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Jena Pincott

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How Can You Be Pregnant (For Months) And Not Know It?

Posted: 11/08/11 01:23 PM ET

Here are some astonishing statistics: Among pregnant women, 1 in 450 doesn't know her status until week 20 or later (more than halfway through the pregnancy), and 1 in 2,500 is oblivious until she actually goes into labor.

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

Yet when I explored the origins of cryptic pregnancy -- the clinical name for this condition -- I realized that denial or mental illness doesn't fully explain the phenomenon.

Only a minority of cryptic pregnancy cases has been attributed to personality disturbances (eight percent) or schizophrenia (five percent). It appears that most unexpectedly expectant mothers are perfectly sane and educated. 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. They may still have their periods, or have always had irregular periods. If they have symptoms, they're so subtle as to be easily mistaken for something else. Indigestion, perhaps.

There's a very real and perfectly valid reason for this, according to Marco Del Giudice, a cognitive scientist at the University of Turin. And it's linked to an expectant mother's stress-levels.

Pregnancy is often a tug-of-war between mother and fetus for the mother's limited resources. Most of the time it ends in a happy equilibrium -- the fetus takes nutrients from the mother, but not enough to cause harm. The mother holds back, but not enough to harm the fetus.

Sometimes, though, under some conditions, mom gets a lot of rope -- at the fetus's expense.

One way that embryos and fetuses make their demands known is by putting out a hormone called human chorionic gonadotropin (HCG). This is the hormone that makes a home pregnancy test turn positive. A baby that produces a scant amount amount of HCG might go "under the radar," failing the pregnancy test and going undetected by the mother.

When a fetus doesn't put out much HCG, he or she also gets fewer resources. This explains why these babies are so often small for their age and are born preterm and underweight.

There are a few factors that contribute to a fetus not producing enough of the pregnancy hormone:

1. Chromosomal anomalies: That is, the fetus has a birth defect.

2. Genes: It's also possible that an otherwise healthy fetus simply puts out low quantities of the hormone due to a genetic quirk.

3. Stress: According to one theory, a fetus could produce low levels of HCG because the mother is facing extraordinary stress. In this case, it's in the fetus's best interest for the mother to be happily oblivious to the fact that she's pregnant. Sometimes, the normal stresses of a pregnancy combined with other stresses in a mother's life can lead to miscarriage. But a 'stealth' pregnancy that uses few resources in a mother's body can actually increase the fetus's chance of survival.

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. This stealth strategy isn't helpful in good times (there are advantages to nausea and food aversions and, obviously, a full-size, full-term fetus). But in hard times (famine, war, loss of mother's partner or support network, etc.) an undemanding, under-the-radar pregnancy could be tremendously advantageous. Under these conditions, fetuses put out less HCG, or stressed-out moms may unconsciously lower their sensitivity to the hormone.

Seen this way, a cryptic pregnancy is an adaptive "emergency" mechanism -- essentially, the fetus sensing a threat and striking a bargain by demanding little and laying low to maximize its chances of being born.

Bottom line: A negative pregnancy test doesn't always mean you're not pregnant (even weeks or months after a possible conception).


*If you like this blog, click here for previous posts. If you wish, check out my new book,Do Chocolate Lovers Have Sweeter Babies?: The Surprising Science of Pregnancy.

 
 
 

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Here are some astonishing statistics: Among pregnant women, 1 in 450 doesn't know her status until week 20 or later (more than halfway through the pregnancy), and 1 in 2,500 is oblivious until she ac...
Here are some astonishing statistics: Among pregnant women, 1 in 450 doesn't know her status until week 20 or later (more than halfway through the pregnancy), and 1 in 2,500 is oblivious until she ac...
 
