By Kate Halim
Pregnancy is usually an exciting time for expectant parents, but some pregnancies don’t always end with the anticipated babies arriving this world to brighten up the lives of their parents.
In rare cases, women believe they are pregnant, only to find out that their symptoms were caused not by pregnancy, but by something else entirely. This condition is known as false pregnancy. In Nigeria, the rate is as high as one in 344 pregnancies.
A gynaecologist in Lagos, Dr. Philip Ekpo told Saturday Sun that false pregnancy, clinically known as pseudocyesis, is the belief that you are expecting a baby when you are not really carrying a child. People with pseudocyesis have many, if not all symptoms of pregnancy but with the exception of an actual foetus.
He added that 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, backache and nausea.
Causes of false pregnancy
It’s not clear why phantom pregnancy occurs. However, certain people, especially those who have experienced pregnancy loss or who are undergoing fertility treatments, seem to be more at risk of developing the condition. Researchers have noticed there are certain endocrinologic similarities in people who have phantom pregnancies.
In a 2013 literature review of people who experienced phantom pregnancy, the researchers noted shared endocrine traits in people who had polycystic ovarian syndrome (PCOS) and people with major depressive disorder.
The study also found a deficit in brain dopamine activity and dysfunction of the sympathetic nervous system and central nervous system in people experiencing a phantom pregnancy. The researchers suggested that these shared traits may lead to endocrine changes that cause the symptoms that arise—such as abnormal periods, protruding abdomen, phantom foetal movements, and labour pains—in people who experience phantom pregnancy.
Only recently have doctors begun to understand the psychological and physical issues that are at the root of pseudocyesis. Dr. Ekpo stated that although the exact causes are still not 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, or impending menopause, their body may produce some pregnancy signs which are swollen belly, enlarged breasts and even the sensation of foetal movement”, Ekpo said.
According to Ekpo, “the woman’s brain then misinterprets those signals as pregnancy, and triggers the release of hormones such as oestrogen and prolactin that lead to actual pregnancy symptoms.” According to WebMD. com, 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.
Some medical experts suspect that most phantom pregnancies happen due to mind-body feedback hoop in which a strong emotion causes an elevation of hormones which in turn results in physical symptoms that mimic those of a true pregnancy.
Symptoms of False Pregnancy
Ekpo said that women with pseudocyesis have many of the same symptoms as those who are actually pregnant. These symptoms include interruption of the menstrual period, swollen belly, enlarged and tender breasts, changes in the nipples, and possibly milk production, nausea and vomiting, feeling of foetal movements as well as 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 labour pains,” Ekpo added.
Tests for False Pregnancy
To determine whether a woman is experiencing a false pregnancy, Ekpo said the doctor will evaluate the patient’s symptoms, perform a pelvic exam and abdominal ultrasound, the same tests used to feel and visualise the unborn baby during a normal pregnancy.
Ekpo stated that 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.
He said: “Urine pregnancy tests will always be negative in cases of false pregnancy, with the exception of rare cancers that produce similar hormones to pregnancy.” According to him, 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.
Treatment
Ekpo stated that there is no universal clinical treatment for phantom pregnancy as a doctor needs to evaluate each case individually to determine which treatment or combination of treatments will be the most beneficial.
“Since phantom pregnancy involves physical and mental health symptoms, effective treatment requires cooperation between medical and mental health professionals,” he stated.
Possible treatments for phantom pregnancy include psychotherapy, clinical tests that disprove pregnancy, hormonal therapy, medications such as antidepressants or antipsychotics, and uterine dilation and curettage (D&C).
Ekpo added that when women believe they are pregnant, especially for a period of several months, it can be very upsetting for them to learn that they are not. He noted that doctors need to gently break the news, and provide psychological support, including therapy, to help the patient with pseudocyesis recover from their disappointment.
“In some cases, a person may reject the diagnosis and continue to believe that they are pregnant, despite evidence to the contrary. In these situations, the care of a mental health professional is crucial,” Ekpo said.