Supporting Men Through Unintended Pregnancy: Lessons from Norwegian Counselors

When an unintended pregnancy occurs, the focus naturally centers on the woman, who faces both the physical reality and the legal right to make decisions about continuing the pregnancy. Yet men also navigate this challenging situation, experiencing their own emotional turmoil while trying to support their partners. A study of Norwegian pregnancy counselors reveals how healthcare professionals attempt to balance supporting both partners while respecting women's autonomy in decision making.

A Shared Crisis

Researchers interviewed 13 counselors working at a nationwide, government supported service in Norway that provides free counseling to individuals and couples facing pregnancy related decisions. All the counselors were women, ranging in age from 29 to 64, with varying levels of experience in the field.

The counselors described unintended pregnancies as creating what they called an "existential crisis" not just for women but for men as well. From one day to the next, both partners find themselves thrown into a situation that upends their sense of control and direction. The decision making process forces them to contemplate questions about their entire lives and futures, whether they'll stay together, whether they'll have children, and what kind of life they envision.

This crisis involves a "chaos" of emotions and thoughts that can feel overwhelming. The counselors observed that while the decision making process can be painful, it also serves a necessary purpose, helping clients determine what truly matters to them.

Different Ways of Expressing Distress

One recurring theme in the counselors' experiences involved the different ways women and men typically communicate about their feelings and concerns during this crisis. Counselors noticed that in couple sessions, men often approached the situation more rationally while women tended to be more in touch with their emotions.

This difference in communication styles could create challenges, with partners essentially speaking different languages and talking past one another. The counselors often found themselves needing to "translate" for men, helping them articulate their feelings and enhancing their partners' understanding of what they were experiencing.

The counselors debated whether men genuinely have a poorer emotional vocabulary, whether they suppress emotions to appear rational, or whether they simply avoid exploring their feelings. They noted that some men find sharing emotions difficult and threatening, fearing it might make them appear weak. Men often required more time to open up and discuss what truly mattered to them, and painful feelings frequently emerged once they started talking, having kept so much bottled up.

Interestingly, counselors observed generational differences, with younger men more readily sharing their feelings than older men.

The Challenge of Involvement

The degree of men's involvement in the decision making process varied widely and significantly impacted how both partners experienced the situation. Some men were genuinely supportive, others exerted pressure on their partners, and still others avoided participation entirely.

The counselors noticed that some younger men felt pressure to handle these situations appropriately, with more men now taking the initiative to book appointments for both themselves and their partners. Even men not in committed relationships were increasingly taking responsibility and wishing to be involved.

However, involvement could be complicated. Some men avoided being honest about their desires to protect their partners from feeling upset or influenced. Other men participated in conversations specifically to have the opportunity to shape the outcome. Counselors described how some men appeared passive and claimed to be there only for support, yet subtly exerted pressure through their presence and actions to influence their partner's decision.

The lack of legal decision making authority for men created additional challenges. Men who disagreed with their partner's decision or felt excluded from the process often experienced higher levels of stress and despair. At the same time, counselors recognized that men could influence women's decisions, sometimes resulting in women making choices that went against their personal wishes.

Despite these complications, the counselors generally expected men to be involved, viewing this involvement as beneficial for the woman, the man, and any potential child. They saw men as potential fathers and believed that reluctance in the present doesn't preclude good fatherhood in the future.

The Counselor's Balancing Act

The counselors described their role as requiring careful navigation of multiple competing demands. They felt an ethical responsibility to care for both partners while respecting Norwegian law, which gives women the right to decide about terminating a pregnancy up until the end of the twelfth week.

Maintaining what they called "neutrality" emerged as a central professional value. This meant treating both partners with impartiality, remaining unbiased regarding cultural and religious viewpoints, and avoiding having a personal agenda. When beginning couple sessions, counselors often explicitly stated their neutrality, partly to reassure men that despite all the counselors being women, they would not automatically side with the female partner.

However, the counselors acknowledged that complete neutrality is impossible. Their own life experiences, values, and unconscious biases inevitably influence how they interact with clients. They recognized that their body language, personal triggers, and background all play a role despite their best efforts to remain neutral.

