Experiencing a pregnancy without realizing it, learning that you are pregnant a few months before giving birth or when giving birth to your baby… Focus on this phenomenon with Hélène Romano, doctor of psychopathology and Israel Nisand, head of the Gynecology-Obstetrics department at Strasbourg University Hospital.
Denial of pregnancy is a difficult phenomenon to understand, but it turns out to be less rare than you might think. Some pregnant women do not seem to be pregnant, the belly is not visible, others realize that they are pregnant when they give birth… But then, how does the fetus develop? Hélène Romano, doctor in psychopathology and Israel Nisand, head of the Gynecology-Obstetrics center at Strasbourg University Hospital answer our questions.
What is a denial of pregnancy?
When a pregnant woman is not aware of being pregnantwe are talking about denial of pregnancy. The woman is then in an absence of representation of the child. “It is an active mechanism of forgetting in the face of psychological suffering“, explains Israel Nisand. There is a physical pregnancy, but not psychological pregnancy. The woman thus lives as if she were not pregnant. “The mother-to-be is psychologically paralyzed by thinking she is pregnantadds Hélène Romano, doctor in psychopathology and court expert. It is because of this that she does not perceive her pregnancy. There is in fact a disconnect between body and thought.”
Who is affected by a denial of pregnancy?
Women of all ages, from all social backgrounds, from all marital profiles, etc., may be affected. “This can also affect women who believe they are sterile or menopausal, who think they are taking care by using contraceptives or an IUD, etc.specifies Hélène Romano. The latter, however, asserts that “all women can deny pregnancy. These are people in intense psychological suffering and psychologically isolated at a given moment. The woman is injured in her ability to be a mother“.
Denial of pregnancy: in what month?
“Denial begins at the end of the first trimester of pregnancy, i.e. at fourteen weeks of amenorrhea. Throughout this period, voluntary termination of pregnancy (abortion) is legal. However, there were already, at that time, some signs of possible denial“, assures Israel Nisand. The first clue, understood after the fact, is the inability of the future mother to notice her condition.
What are the symptoms of denial of pregnancy
The signs of denial of pregnancy cannot be easily seenespecially since the pregnancy symptoms usually present are not felt. In denial of pregnancy, there is indeed a physical pregnancy even if the body tries to hide it. He himself seems to be hiding the pregnancy from the future mother. “A woman who denies pregnancy perceives changes in her body, but not as signs of pregnancy“, however, assures Hélène Romano. Bleeding can thus pass for periods, a stomach ache for gastro… There is no or few physical signs revealing a possible pregnancy. In fact, the body adapts by positioning the uterus differently. Normally, the uterus tilts forward.
In the case of denial of pregnancy, the uterus develops vertically. The fetus is then under the mother’s ribs. The muscles of the abdomen remain tense. The stomach is sometimes slightly rounded, but it remains relatively flat, thus deceiving the woman and those around her.
What are the causes?
The history of women has a lot to do with it. Dr Nisand believes that “the causes of denial of pregnancy are multiple: pressure, relationship problems…“. It can be due to an unwanted relationship, but not only that. Hélène Romano indicates that denial can also be the consequence of a pregnancy that comes at the wrong time : “for example, for professional reasons, these women want to prioritize their career and ensure that there is no room for a baby“. Denial of pregnancy is a mechanism of the body and mind that is still little understood, but we know that it can also occur after a miscarriage or a pregnancy ended prematurely in traumatic circumstances (in the context of a medical termination of pregnancy, for example). The woman may unconsciously refuse to be pregnant for fear of reliving this traumatic ordeal, especially if she has experienced it several times.
What are the consequences of denying pregnancy?
A denial of pregnancy can last for a variable amount of time. It may be discovered by chance before the end of the pregnancy or at the time of delivery. It may or may not be accompanied by the death of the child in the first 24 hours of life through infanticide. Israel Nisand states:if denial is discovered in the first trimester, the majority of women will have an abortion. In the second trimester, the woman will very often choose to abandon her child or make up for the communication deficit. Moreover, “The later the denial is lifted, the more risk there is for the baby.specifies Dr. Romano, before continuing: “when the lifting of denial takes place at the time of childbirththe woman may have different reactions. She can, for example, call Samu, because she thinks she is having a hemorrhage, while she is giving birth. It is then the baby’s cry that will resuscitate her.“
