Denial of pregnancy: a complex subject

Denial of pregnancy is an astonishing and complex phenomenon affecting between 600 and 1,800 women per year in France. This subject should therefore not be taken lightly. It involves learning of one's pregnancy a few days or a few moments before giving birth, having felt no pregnancy symptoms. However, how can this complex phenomenon occur? How does it manifest itself in the body, womb and psychology of the pregnant woman? This article discusses this.

What is pregnancy denial?

Denial of pregnancy

When a woman is pregnant but is unaware of it, we can discuss pregnancy denial. The individual is completely unaware of the child. This is an active psychological mechanism of forgetting. It is an extremely complex pathological situation. It is often a sign of intense psychological distress. That is, there is a physical pregnancy, but psychologically, it does not exist. For the person in denial of pregnancy, everything occurs as if she were not pregnant. The body can even create an illusion by maintaining a period. However, the pregnancy test cannot be negative. Therefore, there is a break between the mind and the body, so that some women learn of their pregnancy at delivery.

At what point can we discuss pregnancy denial?

We can discuss denial from the end of the first 14 weeks of pregnancy, at the end of the first trimester. It is impossible to discuss pregnancy denial before the end of the first trimester because the belly is not yet round, and the baby has not yet taken shape in the mind of the mother-to-be. Only from the 4th month onwards does the woman feel truly pregnant, with the certainty that she is expecting her baby.

What are the causes, risk factors and symptoms of pregnancy denial?

Causes and risk factors

Pregnancy denial affects all social groups. All women of all profiles, ages and sociocultural backgrounds can be affected. All marital situations are also affected. Women who believe they are menopausal or infertile may experience pregnancy denial.

However, identifiable causes allow identification of specific profiles for pregnancy denials:

Denial of pregnancy can occur after a miscarriage, a traumatic pregnancy or a termination. Unconsciously, because of these events, the woman may refuse to become pregnant for fear or even phobia of having another pregnancy. Traumatic circumstances are the most frequent causes.

The symptoms of pregnancy denial

The difficulty with this phenomenon is that no symptoms of pregnancy are evident. Yet, a physical pregnancy exists. An embryo is developing, although the body hides it from the mother-to-be and others.

However, symptoms occur. A woman in denial of pregnancy does not perceive the changes in her body as signs of pregnancy. If she is bleeding, she believes it is a period; if she has a stomach ache, she believes it is gastroenteritis.

Similarly, the body adapts to the beliefs of the mother-to-be. The foetus is then located under her ribs. It develops vertically instead of in the normal foetal position. The abdominal muscles may remain tense so that the abdomen appears flat, leaving no indication of pregnancy. However, a positive pregnancy test would confirm a pregnancy.

What are the consequences of pregnancy denial?

First, a pregnancy denial does not always last 9 months. The denial time can vary. The pregnant woman may discover her pregnancy after a few months, by chance, but she may also discover it when she is due to give birth.

Moreover, the longer the denial lasts, the more the baby's life is at risk. An unexpected delivery may involve several scenarios:

The woman believes she is haemorrhaging, so she calls the ambulance when she is unknowingly giving birth. She may then lose consciousness and be woken by the child's cries.

The person may then be in such a state of shock that they cannot provide first aid to the newborn, who may then lose their life.

The state of anxiety may be so high and the emotion so strong that the woman may, in an extreme case, try to dispose of the child. As the woman was unaware she was pregnant, giving birth could be extremely psychologically violent.

Psychological consequences for the mother

Denial of pregnancy is invisible but has serious consequences. Discovering the denial, once the pregnancy is revealed, can cause a severe shock:

In some cases, the woman does not want to give birth or feel she is pushing to let the baby out. She may feel that she has been pregnant without her knowledge, leading to a sense of depersonalisation.

The mother-to-be may also feel guilty. The feeling of not having given attention and love to the baby and having denied its existence unknowingly can cause extreme guilt. Pressure from society may also cause guilt.

Guilt and suffering can occur when the birth is announced to relatives. This situation can be extremely burdensome.

Being a mother without knowledge and having been unable to plan for everything required for the birth, such as clothes, food, nappies and responsibilities, is extremely difficult to bear.

Therefore, pregnancy denial is an extremely complex subject and still receives too little attention. Fortunately, the French Association for the Recognition of Denial of Pregnancy is fighting for the recognition of this disorder, in the medical community and for individuals.