also refers to a maturative crisis of the personality characterized by important psychic rearrangements (Benedek & Corlobé, 2013; Cupa, 2004; Senécal et al. 2013). For example, significant interpersonal relationships of the future fathers are transforming, their preoccupations are rather focused on the family and the child, they have more responsibilities, feel bigger emotional lability and feel themselves becoming different. These men are also more dependent of their partner during this period and feel admiration towards their partner’s body. While being experienced as exciting, the transition to fatherhood is also imprinted with anguish towards the new financial responsibilities. Finally, we observe how men present an abstract experience towards their baby. In fact, there seems to be a significative difference compared to the mother who lives the pregnancy in a biological and apparent way, steaming from the presence of physical transformations. The father, on the other hand, doesn’t seem to have those thoughts and symbols to help himself in this psychic labor and in his ascension process to fatherhood (Senécal et al. 2013).

8The concept of the father constellation, introduced by Cupa and Riazuelo-Deschamps (2001), refers to the reorganization of the unique identity of the man, to the questionings and to the construction of the fatherly representations. In that sense, the paternalization process organizes itself in an intergenerational logic based on the reinvestment of the oedipal problematic. That is that the man is “returned to his own birth, introduce his father has a grand-father and anticipates himself as a grand-father himself” the whole organizing itself in ambivalent conflicts towards his own father (Cupa & Riazuelo-Deschamps, 2001, p. 59). On the other side, the father is also in an ambivalent position, of aggressivity and protection towards the baby, notably because it takes a place between the father and the mother (Cupa, Deschamps, Michel & Lebovici, 2000; Lamour, 2004). Thus, the father must also overcome the renunciation to a privileged place beside his wife; newly mother (Marciano, 2003), because having a baby reactivates “the aggressive side of the oedipal problematic” (Cupa, Deschamps, Michel & Lebovici, 2000, p. 94).

9In fact, the pregnancy is a particular moment for the father-to-be, Cupa (2004) conceptualized this array of issues under the concept of father’s pregnancy complex (Cupa, 2004). It’s possible to represent ourselves a father as a man investing his child, a man that loves, that adopts and psychically recognizes his child, without forgetting the mother’s part in the recognition of his paternity (Cupa, 2004; Noël & Cyr, 2009).

10Martine Lamour (2004) retook the triadic model of Fivaz-Depeursinge and Corboz-Warnery (1999) to propose a conceptualization of fatherhood that constructs itself in the interactions within the triad (Lamour, 2004, p. 94). Paternality refers to the feeling that has the man of being a father and “in the context of dyadic father-infant interactions” the mother participates to the paternalization of the father by giving him access to the baby that also itself paternalizes its father (Lotz & Dollander, 2004). In fact, the child participates in the process of “paternification” of the man, namely to all the psychic issues of the father-to-be (Lamour, Davidson & Lebovici, 2000, p. 112). That way, fatherhood rests on the recognition of his child and his wife on one hand, and on the other, he must also recognize the new maternal function of his wife. By accepting and helping his wife to realize and exercise this new role and this new maternal identity, fatherhood is constructing itself.

Transition to fatherhood and assisted procreation

11Studies specifically interested about the trajectory of men and fathers in fertility consultations are principally about masculine infertility and reflects the feeling of powerlessness of the man towards the infertility of the couple and the turmoil of his identity as a virile man when he becomes himself infertile (Epelboin, 2010; Hopker-Azemar, 2011). However, the man may have the impression of an “adulterous fantasy” and feel excluded from the procreation of his child when they resort to medical help (Hopker-Azemar, 2011; Marciano, 2003, p. 14). This may be experienced as a narcissistic threat and may have consequences on the bond with the child-to-come since it reminds him of the past experience of infertility (Lazaratou & Golse, 2006; D. Pruett, 2015). For Delaisi de Parseval (2003), due to the desexualization of procreation induced by the assisted procreation, the man’s feeling of exclusion towards the procreation of his child proves to be an essential element in the representations that he will construct around his fatherhood. Thus, Epelboin (2010) concludes that the passage to fatherhood in a context of medical-assisted procreation has specificities that may fragilize the experience of the father.

