Empty Crib, Whole Woman: The Phenomena of Pseudocyesis

       

       Every biological occurrence has an explanatory story; unfortunately, not all of them end in happily ever after. Once upon a time, there lived a middle aged woman who happened to be the Queen of England. Mary – or as history would crown her, Bloody Mary Tudor – fell in love with handsome Phillip, the prince of Spain and twelve years her junior. As custom dictated, Mary and Philip married in a lavish ceremony, and soon after Mary fell pregnant. As Mary had been facing the pressure of producing an heir to the throne, the event could not have been better timed. The Queen was ecstatic as she watched her belly swell with life, her long awaited heir. Except…nine months came and went, then twelve months, then fifteen months. It became painfully obvious that Mary had never been pregnant, despite her distended abdomen and lactating breasts[1]. Needless to say, Mary was depressed, her physicians were perplexed, and historians were intrigued. How could a woman’s body simulate a physical pregnancy, with no medical aid whatsoever? What was this powerful mind-body connection in which desire and sheer will could create a pregnancy without a fetus? Such were the questions behind the story of pseudocyesis.             Pseudocyesis, or false pregnancy, is a medical phenomenon in which women (and a few men, it has been reported) experience all the symptoms of pregnancy without actually being pregnant. Those affected by this disorder exhibit amenorrhea (the discontinuation of menstruation), tender and swollen breasts, distended abdomen, morning sickness, and even “fetal movement”[2]. In very rare cases, a woman may even experience labor pains and phantom delivery. What makes the body so fervently believe it is carrying and birthing a child, when in fact there is nothing but air?            Typically, this condition occurs in thirty-something women (though some cases have reported both female children and more mature adults). Statistics show that 80% percent of women with the condition are married, 14.6% are single, and 2.3% are widowed; at least one third of them have been pregnant before.3 Pseudocyesis manifests itself when a woman is either:

1. desperately wanting a child, because of a basic biological or emotional need
2. extremely afraid of becoming pregnant, or giving birth
3. suffering from a severe depressive disorder. [3]

Above all, pseudocyesis is a psychological condition occurring when a woman’s overpowering fears or needs of pregnancy manifests. It is believed that this psychological desire or depression triggers the pituitary gland to secrete elevated hormones, mimicking the hormone changes of real pregnancy[4]. Similarly, the body accumulates increased amounts of gas, fat, feces, or urine to mimic the swollen belly. Women who have been trying to conceive for long periods of time to no avail (either because of infertility or miscarriage) develop severe depression, and couple with their intense longing for a child, trick their bodies into “becoming” pregnant. The physical changes in their bodies coupled with the strength of their delusion can result in false positive pregnancy tests. When these women undergo routine prenatal procedures such as sonograms, and are told by physicians of their condition, they refuse to believe that they are not truly expecting. As time goes by and no child is born, however, they must face the reality of their situation; sometimes they fall into clinical depression. Pseudocyesis usually lasts nine months, although it can last as little as a few months or many years. 1% of women with this condition go so far as to actually experience labor pains, and need to “deliver” their non-existent child. Fortunately, cases of pseudocyesis have declined with time; advancements in technology and psychology make diagnosing this condition easier, as well as offering more efficient treatment. Currently 1 to 6 cases per 22,000 births are reported in the United States, a steady decline from the 156 cases reported between 1890 and 1910[5]. This condition is most commonly known and observed among non-human mammals, especially dogs and cats. In that instance, the animal will begin to nest, preparing a home and birthing space for themselves; they might also gain weight, produce milk, and “mother” inanimate objects. Canine pseudocyesis can manifest itself both overtly and covertly – if the animal exhibits physical symptoms of pregnancy it is overt pseudocyesis, if they exhibit no physical symptoms but show expecting behavior, it is covert[6]. Some animals may “undergo” this phantom pregnancy in order to be able to lactate and feed abandoned young from their tribe; it is also a response to their ovulation cycles. These animals suffer from the same desire their human counterparts do: they do not merely want offspring, but they yearn passionately for them. Unlike humans, however, once a canine experiences pseudocyesis, the condition is likely to return over time.             The usual course of treatment for women with pseudocyesis is intense therapy sessions, as well as medical procedures to “cure” them of their conditions. To terminate their distended bellies, they are placed under general anesthesia; for the amenorrhea and elevated hormone levels, they are prescribed certain medicines. Alternative medicine such as massages, hypnosis, and opiates are also employed as a course of treatment, but their effectiveness is not proven. Usually the extinction of their physical symptoms, and a sonogram, partly resolves the situation; however, psychotherapy is the best recourse to ensure the restoration of their mental health.[7]            Many people believe we exist in order to reproduce: to create more life, and increase the chance of “getting it right” this time around. Consequently, we also believe that immortality is truly only achieved through procreation – a small part of ourselves will live on in our children and our children’s children. Women in particular have been instilled with the notion that their sole role is that of a mother, increasing the pressure of having children. Pseudocyesis has perhaps decreased because the roles we now “offer” women are vaster: self-accomplishment can be achieved through excelling in professions, education, charity work, and spiritual endeavors. Mary Tudor never did have children, and that is not the reason for which she is remembered: Mary fought for her crown, her government, her faith, and her people. She is a reminder that one does not have to have children in order to be a woman. The story of pseudocyesis might never be complete for we still do not fully comprehend the causes or treatment for this condition. Its existence, however, allows us to observe the intensity and power of the mind over body: our greatest desire or fear can affect our corporeal composition and harmony. How to know how much of our ailments or experiences are controlled by the mind, how much it can cure? We are left in the darkness of the unknown, comforted only by the infinitesimal possibilities our mind can accomplish.