Can you Believe you’re Pregnant When you’re Really Not?

While most people are familiar with stories of women showing up to the Emergency Room with abdominal pain who unknowingly are pregnant and give birth moments later, fewer have heard of the phenomenon known as pseudocyesis. This word is of Greek origin meaning “false pregnancy,” and is a psychiatric disorder where a woman has the signs of pregnancy and truly believes she is pregnant when she is not.

Many women who develop pseudocyesis have other psychiatric issues occurring at the same time. It is also more common for these women to be from developing countries where bearing children is seen as very important.

For example, an infertile woman may develop pseudocyesis to keep her husband from leaving her for another woman who can give him children. They also are more commonly the victims of domestic violence and are more likely to live in poverty than those women who don’t have this disorder.

It’s hard to know for sure how common this disorder is, but one estimate is that it occurs in 1 to 6 births out of 22,000 in Western countries, with a rate that is much higher (1 in 344) in countries like Africa. Keep in mind that many women who develop pseudocyesis in these developing countries do, in fact, have enlarging abdomens and some physical symptoms, but these can often be related to fibroids and signs of ovarian tumors and cervical cancer (especially in developing countries where diseases may be diagnosed in very late stages).

Women who develop pseudocyesis may have some symptoms as stated above or may be on medications that stop their periods or make their breasts leak milk that can lead to the delusion of pregnancy. They may have weight gain, increased appetites, and tender breasts. However, pseudocyesis is more than the casual belief a woman might be pregnant because of a few symptoms, even though her tests and ultrasounds are negative, she is truly convinced she is pregnant. Women who haven’t even had sex recently will believe they were inseminated through magic or through a fertility injection that they were unaware of.

Some women who develop pseudocyesis are actually afraid to be pregnant or aren’t sure if they want to be, but have been recently trying to start a family with their partner. Some symptoms may arise because of the stress (abnormal periods, for example), and these symptoms along with the anxiety lay the groundwork for pseudocyesis.

When a woman is diagnosed with pseudocyesis, the treatment needs to be tailored to her specific needs. Has this developed as the result of her being in an abusive relationship where she’s been told she needs to give birth to a son or her partner will leave? Does she actually have gallstones that are causing abdominal pain? Is she also suffering from schizophrenia at the same time? Treatments like therapy and antipsychotics are often used in combination to treat these women, but it needs to be individualized for each woman.

Sources:

• MV Seeman
• Pseudocyesis, delusional pregnancy, and psychosis: the birth of a delusion
• World J Clin Cases
• 2014 Aug 16; 2(8): 338–344.
  T Yadav et al
• Pseudocyesis versus delusion of pregnancy: differential diagnoses to be kept in mind
• Indian J Psychol Med
• 2012 Jan-Mar; 34(1): 82–84.
  PC Ibekwe and JU Achor
• Psychosocial and cultural aspects of pseudocyesis
• Indian J Psychiatry
• 2008 Apr-Jun; 50(2): 112–116.

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