Participants

13The dyad, from which was produced this case study, comes from a sample of a larger study that focuses on the transition to fatherhood (Noël, 2015). It is a case study of a dyad of primiparous future parents, with the specificity of having resorted to assisted procreation without a third-party donor for the conception of their child. A consent form was signed as asked by the Université du Québec à Montréal’s (UQAM) research ethics committee that gave its approbation for the project.

Procedure

14In a longitudinal perspective, interviews were conducted at each of the trimesters of the pregnancy and another one at one month in the postnatal in an interview room of UQAM by a doctoral student involved in this project. At each of those four times, an interview of 60 minutes was devoted to the father and an interview of 20 minutes to the mother (see figure 1). The interviews aimed the exploration of “the dimension of the process of co-construction of the paternity’s labor by offering a narrative space allowing the progressive transposition into words of the different issues” (Noël, 2015). During the prenatal period, the instruction for the father at the beginning of the interviews was: “Your partner is pregnant, tell me how it is for you” and the one for the mother was: “You are pregnant, tell me how it is for your partner” (Noël, 2015), as a complement for the research “Prévention en périnatalité. Étude comparative interculturelle de l’attente des hommes et des femmes d’aujourd’hui en période périnatale, au regard de la démarche préventive d’éducation à la parentalité” proposed by Schauder (2007) and conducted in Quebec with a sample of women only (Reeves, Pelletier, Schauder, Thériault et Wendland, 2016). During the postnatal period, the instruction at the beginning for the man was: “How is it for you since the birth of your baby?” and for the woman was: “How is it for your partner since the birth of your baby?” (Noël, 2015). Then at every interview, the follow-up questions presented to the participants followed their associative thread. In this study, the mother’s voice is taken into account in a perspective to enrich the data collected. As a matter of fact, it was collected to validate, nuance or precise the discourse of the future father and his motivations. Afterwards, the discourse of the partner also had for function to observe if her perception converges or diverges from the father’s perception. Finally, the choice of a semi-directed format for the interviews is based upon the intention of giving place to the subjectivity of the participants and allowing them to elaborate on their experience at their own rhythm, spontaneously without any suggestion of a particular theme. Special attention was given not to use terms such as father and mother or parent and parental until they spontaneously emerged from the participants’ discourse. Thus, this case study, with multiple and repeated observation times of the subject at key moments of the pregnancy process, aims to follow the evolution of the themes and mental representations of the father-to-be within his psychic temporality of the pregnancy. Each of the eight interviews was recorded with the participant’s authorization and transcribed word-for-word with a software support (usage of the software SONAL).

Figure 1

Qualitative methodology: four observation times (from T1 to T4)

Qualitative methodology: four observation times (from T1 to T4)

Measures and data analysis

15The analysis of this qualitative research results from an approach with multiple levels. Firstly, the iterative method (Paillé, 1994), consists in practicing simultaneously the data gathering (interviews), as well as the comprehensive (synthesis memos) and the descriptive analysis (thematic analysis). Those were the principles that supported the entirety of the research. Based on the inductive logic, we left our conceptual frames behind and we tried to be as close to the participants’ as possible to describe and then comprehend their experience. Thus, without negating our subjectivity, we listened to the dyad while suspending our preconceptions, but mostly, we never stopped to question ourselves on our hypothesis and our comprehension (Guillemette & Luckerhoff, 2015) and without hesitating on regularly going back to the data.

16After the transcription of the interviews, verbatims were annotated by the student and her reflections were redacted in a logbook (Baribeau, 2005). The “ongoing process” is a thematization method that encompasses simultaneously theme listing and the construction of thematic trees, permitting a precise and rich analysis of the corpus. This supported the theme listing (level 1) throughout the project, which permitted the exhaustiveness of the analysis (Paillé & Mucchielli, 2016, p. 241) and the groundedness in the data (Guillemette & Luckerhoff, 2015). Analysis team meetings took place and memos of analysis and synthesis (level 2) were redacted for each participant at every time, testifying for a reflexive practice and reflecting the pooling of the three subjectivities: the first author’s subjectivity, the research assistant that conducted the interviews’ subjectivity and the subjectivity of the lead researcher for the project. Furthermore, the data’s triangulation was made possible by considering the discourse of the mother, in parallel with the data gathered from the father’s discourse.

