Skip to main content

Verified by Psychology Today

Pregnancy

How Could You Be Pregnant (For Months) and Not Know It?

Why 1 in 450 doesn't know her status until she's four months from delivery

Here are the astonishing statistics: among pregnant women, 1 in 450 doesn't know her status until week twenty or later (more than halfway through the pregnancy), and 1 in 2,500 is oblivious until she actually goes into labor. The latter are known to give birth, without medical assistance and in agonizing pain, in Walmart bathrooms and at proms, in dorm rooms and in their own bathrooms.

But I know what you're thinking because I've thought it too: it's denial. On some level these women must've known they were pregnant but couldn't deal with the reality.

Yet the more I explore the origins of cryptic pregnancy, as the condition is clinically called, I realize that denial or mental illness doesn't explain most of the cases.

Only a minority of cryptic pregnancy cases has been attributed to personality disturbances (8 percent) or schizophrenia (5 percent). It appears that most of these women are perfectly sane, educated, and in stable relationships. Quite simply, they do not know they're pregnant because they have no symptoms -- no weight gain, no nausea, and little to no abdominal swelling. Or the symptoms are so subtle as to be easily mistaken for something else.

According to evolutionary psychologist Marco Del Giudice, cryptic pregnancy might happen in a few ways.

Every pregnancy is a tug-of-war of resources between Mom and fetus. Each has her self-interest in mind. Most of the time the tug-of-war ends up in a happy equilibrium. Mom provides enough nutrients, but not too much too handicap herself. But sometimes Mom gets more rope....at the expense of the fetus.

Del Guidice claims that in some situations the fetus might not be putting out enough signals that it exists and needs resources. One way fetuses make mothers aware of their existence is through HCG, the hormone that makes a home pregnancy test turn positive. In many cases, the higher the HCG, the more severe the morning sickness and other symptoms.

A baby that produces a scant amount amounts of HCG might go "under the radar," failing the pregnancy test and going unnoticed by the mother -- physiologically and psychologically. This would mean the baby gets fewer resources than she otherwise would. The lack of HCG signaling in cryptic pregnancies explains why these babies are so often born preterm, underweight, and small for their gestational age. They didn't ask for more resources from Mom, and they didn't get any.

There are a few reasons why a baby wouldn't produce enough HCG. One is chromosomal anomalies; that is, the fetus has a birth defect and is in danger of miscarrying. It's also possible that an otherwise healthy fetus simply puts out low quantities of the hormone due to a genetic quirk.

Or, here's an interesting theory: Maybe Mom has stress and relationship problems. In this case, biologically speaking, it may be in the fetus's best interest for the mother to be completely oblivious to the fact that she's carrying to prevent being rejected and miscarried, which may happen when a woman is stressed.

As Del Giudice points out, in our evolutionary past a woman who did not know she was pregnant and had few to no symptoms could conserve precious energy. She would be able to move freely and eat food of any kind, and as a result be better able to survive in the face of stresses and threats. In this case, babies may put out less HCG or stressed-out moms may unconsciously lower their sensitivity to the hormones.

Seen this way, cryptic pregnancy is an adaptive "emergency" mechanism -- essentially, the fetus sensing a threat and striking a bargain with the mother by demanding little and laying low. When the normal stresses of pregnancy might otherwise trigger a miscarriage, this "stealth strategy" allows the fetus to survive.

*If you like this blog, click here for previous posts (including this one) and here to read a description of my most recent book, Do Gentlemen Really Prefer Blondes?, on the science behind love, sex, and attraction. If you wish, check out my forthcoming book, Do Chocolate Lovers Have Sweeter Babies?: The Surprising Science of Pregnancy.

advertisement
More from Jena E Pincott
More from Psychology Today