She’d had no idea she was expecting as she had not noticed any change in her body. Moreover, her menstrual cycle continued, although it was irregular at times, and she never experienced nausea, headaches or cravings – symptoms commonly associated with pregnancy.
Mariah’s condition is known as a cryptic or stealth pregnancy, where a woman remains unaware of her pregnancy until the late stages or even labour.
According to associate professor Dr Ixora Kamisan Atan, a consultant in obstetrics, gynaecology and urogynaecology, women who undergo such pregnancies are not aware of their condition owing to the absence of symptoms like nausea, vomiting, breast tenderness or abdominal discomfort.
Alternatively, they might mistake the signs for other health issues.
Studies have shown that one in 475 women worldwide only realises she is expecting when her pregnancy reaches 20 weeks, at which point she may start noticing a “baby bump” or feeling foetal movements.
Meanwhile, one in 2,500 women remains unaware of her pregnancy until full term and only discovers it when she experiences labour pains, Ixora told Bernama.
She said some obese women, for example, may not feel foetal movements, which are usually noticeable between 16 and 20 weeks of pregnancy. Their family and friends may not notice any change in their belly size due to their body shape.
“In addition, some women with irregular periods may find it normal to not menstruate for three to four months, so they do not take a pregnancy test.
“While early-pregnancy bleeding can sometimes be mistaken for menstruation, it could also be implantation bleeding, which occurs when the embryo attaches to the uterine wall. Or it could be a sign of a threatened miscarriage,” she said.
Several factors contribute to irregular menstruation, including conditions such as polycystic ovarian syndrome (PCOS), hormonal imbalances, obesity, and certain types of birth control. Women who are breastfeeding or approaching menopause may also experience irregular menstruation.
Meanwhile, obstetrics and gynaecology consultant Dr Sharina Mohd Razali said cryptic pregnancy can also be referred to as “pregnancy denial”, where a woman has set her mind not to get pregnant and chooses not to believe she is with child.
This, Sharina explained, is more common among young, unmarried individuals.
“There are two categories of cryptic pregnancy: psychotic and non-psychotic. The psychotic type involves individuals with mental health issues who are completely unaware that they are pregnant. The non-psychotic type involves women without mental health conditions but who are in denial about their pregnancy.
“They do not expect to be pregnant, either because they are unmarried or use contraception. Since they do not anticipate pregnancy, they tend to ignore symptoms like missed periods,” she explained.
Sharina noted that denial is often seen in individuals who have experienced childhood trauma or sexual abuse, making it difficult for them to accept the pregnancy.
However, she warned that cryptic pregnancy can lead to risks such as low birth weight in babies owing to inadequate nutrition during the prenatal stage, and absence of routine pregnancy care. It could also lead to pregnancy complications for the mother.
She thus advises women who have engaged in unprotected sex or are victims of sexual assault to consult a doctor if they experience delayed menstruation and abdominal enlargement, so they can receive appropriate care in the event they are pregnant.