17Thus, the results presented in this article lead to a modelization of the transition to fatherhood, following the two-time analysis, corresponding to the two levels described above. The thematization of the father’s discourse was supported by the construction of thematic trees, guaranteeing the groundedness of the data. The categories (level 2) emerged of this descriptive level (level 1) by a job of conceptualization. Then, the modelization (level 3) stemmed from the emergent links between the categories, thus bringing a dynamic perspective linked to the pregnancy’s temporality.

Two realities that collide

20As early as the first words from the father in the first interview, we understand that he finds himself in a fight against the medicalization of the pregnancy, experienced as an over-medicalization. For him, this reality is in confrontation with another reality, which refers to a desire of a natural pregnancy. This desire for the natural is understood as the result of his fundamental values and is translated by the desire to welcome the baby as it will be and refers to the consequence of a medicalized conception because of resorting to the technics of assisted procreation.

21

“Are we going towards a birth interruption or are we welcoming what life sends us. Well, we arrived at the conclusion that we will welcome the child no matter what […] that lead us to decide of, to have the least procedures possible.”

22At the second trimester, the participant added that he perceives doctors as being in search for information, understood as useless in the light of the impossibility to proceed to a medical intervention in the case of discovering a fetal abnormality.

23

“[…] the problem I find with all of this is that, if you have a test to do to do something, ok, fine, go ahead, but if for you it’s only to go searching for information to only be able to act later, and that you can gather this information later, in another way […] why not do that.”

24The father also dreads the speed of the medical world, characterized by a lack of listening to the patients, patients that he describes as being docile. Also, in addition to his fundamental values and the consequence of a medicalized conception, his wish to minimize the medical procedures is also understandable as the result of the ultrasound’s experiences experienced as negative, since the start of the pregnancy.

25

“[…] It goes fast, there is a lot of information and you don’t have the time of, of processing, the, the information and to ask questions, and, at the same time eh, it feels like you, like you fall into a docile patient mode, in fact, that’s it. And also, they are in a hurry, so, when you’re asking questions, you’re under the impression that, you take more time and, well that’s it.”

26At the third trimester, the discourse of the participant was mostly characterized by the booming number of medical follow-ups. The father notes that they are omnipresent and anguish-inducing and he associates the extent of the follow-ups to the etiquette of at-risk pregnancy that is imposed on the dyad. This label removes for him, a certain maternal power in the decision-making and is experienced as a lack of flagrant listening on the doctors’ part.

27This resentment is felt as an obligation to be a passive patient in front of the medical team, experienced as almighty.

28

“It’s like we get rapidly an etiquette of at-risk pregnancy and what it implies is that, we take a little of the power away from the mother, we tell her that it’s a disease that she has, it’s not a natural process that is taking course in your body.”

29Thus, the father faces again the medicalization of the pregnancy, experienced as a disrespect of his fundamental values, such as the desire for a natural pregnancy, as well as an unconditional welcoming of the baby. To counter this discrepancy in terms of position, strategies such as the active research of information in books or on the internet are used to confront the medical professionals. According to him, to adopt the position of a fighter, you need to be in action. Furthermore, the father takes himself the role of the “vigilant protector ready for the fight” to counter the over-medicalization of the pregnancy, to support, accompany and reassure his partner, but mostly to maintain their power in front of the medical professionals.

30

“And concretely it [the role of the vigilant protector] implied that when Nathalie met the new specialists, well I was on her side, to be two, rather than alone in front of ‘god the doctor’.”

31The intensification of this fight, consequence of the numerous medical follow-ups of the third trimester, still permits the concretization of the baby in the father’s imaginary and the continuing process of the pregnancy.

