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A puzzling phenomenon -

Pseudocyesis is a rare condition in which a woman experiences symptoms of pregnancy (including physical changes like missed periods and swollen bellies) without actually being pregnant. Its intricacies blend psychological, cultural, and medical challenges that remain partly unexplained.

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Queen Mary I -

Queen Mary I (better known as “Bloody Mary”) is one of the earliest documented cases of pseudocyesis. The Queen secluded herself in April 1555 as she awaited the birth of her first child.

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Desperation -

The Queen was 38 years old, and was the eldest daughter of King Henry VIII (pictured). She was desperate for a male heir to secure her rule in England and her alliance with Spain. However, it was not to be.

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Symptoms -

Mary displayed convincing symptoms of pregnancy, such as a distended stomach and morning sickness. She even experienced movement in her womb, and the kingdom rejoiced the imminent arrival of the baby.

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Rumors -

Weeks after the baby was meant to be delivered, however, no news had arrived. Rumors spread that the Queen had perished in childbirth, but the truth was less scandalous: Mary had never been pregnant to begin with. These events ended in heartbreak for the Queen and her kingdom.

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All physical - Women with pseudocyesis often show pregnancy-like signs such as abdominal swelling, lactation, and even perceived fetal movements. Although these symptoms are entirely physical, they appear without the presence of an actual fetus.

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A condition of changes -

A woman suffering from pseudocyesis would experience major changes in her body that are in line with pregnancy. It is no mere delusion, even though such medical cases were often dismissed in the past on the basis of hysteria.

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An enigma -

Phantom pregnancies bridge the fields of psychology and medicine. A person’s intense emotional desire to conceive often interacts with physical changes, which leads to the manifestation of pregnancy symptoms without conception.

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Diagnosis -

In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), pseudocyesis has been placed in the same category as other somatic (or bodily) symptom disorders, as well as difficult-to-categorize disorders (such as hypochondria or Munchausen’s).

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A condition once common -

In 2007, biologists estimated that pseudocyesis occurred in between one to six cases for every 22,000 pregnancies in the US. But in the 1940s, phantom pregnancies occurred in one out of every 250 pregnancies, similar to the odds of natural twins.

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Technology -

Medical advances, especially ultrasound technology, have reduced the frequency of phantom pregnancies. However, it still emerges in isolated cases worldwide, such as in Africa where medical care is difficult to obtain.

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Cultural factors -

In cultures where fertility is deeply tied to a woman’s value, pseudocyesis is more common. Societal pressure to conceive, coupled with limited access to medical care, can drive women to experience the condition without realizing the absence of a fetus.

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Early detection -

Today, ultrasounds and reliable pregnancy tests often identify pseudocyesis early, thus minimizing prolonged delusion. In the past, as with Queen Mary I, the condition could persist for months or even years due to the absence of medical technology.

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Headlines -

Even in contemporary times, pseudocyesis occasionally captures public attention. In 2014, a Quebec woman claimed to be expecting quintuplets, fooling her entire community. It wasn’t until she arrived at the hospital that medical professionals confirmed she was not pregnant at all.

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The deep desire to conceive -

While phantom pregnancies are notoriously difficult to study, a hallmark factor is that a patient has an overwhelming desire to become pregnant, which often stems from societal expectations, emotional needs, or even personal grief.

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A mirror of symptoms -

The desperate desire to have a baby can be so powerful that the body mirrors pregnancy symptoms, doing nothing more than reinforcing the illusion of conception.

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Perceived benefits -

For some women, pregnancy provides social advantages, such as care, attention, or societal respect. In cultures where motherhood is considered a woman’s ultimate role, these perceived benefits can psychologically contribute to phantom symptoms.

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Misunderstandings -

Despite its documented history, pseudocyesis is still poorly understood by many medical professionals, including those in obstetrics and gynecology. This lack of knowledge can lead to misdiagnosis or dismissive treatment, all of which further isolate patients who experience this rare condition.

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Pop culture’s damaging portrayal -

Media and pop culture have also depicted pseudocyesis inaccurately, often framing it in horror or drama narratives. Such portrayals (like in ‘American Horror Story’) stigmatize the condition and overlook the emotional and psychological struggles faced by real patients.

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The complex role of hormones -

Although hormonal changes (such as elevated prolactin and estrogen levels) may contribute to pseudocyesis, no consistent pattern explains the condition.

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The role of stress -

Experts believe that stress-related hormonal responses likely exacerbate symptoms, but this does nothing more than complicate the already murky understanding of its physiological roots.

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The paradox of treatment -

Psychiatric medications prescribed to address pseudocyesis sometimes worsen symptoms. Some antipsychotic drugs, for instance, raise prolactin levels and may also increase lactation and inadvertently reinforce a patient’s belief that they are pregnant.

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The stress hormone -

Stress significantly influences pseudocyesis. Elevated prolactin levels associated with anxiety or emotional turmoil can cause physical symptoms like breast enlargement or milk secretion.

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All demographics -

Pseudocyesis can affect anyone across various communities, regardless of ethnic, racial, and socioeconomic background. While most cases occur in women aged 20 to 39, it can also emerge in post-menopausal women.

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A rare phenomenon in men -

Though exceedingly rare, pseudocyesis has been documented in men, particularly those with severe mental illnesses. Notable cases include two American men in the 1980s and '90s who believed themselves to be pregnant.

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Delusions that defy evidence - Patients with pseudocyesis often reject medical evidence that disproves their pregnancy. They may suspect conspiracy among doctors, family, or even their spouse. Oftentimes, they cling to their perceived reality despite repeated testing and diagnostic procedures that confirm the absence of a fetus.

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Breaking through denial -

Overcoming a patient’s denial requires empathy and patience. Dismissing their experience as delusional only deepens their distress. Instead, compassionate care encourages them to process the emotional parts of their condition and move toward acceptance.

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Growing sensitivity -

Psychiatry has begun addressing pseudocyesis with increased sensitivity, moving beyond dismissive attitudes that labeled it as “just a women’s issue.” This shift marks progress in understanding the emotional depth and complexity of the condition.

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Reducing stigma -

Greater public awareness about pseudocyesis is essential to reducing stigma. By educating people about the condition’s psychological and physiological roots, society can foster empathy and understanding for those affected by this rare and misunderstood phenomenon.

Sources: (National Geographic) (WebMD) (Healthline) (Britannica) (American Psychiatric Association)

See also: Pregnancy myths people still believe

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