Denied and false pregnancies: Opposite settings of a single evolutionary conflict

Abstract

Abstract:Aim: A woman in denial of pregnancy is pregnant but remains unaware of her gravid state. In the case of a false pregnancy; the woman is not pregnant but believes she is and presents signs and symptoms of pregnancy. These syndromes correspond to opposite contradictions that were mainly explored separately. Our aim is to explain them by a common and consistent etiology. Method:We explore internal conflicts inherited from the evolutionary transition from solitary animals to social species. Results:The solitary and social characters are contradictory. They induce internal conflicts intrinsic to the human condition. At the reproduction level, those conflicts oppose primitive interests (genes transmission) to social identity ones (to become a parent). Both syndromes are described by powerful identity interests in contradiction with the actual physiological state: i) actual pregnancy but unacceptable motherhood (denial), and ii) imperative motherhood in a non-pregnant woman (false pregnancy). The physiological symptoms results from a temporarily adaptive artifice hiding the internal tension and fulfilling simultaneously (but superficially) the incompatible demands. Conclusion:The proposed model explains clinical observations satisfactorily. It complies with a huge diversity of causative events for the identity tensions involved as reported in literature.The model also elucidates the temporary adaptive character of those psychosomatic dysfunctions. To explain those syndromes in a rational and understandable way will facilitate health professional information, thus favoring the detection and follow-up of cases. The acceptation of their condition by concerned women will also be made easier. Keywords: Denial of pregnancy, false pregnancy, gene transmission, to become a parent, evolution, solitary-social conflict, standby-in-tension response, etiology.As a dysfunction, denial of pregnancy (DP) is as mysterious as astonishing. It happens that a woman life course is deeply transformed by a totally unexpected delivery (with a rate of about 1/2500 births following Wessel 1 ). Stories are numerous and striking. For instance a young and slim woman arrives to the emergency unit complaining of abdominal pain and delivers a 3kg newborn. One week earlier, she was on a naturist beach and no one of accompanying people did notice her pregnancy 2 . Such a scenario is only possible thanks to a deep transformation of the physiological course of the gestation. The fetus lays vertically, to the detriment of the diaphragm and other internal organs, rather than horizontally as in a normal pregnancy 3 . The other symptoms associated with a gravid state may also be significantly reduced or absent. In Brezinka study 4 , none of the 11 women who experienced an unexpected delivery did present nausea symptoms that affect normally from 50% to 80% of pregnant women. Regular bleedings appraised as periods are also reported in numerous cases. Even fetus movements can be unnoticed or associated to gastric disturbances.It happens however than tho...