Competition of ideals

32Regarding the ideals of the participant, the data analysis shows the importance of the provider role that the father desires to assume throughout the pregnancy and after the birth of the baby, as well as his desire to prosper professionally. Supporting his partner, the reduction of her stress and also the desire to financially provide for the couple are actions that he wishes to realize.

33

“[…] I wish for my family to be well, I wish for my family to be in security, I want that my spouse be well throughout the pregnancy, that she doesn’t need to bother with financial insecurities, if I can reduce the maximum amount of stress around, it’s a little that, yes, it’s a way of taking care.”

34Moreover, the participant is surprised to feel this traditional masculine urge, which isn’t inherited from his familial environment characterized by feminist values. He also understands the emergence of this role as a provider as being stimulated by the baby’s coming.

35

“[…] I realize as a man, I don’t necessarily relate to the traditional or masculine roles, but the awaiting of this child brings back a little this provider fiber inside of me.”

36Regarding his personal realizations, the participant refers to the aspiration to a professional stable life that will only present itself at the end of his acquired diploma, a moment still unknown to him. The entirety of this competition is experienced as a big inner tension, also animated by culpability and negotiated with avoidance.

37

“And it bothers me a little to be in a context where I should like dive fully into my diploma and have less time for her because I have like a “blitz” right now, it’s something that also bothers me to have all those elements happening at the same time.”

38At the second trimester, the participant continued to note the difficulty to conjugate his role as a father with his role as a student. Moreover, finishing his diploma is a big chapter in his life that he wishes to complete before the baby’s arrival. He recognizes the extent of the emotions that he faces and agrees that the unknown, the changes of priorities imposed by the baby’s arrival, as well as his doubts about his capacity to provide, are anguish-inducing elements for him.

39

“There is a lot of unknown, there is well, will I make it? Sure you know, there is a doubt related to the timeframe that I have and, what needs to be done, and excuse me, but there is also all the financial aspect […]”

40More precise questionings related to the work-family-study conciliation after the baby’s birth emerged at the third trimester. The desire for personal fulfillment before the arrival of the baby, as well as anguish facing the unknown, to be on a day-to-day basis in presence of a baby, are noted in the father’s discourse. However, the participant understands that the “clock is ticking” and that the paternal responsibilities are to be prioritized, considering the passage from a dyad to a triad.

41Thus, at each time, we hear that the difficult arrangement of the different roles that the participant must occupy, such as the protector, the provider, the student and the future father, seems to cause a lot of anguish to the father that seems to have difficulties to mourn his ideals, ready to abandon them if he cannot attain them as they are.

Construction of the parental identity

42It’s by narrating his follow-ups in the fertility clinic, at the first trimester, that the participant reflects on his parental representations: what he wants and doesn’t want to be as a parent. “The support of a being to become” corresponds to the parental function that he wishes to exercise alongside his child. The participant also notes his anticipation regarding more difficult moments, such as sleep deprivation and the moments where he’ll be more personally confronted, related to the baby’s arrival.

43

“I anticipate, in all cases, to be confronted, I mean, I the sense that, I know that it won’t be easy because firstly, when I’m sleep deprived, I am already impatient without a child so eh, I know that to have that added, a child with needs, I might have moments where I lose patience.”

44Afterwards, the participant makes a reference to his own mother as a basis of an inspiring parental model. His discourse on this subject is characterized by a movement of idealization and admiration towards her.

45

“She’s an inspiring model for me […] she’s able to keep seeing the other with whom she’s in conflict with for example, continue, eh to recognize what she loved about this person, to see beyond the character, to go into a space of unconditional love, also while being in the affirmation, respect of self and of the other […]”

46The second trimester wasn’t characterized by medical events that support the construction of the baby, such as the ultrasound of the first trimester, for example, and the father doesn’t express much investment in the child. Furthermore, when realizing that the baby isn’t in his body, the participant is looking for actions. For example, the preparation of the baby’s room to concretize it, being frustrated by its immateriality and his still imaginary status to him.

