He was the obstetrician on call for women who came to the emergency room with pregnancy-related issues and had no prenatal care. The young 19-year-old Rashidat (not real name) came in an emergency with abdominal pain and a pregnancy test among other positive tests.
The doctor ordered an ultrasound having an ectopic pregnancy as a concern. It turned out Rashidat was carrying a full-term baby and was in labour. So, she was transferred to the Labour and Delivery ward before the doctor was called in.
It was difficult to believe that she was at term, as the woman was reasonably small structured, had no obvious pregnancy bump that is associated with pregnancy and looked shocked to be in this predicament,same for her family who was in attendance.
Rashidat literally had no idea that she was pregnant, as she attributed her weight gain to being less physically active while she was studying. Her menstrual periods had always been irregular so that didn’t raise any red flags for her.
She had some irritable bowel issues so she thought what was probably babies’ movement was bowel related. She wasn’t trying to hide the pregnancy from her family and it was apparent that she was as shocked as they were when she went to the hospital and found out she was in labour.
How could she not have known she was pregnant? But the more pertinent question may be: why would she have thought she was? Rashidat had experienced medically cryptic pregnancies. She is one of the few women who did not realise that they were pregnant until they were in labour or had given birth.
Most women will find it incredible that pregnancy would go unnoticed for several months or more since there are numerous signs of pregnancy. Also, a few women who had known they were pregnant and experienced an early miscarriage only realised they were still pregnant when the baby was being born.
But, while unusual, pregnancy can go undetected. A woman’s period stops, the breast becomes more sensitive, morning sickness often occurs in the early stages and women feel their bodies changing and their tummy expanding as the unborn baby grows inside. At around 20 weeks of pregnancy, most women start to feel their baby moving too.
For women who have had a typical pregnancy, the assumption is that there is no way to not “feel” a pregnancy. However, Professor Dosu Ojengbede, a consultant obstetric and gynaecologists, says that a woman does not feel that she is pregnant does not rule out the fact that she is pregnant.
According to him, “If you are pregnant, you are pregnant. Pregnancy is a physical thing. Pregnancy occurs the moment the sperm and the egg meet together but you may not know. It is certainly somewhere inside the body. If it is not inside the womb, it may anywhere. That includes the abdomen, the ovaries and the fallopian tube.”
Professor Ojengbede stated that even if the pregnancy is invisible, “the woman will continue having symptoms of pregnancy that will make you do further investigations. You will eventually find it.”
He declared that years back, a pregnancy outside the womb because of infection in women’s reproductive trait was very common. Also, many women had blocked fallopian tube, fibroids, endometriosis and general pelvic sepsis, which made ectopic pregnancy more likely.
Howbeit, Professor Ojengbede said “but with Improvement in the health care system, technology and all of that, you diagnose it sometimes as soon as they start having symptoms. So medical care is better; personal care is better.”
The causes of medically cryptic pregnancies are either physiological, that is, there were no recognisable symptoms of pregnancy, or can be due to psychological problems. Women use bodily cues to determine whether they are pregnant or not. In the cases of cryptic pregnancy, these cues are reduced or absent.
There can be many medical reasons. The pregnancy is a result of rape or incest, and the mother does not acknowledge that she is pregnant due to the trauma of the event. This phenomenon, called denial pregnancy is sometimes linked to other mental health diagnostic labels.
Sometimes, the mother is an athlete who is training hard enough and may have no periods at all, which could make detection of pregnancy harder or has taken a pregnancy test which gave incorrect negative results or she has an irregular menstrual cycle and, thus, does not miss her period until she is several weeks or even months pregnant. Also, if women are overweight, they may not notice the bump getting bigger and they can also miss the baby moving.
Hidden or denied pregnancy can happen in every socio-economic group, race, religion, etc. Being unaware of the pregnancy, even for only the first 20 weeks, has the potential to risk the health of both mother and baby.
So, if a woman is sexually active and experiences persistent, unexplained weight gain, missed periods, or any other symptom that could be associated with pregnancy, it is important to seek medical attention.
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