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There are two distinct pregnancy experiences that aren’t well known but which are quite significant phenomena with potential implications going beyond the confines of pregnancy and childbirth. These are Phantom pregnancy (pseudocyesis) and concealed pregnancy.
Phantom Pregnancy
A woman with phantom pregnancy exhibits all or most of the usual pregnancy signs and symptoms. These would include lethargy, nausea and vomiting, breast engorgement, increasing abdominal size and of-course absence of menstrual periods.
Phantom pregnancy which is also medically termed ‘Pseudocyesis’ (Greek: pseudes[false] and kyesis [pregnancy])is not a new phenomenon. The most famous historical sufferer was probably Queen Mary I, the daughter of King Henry VIII and ruler of England in the mid-16th century. Even Hippocrates ‘The Father of Medicine’ described cases of pseudocyesis all those centuries ago.
Causes of Phantom Pregnancy
Nobody knows for sure what causes phantom pregnancy. However, one thing binds sufferers together: The extreme desire to bear a child. Contrary to some descriptions, Phantom Pregnancy is not the same as ‘feigned pregnancy’. There is one important difference: Women with phantom pregnancy are absolutely convinced that they are pregnant. Even a negative pregnancy test and a negative ultrasound scan are not sufficient to shake their belief. They are not trying to deceive anybody and will describe all the common experiences of a pregnant woman including fetal movements.
Feigned pregnancy merely refers to women who set out to deceive others that they are pregnant for a variety of reasons. This includes the women criminals who put out an elaborate plan, the end of which is meant to be the stealing of infants from other women and passing them off as their own newborns after a well demonstrated ‘pregnancy’. That is not Phantom pregnancy.
True phantom pregnancy is thought to have a deep psychological basis, strong enough to bring about the hormonal changes which cause the display of the physical features such as absence of periods, breast engorgement and abdominal swelling which is merely gaseous distension of the bowel.
Treating Phantom Pregnancy
Phantom pregnancy is quite uncommon. However, women who suffer from this do require sympathetic specialised counselling by a psychotherapist. It is a condition that affects women of any age even though it is more common for women in their 30s and 40s. It could and often does affect women who already have children.
Concealed Pregnancy
At the other end of the spectrum we have a rather more common phenomenon; that of Concealed Pregnancy. Many and varied issues surround the issue of concealed pregnancy.
- Historically and to this day in many parts of the world, concealment of a pregnancy was prompted by the harsh consequences of conceiving while still unwed. There was the social stigma of being an unwed mother and in some cases being ostracised. Whilst this has largely disappeared in many parts of the western world, pockets of this remain in some communities. Sometimes the concealment is actively pursued to buy time to terminate the pregnancy before it become apparent to others. This is particularly significant in many developing countries where safe pregnancy termination services remain unavailable. Even in some western countries, this is a live issue as exemplified by a study in Ireland (where abortion is illegal) reported in 2006 which showed that the problem remains with the chief reason being the expected disapproval by the immediate family when pregnancy is conceived in unconventional circumstances.
- Concealment may be related to Child Protection Issues. This is when a mother has been identified by Social Services to be potentially unfit to look after a child, usually on the basis of what had transpired previously with other older children. The mother may then opt to actively conceal a pregnancy to offset the possibility of having the expected child being taken away from her.
- Denial of Pregnancy: This is rather different from classic pregnancy concealment. Here the woman refuses to accept the reality of the pregnancy, both to her and the society at large. She therefore refuses to make any appropriate adjustment or preparations and in effect wishes it away. This is usually born of the deep fear of the consequences of the pregnancy which she perceives to be horrific and unimaginable.
Consequences of Pregnancy Concealment
In those countries where safe pregnancy termination services are unavailable, pregnancy concealment continues to take a heavy toll in the shape of thousands of lives lost and countless others, usually young women, permanently maimed in the process of procuring illegal pregnancy termination. In 2003, the World Health Organisation (WHO) reported that over 4 million women have illegal abortion every year in South America alone, with hundreds of thousands being left maimed or dead in the process.
In January 2007, the BBC reported from Ghana (where pregnancy termination is illegal) that official figures there show that 30% of all maternal deaths each year are due to illegal abortion.
For those women who conceal pregnancies with no intention of termination, the potential problems are of a different nature. What binds these women, wherever they might be in the world, is the fact that they do not get any sort of antenatal care. In fact many of them will also make arrangements that they give birth alone, without any sort of help.
The absence of antenatal or intrapartum (during labour) care means the lives of both mother and baby is put in peril. It is true that most pregnancies and deliveries do progress without a hitch. Unfortunately some women with concealed pregnancies will experience complications which could and in some cases does lead them to lose both their lives and that of the baby. Even where delivery is uneventful, tragically, some newborns are abandoned by their mothers soon after birth in a determined effort to carry on with the concealment. Many of these babies perish.
Pregnancy concealment is a huge and complex social issue rather than a medical one. As shown above, there are several varied strands that influence this.
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Gerri Santoro died alone in a motel room in Connecticut in 1964 after this botched illegal abortion
Phantom Pregnancy and Concealed Pregnancy:
Two ends of a broad spectrum