47

“But eh, related to the fact that I don’t feel him, well I find it a little bit frustrating not to succeed in, to feel another thing than my own pulse, to not be able to decode what it is exactly […]”

48The third trimester is mostly characterized by a certain awareness of the time that passes by rapidly. Thus, the participant maintains that he’s really enthusiastic and excited about becoming a father, but he also questions his parental capacities and feels anguish about the arrival of the baby that is coming soon.

49

“Well, it’s sure that time flies, it’s coming really soon, there is like a mix of I’m really excited to see his nose, to see his face, and at the same time there is like, are we going to be ready in the end?”

The prenatal anguish of loss

50The prenatal anguish of loss is also a theme present in the background at every trimester of the pregnancy. At the first time of observation (T1), the past experiences like the miscarriage and the ART trajectory seem to result into an anguish of loss and thus prevent the future father from future projections that he may have of his child.

51

“[…] That’s it, the past experience [miscarriage] that may repeat itself, so we navigate between hope, to project ourselves in the future, and at the same time, we keep our feet on the break because there may be this possibility.”

52In fact, in the second trimester the medicalized conception of the baby, as well as the prenatal anguish of loss, seems to be associated for the father; and it’s in the postnatal time that he has the insight about this link.

53

“[…] there is always the possibility that it won’t happen, that it ends, given that we have had a lot of difficulties at the conception level […]”

54According to him, since the conception was medicalized, it may be possible that “it won’t happen”, referencing to the birth of the child.

55

“And there is also the fact that we have a history of miscarriages with difficulties to be pregnant, difficulties of fertility, well it’s like, like, there was always this fear, eh, ok, will we lose it, is it still there […]”

56This anguish translates into an active attention and search for signs of the baby’s life and of the physical transformations of his partner which, for the participant, concretize and prove that the process is going forward. Furthermore, he notes that the concretization of the baby is difficult for him, evoking the absence of physical signs for men.

57Moreover, it’s at the third trimester that the participant speaks about the pregnancy as going forward in time. Thus, the physical signs of his partner are more important, which allow him a concretization of the baby and allow him to “tame the reality to come”, but mostly, participate in the decrease of the prenatal anguish of loss.

58As we will see in the next section, this prenatal anguish, which stays in the background during the pregnancy, is expressed clearly and spontaneously by the two participants at the postnatal time (T4). It explains a number of their positions and aspects of their experience of pregnancy, which validates the existence of such anguish, heard and elaborated since the prenatal interviews in our analysis.

The postnatal (T4): Emergence of meaning

59The beginning of the fourth and last interview, conducted at one month postnatal, is mostly characterized by the history of the medicalized pregnancy, still experienced at this stage as an over-medicalization. The participant comes back on his own on his fight against the doctors and describes the course of the pregnancy as “rollercoasters”, filled with hurdles and emotions. During this last interview, the participant seems to understand on his own his fight against the doctors as a tussle against their excessive worries, against the passivity that he must adopt and against the etiquettes of at-risk pregnancy that are imposed to him. But mostly, he expresses how much the medicalized conception of the baby namely, resorting to assisted procreation in what he recalls as experiences of perinatal losses, seems to be the origin of this fight present throughout the prenatal period.

60

“[…] I have the impression that, I’m asking myself if, the conception was as much medicalized, if it didn’t put me in a reaction state relatively to the pregnancy monitoring which was also medicalized and that I just wanted to have something closer to a natural experience […]”

61The participant’s discourse at this postnatal time is also characterized by the announcement and the experience of the induced labor, a couple weeks before the planned date of birth. The announcement of this medicalized childbirth seems to be a source of anguish for the man, who, firstly, tries to negotiate the birth date, a date that arrives too fast according to him. He expresses at this moment that he wasn’t ready for the baby’s arrival, which was making him really anxious.

62

“[…] I’ve been through all the states. It was like I was crying, I was laughing, I was anxious, it was like, it was happening too fast, we were not expecting that, it was still one month early […]”

63However, a certain letting-go stands out during the childbirth, understood by him as a “tiredness of fighting against the medical system”. Also, it’s by narrating the experience of the induced labor, therefore medicalized, that this man reveals having appreciated this event, due to the respect that was dedicated to him and his active role alongside his partner, role that he describes as gratifying. This time, after resisting doctors for the duration of the pregnancy, the participant seems to have benefited from the medical support during the childbirth and during the immediate postnatal time. He expresses his gratitude towards the medical staff, and their advice are appreciated, a literal turnaround of the situation.