 
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02:42 PM on 12/23/2011
Hey now! I was 17.3 weeks along before I knew! And the only reason I even knew then was my cousin bought tests...at the DOLLAR STORE hahaha and I took one for fun with her and hers was negative and mine was positive! And here I am today with a 2 month old son! :) If ur mind isn't prepared or doesn't believe u are ur body actually responds to that belief, I stayed the same size right up until I found out then all the sudden when I came to terms with it I went through some severe growing pains and BAM a belly appeared. :)
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Brianne DeRosa
01:57 PM on 12/16/2011
This finally explains it. :-)
With my first son, I KNEW I was pregnant. I didn't have any symptoms to speak of, other than a missed period, but I just knew. And the pregnancy test showed it.
With my second son, I was going through a horribly stressful time in life -- sudden loss of job, long period of unemployment, financial stresses, developmental stresses with the first child, etc., etc. I was also taking birth control pills, so even though my periods became irregular, I attributed the whole thing to stress (irregular periods have happened to me during very stressful times before). I had no other symptoms; just like in my first pregnancy, I didn't show until almost 6 months along, I had no nausea, etc. It wasn't until one day my husband accidentally bumped into me and I winced at how tender my breasts felt that we looked at each other and said "Uh-oh."
I was over 16 weeks along at that point. My now 2 1/2 year old son has proven himself to be a determined fighter who can figure out how to get what he wants in life. The concept of a "stealth" pregnancy working to his advantage does not surprise me at all!
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11:57 AM on 12/18/2011
Missing your period is usually a pretty good indicator that you are pregnant, just like having sex is a good predictor of it.
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Brianne DeRosa
10:46 AM on 12/19/2011
Agreed. But you'll notice I didn't say "missed." I said "irregular." Two different things.
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PootiePoot
100% stardust
01:17 PM on 12/16/2011
In order for a woman to be pregnant without knowing it (passed, say the 5th month). A woman has to be seriously disconnected from her body, in complete denial of reality or a little/lot of both. I was somewhat disconnected from m body when I became a mom for the first time but the staggering changes in my body, feelings, mood, sensations, etc. Wow! Ladies, come on?? This is scary.
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01:07 AM on 12/15/2011
Prior to having a successful pregnancy (the first ended in miscarriage) I used to judge big time. How could a woman not know she was pregnant? What pregnancy taught me is that every woman is different. It seemed I had EVERY symptom ever documented from vertigo to bloody nose to “super” smell to super duper itchy skin to hemorrhoids. And, I knew I was pregnant at about 6 weeks – something was just “off”. When I discussed these symptoms with my friends who were moms, the response was absolute “Oh, I never had that.”
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ziggy3339
07:52 PM on 12/13/2011
True story: Friend went to a doctor who told her she wasn't pregnant. Took home tests twice w/ not pregnant results. Went back to doctor who told her she needed more rest is all. Didn't realize she was pregnant until she went into LABOR! This happened back in the 60's but I never forgot it. Thought I'd share.
01:18 PM on 12/11/2011
I like everyone else thought "there is no way that they couldnt know" But i ended up going through this myself and didnt find out i was pregnant until i was 24 weeks. I had gained weight I was actually lost weight which made my pregnancy high risk. I also was carrying deep so i never showed until my last month. My whole pregnancy I didnt get any symptoms. No swollen ankles, nausa, and my period was the same maybe just a little lighter but I chalked that up to me being stressed from going to school and working 2 jobs at the time. but i never thought I may have been pregnant. But I am SOOOO happy i had here and I love my baby with everything.
07:02 PM on 12/09/2011
I can definitely understand how some women wouldn't know. I was trying to get pregnant, so I was taking an obscene amount of pregnancy tests (the ones that claimed up to 7 days before pregnancy!). That said, if I hadn't been trying, I would never have known with my first pregnancy. I didn't have symptoms first trimester, and I didn't start showing until the end of my 6th month. Every woman's body is different. Some women don't get their periods regularly, some don't show, etc.
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riverlee34
03:14 PM on 12/09/2011
I didn't find out until about 4 months with my Daughter. I had alot of issues with my son (almost 9 years ago) he was VERY premature and after, when I tried to get Pregnant, I was told I would not be able to. I tried and tried, for about 2 years, then fianally just accepted it. Last year, I got Pneuomonia, after I was done with the Meds, I still didn't feel good, months went by, finally I went to the Dr and found out I was 15 weeks along. Shocked doesn't even cover it, LOL! But we were happy, now I have a 10 month old Daughter who was a huge suprize, but I couldn't be happier. (I did however, have my tubes tied to, hopefully, prevent any more suprizes in another 8 years!)
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Mustangallee
What you write here will be in cyberspace forever!
01:35 PM on 12/09/2011
I don't like when the writer said it is denial. Not all brains work the same way!
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PootiePoot
100% stardust
01:21 PM on 12/16/2011
It's not denial, it's disconnection. Plain and simple and for whatever reason.
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dancerctry
I love Gardening and Decorating
01:33 PM on 12/09/2011
I miscarried for the first time at 13 weeks and didn't know I was pregnant. That was in 2002 when I was in college (engaged to my husband of 7 years now). Had had a strange version of my period each month (hard and stringy but the pattern and quantity was the same). I was a little more nausous but in the middle of an eating disorder and was a Dance Major at that time (21 years old). The only real way I suspected pregnancy was that I couldn't get this thought out of my head: "my only way out is a miscarriage because I could never do abortion" (emotionally not religiouly). I went on to have two more miscarriages after we had been married for two years and were trying to get pregnant and now have a 2 1/2 year old son (I'm A SAHM). My problem is low progesterone. If I don't find out right away and take medicine I will miscarry. It's High Risk.
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Watching rock grow
FE = Iron, and Female = Iron Male :)
12:55 PM on 12/09/2011
Thank you for the real reasons why this exists. However, I can assure you many will simply continue to believe their own knowledge is greater than fact.
12:45 PM on 12/09/2011
My cousin went through a whole pregnancy being treated for kidney problems ( which were non existent, she would later find out). She was actually at a party , drinking beer the night of the delivery. When the pain was too intense she went to the ER and delivered her unknown daughter while being questioned by the ER physician in the exam room. She never looked pregnant the whole time but she had retained "water" everywhere and blew up from head to toe during her pregnancy. She almost lost her daughter to the state thanks to her doctor's ineptness. She had to go to court to prove to the state that she unknowingly consumed alcoholic beverages while pregnant due to a misdiagnosis by her physician. She didn't even get to hold her daughter for over 3 months after the delivery.She should have sued but she was just so grateful to have her daughter after being told she couldn't have children that she never pursued justice for herself or her child. Crazy things happen to sane people, period. It doesn't mean that they have a mental defect.
12:36 PM on 12/09/2011
When I was younger,I got pregnant.This was when I was a mess-partying all of the time,addicted to drugs,drunk every day. I admit,I was in denial for a little while,but,by week 11,I had realized that there was something going on. I went in and found out I was pregnant. I'm saying this because,if I an figure it out when I was living in a dark,dank hole,drugged up and drunk every single day,then there is absolutely no reason why a normal,healthy woman can't figure it out sooner than week 20.
07:04 PM on 12/09/2011
Not everyone's experience is the same.
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cwebster
predominantly exasperated
06:23 PM on 12/11/2011
Everyone has different symptoms, and different experiences.
12:03 PM on 12/09/2011
I have had every pregnancy symptom imaginable (I was sick all day and night until most of the way through my second trimester), and I started showing very early on. I still have three more months to go but there was no denying I was pregnant, even in my first trimester.

