May 21, 2014 • 28 mins
Not long ago, a Canadian woman went to the hospital intending to deliver quintuplets. But it turned out she had never been pregnant at all, despite her bulging belly. Cristen and Caroline look into the mystery of pseucocyesis, better known as phantom pregnancy.
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Speaker 1 (00:03):
Welcome to stuff Mom Never told you. From house Supports
dot com. Hello, and welcome to the podcast. I'm Kristen
and today's topic comes from a listener And I'm so
glad that she suggested this because I had never heard
(00:24):
of it before. Yeah, it's phantom pregnancy, yes, also known
as pseudosiasis. But I had heard about it and just
didn't realize that I had heard about it like I had.
I had heard about people imagining they were with child
when in fact they were not. I just didn't realize
(00:46):
that there was like a whole slew of medical research
behind it. Yeah, I was a lot more familiar with
sort of the exact opposite of pseudosiaesis of women not
knowing they're pregnant, and then oopsie, baby, where did you come?
Just thought I really had to pay exactly. But pseudoscisis, meanwhile,
is like you said, thinking that you're pregnant, sometimes having
(01:09):
the physical symptoms associated with pregnancy, such as a swollen belly,
and even in the case of a Canadian woman in March,
so only a few months before we were recording this episode,
going to deliver at the hospital what she thought was quintuplets,
(01:29):
which turned out to be zero tuplets, zero tuplets, no
tuplets at all. She had this. So this couple had
um you know, told everybody, friends, family, the community that
they were expecting five babies. Websites were set up for
them to help them afford the cribs and the toys
and the diapers, because how does just your average couple
(01:51):
afford all that? That's crazy. Well, uh, it turns out
that the boyfriend had to return as much as he
could to the people who had donated and to the
store because the woman had never been pregnant. She wasn't
It's not that like she had been pregnant and lost
the child. She had never been pregnant. So she shows
(02:12):
up to the hospital to deliver via c section. I mean,
this woman had experienced morning sickness, actual lactation UM. And
so after people realized what had happened, that this woman
was experiencing pseudoscisus, she ended up going in for psychiatric treatment. Yeah,
they had to. The doctor said to pull aside her boyfriend,
(02:35):
you know, as they were preparing her to go into labor,
you know, and they did an ultrasound and realized, oh,
there's nothing in there. So they would pull him aside
and say, hey, this, uh, there there's no baby. But
the way that her pregnancy or alleged pregnancy had progressed,
I think it started out where she said that she
was pregnant, and then it developed all of a sudden
(02:56):
into multiples, first twins and then all the way up
to quintuplets. So they had they had names picked out
the whole nine cribs. I can only imagine. But that's
still a better scenario than what happened in North Carolina
in two thousand eight, when another woman who was also
suffering from pseudoscisis went into a hospital to deliver. The
(03:21):
doctors actually make the incisions for a cesarean, only to
find lo and behold the womb is empty. Yeah, and
this wasn't something sudden. It's not like she ran screaming
into the hospital and they did the C section then
and there. They had been trying to induce labor for
two days before they went for the surgical option. I mean,
(03:46):
she comes into the hospital, she's got the full round stomach,
she's writhing in pain, and she drenches the doctor with
a clear liquid as if her water had broken. It
sounds like she's just through a water bottle on him.
