False pregnancy, or pseudocyesis, is a condition in which a woman believes that she's pregnant, yet conception hasn't taken place and no baby is forming inside. Common, and often lasting, pregnancy symptoms help to reinforce this idea, which can lead a woman to be absolutely certain she's expecting, for months or even years!
Exact numbers are hard to come by, but experts agree the condition is extremely rare. "I see many, many patients, but will typically identify just one case a year," says Bonnie J. Dattel, M.D., an obstetrician at Eastern Virginia Medical School in Norfolk, Virginia.
What are the signs of false pregnancy?
A woman with a case of pseudocyesis may experience many of the same symptoms as an actual mom-to-be, including the following:
These symptoms can persist for as long as a few weeks to the full nine months of pregnancy -- or even longer. "As unbelievable as it may sound, the mind is actually able to take control and prompt the body to produce believable signs of conception," says Nada Stotland, M.D., a professor of psychiatry at Rush Medical University in Chicago and the past president of the American Psychiatric Association.
It's important to not confuse a false pregnancy with a false positive pregnancy test, notes Dr. Dattel. "A false positive is often due to hormonal interference during the menstrual cycle which then cross reacts with the testing process," she explains. A woman may also receive a false positive pregnancy test because she truly did have a pregnancy but at a later point it was spontaneously lost, she explains.
What causes false pregnancy?
In a few cases, false pregnancy may be the result of an actual physical symptom such as an ovarian tumor. A history of depression, as well as past medical issues, including the inability to conceive, multiple miscarriages, or the loss of a child may also contribute to this erroneous claim. Sexual abuse may play a role too, since "past abuse can leave a person more vulnerable to a wide variety of psychological problems and insecurities," Dr. Stotland says.
But for the most part, pseudocyesis isn't a condition with an easily identifiable cause. "For some it's the manifestation of psychosis, but in others it can be simply the result of a very strong wish to be pregnant," says Dr. Stotland. Other women have a dissociative disorder, which means they go partly into another mental state while the rest of their thinking remains rational, she explains.
It's difficult to obtain reliable data about false pregnancies because of the very nature of the condition. "Some patients can be persuaded by the lack of confirming evidence but there are others who just stop coming in for prenatal care," says Dr. Stotland. When it becomes clear that there's no baby, many women will push back the claimed due date to a later time and continue to insist they're expecting.
Treatment of false pregnancy
To determine whether conception has occurred, a doctor will note the symptoms and perform a pelvic exam, abdominal ultrasound and urinalysis. If a physical tumor is found, it will be evaluated and treated based on the diagnosis, says Dr. Dattel. The patient can also be screened for an underlying psychiatric disorder.
But in most cases, emotional support, including psychotherapy, is the best way to treat false pregnancy. Helping a woman to understand and cope with the factors that led to pseudocyesis is important, although often women will go to another ER or clinic, or see a different ob-gyn, for a different opinion. "It's better not to insist the patient isn't pregnant," Dr. Stotland says, "but instead to simply relay the lab findings and then let her gradually come to the correct conclusion."
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