64At one month postnatal, the participant also expresses the changes induced by the baby’s arrival. It seems like this period is characterized by an adaptation filled with ups and downs. The participant expresses the immediate changes in his day-to-day life, such as the absence of control and his self-decentration, given the prioritization of the baby’s needs. The adjustment to a passage from two to three also stands out in his discourse. On this matter, the participant notes that the baby’s arrival “puts things into perspective” when he reflects on the work-family-study conciliation.

65At this fourth time of the interview, we also understand that the assisted procreation seems to have impacts on the relationship with the baby. It seems like the fact that it was a baby as expected as he was, the situations with more tensions, filled with negative affects towards the transformed day-to-day with the baby’s arrival, like anger, for example, are worstly experienced by the participant and are mostly characterized by culpability.

66Finally, the father mentions the meeting with his baby by starting with the scene of his partner, now a mother. Seeing this baby, that much expected, in the arms of his spouse, he is brought to tears and the mother-baby meeting touches him deeply.

67

“[…] the most touching moment I found was when he, when Patrice came out and that the doctor placed him on Nathalie, and then she exclaimed “my baby”, it was like, it was so beautiful, it was like a reunion.”

68His own meeting with his baby will happen secondly, during a “skin-to-skin” night. He expresses the marvelous of the proximity with this little being but also notes the anguish in the “après-coup” (Green, 2004).

69

“[…] he was sleeping, he was sleeping, and then I asked myself if I didn’t, if I didn’t hurt him, if it didn’t, if he wasn’t too hot with me during the night, I was worried […]”

70The material from the mother will now be presented under the guidance of a comprehensive analysis, by noting how it validates the father’s perception and how it differs from it, in order to highlight the co-constructive dimension in the process of the transition to fatherhood.

Comprehensive analysis of the mother’s discourse

71The data from the mother’s discourse confirm the emergence of the four central themes in the father’s discourse, which then came to be conceptualizing categories. The first trimester (T1) is characterized by putting in place the foundation of their philosophical perspective of the pregnancy and the announcement of the real baby between each other and their mutual collaboration to announce it to others. She perceives well the father’s issues regarding his desire for a natural pregnancy and the medicalization of the pregnancy imposed by the medical staff. It’s an experience that she shares as well and that she speaks of. The second trimester (T2) is characterized by a large synchronization around the tussle against the medical staff to assert their philosophy of a natural pregnancy that defines their under construction parental identity. She also describes how much her partner is torn between the demands of his incipient paternity and those of his diploma to be completed. While building her identity as a future mother, she testifies of the different elements that are taking place in her partner at the parental identity level. Just like him, the prenatal anguish of loss appears in the background and will confirm itself as it is during the postnatal, once the real baby is there. It’s at the third trimester (T3) that a more differentiated perspective settles in: she doesn’t evoke at all the medicalization of the pregnancy, but stay really centered on the childbirth, the preparations, the job that must be delegated, finishing the preparation for the room, all while projecting towards the baby’s arrival. Finally, the fourth observation time (T4) illustrates the two participants’ synchrony of discourses, notably by the links of meaning that the couple elaborates relatively to the prenatal anguish of loss experienced throughout the pregnancy as a heritage of the assisted procreation and by the links elaborated between the anguish of loss and the fight against the doctors.

Modelization of the issues of the paternal identity’s construction, during the transition to fatherhood, following medical help for procreation

72Throughout the prenatal period, the father seems to find himself in a fight with the medical staff, experienced as a persecutor. Over the course of the interviews, we further understand what constitutes this position and the basic issue will veritably be revealed by the participant spontaneously at T4, with the real baby in his arms. It’s a conflict regarding issues of legitimate and classical ambivalence during a process of psychic gestation (Cupa, 2004; Vasconcellos, 2003), but taboo in the social discourse that tends to idealize the experience related to pregnancy. Ambivalence’s negative affects, which are hostility and aggressivity, felt towards the arrival of the baby are particularly nerve-racking. The way for the father to protect himself from this anguish will be to fight the entire medical staff (projection of his hostility as coming from the doctors), experienced as intrusive in their investigation and verification demands regarding different medical analysis. During the postnatal period, this father will spontaneously make a comprehensive link between his fighting stance during the pregnancy against the medical and the fact that his child has been conceived by assisted procreation.