Every pregnancy is different though, and body type can make a difference too. I can't imagine what it would be like to go to the hospital for stomach cramps and come home with a surprise baby.
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Mustangallee
What you write here will be in cyberspace forever!
01:38 PM on 12/09/2011
With my oldest daughter I just looked like I got fatter..in no way did I look pregnant!
With my middle daughter..I looked pregnant from month 2...nothing on the sides or the back, just a long water melon shaped belly sticking straight out. It is weird!
11:39 AM on 12/09/2011
I've been pregnant four times and have four children. In each case, I knew I was pregnant before I missed a period. I'm sure this happens VERY rarely, but in most cases I'm certain it's either ignorance or denial. OTC pregnancy tests are reliable, and if you're still not sure, you can get a pregnancy test at your doctor's office.
07:37 PM on 12/10/2011
Did you read the article? Pregnancy tests don't register pregnancy if someone is pregnant but doesn't have sufficient level of pregnancy hormone. And the article explained how it isn't ignorance or denial. Not everyone's body and mind are the same as yours.
01:57 PM on 12/14/2011
Are you commenting on the same article? Thank you for your wise advice about OTC pregnancy tests. Not everybody's body reacts the same to pregnancy; some people have irregular periods, so they don't know a difference and they can also chalk up weight gain or sickness to other reasons. You're certain it's ignorance or denial? I have heard of women who have taken OTC pregnancy tests and it said negative for whatever reason, so why would they then go their doctor and request a blood test?