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    What Is Pseudocyesis - Here's The Science Behind Phantom Pregnancies

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    Rey Dinero
    Queen Mary I of England experienced a rare condition called pseudocyesis in 1555, where her body exhibited physical signs of pregnancy like swollen breasts and a distended stomach, despite not actually being pregnant. Pseudocyesis, also known as a phantom or false pregnancy, can be triggered by psychological and physiological factors. It is difficult to study due to its rarity but usually occurs in women who desperately want to be pregnant. While advances in modern medicine have helped detect most cases of pseudocyesis before "delivery", it remains poorly understood and more research is needed to reduce the stigma around it.

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    What Is Pseudocyesis - Here's The Science Behind Phantom Pregnancies

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    Queen Mary I of England experienced a rare condition called pseudocyesis in 1555, where her body exhibited physical signs of pregnancy like swollen breasts and a distended stomach, despite not actually being pregnant. Pseudocyesis, also known as a phantom or false pregnancy, can be triggered by psychological and physiological factors. It is difficult to study due to its rarity but usually occurs in women who desperately want to be pregnant. While advances in modern medicine have helped detect most cases of pseudocyesis before "delivery", it remains poorly understood and more research is needed to reduce the stigma around it.

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    What is pseudocyesis_ Here’s the science behind phantom pregnancies

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    Queen Mary I of England experienced a rare condition called pseudocyesis in 1555, where her body exhibited physical signs of pregnancy like swollen breasts and a distended stomach, despite not actually being pregnant. Pseudocyesis, also known as a phantom or false pregnancy, can be triggered by psychological and physiological factors. It is difficult to study due to its rarity but usually occurs in women who desperately want to be pregnant. While advances in modern medicine have helped detect most cases of pseudocyesis before "delivery", it remains poorly understood and more research is needed to reduce the stigma around it.

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    © All Rights Reserved
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    22 views12 pages

    What Is Pseudocyesis - Here's The Science Behind Phantom Pregnancies

    Uploaded by

    Rey Dinero
    Queen Mary I of England experienced a rare condition called pseudocyesis in 1555, where her body exhibited physical signs of pregnancy like swollen breasts and a distended stomach, despite not actually being pregnant. Pseudocyesis, also known as a phantom or false pregnancy, can be triggered by psychological and physiological factors. It is difficult to study due to its rarity but usually occurs in women who desperately want to be pregnant. While advances in modern medicine have helped detect most cases of pseudocyesis before "delivery", it remains poorly understood and more research is needed to reduce the stigma around it.

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    Queen Mary I pictured in 1554, the year before she experienced pseudocyesis.
    PHOTOGRAPH BY VCG WILSON, CORBIS/GETTY IMAGES

    SCIENCE

    The science of phantom pregnancies: a very


    real—and very rare—condition
    First highly detailed in Queen Mary back in 1555, the uncommon disorder can cause
    a woman’s body to mimic signs of pregnancy, from a lack of menstrual periods to a
    distended stomach.

    BY RO S E M A RY C O U N T E R
    PUBLISHED SEPTEMBER 11, 2023

    • 7 MIN READ

    In April 1555, Queen Mary I—better known to history as “Bloody


    Mary”—went into seclusion as she awaited the birth of her first child.
    At 38, the eldest daughter of King Henry VIII desperately needed an
    heir, preferably male, to secure an alliance with Spain and continued
    Catholic rule in England. The stakes were high.

    Still, both Mary and the nation were optimistic. The year after she'd
    married Philip II of Spain, the Queen looked pregnant: Her breasts
    and belly had swelled, and she reported morning sickness and
    movement in her womb. As such, the nursery was prepared, wet
    nurses were on call, and announcement letters were prepared and
    signed, leaving just the date of delivery and sex of the child to be
    filled in.

    Yet “as the weeks passed, the mood became one of despair,” writes
    Anna Whitlock, author of Mary Tudor: Princess, Bastard,
    Queen. Rumors spread the Queen was dead, or that the child had
    died, and another would be swapped in its place.

    The truth was less scandalous: Despite all appearances to the


    contrary, Mary had never been pregnant to begin with, having the
    misfortune of being history’s first well-documented case of a very
    rare phenomenon called pseudocyesis.

    Sometimes called false, hysterical, phantom, or delusional pregnancy,


    pseudocyesis manifests most or all symptoms of pregnancy, but no
    fetus.

    For instance, a sufferer doesn’t have a menstrual period, her breasts


    get larger and may even express milk, and her stomach is distended,
    says Mary Seeman, professor emerita at the University of Toronto’s

    Department of Psychiatry. Such physical manifestations also occur


    alongside fatigue, nausea, and frequent urination.

    “Her body is acting pregnant, so she believes she’s pregnant, but she’s
    not otherwise delusional,” says Seeman, who’s long studied the
    mental disorder. (Why women’s health concerns are dismissed more
    and studied less.)

    Most cases have psychological and physiological elements. The


    American Psychiatric Association’s diagnostic manual, DSM-5-TR,
    places pseudocyesis in the category of other specified somatic
    symptom and related disorder, along with other difficult-to-
    categorize disorders such as illness anxiety disorder (aka
    hypochondria) or factitious disorder (aka Munchausen’s).

