Pregnancy

Cryptic Pregnancy: Is it possible to be pregnant without knowing it?

A cryptic pregnancy is a pregnancy that for some reason is not recognized by tests or by the woman herself. In this article we explain why it can happen, on a case-by-case basis.

Cryptic pregnancy , also known as hidden or invisible pregnancy , is a rare event which however, when it happens, has a particular media resonance. TV shows like “ I Didn’t Know I Was Pregnant ,” which you may have heard of, feature extreme examples of this condition.

In fact, about 1 in 475 women may not be aware that they are pregnant, for the first few months or even for the entire duration of the pregnancy. But how is it possible to be pregnant without knowing it?  In this article, we will see in which situations it can happen: from false negative tests, to the absence of obvious symptoms (including the belly), up to causes of a psychological nature.

Why might a woman not realize she’s pregnant?

To understand cases of cryptic pregnancy, we must first consider what happens in a “normal ” pregnancy.

At what week do you find out you are pregnant?

Most women realize they are pregnant between 5 and 12 weeks of pregnancy. Usually, if menstruation is delayed compared to the expected deadline, home pregnancy tests are used , which will show a positive result in case of conception.

Further tests, such as beta HCG in the blood and subsequently the first ultrasound (not before 5 weeks of pregnancy) will confirm the sweet expectation.

In the meantime, most women will notice the first symptoms of pregnancy , i.e. typical first trimester ailments which vary from person to person and which can include breast tenderness, mood swings, tiredness, nausea and above all the failure to arrive Menses.

In the case of a cryptic pregnancy, there is no chain of events (or the woman herself does not want to see or accept) that should lead her to take a pregnancy test or the appropriate investigations.

The woman is pregnant but the test is negative

pregnancy test may come back negative if it’s taken too early, done incorrectly, or if it’s simply overdue. In this case, we speak of a false negative .

For example, if the woman records a delay in menstruation but it is not effective, because in that cycle she ovulated much later than usual, a test performed at the menstrual due date would not reveal a possible pregnancy in progress. In this regard, it is important to remember that we can speak of a real menstrual delay only if more than 16 days have passed since ovulation has been ascertained.

Pregnancy without symptoms

In some cases, the gestation can proceed without any obvious symptoms. Other times, the first symptoms of pregnancy may not be recognized: nausea, for example, could be mistaken for symptoms of stomach flu or indigestion.

Bellyless pregnancy

The  size of the belly varies from woman to woman and from pregnancy to pregnancy: in some situations the waist increases very early, while in others the belly only becomes evident later.

In overweight or obese conditions , abdominal growth and weight gain may go unnoticed or be confused with an increase in body fat.

Period in pregnancy

Even in a normally proceeding pregnancy, it can happen that you have some small bleeding due to hormonal fluctuations, which can be interpreted as menstruation. The woman, especially if she does not recognize or experience other particular symptoms, is not motivated to carry out any type of test or assessment.

apparent infertility

If the woman has been diagnosed with infertility  or suffers from polycystic ovarian disease , she may not evaluate the delay or lack of menstruation as a symptom of pregnancy, especially if the cycle is very irregular. Anyone who has already experienced so many disappointments, has never seen a positive test and comes from so many unsuccessful attempts, may have dismissed the possibility of pregnancy. In these cases, it may happen that you do not believe in the possibility of being pregnant and do not investigate further with a test.

A woman who is unaware that she is pregnant and does not feel or recognize the symptoms of pregnancy could go several months without realizing the situation, especially if she has never been pregnant before .

In fact, at least initially, it’s not that difficult to ignore early pregnancy symptoms (such as slight weight gain and fatigue) or to justify them as a consequence of dietary or lifestyle choices.

Cryptic pregnancy: the most common causes

The most frequent situations that lead to not immediately noticing pregnancy are the following

Polycystic ovary syndrome (PCOS)

This condition can limit fertility, create hormonal imbalances and cause irregular periods and absence of periods for months.

Perimenopause

This defines the interval between the moment in which menstruation begins to become less regular and in which fertility is completely interrupted (menopause). Some pregnancy symptoms, such as weight gain and hormone fluctuations, can be very similar to perimenopause symptoms.

Incorrect use of the pill or other contraceptive methods

The use of birth control pills, such as the pill , intrauterine devices (IUDs) or condoms , can make people think they are “immune” to pregnancy. Although these methods are very effective, using them incorrectly can still expose you to the risk of becoming pregnant.

Unprotected intercourse after childbirth

It is possible for fertility to resume soon after a pregnancy, even during breastfeeding and before menstruation returns (the so-called foreman ). Because breastfeeding and hormonal factors can cause the body to delay ovulation for several months after birth, a woman may not realize she is pregnant because her period has not returned yet and think that pregnancy symptoms are related to postpartum.

Excessive thinness and/or competitive physical activity

These conditions can cause menstruation to disappear for months. Furthermore, people who practice high-level sports may have low levels of some hormones, which makes it more difficult to diagnose pregnancy.

Psychological, social or cultural causes

There are situations where a woman does not realize that she is pregnant because she is unable to recognize that she is pregnant. We are talking, for example, of mental disorders in which the woman is unable to understand what is happening to her or cases of violence, abuse  or severe social discomfort , in which there is an abusive partner or a family that would not offer her support or would not approve the pregnancy. Furthermore, there are also situations where women  become pregnant in their early teens , even before they understand what the symptoms of pregnancy are.

Labor and delivery after a cryptic pregnancy

The labor and delivery at the end of a cryptic pregnancy is physically similar to any other pregnancy. What changes is that the woman does not expect this event and this can cause significant psychological discomfort.

If the woman is having contractions but does not know she is pregnant and therefore feels unjustified pain for her, she may be late in seeking and receiving adequate prenatal care.

The downsides of cryptic pregnancy

Being pregnant without knowing it can expose mother and child to a number of risks. For example, the lack of prenatal care, poor diet and lifestyle of a person who is unaware of their pregnancy could, for example,  increase the chances of a premature birth .

In conclusion

Cryptic pregnancy is a real condition albeit, fortunately, quite rare.

If you have any doubts that you may be pregnant , please note that conventional first trimester testing methods, such as blood tests, urine tests and ultrasounds , are all reliable tests for most pregnancies.

If you continue to have symptoms of pregnancy after having already taken a negative test , repeat the test one week later. If the result is still negative and your period has not arrived, talk to your doctor right away.

Remember that if you are in difficulty or fear that you will not be able to manage the pregnancy or that you will not be able to talk about it with your family , you can go to the local consultants or women’s aid centres.

Dr Kathryn Barlow

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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