73We also understand that the fear of losing the real baby inhabited him throughout the pregnancy and would have constituted an obstacle to the recognition and the acceptation of more ambivalent and/or negative affects towards the arrival of a baby that shakes the day-to-day and the future. There would be that way a displacement of the hostility on the medical staff, experienced as a persecutor in the avoidance of the culpability, linked to the ambivalence. In this idea of the prenatal anguish of loss, to stay on the imaginary baby’s side while refraining from going towards the knowledge of the real baby (for example, not want to know the sex of the child) seems to have been a solution to protect himself from an eventual loss.

74This culpability also seems to be at stake in the competition of ideals, theme which emerged throughout the interviews. Going back to ourselves and our needs, when it is time to make space for a new being, is extremely conflictual, but will find a beginning of appeasement in the postnatal period with the baby in his arms.

75Thus, the real baby’s arrival at T4 allows for the abandonment of the fighting stance to profit from the good there is to live with the medical staff (support, presence, teaching of the baby’s care…) and distances any anguish of loss that seemed to prevent him to do so in the first place. The hypothesis of the fighting stance as a protection from the intolerable ambivalent position due to the anguishes of loss confirms itself since, with the imminent and still alive baby, the doctors become good objects, protectors, supporting and validating.

76The arrival of the real baby allows the arrangement of the ambivalent position that stays conflicting, yet less intrusive. The different ideals don’t appear to be in a frontal competition anymore, but to be put into perspective.

77It seems like the whole array of those process constitutes the different issues in the construction of the paternal identity. Thus, the central themes, underlined in our descriptive panorama, are conceptualized into categories when we elaborate and illustrate them, then are integrated and articulated into a model presented at figure 3. A modelization that accounts for the process of the parental identity’s construction, namely, the passage of themes into conceptualizing categories, following their selection and linking.

Figure 3

Issues related to the construction of the parental identity during the transition to fatherhood following an assisted procreation

Issues related to the construction of the parental identity during the transition to fatherhood following an assisted procreation

The paternal identity’s construction stage

78It seems like the construction of the paternal identity of our participant may also be understood by the passage of different stages at the heart of the pregnancy’s temporality. In fact, even before knowing that the couple awaits a child, a transition process to fatherhood seems to be already activated for him, due to his history, long of many years, of fertility consultations (heritage of the assisted procreation). We understand that, as early as the first trimester, the participant questions himself on his parental representations, in search for parental models. However, the integration of the real baby’s presence takes a certain time and the accomplishment of concrete and materialistic actions at the second trimester concretizes the reality of the baby for whom the proofs of life are expected. The signs of life of the real baby at the third trimester allow the participant to construct it a place, while at the same time, constructing his own place, oscillating with ambivalence between the baby’s needs and his own. Finally, the baby’s arrival allows an arrangement of the different issues and participates to the disappearance of the anguishes of loss that were present throughout the pregnancy. Thus, it seems that the construction of the parental identity of the father occurs in a temporality in which the baby’s presence is psychically constructing itself slowly and it completes its construction with the postnatal period (T4) with the real baby in his arms.