The key, they felt, was maintaining awareness of these influences and continuously reflecting on them. Being conscious of and striving for neutrality helped them remain open to what was truly at stake for both women and men in each unique situation.

Navigating Difficult Emotions

One particularly challenging aspect of counseling men involved handling intense emotional expressions, especially anger. Counselors discussed how angry men, particularly physically large ones, could have a strong presence in the room that made both the counselor and the female partner feel uncomfortable or unsafe.

The counselors tried to maintain fearlessness and readiness to face a broad spectrum of emotions. They recognized that anger might stem from feelings of powerlessness about not being able to decide, or that other emotions like fear and sadness might underlie the anger. They used various strategies to maintain calm, balanced conversations, including naming emotions, taking breaks, ending conversations when necessary, or inviting men to individual sessions where their anger felt less threatening.

The counselors felt particularly responsible for women's safety when men expressed anger, concerned it might indicate pressure or potential violence in the relationship. Yet they also tried to create space for men to explore and express their genuine feelings.

Time Pressure and Structure

Time emerged as a crucial factor affecting both clients and counselors. With women having only until the end of the twelfth week to decide about termination, counselors often met clients with just a few weeks remaining. This created pressure to build trust and rapport quickly to address what clients truly needed to discuss.

The limited timeframe meant counselors had to effectively structure conversations while still providing space for reflection. They aimed to create a safe environment where clients could think freely, share thoughts, and openly express feelings. Building safety, trust, and recognition in the counselor relationship was critical.

The counselors used strategies like open ended questions, providing information, normalizing emotions, and raising awareness to help clients gain confidence in their decision making. They adapted their communication during crises to ensure comprehension and repeated information when needed.

Cultural and Religious Challenges

Counselors reported particular challenges when working with men whose cultural or religious beliefs led them to oppose abortion or hold conservative views about women. In these situations, they felt responsible to speak clearly about Norwegian laws, support women's autonomy, and address what they viewed as unethical behaviors like controlling women or deceiving them about relationship intentions.

These situations tested their commitment to neutrality and required heightened awareness of their own biases. The counselors emphasized the importance of reflecting on their personal values and how these might affect their interactions with clients from diverse backgrounds.

A Relational Understanding

The counselors' approach reflected what researchers describe as a relational understanding of decision making. Rather than viewing the pregnancy decision as solely the woman's concern, they recognized that partners often navigate the situation together and that their decisions influence each other.

This perspective acknowledges that respecting individual autonomy involves understanding the relationships people hold important and recognizing how individuals incorporate values from these relationships into their decisions. Including men in counseling enables them to support their partners and fosters shared responsibility for the situation and its consequences.

The approach also represents a shift from viewing unintended pregnancies as exclusively women's issues toward recognizing the involvement and impact on both partners.

The Need for Specialized Skills

The counselors stressed that their work required what they called "double competence" in both reproductive healthcare and counseling skills. They needed extensive knowledge of crisis management, abortion, pregnancy, laws, and rights, as well as understanding of the ethical considerations inherent in these sensitive conversations.

They also highlighted the importance of understanding different constructions of masculinity and how these shape both men's experiences and counselors' own expectations and perceptions. This awareness helped them recognize when their assumptions about how men "should" behave might be limiting their ability to meet men where they actually were.

Regular professional supervision provided crucial support, giving counselors space to reflect on their practice, examine their values and biases, and ensure they were providing ethical, competent care.

Implications for Healthcare

This study reveals the complexity of supporting both partners through unintended pregnancy while respecting women's legal rights and autonomy. The Norwegian counselors' experiences suggest that inclusive pregnancy counseling requires careful attention to power dynamics, communication differences, emotional intensity, and personal values.

Their approach recognizes that men, like women, may experience unintended pregnancy as an emotional and psychological challenge deserving of support. At the same time, it maintains awareness that including men must not compromise women's rights or autonomy in decision making.

The findings highlight gaps in understanding how healthcare providers can best support men in these situations. Further research could explore men's own experiences of unintended pregnancy and their interactions with healthcare services, as well as examining how different cultural contexts shape both men's involvement and providers' approaches to counseling.

As societies continue evolving their understanding of gender equality and shared parenting responsibilities, healthcare services face the ongoing challenge of developing practices that truly support all individuals affected by unintended pregnancy.