What Is Cryptic Pregnancy

Overview

Cryptic pregnancy, also known as "denied pregnancy," refers to a pregnancy that is not recognised by the expectant mother. This is because a woman with a cryptic pregnancy may not experience the typical signs and symptoms of pregnancy, such as morning sickness, weight gain, or a noticeable bump. They also often miss their menstrual periods and may have a negative pregnancy test result. As a result, many women with cryptic pregnancies  remain unaware of their pregnancy until they are far along or even in labour.¹  

A cryptic pregnancy can be emotionally and psychologically difficult for both the woman and her partner. The absence of physical symptoms can cause confusion, disbelief, and even a sense of guilt. Women with cryptic pregnancies may also face difficulties obtaining prenatal care, as they may have missed the opportunity for important early pregnancy check-ups. However, the exact causes of cryptic pregnancy are not well understood, but it is thought to occur due to a combination of factors, including irregular menstrual cycles, hormonal imbalances, and psychological factors.¹

In this article, we will explore the causes, symptoms, and impact of cryptic pregnancy, as well as what women can do to ensure they receive the proper care and support they need during their pregnancy. By understanding cryptic pregnancy, we can help women navigate this unexpected experience and ensure they receive the care they need to have a healthy pregnancy and birth.

Causes of cryptic pregnancy

The exact cause of cryptic pregnancy is not well understood, but there are several reasons why women might not be aware of their pregnancy, including:

• Irregular menstrual cycle: Women with irregular periods may not realise that they are pregnant as they may not miss a period¹
• Minimal pregnancy symptoms: Some women may experience very mild or no pregnancy symptoms, making it difficult to identify a pregnancy^1,2
• Overweight or obesity: Women who are overweight or obese may not notice changes in their body shape or weight gain, making it difficult to identify a pregnancy²
• Infertility diagnosis: Women who have been diagnosed with infertility may not believe they are pregnant, especially if they are not experiencing typical pregnancy symptoms.
• Stress and denial: Psychological factors such as stress, anxiety, and denial may cause a woman to ignore or dismiss pregnancy symptoms³
• Psychiatric conditions: Women with psychiatric conditions such as bipolar disorder or schizophrenia may not be able to process or recognize pregnancy symptoms³
• Inaccuracy of pregnancy tests: False negative pregnancy test results may occur if the test is taken too early or if the woman has a low level of the pregnancy hormone human chorionic gonadotropin (hCG)¹

It is worth noting that if you are experiencing some pregnancy symptoms but not all, you should make an appointment with a doctor as soon as possible. Missing treatment in early pregnancy can cause serious health complications for both the mother and the baby, such as abnormal foetus growth, preeclampsia, and hypertension.⁴

Signs and symptoms of cryptic pregnancy

Cryptic pregnancy is a condition in which a woman is unaware of her pregnancy, and the signs and symptoms may vary depending on the individual; in some cases, they experience no symptoms at all. Studies suggest that in cryptic pregnancies, the symptoms associated with pregnancy (nausea, amenorrhea, and bloating) are greatly reduced or absent.⁵

 Some common signs and symptoms of cryptic pregnancy include:

• Absence of menstrual periods
• Lack of physical symptoms
• Fatigue
• Abdominal pain
• Back pain
• Negative pregnancy test result: It is also possible for women with cryptic pregnancy to have a negative pregnancy test result, as the levels of the pregnancy hormone human chorionic gonadotropin (hCG) may not be high enough to be detected

Management and treatment for cryptic pregnancy

The management and treatment of a cryptic pregnancy will depend on several factors, including the woman's physical and emotional health, the stage of pregnancy, and any underlying medical conditions. Here are some of the steps that may be taken:

• Medical evaluation: The first step is to obtain a complete medical evaluation to assess the woman's physical and emotional health. This may include a physical examination, blood tests, and ultrasound to determine the gestational age of the foetus¹
• Prenatal care: Women with cryptic pregnancy may have missed the window for important early-pregnancy appointments, and it is essential to provide adequate prenatal care to ensure the health of both the mother and the foetus¹
• Emotional support: Cryptic pregnancy can be an emotional experience, and it is important to provide emotional support to the woman and her partner. This may include counselling, support groups, or therapy
• Labour and delivery: Depending on the gestational age of the foetus, the woman may require a vaginal delivery or a caesarean section. The delivery will be managed by a team of healthcare providers to ensure the safety of both the mother and the foetus
• Postpartum care: After delivery, women with cryptic pregnancy may need additional support and care. This may include postpartum care, lactation support, and counselling to address any emotional and psychological issues

