How can a pregnancy denial be explained and detected?

The exact definition of pregnancy denial and how it can occur in a woman’s life are still highly controversial topics within the scientific and medical communities.

Let’s take a look at what we currently know about pregnancy denial.

What is pregnancy denial?

Pregnancy denial is when a woman is pregnant but unaware of it. Pregnancy denial is classified into two types: partial denial (which ends before the due date) and total denial (which continues until childbirth, or even afterward).
It’s important to note that pregnancy denial is different from a hidden pregnancy. In a hidden pregnancy, the woman is aware that she is pregnant but chooses to hide it from those around her. In a pregnancy denial, the woman herself is unaware that she is expecting a child.

It may seem improbable to be pregnant and not realize it, especially since the usual signs of pregnancy are so apparent: missed periods, a swollen belly and breasts, etc. Yet, in the case of pregnancy denial, these signs are very subtle or even invisible.

As a result, women who are pregnant but experiencing pregnancy denial may have bleeding that resembles periods, abdominal pain mistaken for digestive issues, and no visible bodily changes—even in women who are not overweight!

How does pregnancy denial manifest? Can it be detected?

This is the main issue with pregnancy denial: it either doesn’t manifest or shows very few signs. Yet most women agree that their bodies change significantly during pregnancy. For women experiencing pregnancy denial, the signs are minimal, absent, and/or attributed to other health problems:

• Weight gain is minimal and/or ignored or attributed to another cause (the belly doesn’t round out much because, instead of settling in the amniotic cavity, the fetus positions itself toward the back of the body, near the spine),
• The menstrual cycle continues (early pregnancy bleeding is mistaken for periods, some pregnant women on the pill continue to have “withdrawal bleeding” during the pill break, and bleeding can occur during pregnancy), or the absence of periods is explained by something else (menopause, stress, etc.),
• Nausea and fetal movements are mistaken for digestive issues, etc.

Despite everything, a pregnancy (even in the case of denial) remains detectable by standard tests and visible via ultrasound. Again, the problem is that a woman in the midst of pregnancy denial typically won’t consider whether she might be pregnant.
Once the denial lifts, the body changes very quickly, and the belly of a woman who has just discovered her pregnancy late may suddenly become visible in a short time.

What are the possible causes of pregnancy denial?

This is another area where healthcare professionals haven’t reached a clear consensus, likely because the causes are multifactorial, specific to each situation, and difficult to identify.
Among the possible explanations for the causes of pregnancy denial, psychological factors are frequently cited. For some women, the rejection of being pregnant is so strong that it convinces the mind.

In some cases, this rejection can be caused by a non-consensual sexual encounter. For others, believing that they cannot get pregnant—due to an IUD, consistent use of birth control pills, a diagnosis of infertility, etc.—can lead to denial.

Even women who already have children can experience pregnancy denial. There is no specific profile predisposed to it.

Can you have your period while pregnant during a pregnancy denial?

Here again, we still lack information. A woman going through a pregnancy denial is unlikely to consult a medical specialist, making it difficult to study exactly how the menstrual cycle behaves in such cases.
Many women affected say they had regular periods during this time. But (as mentioned above), without proper medical exams, it’s hard to determine whether these were actual periods, pregnancy-related bleeding, or disruptions caused by hormonal birth control.

As a reminder, it is possible to bleed during pregnancy, but this is not the same as menstruation. The most common causes of bleeding are:

• Bleeding can be harmless and of unknown origin, with no apparent cause,
• Trophoblastic detachment: this is the partial detachment of the egg from the uterine wall. Some cases resolve spontaneously, while others worsen.

Want to learn more? Feel free to download the May app, where you’ll find plenty of resources to support and guide you throughout your pregnancy.

What are the possible psychological consequences of pregnancy denial?

Discovering your pregnancy overnight can be a shock—this is especially true in the case of pregnancy denial.
For women who have experienced a partial denial: they must decide very quickly what to do about the pregnancy. These are extremely difficult decisions to make, sometimes under tight time constraints depending on when the denial is discovered. Options such as abortion may no longer be possible if the pregnancy is discovered too late (allowed up to 16 weeks of amenorrhea). When a child is born after a pregnancy denial, the mother must decide whether to keep the baby, place the child for adoption, give birth anonymously, etc.

For women who have experienced a total denial: they have even less time to make decisions, as the denial is only revealed on the day of delivery. They think they’re experiencing stomach cramps but are actually in labor. Some go to the hospital due to the pain of contractions or water breaking. Others may give birth outside the hospital, which poses risks for both the mother and the baby.

Overall, pregnancy denial is a major psychological shock for the women who experience it. In some cases, the shock is so intense it can lead to serious actions, including toward the baby.

What kind of support is available after a pregnancy denial?

Medical support:
In all cases, it is important for a woman who has gone through pregnancy denial to be followed by a healthcare professional who can assess her psychological well-being and set up a tailored support system. This help may come directly from the hospital staff (if the denial is discovered early enough for the pregnancy to be monitored in a hospital). Your general practitioner can also refer you to a qualified professional—the key is not to go through it alone.

Social support:

A woman who chooses to give birth anonymously or place a child for adoption has two months to change her decision. During this time, the child is placed under the care of child protection services (ASE). No ID is required at the time of anonymous birth—she simply needs to inform the medical team of her decision. A woman who gives birth anonymously can reveal her identity at any time and request psychological and social support from ASE.

Being surrounded by supportive people:

In addition to medical support, it is advised to surround yourself with caring individuals with whom you can talk openly. As explained earlier, pregnancy denial can be particularly traumatic. Some women may feel the need to share their experience with close ones or others who’ve been through the same thing—such as through support groups.

In summary, pregnancy denial is a mysterious psychological phenomenon about which we still know very little. One thing is certain, however: a woman affected by this phenomenon needs support and care to get through it.

This text was translated from French by an artificial intelligence. The information, advice, and sources it contains comply with French standards and may therefore not apply to your situation. Make sure to complement this reading by visiting the May ES/UK app and consulting the healthcare professionals who are supporting you.