Who me, pregnant?
Despite the shocking headlines, pregnancy denial is an uncommon but fascinating condition, as is phantom pregnancy.
When I was at varsity, my housemate Michelle went through a stage of being constantly tired, feeling nauseous and skipping classes. ‘You aren't pregnant by any chance?’ I asked. She joked, ‘That would explain my period being late!’

Alarm bells sounded, but she wouldn't take a pregnancy test. A few weeks passed but she still hadn't gotten her period. She said it was due to stress. By the time she finally took the test, the result did not surprise either of us.

I know few pregnant women who did not at one stage or another refuse to believe they were pregnant. Especially if the pregnancy was not planned or unwelcome. These women, like Michelle, would pretend they weren't pregnant and hoped the symptoms would simply ‘go away’. 

But there are some women who are believed to suffer from a controversial psychological syndrome called Pregnancy Denial. These women typically refuse to believe they are pregnant, right up to the point of giving birth. They may not display any signs of pregnancy, gain very little weight and hide the pregnancy from those around them. When the baby is born, they may even kill the baby and hide the body, pretending it was never there to begin with.

Recently, a French woman, Dominique Cottrez, made headlines when she was arrested for killing eight of her newborn babies. Her defence team argued that she suffered from Pregnancy Denial.

According to Michel Delcroix, a former gynaecologist, who testified in a similar case: ‘These women are so convinced pregnancy is impossible that once the child they never wanted arrives, they don't accept it as real and get rid of it to restore order to what they believe is non-pregnant reality .’

There appear to have been quite a few documented cases of Pregnancy Denial in Europe, specifically in France and Germany. In South Africa, however, such cases are uncommon.

Western Cape psychiatrist Professor Liezl Koen says it is more common to find women who are suffering from pseudocyesis, also known as false pregnancy. A woman may be experiencing all the symptoms of a pregnancy, including cessation of menstruation, a swollen belly and nausea, despite no foetus being present.

While in some cases, there may be a physical explanation for the belief that one is pregnant, it is possible for these symptoms to exist only in the mind and to be purely psychological. 

A case of extremes

Pregnancy is an emotional and stressful time for most women – even for those who plan it. But for many women, especially those who fell pregnant under traumatic circumstances, the stress of pregnancy may produce psychiatric symptoms ranging from a depressed mood to psychosis. In such cases, people who otherwise appear stable, could display psychiatric symptoms and in extreme cases – may even perform extreme acts.

While it is difficult for people – and parents especially – to understand how any mother could kill her babies, Professor Koen extends a word of caution. ‘Mental illness is still very much stigmatised by our modern society.’

She explains that instead of reacting with horror to a case where mental illness is suspected, one should rather try to understand the circumstances surrounding the act and what lies behind it.

It is almost 20 years now since we were at varsity together, but Michelle and I still keep in touch. I'm happy to say that her story had a happy ending – she married her boyfriend (and father of the baby) and they're still together.

We don’t talk about how she tried to get an abortion back then and found out she had left it too late. I never ask her if she regrets marrying at the time. You don't have to be a psychiatrist to know that when it comes to pregnancy and women, you can never be too supportive.

Have you know of any cases of pregnancy denial or phantom pregnancy?


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