Pregnancy is a special moment in every woman’s life. It can be a time of joy or, unfortunately, a cause of suffering, but it remains indelibly imprinted in the memory. Or at least almost always: in some cases, quite rare, it is possible that a pregnant woman does not realize she is pregnant. For months, or even until labor pains arrive. They are called cryptic pregnancies (or also, in English, pregnancy denial), and they are a real phenomenon, although rare, that can affect women of any age and social background, and have very different causes. Let’s see what it is.
Invisible pregnancies
The idea that pregnancy, with all the changes it imposes on the female body, can go unnoticed is certainly surprising. And in fact, as rare as it is, the phenomenon of crypto pregnancies regularly finds space in the media. And it was the focus of an American docuseries, distributed in Italy with the title “Non sai di essere pugno”, which recounts some of the most incredible cases of unexpected births that have occurred in and outside the United States.
There is no shortage of recent stories. There is that of a forty-year-old from Saronno, who on January 22 showed up at the city’s emergency room with abdominal pain and incontinence problems, only to discover there that she was pregnant and about to give birth. Or that of the Texan student Teagan, who found herself giving birth sitting on the toilet while talking to a 911 operator (the American number for emergencies), after mistaking contractions for colic, and who decided to tell the story of this unexpected pregnancy (of which she had no warning) in a series of viral videos on Tik Tok.
The symptoms that are missing
As the cases just cited demonstrate, cryptic pregnancies are a rare phenomenon, but not that rare. In the scientific literature, an incidence of one case in 475 pregnancies is estimated in which the woman discovers she is pregnant around the twentieth week of gestation (so more or less in the fifth month, when physiological changes have normally already made it obvious to most women that they are pregnant), and one case in 2,500 in which she discovers it only at the moment of delivery.
In some cases, some symptoms, or rather the lack thereof, complicate the recognition of pregnancy: nausea is not always present during pregnancy, there may be light bleeding caused by pregnancy that is mistaken for normal menstruation, or it may be the case that menstruation was absent even before the pregnancy, due to pathologies or the intake of medications. Even the appearance of the baby bump is not the same for all women, and may not be recognized as such, especially in the case of obese or very tall women. Recently, for example, 23-year-old Nikki Salazar from New Jersey testified with a series of videos on Tik Tok to her strange pregnancy, which reached the moment of birth without any obvious signs of the baby bump (much to her disappointment, since apparently she would have wanted a long series of souvenir photos with the baby bump to share with the family).
Causes of cryptic pregnancies
As we were saying, cryptic pregnancies can be of many types, and often incorporate a psychological or psychiatric aspect (the cases in which the body does not really give any indication of a pregnancy are very rare, and therefore almost always there is at least a component of denial, or denial in English, that is, a psychological refusal to accept the situation). Those classified as “psychotic”, for example, are linked to psychiatric pathologies, such as schizophrenia, which prevent the woman from recognizing the fact that she is pregnant, or make her believe that the symptoms of pregnancy are attributable to health problems, such as a tumor. Non-psychotic cryptic pregnancies are then usually catalogued into three other subgroups.
In the “pervasive” ones, pregnant women never realize they are pregnant, at least consciously, for psychological reasons and often due to the lack of obvious physiological symptoms. In the “affective” ones, on the other hand, women are aware of being pregnant on a purely intellectual level, but do not want to recognize it on an emotional level, and therefore avoid making any physical or emotional preparations for childbirth. The last subgroup, the one defined as “persistent,” concerns women who realize they are pregnant within the third trimester, but refuse to accept it consciously, and therefore do not seek medical assistance during the pregnancy, and often end up giving birth alone, at home and without the help of specialized personnel.
On the epidemiological front, cryptic pregnancies can occur at any time in a woman’s life, in any sentimental and socioeconomic context. The only potential risk factors found in the scientific literature, which are quite obvious, are young age, being single and having a history of psychiatric problems. As for the risks of cryptic pregnancies, available studies speak of difficulties in emotional attachment with the newborn, risks of mistreatment, infanticide or other types of abuse in the first months of life.