Figure 4

Transition to fatherhood in assisted procreation: paternal identity construction stage

Transition to fatherhood in assisted procreation: paternal identity construction stage

Linking with the literature and dynamic comprehension

79The model that we just described, in its issues and temporality’s version of the construction of fatherhood in a context of assisted procreation, intersects with different points in the existing literature. In fact, in a more interpretative dimension, it is possible to think that experiences of physical and psychological intrusions are one of the consequences of the assisted procreation and that by refusing to medicalize the pregnancy, the participant seems to fight against the intrusiveness of the medical procedures. Thus, the different psychic envelopes of the father (and of the couple) may have been damaged by the assisted procreation experience, which would lead the parents to be even more fragile and vulnerable during the pregnancy. Furthermore, the process of assisted procreation has the specificity of introducing a medical third-party into the intimacy of the couples, which can be very intrusive and the man may feel powerless and passive regarding the conception of his child (Beauquier-Maccotta, 2010). According to this author, it seems that when faced with the passivity and dependence in regards to the medical professionals, the feeling of fight and tussle is frequent to rearrange the active part of the couple in the conception of the child.

80The literature on the couple allows us to understand that the passage from two to three, thus the interaction between the co-parental system and the conjugal couple system, may be a source of conflicts in the couple. In fact, awaiting a first child consists of many psychic rearrangements as much for the man as for the woman and after the birth of the child, those two systems will influence themselves (Frascarolo-Moutinot, Darwiche, & Favez, 2009). In the case of our two participants, the synchrony of the discourses and their capacity to anticipate well what one and the other lives in this awaiting of their child seems to translate a parental couple already well put in place. It is possible to make the hypothesis that the successful crossing of the adversity related to the fertility consultations participated in reinforcing the couple conjugal system and in constructing the co-parental couple system. The awaiting of many baby’s projects (miscarriages, unsuccessful attempts with the assisted procreation) may offer occasions to elaborate their own process of parentalization, and therefore, lead to a premature construction of the parental identity. The trajectory of consultation in assisted procreation may not uniquely be conceived in a traumatic perspective but could also result in a constructive heritage for the parental identity under the condition that there is a positive outcome to this process, which are namely, a pregnancy and a real baby.

81In fact, the experience of pregnancy of this dyad seems to present many traumatic characteristics of a pregnancy following a prenatal loss. Just like these pregnancies, the loss related to the miscarriage, experienced some years before, as well as the losses related to the infertility, seem to make this a pregnancy imprinted with anguish, without much representations and projections into the future, linked with a fear of repetition of the traumatic event and the mourning that is associated to it. Thus, the investment of the baby seems to be affected both at the psychic anticipation level, as well as at the physical anticipation level of the baby’s arrival (Meriot, Shulz, Soubieux, Missonnier, & Beauquier-Maccotta, 2014).

82Considering the discourse of the participant in the interview at the postnatal time, it seems that this last observation time appears like a particular time. In fact, spontaneously, the father brings links of meaning at the postnatal time that the research team had made a hypothesis about throughout the analysis that was made during the pregnancy, simultaneously with the data collection, without submitting the participant to those questionings. Thus, is it possible to understand the postnatal as an “après-coup” (Green, 2004) of the prenatal time considering the elaboration and the integration of the pregnancy’s experience present at this last time of the interview (Abella, 2010). In fact, the clinical researches of Green (2004) support the notion of “après-coup”, a fundamental concept in psychoanalysis that allows a reinterpretation of the memories, within a perspective of psychic’s temporality (Green, 2004). According to him, “the moment where it happens isn’t the moment where it means and the moment where it means isn’t apprehensible as an actual moment, but as retrospection […]” (Green, 2004, p. 22). Thus, is it possible to think that the postnatal allows a rereading of the prenatal?

83Finally, it is interesting to highlight the relevance of the longitudinal study design of this research. The three interviews in the prenatal period, as well as the interview at one month in the postnatal seem to have constructed a space to think and talk inscribed in the continuity for the participant, allowing him to put his affects into words, to narrate his experience to then, in the “après-coup” (Green, 2004), elaborate and create links with his experience. Thus, just like the issues in the therapeutic accompaniment, the narration of the experience allows to give it meaning, to reconstruct the memories and to acquire new symbolizations (Abella, 2010). By this way, listening and welcoming what the future parents have experienced, without any interpretative aim (Golse, 2006) seem to characterized the follow-up in the prenatal. Such supporting presence during the prenatal period seems to allow the subject to make his own links of psychic elaboration in the postnatal period.