Of all the patients my father encountered as an OBGYN resident, there was one he would never forget. She presented with all the outward signs of pregnancy. She believed herself to be pregnant. And yet, an ultrasound revealed no fetus. When placed under general anesthesia, her belly flattened, and when she recovered from the anesthetic, her belly swelled again. Even when shown the results of the ultrasound, the woman insisted she was pregnant. Often, she said, in the dark of night, I feel the baby move.
That recounting would haunt me for years.
“What happened to her?” I asked impatiently when my father stopped talking.
“It wasn’t my specialty,” he answered. A psychiatric consult had been ordered, and the woman relegated to memory as he’d worked his way through a sea of patients on little sleep.
So, what could he tell me about her?
She had a medical condition called pseudocyesis (informally false pregnancy or phantom pregnancy). Some doctors postulate it’s caused by an intense desire to be pregnant coupled with the frustration of infertility. Others suggest an acute fear of pregnancy mingled with pressure to conceive might sometimes be the culprit. The condition is so rare that no one has managed to study it sufficiently. About 550 cases appear in the scientific literature, and the estimated occurrence in the West is 1 – 6 / 22,000 births.1 Something similar can happen in men. It’s called Couvade syndrome or colloquially sympathetic pregnancy.
Unlike false pregnancy, sympathetic pregnancy is not a recognized medical condition. Had I suffered from it during my wife’s pregnancy (I didn’t), I doubt she would have recognized it either. We often took walks during her second trimester, pausing occasionally when the cramping in her calf grew too painful. During those moments, I knew intuitively not to complain about any discomforts I might have been experiencing. In fact, had someone zinged me in the head with a small rock as my wife rested her calf, I probably would’ve assured her (clutching my head, tears pouring down my cheeks) that it was a mere trifle compared to what she was experiencing. And for me to suffer sympathetic labor pains during the birth of our child! I can only imagine her ordering me sternly to wait in the hall. In short, my wife wouldn’t have been sympathetic to my sympathetic pregnancy. That isn’t to say I don’t believe Couvade syndrome is real. There are certainly medical professionals who do as evidenced by this BBC article.
False pregnancy is categorized in the DSM-5 under the Not Elsewhere Classified section of Somatic Symptom Disorders. It is distinct from and should not be confused with other disorders found in the DSM-5. Delusion of pregnancy is a condition in which a woman or man believes themself to be pregnant even after it has been demonstrated they aren’t. Delusion of pregnancy does not include physical symptoms of pregnancy. Conversely, a woman who knows she isn’t pregnant but claims to be (often for attention or sympathy) might be diagnosed with factitious disorder imposed on self.
The human mind is truly amazing, and modern science tells us frustratingly little about how it works. My background is in artificial intelligence. Specifically, I’m intrigued by what neuroscience can tell us about artificial intelligence and vice versa. I would gladly travel hundreds of miles on foot (through heavy snow) to meet someone who could tell me how the human brain can trick itself into believing it’s pregnant, complete with physical symptoms. Until that person materializes, I can obsess about it and other mysteries of the mind. I can read everything I find, and I can even write fiction exploring it.
Amanda, one of three main characters in my debut novel THE INTANGIBLE, was born on the day my father told me about the mysterious case he witnessed as a resident. I spent many pleasant hours getting to know her. To everyone who reads my novel: Thank you, and I hope you enjoy your time with her as much as I did.
And even if you haven’t or don’t plan to read my novel, are there any mysteries of the mind that dazzle and spark your curiosity?
- Campos SJ, Link D: Pseudocyesis. J Nurse Pract. 2016, 12:390-394. 10.1016/j.nurpra.2016.03.009