Non Psychotic Denial Of Pregnancy

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Pregnancy denial is a term which refers to the condition in which a woman denies that she is pregnant. At 20 weeks of pregnancy, it is found in 1 of 475 women, but the incidence declines to 1 in 2500 at delivery.
Pregnancy denial may occur in both psychotic and non-psychotic forms. Furthermore, women with pregnancy denial may show different categories of the condition, such as frank denial, suspicion of pregnancy without conscious awareness, and complete knowledge of the fact that she is pregnant with denial and concealment of the condition.

Types of pregnancy denial

Women with psychotic denial of pregnancy have long-term mental disorders such as schizophrenia, which continues throughout pregnancy. They may waver between open acceptance
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These include the need to adapt to changing physical needs and demands, changing shape, prepare for birth and baby care, and develop early bonding to the fetus. All of this may result in overwhelming fears and doubts as to one’s own capacity to successfully carry and look after a baby, and in most severe cases cause the patient to deny that she is pregnant.
Some studies have suggested that the following indicate a higher risk of pregnancy denial:
• Younger age
• First pregnancy
• Low degree of social support
• History of substance abuse or psychiatric
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In such cases, the death is brought about by neglect and exposure, often because the mother becomes extremely disoriented following the birth. In the case of psychotic denial, the mother is more likely to kill the baby actively.

Diagnosis
Interestingly, in one study, almost 4 of every 10 women with denial had seen a doctor with symptoms such as nausea or abdominal pain, but without being diagnosed as pregnant. Thus the possibility of such a condition should be entertained in all women in the reproductive age with symptoms suggestive of pregnancy - irrespective of their protests that they are not pregnant.
By Wessel’s criteria, any woman who willfully does not receive antenatal care, or receives antenatal care only after 20 weeks of pregnancy and then suddenly delivers, may be presumed to have denial of pregnancy. Women who do not perceive that they are pregnant even at 20 weeks or later also fit the

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