The heartbreak of false pregnancy

Pregnancy is good news for every woman because it confirms that she is going to be a mother.

However, for women who are struggling with infertility or have suffered a miscarriage, pictures of glowing women with healthy bumps can be a very painful reminder.

The inability to bear a child, or the frustration of trying again and again to conceive to no avail, is one of the most trying experiences that couples sometimes have to deal with.

The sensitivities involved are deeply connected to an individual’s identity and self-esteem.

Understandably, when conception is elusive or unsustainable, those affected wonder about the adequacy of their body.

At such points, unhealthy psychological defence mechanisms sometimes kick in to the extent that a woman develops the symptoms of pregnancy despite not having conceived.

The women experience missed periods, enlarged abdomens, the sensations of foetal movement, and even breast secretions which are reasons to be hopeful again after gloom.

This was the case for Martha*32, who spent several years with her husband trying to get a child but all their efforts proved futile even after trying several forms of medication from proven specialists.

On the other hand she was receiving pressure from family members who could not understand whether she had chosen to be childless out of choice or otherwise.

But after several trials she was finally convinced that she was going to be a mother after she started developing a number of symptoms related to pregnancy.

From missing her monthly periods to morning sickness, with her abdomen expanding and even felt her baby moving in the same manner as any pregnant woman would.

Martha looked and felt pregnant and was convinced that it was only a matter of time before she became a mother. This was not to be, for she was never pregnant in the first place.

Dr Living Colman is a gynaecologist and obstetrician at Muhimbili National Hospital (MNH), he was on charge of Martha’s case when she was referred to Muhimbili where she was operated on.

“She was brought to hospital’s emergency room to receive obstetrics and gynaecology services. After she felt ill for a few days, she began to believe that she needed urgent evaluation in preparation for the delivery of her child,” says Dr Colman.

According to the doctor when the woman was referred to the hospital she came with her antenatal clinic card.

As the case is with most women she had not done an ultra sound to rule out the presence of pregnancy because the health centre she attended didn’t have such a facility.

“They just carried out the normal procedure like measuring the size of the baby, her blood pressure and her weight and since her stomach was growing with the assumption that everything was okay,” explains Dr Colman.

According to Dr Colman false pregnancy is clinically termed as pseudocyesis and it comes from belief rather than reality.

“She starts believing that she is expecting a baby when in actual sense she is not really carrying a child. A woman with pseudocyesis may have a number of symptoms that resemble that of a pregnant woman such as vomiting, missing her monthly period, mood swing with an exception that she will not have an actual foetus in her womb,” he says.

“She must have a strong faith or belief with no reasonable doubt that she is pregnant. When a woman feels an intense desire to get pregnant, her body may produce some pregnancy signs of which her brain at that point misinterprets the signals as pregnancy.

The physician says the intense desire can influence her endocrine system and pituitary glands to secrete pregnancy specific hormones specifically oestrogen and Prolactin that lead to actual pregnancy symptoms.

“What makes the stomach look big is an increase of gas inside the womb of woman who is suffering from this condition that’s why most of them will feel that the baby is moving without knowing that it is the gas causing that feeling,” he says.

He adds: If there are no ultra sound tests done, then the stomach will continue to grow. This is what happened to Martha, she never had a chance to do proper test to rule out if she was really pregnant or not.

The gynaecologist says these symptoms can last for just a few weeks, for nine months, or even years.

Some of the women have even gone to hospital with what feels like labour pains only to be turned away with disappointment.

According to him, the condition is said to be common in women who are in their reproductive age and especially in areas where women are pressurized to have children.

To determine whether a woman has a false pregnancy, it is important to carry out some tests to assess the symptoms.

“With modern means of diagnosing pregnancy, including human chorionic gonadotropin (HCG) testing and ultrasound imaging, when no baby is seen on ultrasound, there is an absent heartbeat then it is easy and fair to rule out the presence of pregnancy.”

He says that once it is determined that the woman is not pregnant, what follows is to tell the woman the truth and provide her with psychological support that will help her recover from her disappointment.

“This is because it can be very damaging both emotionally and psychologically when a woman learns that she is actually not pregnant after believing that she was for a certain period of time,”

But this is not a case that is only limited to women because men too experience a related condition that experts have come to term as sympathetic pregnancy.

This according to Dr Colman happens when a man can has extreme desire of becoming a father or he may have sympathy towards his pregnant wife to the point that he may develop many of the same symptoms.

“They develop symptoms such as weight gain and nausea, however this may end soon after his wife,” says Dr Colman

According to Psychology Today, once the woman concerned is confronted with irrefutable evidence, it is usually very difficult for her to digest the news that she is not, in fact, pregnant.

Upon accepting reality, she will abruptly lose the hopeful narrative that was protecting her.

“The situation can be extremely complex; however, when she does finally accept the truth, support is critical. In more extreme cases, unexamined and unresolved issues may result in a future re-awakening of the fantasy that she is again pregnant,” says Monica Starkman who writes for Psychology Today.