Can you be pregnant and not know? Cryptic pregnancy is rare—but possible

Klara Dollan woke up at 4 a.m. one morning with a severe cramping episode. Chalking it up to a painful period, the 22-year-old took a painkiller and got ready for her first day as a sales executive. But instead of setting up her office or going to meetings, Dollan spent the day in the hospital—holding the baby girl she had given birth to in the bathroom hours before.

(Her birth story is not dissimilar to the mom who gave birth mid-flight).

Dollan had experienced a cryptic pregnancy. She showed no noticeable signs of pregnancy. She reported no morning sickness, pregnancy cravings or baby bump. Her periods had always been irregular, so it was never a big deal if she missed one. While she gained some weight, Dollan assumed it was from dealing with a breakup five months prior. According to The Guardian, the thought of pregnancy did not cross Dollan’s mind until she was already giving birth.

You might find it mind-boggling to think someone could be pregnant and not know it, but Dollan’s situation is not that unusual. A cryptic pregnancy, also known as a stealth pregnancy, happens for several reasons.

People in this condition may mistake pregnancy symptoms for another cause. Others may also be in denial because they do not exhibit typical signs of pregnancy like morning sickness or a missed period. 

Like any unexpected pregnancy, cryptic pregnancies can feel confusing and stressful. You might be left with little time to prepare for the baby’s arrival or to plan for alternative options. Understanding why cryptic pregnancy happens could help with avoiding the condition in the future.

How common is cryptic pregnancy?

Cryptic pregnancies are unusual, but they happen. Research estimates 1 in every 475 pregnant people have experienced this phenomenon, with most pregnancies being noticed after five months. To compare, 1 in 3 people realize they’re pregnant after six weeks.

On rare occasions, like Dollan’s, there is a possibility you may not realize you’re pregnant until you’re actively in labor. 

A cryptic pregnancy does not necessarily mean there were no signs to indicate a person was carrying. Most cryptic pregnancies exhibit the same symptoms as those in someone who is aware of their pregnancy.

The difference is that cryptic pregnancy involves a state of denial—even when all signs point toward pregnancy.

What causes cryptic pregnancy?

There is no single root cause of cryptic pregnancies. Instead, there are situations that could make it more likely to happen. 

Life factors

Having irregular periods, an infertility diagnosis or currently taking birth control may mean someone is more likely to assume their symptoms are related to another cause. For example, someone might explain away a wave of nausea as due to something they recently ate. Experiencing uncommon pregnancy symptoms such as overheating, heartburn and constipation may also be mistaken for other conditions.

Negative test results

In some cases, people show no symptoms and have little reason to suspect pregnancy. There are other times when people might feel justified in thinking they’re not pregnant. While almost all at-home pregnancy tests are 99% accurate, there is a rare chance for a false negative if you take the test too early or if your human chorionic gonadotropin (hCG) hormone levels are too high.

Age

Age is another factor that could cause pregnancy to go unnoticed. Adolescents with inadequate sex education may be ill-informed of safe sex methods and how to detect signs of pregnancy. On the other side of the spectrum, people in their 40s may be skeptical about getting pregnant at what’s technically considered an “advanced maternal age.“

Cryptic pregnancy can go undetected in those going through perimenopause as several symptoms—irregular periods, weight gain, breast tenderness—overlap with pregnancy. Perimenopause also causes fluctuations in hormone levels, which can cause bleeding or spotting that a person can mistake for their period.

Mental health 

Despite what may seem like obvious signs of pregnancy—positive test, morning sickness, growing belly—a person’s mental state may block a conscious awareness of pregnancy. Research suggests cryptic pregnancies evolved as a defense mechanism to cope with the overwhelming fear of pregnancy.

Psychiatric disorders such as schizophrenia and bipolar disorder may also make someone more likely to deny pregnancy because these conditions often come with experiencing a break from reality. In some cases, the physical symptoms of pregnancy may even be attributed to delusions.

Biological factors

Hormone imbalances, common in conditions such as low body fat or polycystic ovary syndrome (PCOS), may make pregnancy difficult to detect, too. One hormone in particular, estrogen, increases dramatically to maintain the pregnancy—but it is also one of the main contributors to the nausea and back pain people feel during pregnancy. Fluctuating hormones could result in low estrogen levels and cause a symptomless pregnancy. 

Can you deliver a healthy baby from a cryptic pregnancy?

While it’s still possible to give birth to a healthy baby, cryptic pregnancy increases the risk of complications. People unaware of their pregnancies may lose valuable time to prepare for the birth.

For instance, the Centers for Disease Control and Prevention (CDC) recommends all pregnant women take 400 micrograms of folic acid daily to prevent neurological birth defects. To protect the health of the developing fetus, pregnant people are also recommended to avoid alcohol and tobacco and attend regular prenatal visits.

Even if you find out about your pregnancy much later than you would have liked, there is still time to make preparations. One of the first things you’ll want to do is contact your doctor, who can help you set up a plan, including prenatal care, nutrition recommendations and lifestyle changes to keep you and your baby healthy. 

A note from Motherly on coping with cryptic pregnancy

There are resources available to cope with and manage the stress of an unexpected pregnancy, including whether you’re still deciding to keep it or not. The All-Options Talkline, for example, is an anonymous and judgment-free hotline that pairs you with peer counselors who can support you as you navigate all your choices. 

The National Maternal Mental Health Hotline is another resource that can help with processing the complex emotions you might feel about becoming a new mom. No matter what you decide, remember that you’re not alone and there are people and practitioners out there who can help.