By Patrick Mutisya and Brian Okoth
A 36-year-old woman from Machakos County on Friday evening (July 10) gave birth while answering a short call of nature at the Mwala Level 4 Hospital.
The woman, who lives with partial paralysis following a stroke, had been assisted by her teenage son to access the toilet, where she gave birth to a baby boy, and the newborn fell into the pit latrine.
After assisting her mother out of the toilet, the woman’s son heard a baby crying in the pit latrine, prompting him to alert nurses at the facility.
“We managed to get people to demolish the pit latrine and rescued the baby, who was alive. Preliminary examination indicates the new mother had carried the pregnancy to term,” Mwala Level 4 Hospital medical superintendent Dr. Stephen Kitheka told K24 Digital.
Dr. Kitheka says the woman, who is paralysed on the left side of her body, stated that she wasn’t aware of her pregnancy, or did not experience any labor pains prior to giving birth.
The doctor says the patient had come for physiotherapy sessions among other treatments for different ailments.
“After rescuing the baby, we admitted the mother-and-child to a ward, where they were closely monitored. The infant was accorded emergency care, and is now in stable condition. It is actually breast-feeding,” said Dr. Kitheka.
Medical News Today says a situation where a woman carries a pregnancy to term without knowing that she was expectant is known as cryptic pregnancy.
Sometimes the woman will realise she is pregnant when she is in the third trimester or only when she goes into labor.
Recent studies on cryptic pregnancy are hard to come by, says Medical News Today. However, those available studies have suggested that cryptic pregnancies occur more often than doctors might think.
A 2011 review of available research finds that 1 in 475 women deny their pregnancy at 20 weeks or more.
Often, women with a cryptic pregnancy do not experience typical symptoms of pregnancy, such as:
- missed periods
- abdominal swelling
Doctors and relatives may also be unaware that the woman is pregnant.
Babies born from a cryptic pregnancy tend to be underweight, and the lack of prenatal care may affect their development, says the Medical News Today.
Doctors classify most cryptic pregnancy as psychotic or nonpsychotic.
According to the 2011 review, women with psychotic denial of pregnancy may have mental illnesses, such as schizophrenia or bipolar disorder. They may experience symptoms of pregnancy but may link them to delusional causes.
Women with nonpsychotic denial have no history of mental illness and their sense of reality is intact.
Doctors separate nonpsychotic cryptic pregnancy into three categories:
Women with pervasive denial of pregnancy experience a lack of emotional significance to pregnancy and are unaware that they are pregnant.
Women with affective denial of pregnancy acknowledge they are pregnant but do not prepare emotionally or physically for pregnancy, childbirth, and parenting.
Doctors report that women with persistent denial become aware of pregnancy in the last trimester and avoid seeking medical attention.
Research reports that 36% of women with cryptic pregnancies have pervasive denial, 11% have persistent denial, and 52% have affective denial.
Women with cryptic pregnancies may not experience any typical pregnancy symptoms or only vague ones.
Doctors may need to consider that women of childbearing age with symptoms of pregnancy may be pregnant even if they deny it might be the case.
Women with a psychotic cryptic pregnancy may experience a variety of symptoms. One of the only symptoms that women with a nonpsychotic cryptic pregnancy may notice is an unexpected delivery.
Doctors may find it challenging to diagnose a cryptic pregnancy because symptoms may not be present or noticeable. Also, women may never consult a doctor during their pregnancy.
In some situations, women may have consulted a doctor during their cryptic pregnancy but not received a correct diagnosis.
By increasing awareness in healthcare providers, women experiencing cryptic pregnancy may have better access to medical care. This can help to improve outcomes for their baby.
According to the literature, researchers previously thought that women with cryptic pregnancies typically had one or more of the following factors:
- younger age
- learning disabilities
- poor social and family support
- mental illnesses
- history of drug abuse
From the review of studies, the evidence now suggests that most women with cryptic pregnancies are:
- in their 20s
- have other children
- have good social and family support
- Only a minority have lower intelligence, drug abuse, or mood and psychiatric disorders.
External stresses and mental or emotional conflicts around pregnancy may cause pregnancy denial in otherwise healthy women.
Doctors may find it challenging to identify women with pregnancy denying characteristics.
Pregnant women experiencing psychiatric disorders may be aware of their symptoms but deny they are real and link them to other causes.
Other women without mental illnesses may experience stress and conflicts about pregnancy, which can lead to cryptic pregnancy.
Doctors have yet to establish risk factors for cryptic pregnancy because they are unable to identify common features.
As the cryptic pregnancy progresses, doctors have a better chance of detecting pregnancy. The rate of cryptic pregnancy decreases from 1 in 475 pregnancies at 20 weeks to 1 in 2500 pregnancies when active labor begins.
Since women with cryptic pregnancies may only become aware of pregnancy in the later terms of pregnancy, they may experience emotional disturbances.
After giving birth, the women may disassociate from their baby, increasing the risk of abuse, child neglect, and death.
Women with cryptic pregnancies may have unassisted deliveries because they have not prepared for birth.
Denial of pregnancy and its complications put the baby at risk of:
- small size
How does it affect labor?
Women with denied pregnancy may deliver unexpectedly, in some cases, giving birth without assistance.
Unassisted deliveries can be dangerous for both mother and child.
Doctors suggest that up to 15% of all births involve potentially fatal complications. In addition, around the world, more than 500,000 women die from complications during childbirth.
Many healthcare professionals report that unassisted childbirth is not safe, and medical attention is essential during delivery.
What to do despite a negative pregnancy test
Women who are confident they are pregnant, despite having a negative pregnancy test, should speak with their doctor or another healthcare provider.
The most specific and accurate pregnancy test is a blood test. Doctors will check for the presence of human chorionic gonadotropin (HCG) in the blood. HCG is a hormone that the placenta releases.