Pregnant Without Knowing It: What Is a Cryptic Pregnancy?

Cryptic pregnancy is when someone is pregnant but doesn’t know it. Sometimes people are unaware of their pregnancy for several months into a pregnancy. Other times, people don’t know they’re pregnant until they go into labor. Cryptic pregnancies are not common, but they happen more frequently than you might realize.

Although researchers started describing cryptic pregnancies in literature as far back as the 17th century, it’s still something that isn’t fully understood. Experts don’t have a formal definition for it, such as how far into a pregnancy someone discovers they're pregnant for it to be considered a cryptic pregnancy. Cryptic pregnancies are also not yet classified in the Diagnostic and Statistical Manuals, Fifth Edition, used by psychiatrists, or the International Classification of Diseases-10, used by physicians.

Cryptic pregnancy is sometimes referred to as unperceived pregnancy, pregnancy denial, or stealth pregnancy.

Cryptic Pregnancy Symptoms

There are a range of possibilities for what you might experience with a cryptic pregnancy.

Pregnancy symptoms like missed periods, nausea, sore breasts, weight gain, and growing belly may be present. However, the symptoms are often less noticeable. These pregnancy symptoms might even be mostly absent for people with cryptic pregnancies.

While some people with cryptic pregnancy might miss a period, others might experience vaginal bleeding or spotting.

How Does Cryptic Pregnancy Happen?

There is no consensus on why exactly cryptic pregnancies happen, and it’s likely that the reasons are different from one person to another. Here are some possible explanations:

Psychological Factors

There may be psychological factors at play. For example, someone may unconsciously convince themselves that they aren’t pregnant because the idea of being pregnant would cause too much anxiety.

A history of trauma might also cause a person to unconsciously block out the idea of pregnancy, even if symptoms are present.

Having a history of mental health conditions may contribute to the development of cryptic pregnancies. In particular, a history of depression has been linked to cryptic pregnancy.

Often, people with cryptic pregnancies don’t believe they are pregnant and are usually surrounded by others, like family and friends, who don’t believe it either.

Physical Factors

Research has found that people who have cryptic pregnancies have few, if any, pregnancy symptoms.

Some researchers have suspected that people with cryptic pregnancies are more likely to have lower levels of human chorionic gonadotropin, or hCG, the hormone released in high amounts in early pregnancy that causes symptoms like nausea, morning sickness, and exhaustion.

If symptoms of pregnancy are present, the pregnant person might not relate them to pregnancy. For instance, someone with nausea might think they have a stomachache while someone who's gained weight might think it's just normal weight fluctuation.

People who are in perimenopause might not believe it’s possible to be pregnant, so brush aside symptoms and believe a lack of a menstrual period means they are in menopause.

Some people who have a cryptic pregnancy take a pregnancy tests which gives them false negative results (meaning they are pregnant, but the test incorrectly says they are not).

Risk Factors

Anyone can experience a cryptic pregnancy, but it’s possible that certain individuals may be at higher risk.

Research from 2021 found that cryptic pregnancy was more common among younger people who were single and did not have a high school diploma. People experiencing cryptic pregnancies are also more likely to have a history of mental health issues.

People who have recently given birth might also be more likely to have a cryptic pregnancy. They might assume they can't become pregnant because their period hasn't yet returned.

Cryptic pregnancy might also be more common among people who have irregular periods, who take birth control pills, and who are in perimenopause (the transitionary time to menopause).

How Common Is Cryptic Pregnancy?

Research from Germany has shown that one out of every 475 pregnancies is not known of until the 20th week or later. That means that just .2% of pregnancies are cryptic pregnancies. So cryptic pregnancies aren't too common. Still, for comparison, they are more common than rare diseases, which are defined as diseases that affect one out of every 200,000 people in the U.S.

Usually, people with a cryptic pregnancy find out they're pregnant before labor. Less often, they find out they're pregnant only when they go into labor. It's estimated that one out of 2,455 births (just .04%) come from a cryptic pregnancy.

Potential Complications of a Cryptic Pregnancy

When a pregnancy unfolds without the pregnant person’s knowledge, it puts the pregnancy at risk. For instance, the person who's pregnant misses out on most if not all of their prenatal care, including necessary prenatal testing, and counseling on appropriate nutrition and activity.

In addition, the pregnant person likely hasn’t made the lifestyle changes people who know they are pregnant usually make, such as refraining from smoking or drinking alcohol, which can affect the health of the parent and child.

Research has found that cryptic pregnancy comes with an increased risk of premature birth, low birth weight, and the diagnosis of small for gestational size.

Cryptic pregnancies also put the pregnant individual at risk for delivering their baby without medical assistance.

Once a person learns they have a cryptic pregnancy, they are at increased risk for emotional distress.

How to Confirm a Cryptic Pregnancy

If you suspect you are pregnant, even if you think you may have missed confirming your pregnancy by several weeks or months, you should visit a healthcare provider.

Your provider will confirm your pregnancy using testing methods used for all pregnancies including:

• Urine test to detect the presence of the hCG hormone in your urine
• Blood tests to detect pregnancy hormones in your blood, if necessary
• Ultrasounds, which give a view of your fetus and placenta
  

How to Cope With a Cryptic Pregnancy

The first step to take if you are experiencing a cryptic pregnancy is to visit with a healthcare provider to ensure that you and your fetus are healthy. Then, you should do what’s necessary to support your pregnancy, including taking prenatal vitamins, visiting your provider regularly, and getting any necessary prenatal testing. If you are in a time in your pregnancy where termination is possible, you can discuss that with your healthcare provider, if that is how you wish to proceed and the care is accessible to you.

It's important to take into consideration the emotional effects of experiencing a cryptic pregnancy. It’s typical to feel distress and shame. People in this situation are often stigmatized by others. It’s also common to feel guilt about not realizing you were pregnant and potentially putting your fetus at risk. If you didn’t realize you were pregnant until you were giving birth, you might feel unsure if you will be able to adequately care for your baby or bond with them.

If you are experiencing mental health challenges in relation to your cryptic pregnancy, know you aren’t alone and that help is out there for you. Don’t hesitate to reach out to a mental health professional for help and support. Your physician can give you a recommendation if you need one.

If you are having thoughts of self-harm, suicide, or are thinking of harming your baby, call 911 or seek emergency medical care. You can also call the National Suicide hotline at 988, which is free and confidential, or visit the 988 website to chat with a trained helper.

A Quick Review

A cryptic pregnancy is when you are pregnant without knowing it. People may not know they are pregnant for several weeks, months, or even the entire duration of their pregnancy. People might not know their pregnant for a variety of factors, which include both psychological and physical factors. In many cases, people who experience cryptic pregnancy have less pronounced or no pregnancy symptoms. Cryptic pregnancies present risks, including putting you at risk for preterm labor and increased psychological distress and the fetus at risk for a low birth weight. If you realize you are experiencing a cryptic pregnancy, you should visit a healthcare provider and, if needed, seek mental health support.