FAQs

How is cryptic pregnancy diagnosed

Cryptic pregnancy is poorly diagnosed as it is a condition that is often not recognised. Just like the diagnosis of normal pregnancy, cryptic pregnancy is diagnosed through a combination of physical examination, medical history, and imaging tests. A healthcare provider will typically perform a pelvic exam to check for any physical signs of pregnancy, such as an enlarged uterus. They may also ask about the woman's menstrual cycle and any symptoms she may be experiencing. In addition, Imaging tests, such as ultrasound, can provide additional important information about the pregnancy, such as the gestational age and the presence of a foetus. As previously highlighted, in cryptic pregnancies, a woman may have a negative pregnancy test result, as the levels of the pregnancy hormone human chorionic gonadotropin (hCG) may not be high enough to be detected⁶

How can I prevent cryptic pregnancy

Preventing cryptic pregnancy can be challenging, as it is often an unexpected and unforeseen event. However, there are a few steps that can be taken to reduce the risk of cryptic pregnancy:

• Regular use of contraception: Using birth control methods such as condoms, hormonal birth control, or intrauterine devices (IUDs) can help prevent unintended pregnancy and reduce the risk of cryptic pregnancy
• Be aware of unusual symptoms: Pay attention to any unusual symptoms, such as abdominal pain or back pain, and seek medical attention if they persist
• Regular check-ups: Regular check-ups with a healthcare provider can help monitor for potential health issues, including pregnancy
• Stay informed about your menstrual cycle: Keep track of your menstrual cycle and seek medical attention if you miss a period or have other unusual symptoms

Who are at risk  of cryptic pregnancy

It is difficult to say who is at risk, as any woman of any race, age, or socioeconomic background can experience cryptic. However, some factors that may increase the risk of cryptic pregnancy include the following:

• Irregular menstrual cycles: Women who have irregular menstrual cycles may be more likely to have a cryptic pregnancy, as it can be difficult to determine when a missed period is due to pregnancy or another cause
• Overweight or obese: Women who are overweight or obese may have a higher risk of cryptic pregnancy, as weight gain during pregnancy may not be noticeable
• Minimal pregnancy symptoms: Women who experience minimal or no symptoms during pregnancy may be more likely to have a cryptic pregnancy, as they may not recognise  the signs of pregnancy.
• Infertility diagnosis: Women who have been diagnosed with infertility may be more likely to have a cryptic pregnancy, as they may not expect to become pregnant
• Stress and denial: Women who are under a great deal of stress or are in denial about the possibility of pregnancy may be more likely to have a cryptic pregnancy
• Psychiatric conditions: Women who have a psychiatric condition, such as bipolar disorder or schizophrenia, may be more likely to have a cryptic pregnancy, as they may not be able to recognize the signs of pregnancy

How common is cryptic pregnancy

The incidents of cryptic pregnancy are thought to be rare and uncommon, however, recent studies believe that it occurs more frequently than previously believed. A recent study suggests that approximately 1 in 475 women do not know they are pregnant until they reach their 20^th week of pregnancy. while 1 in 2500 women in Germany discovered  their pregnancy during labour. In Australia, it is 1 in 400 deliveries, and it is 1 in 500 deliveries in the United States.² It is evident that the frequency of cryptic pregnancy cases has increased and varies among different countries. 

What are the complications of cryptic pregnancy

Cryptic pregnancy can result in several  complications for both the mother and the foetus. Some of the potential complications include:

• Delayed prenatal care
• Preterm labour
• Low birth weight
• Emotional distress
• Postpartum depression
• Complications during delivery

When should I see a doctor

It is important to seek medical attention as soon as possible if you suspect you may be experiencing a cryptic pregnancy, as prompt treatment and management can help to minimise the risk of complications.

Summary

Cryptic pregnancy, also known as denied pregnancy, is a condition in which a woman is unaware she is pregnant until late into the gestation period. The lack of physical symptoms such as menstrual periods, morning sickness, and weight gain can contribute to the stealthy  nature of the pregnancy. It is estimated that 1 in 475 women are unaware of their pregnancy until after 20 weeks. In addition, women who have irregular menstrual cycles , minimal foetal movement and certain psychiatric conditions are at a higher risk to develop cryptic pregnancy. If a cryptic pregnancy is diagnosed, it is important for the woman to receive prenatal care as soon as possible. Without early access to prenatal care, women can experience complications such as preterm labour and delivery, low birth weight, and an increased risk for C-section delivery.