False pregnancy, clinically termed 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 — with the exception of an actual fetus. 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, nausea, and backache.
What Causes False Pregnancy?
Only recently have doctors begun to understand the psychological and physical issues that are at the root of pseudocyesis. Although the exact causes still aren’t 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, impending menopause, or a desire to get married, their body may produce some pregnancy signs (such as a swollen belly, enlarged breasts, and even the sensation of fetal movement). The woman’s brain then misinterprets those signals as pregnancy, and triggers the release of hormones (such as estrogen and prolactin) that lead to actual pregnancy symptoms.
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 (for example, to profit financially), or having delusions of pregnancy (such as in patients with schizophrenia).
Symptoms of False Pregnancy
Women with pseudocyesis have many of the same symptoms as those who are actually pregnant, including:
Interruption of the menstrual period
Swollen belly
Enlarged and tender breasts, changes in the nipples, and possibly milk production
Feeling of fetal movements
Nausea and vomiting
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 labor pains.
Tests for False Pregnancy
To determine whether a woman is experiencing a false pregnancy, the doctor will usually evaluate their symptoms, perform a pelvic exam and abdominal ultrasound — the same tests used to feel and visualize the unborn baby during a normal pregnancy.
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. Urine pregnancy tests will always be negative in these cases, with the exception of rare cancers that produce similar hormones to pregnancy.
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.
Treating False Pregnancy
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. Doctors need to gently break the news, and provide psychological support, including therapy, to help the patient with pseudocyesis recover from their disappointment.