    How common is pseudocyesis?


    In 2007, a review in the International Journal of Reproductive
    BioMedicine estimated there are between one and six cases per
    22,000 pregnancies in the United States. That’s a huge drop since
    1940, when the statistic was one case of pseudocyesis per 250
    pregnancies—exactly the likelihood of natural twins.

    These numbers climb drastically outside the U.S.

    “There are parts of Africa, for example, where pregnancy is very


    valued and medical care is hard to access, so pseudocyesis is not
    uncommon,” says Seeman, who has encountered about 20 cases in
    her practice since 1960.

    Because of modern medicine and the wide availability of


    Because of modern medicine and the wide availability of
    ultrasounds, very few cases of pseudocyesis today go undetected
    until apparent “delivery.”

    Those that do, like Queen Mary’s, often make headlines. In 2014, for
    example, a Quebec woman convinced her town she was expecting
    quintuplets. At 34 weeks, she went to the hospital to deliver—where
    a nurse discovered there were no babies at all.

    “Pseudocyesis is notoriously difficult to study,” says Seeman, mostly


    due to its rarity and the complexities of the patient’s mental health.
    But there's one common thread: “The patient usually
    desperately wants to be pregnant.” (See public places that honor the
    grief of pregnancy loss.)

    Besides a baby, pregnancy may also provide a woman with particular


    benefits, such as better care, attention, and even respect.
    Unsurprisingly, Seeman says, pseudocyesis occurs more often in
    cultures where married women are expected to produce children.

    A still-mysterious condition
    “The medical establishment, even within the field of OB-GYN, does
    not have a good understanding of pseudocyesis,” says Shannon M.
    Clark, a maternal fetal medicine specialist at the University of Texas
    Medical Branch who has seen cases of false pregnancy.
    3:38

    PREGNANCY 101
    While customs and traditions involving pregnancy vary worldwide, the developmental process
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    Understanding what’s happening in the body of a woman with


    pseudocyesis would help both treat the condition and reduce the
    stigma of the sufferer being labeled as “crazy,” Clark says. (Learn how
    increasing temperatures are harming pregnant women.)

    Pop culture hasn’t helped: For instance, the lead character in the
    upcoming TV show American Horror Story: Delicate experiences
    violent and terrifying hallucinations during a supposed pregnancy,
    an example of a cinematic trope called “pregnancy horror.”

    As always, real life isn’t so dramatic. Though changes in hormones


    such as prolactin, estrogen, and progesterone can occur, there’s no
    clear pattern or elevation of hormone levels associated with the
    condition, Clark says.

    And the psychiatric drugs doctors might prescribe to a patient,


    meanwhile, could actually worsen her health.

    For instance, some antipsychotic drugs raise levels of prolactin, a


    hormone responsible for lactation, which may just further convince
    hormone responsible for lactation, which may just further convince
    the patient—and her body—that she’s indeed pregnant.

    Prolactin levels also increase with stress, and “it’s safe to say that a
    woman who’s convinced she’s pregnant when a test repeatedly says
    she’s not is certainly under severe stress,” says Seeman.

    Who suffers from pseudocyesis?


    Immense stress was likely the trigger for Queen Mary’s pseudocyesis,
    experts say.

    Nearly a year into her so-called pregnancy, Mary finally emerged


    from her chamber and no one spoke of it again (at least officially).
    She died three years later, childless, and the throne passed to her
    Protestant half-sister, Elizabeth I.

    “Pseudocyesis affects people from all ethnic, racial, and


    socioeconomic groups,” notes Clark. And although it’s most common
    in those aged 20 to 39, it can occur in post-menopausal women as
    well. (Learn how AI could offer more insight into neglected women’s
    health issues.)

    Pseudocyesis in men is even scarcer, though medical literature


    documented examples of the phenomenon in two American men, in
    1984 and 1995. In April 2022, scientists reported a 28-year-old
    American transgender woman who presented as pregnant with
    twins.

    Unlike many cisgender women with pseudocyesis, these three


    individuals all demonstrated severe mental illnesses.
    A widespread denial
    Just as Queen Mary did for nearly a year in 1555, modern patients
    with pseudocyesis will not accept evidence that they’re not pregnant,
    Seeman says.

    “They might think their husband doesn’t want them to be pregnant,


    that he’s colluding with the doctor or hospital. They might think their
    in-laws are involved. I’ve seen people who believe the doctor has
    impregnated her but won’t admit it,” she says.

    “These delusions can take so many forms because the person can’t
    accept anyone’s reality but their own. Their reality is they look and
    feel pregnant, so as far as they’re concerned, they are.”

    Fortunately, the medical establishment has started treating these


    unusual cases with increased interest and sensitivity, Seeman says.

    “General psychiatry is paying more attention to issues that they used


    to consider ‘just’ women’s syndromes,” she says.

    From the rest of us, adds Clark, “more understanding and empathy
    and less judgment and shaming are needed on all fronts.”

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