Pseudocyesis: The Phantom Pregnancy Phenomenon

Fatigue, nausea, headaches, food cravings, missed menstruation, backache, tender breasts, frequent urination, mood swings... sound familiar? Yes, what I've listed are the common symptoms of pregnancy. Pregnancy: the state, condition or quality of being pregnant. Pregnancy: "the condition of carrying developing offspring within the body" (Dictionary.com). Gestation.

Pseudocyesis, false pregnancy, phantom pregnancy: the state, condition or quality of being pregnant... without being pregnant.

Pregnant: with child, gestating, fruitful, enceinte, expecting...

Not pregnant: without child, not gestating, unfruitful, non-enceinte, expecting...

Mary Tudor, Queen regnant of England and of Ireland, born in February of 1516 was known for being pregnant but never giving birth. Queen Mary had presented with a distended stomach and nausea but her pregnancy "progressed" for over a year without the birth of an infant. People believed that perhaps she may have miscarried without the fetus being properly expelled but there was no proof of miscarriage and no other proof--except the large belly and the sickness--of her actually being pregnant.

It is believed that Queen Mary had experienced hysterical pregnancies, also known as phantom pregnancies or pseudocyesis. Some say that she earned the nickname "Bloody Mary" from the violent bloody acts committed on her behalf as her way of releasing the anger and frustration she felt from not being able to bear an heir.

In the 1940s, pseudocyesis occurred approximately once every 250 pregnancies. In this day and age, with the medical advancements and efficient home pregnancy tests, pseudocyesis is rare. Still, it exists.

The first indication of pregnancy is usually missed menstruation. 56-98% of women with pseudocyesis experience menstrual irregularity or cessation. The explanation for that can be several factors.

• Being stressed out can decreases the amount of the hormone GnRH, causing a woman to miss her period.
• Changing of one's schedule, for example: losing a lot of sleep or even switching from working a day shift to working a night shift.
• Being overweight or underweight
• Using certain medications (especially birth control, of course)
• Being sick
• Menopause and peri-menopause

Another common symptoms of pseudocyesis is Nausea (and vomiting) which can be the result of anything really. A mere nervous stomach at times can lead to nausea and vomiting.

Fatigue is another symptom that can be the result of anything (bad sleeping habits, stress, another sickness, etc...).

Sore breasts can be a premenstrual sign. In the case of a missed period, breast tenderness can still occur.

Breastmilk production is a symptom that can occur without pregnancy, believe it or not. Here are some possible causes:

• Prolactinoma - a benign (noncancerous) tumor in the pituitary gland where prolactin, the hormone that stimulates milk production, is produced.
• Medications such as thioridazine (an antipsychotic) can also stimulate prolactin production.
• Enlarged pituitary gland condition.
• Mammary gland stimulation by sucking on the nipples (as in sexual foreplay). This increases blood flow to the glands.
• Mammary duct ectasia - a condition in which the milk duct beneath the nipple becomes clogged or blocked. Usually occurs in women in their 40s and 50s

The most obvious sign of pregnancy is the large, noticeably distended abdomen. You can't argue against a pregnant belly, can you? The cause of a distended abdomen in pregnancy is the enlargement of the uterus due to a growing fetus. If a pregnant woman's stomach wasn't growing at all, that's a reason to be concerned.

What about if a woman's stomach is gradually growing, just as a pregnant belly grows, but she's not pregnant? Bare in mind that I'm not talking about a little punch or a little fat. I'm taking about a rounded, possibly hard-to-the-touch stomach. 63 - 97% of women with pseudocyesis appear pregnant.

For years, scientists and medical professionals have been trying to find the cause for the large abdomen in women experiencing a phantom pregnancy. There are a few theories that account for this strange symptom. Scientists and medical professionals believe that perhaps the distended abdomen is caused by gas build up, fat, urine, or feces.

Another bizarre symptom for a non-pregnant woman in experiencing "quickening", the sensation of the baby moving. Either this is caused by gas or it is psychological because there is no baby to feel. Still, women with pseudocyesis truly believe that they can feel the nonexistent fetus moving.

In true pregnancy, once the time comes for the fetus to come into this world, the uterus begins a pattern of contractions to push the baby into the birth canal. The cervix dilates, widening for the baby to pass through. As labor progresses, contractions become stronger and get closer together. Usually, when the cervix is fully dilated and contractions are relatively constant, the woman is able to push her baby out of her body and into the real world.

I'm sure that we've all seen or heard about childbirth in one way or another. Either you've seen childbirth portrayed on television, seen it firsthand, heard or read about it or even experienced it yourself. Usually, people know labor when they see it.

I've heard and read stories of women appearing to be full-term going into labor, even down to the breaking of the amniotic sac (water breaking) and then... no baby. How is that possible, you ask me? It still baffles me.

Yes, women with pseudocyesis can go into labor just as pregnant women go into labor. They feel the contractions, their water breaks, they have the desire to push, the whole nine. Yet, there's no baby to give birth to.

Sometimes the only thing that differs false pregnancy from true pregnancy is a sonogram/ultrasound. In medical examinations for pregnancy, such as a pelvic exam, pregnancy may be confirmed in a person with pseudocyesis. This is because a woman with this condition has a soft and enlarged uterus just as a real pregnant woman does.

There have been cases of positive home pregnancy tests due to the production of some of the pregnancy related hormones produced in a woman with pseudocyesis. So, to reiterate, a sonogram/ultrasound is the only surefire way to rule out pregnancy as a diagnosis.

How you you get rid of a baby that doesn't exist? Usually, once a woman gives birth, the pregnancy symptoms all disappear but how does a woman rid herself of the pregnancy-related symptoms when she was never pregnant in the first place?

Some symptoms, such as the cessation of menstruation, can be ended (or in this case, restarted) by medications. Most patients with pseudocyesis may consult a psychologist or psychiatrist. Sometimes, putting a patient under anesthesia can rid them of the distended abdomen. Treatment depends entirely on the patient.

In the United States, between 1 and 6 of every 22,000 births are phantom pregnancies. The youngest documented case was in a 6 1/2 year girl and the oldest documented case was in a 79 year old woman but the average age is 33. More than 2/3 of women who have experienced a phantom pregnancy were married and 1/3 were pregnant at least once in their life.

The people who are most affected by pseudocyesis are women in their late 30s or 40s who have fertility problems or are desperate for a child. Women who have suffered a miscarriage or have lost a child are also susceptible for pseudocyesis. Generally, women going through a phantom pregnancy are emotionally unstable and may have other psychological problems. An extreme fear of becoming pregnant have also been shown as a risk factor for developing pseudocyesis. Women who were the victims of incest have been shown to possibly be at greater risk for pseudocyesis.

To conclude, the main cause of pseudocyesis is psychological. In a way, it can be said that pseudocyesis is mind over matter. In other words, the woman is so desperate and her desire to have a baby is so strong, that her body fulfills her wish. Astonishing, isn't it?