What Is Cryptic Pregnancy? Causes, Symptoms And Duration
Cryptic pregnancy, sometimes called stealth pregnancy or concealed gestation, is when a woman is unaware of her pregnancy; it goes undetected until the end of gestation. A woman who has this type of pregnancy may not have positive results on standard pregnancy tests, and she may not develop any noticeable signs and symptoms of pregnancy.
A cryptic pregnancy may occur due to low hCG (human chorionic gonadotropin) hormone levels. Some studies suggest that about 1 in 475 women could be unaware of their pregnancy until the 20th week of gestation (1).
Curious to know more about the occurrence and meaning of cryptic pregnancy? Read on as we explain the vital details about cryptic pregnancy, including its causes, indications, and ways to prevent this peculiar pregnancy phenomenon.
Cryptic pregnancies or masked conception usually occur in women who have been on birth control methods, reached perimenopause, or have hormonal imbalances. These women come under the ‘least expected pregnancy category’ and experience common pregnancy symptoms such as fatigue and morning sickness mildly, or may also have a lack of pregnancy symptoms. These symptoms may be mistaken as those of some other condition.
The phenomenon of cryptic pregnancy is explained by the following three hypotheses. These hypotheses explain stealth pregnancy in evolutionary terms. These theories are mutually exclusive, which means the occurrence of any one of them implies the nonoccurrence of others (1):
According to this hypothesis, the fetal risk is increased, but evidence shows that infants do not have any significant health problems other than low birth weight.
Several hormonal and psychological reasons can lead to cryptic pregnancy. However, the psychological causes are lower than the hormonal.
High-stress levels can cause a cryptic pregnancy as they influence the hormones (1).
These women come under the ‘least expected pregnancy category’ and also may not experience common symptoms of pregnancy, such as morning sickness.
There is no evidence to determine the duration of the gestation period of cryptic pregnancy. That’s mainly because the woman might not know when the pregnancy started. However, a few pieces of anecdotal evidence shows that a cryptic pregnancy may last longer than a normal pregnancy as the development is slower due to low hormones. Sometimes, there could be regular periods during a cryptic pregnancy due to the partial shedding of the endometrial lining.
Even in such a case, it becomes difficult to determine the duration. Some cryptic pregnancy cases that have been reported were shorter than the usual gestation period, while some were longer. Hence, the duration is uncertain.
Even when the pregnancy is cryptic, it could send you some signals.
The cryptic pregnancy symptoms are similar to regular pregnancy. Note that the symptoms vary from one woman to the other.
The symptoms could be similar to those of normal pregnancy. So, how is cryptic pregnancy different from the normal?
Pregnancy remains a secret because of these reasons (4):
If the mother is overweight, her cryptic pregnancy may be camouflaged, leaving her unaware of her condition (5).
Ashley opens up about her difficult journey through a cryptic pregnancy loss. She recalls, “One day, I woke up and felt something wasn’t right, so I went to the doctor. I thought I had an infection, and then the doctor hit me with the news that I was pregnant! I was pregnant with identical twin boys! Both babies had strong heartbeats. Two weeks later, I went to my OB appointment, and they performed another ultrasound. My doctor had to break the horrible news that both of my twin boys had passed away, and I would have to deliver the babies. This is one of the hardest things I ever had to deal with (i).”
In cryptic pregnancy, the development of the fetus may be delayed and interrupted frequently, taking place at an extremely slow pace. Lack of prenatal care may negatively affect perinatali Period surrounding childbirth, including the last stages of pregnancy and the early postpartum time outcomes (6). However, some women deliver healthy babies after cryptic pregnancy.
Not all women have regular and monthly periods, and a missed period may not bother them, and they may not think of a pregnancy after a missed period. According to the American Pregnancy Association (APA) around 30 percent of women have missed periods with some even having very few within a year (2). Even if periods occasionally occur, spotting during pregnancy may be construed as menstrual bleeding. The irregular or less flow could be attributed to stress, menopause, or other health problems.
Most women keep getting their regular periods throughout the cryptic pregnancy, but this does not indicate a miscarriage. It can be heavy, light, or spot bleeding with a few large or small clots. The bleeding can be bright red, pink, brown, purple, orange, or black. It can be like a normal period, sporadic, or random. The bleeding could sometimes last for weeks or months, but all it does is shed away the uterine lining. This results in little or no hCG.
A French study compared 71 mother-infant pairs who experienced pregnancy denial with a control group of 71 mother-infant pairs and found that 86% of women with cryptic pregnancies continued to have menstrual cycles (7).
In a normal pregnancy, the pregnancy test shows negative if it is taken too early or if you fail to follow the instructions correctly.
But in a cryptic pregnancy, the result is negative because the level of hCG is negligible. The placenta usually secretes hCG, which passes along the lining of the uterus. It builds up and is shown in the urine and blood. In cryptic pregnancy, the lining of the uterus sheds periodically without giving hCG the scope to build up and show up in tests.
Moreover, if you are not anticipating a pregnancy, you would not take the test.
In a known pregnancy, the doctor will do a transvaginal ultrasound in the early phase of pregnancy, followed by abdominal ultrasound tests regularly until the due week.
