Pregnancy can be an exciting time for the expectant parents-to-be. Sometimes, though, pregnancy doesn’t end as anticipated — with a baby. In rare cases, a woman (or even a man) believes she is pregnant, only to find out that her symptoms were caused not by pregnancy, but by something else entirely.
False pregnancy, or pseudocyesis, is the belief that you are expecting a baby when you are not really carrying a child. People with pseudocyesis have many or all of the common symptoms of pregnancy, with the exception of an actual fetus. This condition is very rare, occurring in only one to six out of every 22,000 births. It is most common in women aged 20 to 44, although it can affect women of all ages.
In rare cases, even men can have a false pregnancy. Some men experience a related phenomenon known as couvade, or sympathetic pregnancy. They will develop many of the same symptoms as their pregnant partners — including weight gain, nausea, and backache.
What Causes False Pregnancy?
Doctors have been aware of pseudocyesis for centuries, but only recently have they begun to understand the psychological and physical issues that are at the root of the condition. Although the exact causes still aren’t known, doctors suspect that psychological factors may trick the body into “thinking” that it’s pregnant.
When a woman feels an intense desire to get pregnant, which may be because of infertility, repeat miscarriages, impending menopause, or a desire to get married, her body may produce some of the signs of pregnancy (such as a swollen belly, enlarged breasts, and even the sensation of fetal movement). The woman’s brain then misinterprets those signs as pregnancy, and triggers the release of hormones (such as estrogen and prolactin) that lead to actual pregnancy symptoms.
Some researchers have suggested that poverty, a lack of education, childhood sexual abuse, or relationship problems might play a role in triggering false pregnancy. Having a false pregnancy is not the same as claiming to be pregnant for a benefit (such as for profit), or having delusions of pregnancy (such as in patients with schizophrenia).
Symptoms of False Pregnancy
Women with pseudocyesis have many of the same symptoms as those who are actually pregnant, including:
- Stopping of menstrual period
- Swollen belly
- Enlarged and tender breasts, changes in the nipples, and possibly milk production
- Feeling of fetal movements
- Nausea and vomiting
- Weight gain
These symptoms can last for just a few weeks, for nine months, or even for several years. A very small percentage of patients with false pregnancy will arrive at the doctor’s office or hospital with what feels like labor pains, but they will not deliver a baby.
Tests for False Pregnancy
To determine whether a woman is experiencing a false pregnancy, the doctor will usually evaluate her symptoms and perform a pelvic exam and abdominal ultrasound — the same tests used to feel and visualize the unborn baby during a normal pregnancy. In a case of false pregnancy, no baby will be seen on the ultrasound, and there won’t be any heartbeat. Sometimes, however, the doctor will find some of the physical changes that occur during pregnancy, such as an enlarged uterus and softened cervix.
Certain medical conditions can mimic the symptoms of pregnancy, including ectopic pregnancy, morbid obesity, and cancer. These conditions may need to be ruled out with tests.
Treating False Pregnancy
When a woman believes she is pregnant, especially for a period of several months, it can be very upsetting for her to learn that she is not. Doctors need to gently break the news, and provide psychological support, including therapy, to help the patient with pseudocyesis recover from her disappointment.