Pseudocyesis

Pseudocyesis is the medical term for a mental disorder that causes a woman to believe she is pregnant when she is not. I am not sure how common this is but I have seen it several times in my practice.

I have cared for several women who were so disabled by Pseudocyesis that they are in the hospital all the time. They are well known to staff in both the Emergency Department as well as Labor and Delivery where they go insisting they are in labor.

Here are a couple of specific cases I have recorded:

Pseudocyesis Case 1

A 27-year-old woman presented at triage saying that her water broke, she was in labor and was about to deliver. She was rushed right up to Labor and Delivery where an examination, pregnancy test and ultrasound proved she was not pregnant. She then admitted she had been seen at another hospital earlier that same day where they told her she was not pregnant. The Labor and Delivery staff sent her back down to the emergency department to evaluate her abdominal pain.

My examination and laboratory tests failed to uncover a reason for her abdominal pain. This didn’t bother her because she didn’t care at all about her abdominal pain. She continued to insist, in the face of all the evidence, that she was pregnant and in labor.

I did my best to convince her, which was not possible. I then tried to reassure her, which was also impossible. I finally resorted to the speech I use in the rare situation where someone cannot be convinced after all I can do. I said something like, “I know you are not pregnant and there is nothing you can do to convince me that you are. You know you are pregnant and there is no way I can convince you that you are not. We are just going to have to agree to disagree.”

After giving my speech, as sympathetically as possible, I turned to walk out of the examination room. She then started to scream, saying the baby’s head was pushing out.

Though frustrated, I stopped, went back in with the nurse and examined her down there again. When I found nothing, she finally left, continuing to complain of feeling the baby coming out and saying that we had done nothing to help her.

Pseudocyesis Case 2

A 51-year-old woman came in by ambulance complaining that her water broke. She claimed to be one month pregnant, which was making her nauseous. She admitted to having had a negative pregnancy test at her doctor’s office earlier that day.

She insisted to me that she was pregnant and demanded to know how far along she was. She said she had seen the fetus and the umbilical cord “with my eyes closed.”

I told her it would be very unlikely for her to be pregnant being 51 years old and having a negative pregnancy test. Upon hearing that, she got irate and started to swear and yell at me, refusing to let me examine her. As she walked out she threatened that if she lost the baby because I didn’t provide her with needed care, she was going to sue me.