In a society that has a low tolerance for uncertainty, cases that challenge our collective notion of the possible fascinate and confuse us. Headlines such as “Baby birth shock for soldier on Afghanistan deployment”, or “I had this extremely painful urge to push and that’s when the head came out” are received with a mix of incredulity and scepticism. Yet cases of “cryptic pregnancy” – also known as “pregnancy denial” – are not particularly rare. In fact, they are estimated to occur in around one in 2,500 cases, suggesting around 320 cases in the UK annually, or a potential headline story almost every day.
In these cases, women lack all awareness of pregnancy and report experiencing few, if any, of the common symptoms. But uncertainty over the diagnosis of pregnancy is not unusual. While a woman who thinks that she may be pregnant can now carry out a shop-bought pregnancy test with a high degree of accuracy, historically and – even in the relatively recent past – it was not easy to confirm that a woman was pregnant. Signs and symptoms were described as “probable” and “presumptive” rather than diagnostic.
The symptoms of pregnancy
But if awareness of pregnancy can now be regarded as a notorious fact, what are the symptoms that any woman would recognise? And how could they still be overlooked, dismissed or ascribed to another cause?
Absence of menstrual periods is the most common early symptom of pregnancy. However, there are many reasons why a woman may not menstruate regularly, including some medical disorders and factors such as poor diet or stress. Women approaching the menopause are likely to have disrupted menstruation and some women stop having periods altogether when taking the contraceptive pill. Conversely, “menstrual–like” bleeding during pregnancy (any pregnant woman who experiences any vaginal bleeding should seek medical attention) is reported, although not explained, in around 1 per cent of women.
People can be suspicious about cryptic pregnancies. Image via iStock.
Morning sickness, the most common pregnancy symptom portrayed in the media and drama, is experienced by around 70 per cent of pregnant womenbut varies widely in severity and duration and may again be attributed to numerous other causes.
Weight gain is another usual symptom. The “average” pregnant women would be expected to gain around 12.5kg but this is widely variable and subject to cultural and ethnic difference. But many women anticipate gaining weight and an increased waist circumference around the menopause – and, at any age, weight gain is easily explained: for example, as the result of comfort eating in times of stress. The relationship between maternal and fetal nutrition is complex. Women who have a restricted diet (intentionally or unintentionally) throughout pregnancy may gain very little weight, while the baby’s birth weight may still be within the normal range. Although there may be longer-term health consequences for babies of mothers whose diet is very poor during pregnancy. Either way, it is another symptom that easily can be overlooked.
Most women start to feel fetal movement between 18 and 20 weeks of pregnancy. Early movements are often described as a flutter, and in the early weeks are easily confused with abdominal gas. However, fetal movements do increase in strength as the baby grows and women are advised that they should feel movements right up until and beyond the start of labour. For those pregnant women who have had a cup kicked from their belly by the baby within, it is difficult to understand how this can be mistaken, but cases of cryptic pregnancy in which women have reported feeling no fetal movements indicate the contrary.