However, in most cryptic pregnancy cases, women may not consider going to the doctor or getting an ultrasound. Even if they do, ultrasound scans cannot detect the growing fetus in a majority of women. It may be due to irregular implantation of the embryo, abnormal shape of the uterus, or technical errors in the ultrasound device. The following abnormalities in the abdominal region or uterus may give a false negative result:
Low levels of hCG hormones may reduce maternal involvement in pregnancy and prevent the body from generating signals essential for baby development. The fetus will thus grow slowly. The babies measure smaller than they should be at various pregnancy phases.
There would not be prenatal care, as you are not aware of your pregnancy. The delivery, thus, turns out to be unassisted, at home, or in an emergency room.
To prevent complications, obstetrician-gynecologist Rebecca Russell, MD, suggests, “Any woman who could get pregnant should be on a multivitamin with folic acid. Folic acid greatly reduces the chance of birth defects. It’s one of the most important things you can do if there’s a chance of becoming pregnant (5).”
Labor and childbirth at the end of cryptic pregnancy will be physically the same as in normal pregnancy. Unexpected contractions may feel like severe cramps. Women may experience more psychological distress during delivery since they would not be expecting it.
Erin Langmaid, a 23-year-old Australian model shares her experience with cryptic pregnancy. She says, ‘I wasn’t visibly pregnant because I could still fit into all my clothes. It’s truly surreal.’ She realized she was pregnant when she felt some discomfort and went into the bathroom. Less than 10 minutes later, she was holding baby Isla. When her boyfriend, Daniel Carty, heard her scream and rushed to the bathroom, he was taken aback, thinking, ‘Wait, there are two? (i)’
The following symptoms may help you recognize that you are in labor after an unidentified pregnancy:
You may experience all or a few of these symptoms during labor. In most cases, the actual process of cryptic pregnancy delivery is sudden and does not last long. It may be due to premature birth and low birth weight due to a lack of prenatal care or ignoring and mistaking labor symptoms (8). If you are experiencing intense cramping and uncertain that you are in labor, it is recommended to get immediate medical help.
Although the case of cryptic pregnancy is rare, there are some surprising stories.
Take pregnancy tests periodically if you are sexually active and do not get regular periods. Use reliable birth control methods precisely as directed. Keep track of your menstrual cycle and stay alert to potential symptoms, including minor abdominal cramps and dull pain in the pelvic region. Obstetrician and gynecologist Rebecca Russell suggests, “If you start noticing any unusual symptoms, even if you’re on birth control, take a pregnancy test. And if that comes back negative and you’re still suspicious in two weeks, take another one (5).” Speak to your gynecologist about irregular periods and get a pregnancy blood test in case you suspect pregnancy. You should also get a checkup if you think you have entered menopause. Though it is rare, cryptic pregnancy is a real medical condition.
1. How will the cryptic pregnancy baby movement be?
The fetal movements in cryptic pregnancies are the same as in normal pregnancy. Sometimes, the fetus may have fewer movements if there is a delay in development. In most cases, women may misinterpret fetal movements as gas or muscle spasms.
2. How long does a cryptic pregnancy last?
Cryptic pregnancy can be for the same duration as a normal pregnancy. It can also be for a shorter or longer duration. The length of pregnancy depends on maternal and fetal factors contributing to preterm, term, or post-term birth, similar as in typical pregnancy. There is no reliable data showing the exact length of stealth pregnancies.
3. How to confirm a cryptic pregnancy?
If there is a suspicion of pregnancy and the conventional pregnancy tests such as blood and urine tests, and an ultrasound scan is negative, your practitioner may use a Doppler (monitors fetal heart rate) to confirm the pregnancy (6).
4. How common is cryptic pregnancy?
The prevalence of cryptic pregnancy is not well established as they are rare. Some studies suggest that about 1 in 475 pregnancies go unnoticed up to 20 weeks of gestation, while others indicate that 1 in 250 pregnancies go unnoticed until delivery (4). However, the actual incidence may be higher due to underreporting and misdiagnosis.
5. What are the emotional and psychological effects of cryptic pregnancy?
Cryptic pregnancy may affect a woman’s emotional and psychological well-being as it may be associated with total denial of pregnancy until delivery. Lack of neonatal care due to unawareness may lead to pregnancy loss, adding to stress and anxiety.
Cryptic pregnancies may occur in women who suffer from hormonal imbalances or have reached perimenopause. Since these women experience common symptoms such as fatigue, nausea, frequent urination, or mild morning sickness, their pregnancy may go unnoticed until the end of gestation. Even the partial shedding of the endometrial lining during a cryptic pregnancy might hide the condition. Although there have been reported cases of women with cryptic pregnancies delivering a healthy full-term baby, such unexpected pregnancies and deliveries might be stressful. Hence, if you are sexually active, take pregnancy tests frequently. Also, inform your gynecologist if you experience irregular periods or notice other accompanying signs that you’re pregnant.
Being aware of pregnancy and ensuring timely prenatal care can improve pregnancy outcomes. However, it may not be possible for most women with a cryptic pregnancy. The lack of adequate care due to a cryptic pregnancy may increase the risk of certain conditions. Go through the infographic to know the complications of cryptic or stealth pregnancy.
Join the conversation and become a part of our nurturing community! Share your stories, experiences, and insights to connect with fellow parents.