All signs point to pregnancy, except for one

KANSAS CITY, Mo. — Recent news suggests that some women may be so desperate to become mothers that they would kill for a baby.

On rare occasions a woman is so desperate to be pregnant that her body obliges.

“I’ve seen it … two remarkable cases,” said Brendan Mitchell, a Johnson County, Kan., obstetrician-gynecologist. “In my residency, a patient came in and appeared to be in delivery. She had a lot of pain and involuntary pushing.”

But oddly, her cervix was closed. Mitchell placed a fetal monitor on her abdomen. It registered a heart rate in the 70s to 80s range. That’s low for a fetus, dangerously low. So Mitchell called for an emergency C-section. The staff scurried to prepare the room. “It looked like a scene out of ‘ER,’ ” the doctor recalled. “There was all this commotion because we were going to save this baby.”

Mitchell put the sonogram scanner on the patient’s belly.

There was no baby.

“All I could see was dilated loops of intestine and this tiny, nonpregnant uterus,” he said. “I told a nurse to get a urine specimen and to run a pregnancy test. They looked at me like I was crazy. I said, ‘We’re dealing with a psychiatric condition.’

“Her pregnancy test was negative. Everybody just walked away from the bedside. I gently talked to her about how she was not pregnant and needed to talk to a psychiatrist. She just looked bewildered. Her boyfriend came over and told me she did this every three or four months, when she was stressed out.”

In layman’s terms it’s known as false pregnancy. In medical jargon it’s pseudocyesis. Hippocrates wrote in 300 B.C. about a dozen women who thought they were pregnant but weren’t. And according to an article published in 1990 in the Journal of Family Practice, Mary Tudor, queen of England in the 16th century, was so distressed when informed that she wasn’t pregnant, she embarked on the persecutions for which she would become famous.

False pregnancy is unusual, according to Paul M. Paulman, who wrote the journal article. Between 1959 and 1979, just 42 cases were reported.

Women who falsely believe they are pregnant can develop a range of convincing symptoms that are typical of pregnancy. According to Paulman’s analysis, 63 percent of patients have abdominal enlargement; 56 percent have menstrual irregularities; 48 percent report feeling fetal movements; and 40 percent have breast secretions.

“We’re not sure why these physical symptoms develop,” said Gerard Malnar, an assistant professor of obstetrics and gynecology at the University of Missouri-Kansas City medical school. It’s likely that women who desperately wish to conceive but cannot become depressed, he said. Depression can trigger a cascade of neurochemical and hormonal reactions that can lower a woman’s estrogen level. That could cause a woman’s menstrual periods to stop, giving her one reason to believe she’s pregnant.

During her four-year residency, Reagan Wittek saw two cases of false pregnancy. One of the women said that when she heard babies cry, she felt milk moving through her breasts.

“It’s quite amazing,” said Wittek, now an obstetrician-gynecologist at Shawnee Mission (Kan.) Medical Center. “It shows you the power of our mind.”

False pregnancy also may reflect just how ingrained is the drive to reproduce, she said, pointing out that the phenomenon is more common among dogs and cows and other mammals than it seems to be among humans.

“It’s not just an emotion and not just instinct,” she said. “It’s the way our bodies are made – to rear children. You add some passion and some desire, and you can get some weird stuff.”

According to Paulman’s article, false pregnancy is more common in a woman’s second marriage. Symptoms generally last about nine months, but they can last for just a few months or as long as a few years.

Mitchell came across his second case of false pregnancy seven or eight years ago. A woman came into his office on a Saturday and reported that she needed prenatal care.

“Her belly was distended, but her uterus was small,” Brendan recalled. A pregnancy test turned out negative, as did an ultrasound.

“I told her she wasn’t pregnant, and her response was, ‘What kind of doctor can’t diagnose a pregnancy?’ She grabbed her stuff and stormed out of the office.

“These are just people who are tortured by their delusions,” he said. “And because of the mind-body connection, the mind convinces the body there’s a pregnancy.”

When such a woman is told by a doctor that she is not pregnant, she will typically move to another physician in search of confirmation, Malnar said.

“Sometimes they’re so deluded they’re living in their own world. They’re convinced that everybody else is wrong.”