In a “typical” pregnancy, one can expect nausea, missed periods, and abdominal swelling—all the tell-tale signs. Most people discover they’re pregnant within 5 to 12 weeks after conception, usually due to a missed period.
An at-home test, followed by urine testing, blood testing and an ultrasound with an OB-GYN, will then confirm the pregnancy, giving the pregnant person the information and guidance needed to prepare and proceed.
However, there are some situations when a pregnant person might not experience these symptoms at all, or may not be able to fully grasp and acknowledge the symptoms they are experiencing. This is called a cryptic pregnancy.
Sometimes referred to as stealth or hidden pregnancy, a cryptic pregnancy is one in which the pregnant person is unaware of their condition until late in their pregnancy, even up until the beginning of labour.
Cryptic pregnancy is rare. According to the Cleveland Clinic, about 1 in 475 pregnancies go unnoticed until about 20 weeks gestation. About 1 in 2,500 pregnancies go unnoticed until delivery. But these pregnancies also make headlines, and are even the subject of sensationalist reality TV shows like “I Didn’t Know I was Pregnant”.
But how does one go through pregnancy without knowing they are pregnant? There are a few factors to consider.
Categories of Cryptic Pregnancy:
The National Library of Medicine says that cryptic pregnancies are either “psychotic” or “non-psychotic” in nature.
The psychotic type is linked to psychiatric disorders and is much less common.
The non-psychotic type is either affective, pervasive, or persistent.
- In affective denial, the patient understands they are pregnant on an intellectual level, but cannot acknowledge the pregnancy fully because they are not emotionally or physically prepared for pregnancy, childbirth and/or parenthood.
- In pervasive or persistent denial, the pregnant person simply does not know they are pregnant.
Causes of Cryptic Pregnancy:
While there is no clear cause of a cryptic pregnancy, some risk factors include younger age, lack of social support, and struggles with mental health.
On top of that, there are certain conditions associated with cryptic pregnancy, such as PCOS, perimenopause, and low body fat.
PCOS can cause irregular periods, which can make it more difficult to use cycle tracking as a tool for knowing you’re pregnant. It’s also possible for PCOS to impact the pregnancy hormone that gives a positive result on an at-home pregnancy test, potentially leading to a false negative.
In perimenopause one faces a similar issue when periods grow less consistent or stop altogether. Hormone fluctuations and weight gain associated with pregnancy may be inaccurately chalked up to perimenopause symptoms.
Finally, intense athletic activity and low body fat may also impact the frequency of your period, making it less likely for you to know you are pregnant in the early stages.
Complications:
When a pregnancy goes undetected, there can be impacts on the pregnant person and the baby. If someone doesn’t realize they are pregnant, they are unable to take adequate steps to seek prenatal care and make appropriate lifestyle adjustments to support their pregnancy. They may also be uneducated on the experience of childbirth, which may lead to an unassisted delivery.
Home births can be very safe, but they are not without risk, especially when the person going into labour does not know they are pregnant. In rare instances, there may be a chance of prematurity in the newborn, as well as hospitalization and death.
As cryptic pregnancy progresses, individuals and doctors are more likely to detect the pregnancy, so these types of situations remain uncommon.
Course of action and takeaway:
Cryptic pregnancies are sometimes caused by an inability to acknowledge the pregnancy on the pregnant person’s part. In these cases, mental health factors and the potential of an abusive situation must be considered. Education and psychological and social support are necessary to provide the patient with care, to give them agency and to help prepare them for the next steps, whatever they may be.
These types of pregnancies can be a symptom of a larger social problem. Whether they involve a young person who fears ostracization or rejection from family members, a woman who cannot emotionally acknowledge the pregnancy because she’s concerned for her safety, or someone struggling with mental health or substance abuse issues who is not fully in tune with their body and its signs—cryptic pregnancies show up in a myriad of ways. Most of them point to a need for more education and support.
Cryptic pregnancy can clearly have an impact on the pregnant person and their baby. All people with the potential to carry children need access to decent medical care to rule out pregnancy, or, in the case that they are experiencing a cryptic pregnancy, immediate assistance moving along their journey.