Though it turns out she had a full bladder. Oh
she's just okay, but nobody but you know, she's in
(04:07):
such a state and they're in such a state trying
to take care of her. I mean, like, I mean,
you know, talk about we talked about with the first
woman preparing for the arrival of quintuplets, like talk about
people who weren't prepared, and I means what I mean,
it blows my mind, like he didn't. Nobody wanted to
do like an Ulders. Well, I think for that reason,
the doctors involved are actually under medical review because or
(04:29):
we're under medical review that was two thousand eight, because
something like that should not have happened. Their medical training
should have taught them a little bit better that if
a woman comes in and peace on your feet, it
doesn't necessarily mean you should give her a C section. Well, okay,
so talking about talking about symptoms, you know we mentioned
you know, your your belly can swell to look like
(04:51):
you're pregnant. You can experience pregnancy symptoms like nausea, backache, a, minorrhea,
so the cessation of your period um. Some women even
report feeling actual fetal movement, which may or may not
be gas. But the thing is in addition to all
of these crazy symptoms happening, they can last weeks, months,
(05:14):
or years. Yeah, and a small percentage of these women
will feel labor pains as well, and it's reminiscent of
the sort of sympathy pains that some you know, male
partners will report feeling if you know their girlfriends or
wives are pregnant. Some men actually will lactate, but this
(05:37):
is a different kind of thing, so it is not
very common at all. Pseudoscite uses happens in about one
to six out of every pregnancies, so not very common,
but yet it's still does happen. Well, it's not very
common in the US, but will explain the difference there
in a little bit. But Kristen, speaking of men ex
(06:00):
beriencing sympathy labor pains or sympathy lactation, it is a
thing that is a thing, and it's called Kuvad syndrome
and it's seen in men during or after the birth
of a child and their family. And basically the man's
behavior resembles that of his pregnant partner, although of course
he knows he isn't pregnant, but it's part of this
(06:20):
whole mind body loop, which is how a lot of
researchers describe pseudoscisis itself. Yeah, and pseudoscisis or phantom pregnancy
also shouldn't be confused with delusion of pregnancy, which is
a somatic type delusional disorder classified in the d s
M five within the schizophrenia spectrum. And essentially it's the
(06:41):
false belief of being pregnant, but you don't have those
attendant physical symptoms. And then on top of that, you
also have something called deceptive or simulated pregnancy. So that
would be, for instance, if that Canadian woman was simply
lying outright about believing that she was pregnant with quintuplets,
like knowingly deceiving her boyfriend, the community, etcetera. And then
(07:02):
there's erroneous pseudoscideusis, which involves those symptoms of what looks
like it could be pregnancy, but it's actually attributed to
something else. It might be resulting from an organic disease,
exposure to a substance, etcetera. Unless you think this is
a modern development of our modern overworked brains, we we
(07:25):
have to give you some history, pseudosieusis is definitely not
a new thing, and this is coming from a story
in the New York Times as well as a nineteen
forty one history written in the New England Journal of Medicine. Basically,
it's something that's been around forever, way back to three BC.
Hippocrates described twelve women who quote unquote felt they were
pregnant um. But the term itself, pseudosiusis, was coined in
(07:47):
eighteen twenty three by medical writer John Mason Good from
the Greek words suities false and casis pregnancy, so that
makes sense. But over the course of history and of
doctor's writing about it's been referred to as brain pregnancy
and also wind in the bowels, which is how I
refer to my own flatulence. And one historical point that
(08:09):
I thought was really interesting I had never heard this before, uh,
was the theory that Mary Tutor a k a. Bloody
Mary of England is widely believed to have suffered from
pseudo si esis because she was unable to produce a
male heir. There's lots of stress, and as we'll talk
about more that a lot of that can contribute to
(08:29):
the development of a false pregnancy and even before John
Mason Good describes it in eighty three. You also have
sixteenth century English physician William Harvey suggesting that the brain
and uterus of a woman were filled with quote imagination
phantasma brought on by sex or conception without results. And
(08:50):
then in the seventeenth century French obstetrician Francois Maris So
describes a false great belly created by wind mixed with waters.
And for this next historical point, maybe I don't know,
maybe some medical history buffs out there. Listening can fill
us in. But there is an individual with the name
(09:12):
Schmidt who was the first to consider a brain connection
with with false pregnancy. Um. Literally, guys, I searched high
and low for who Schmidt was, could not figure it out.
Assume he's some type of obstetrician um, but just can't
find his first name. And that's maddening to me. But anyway,
(09:33):
he's like the Madonna of obstetricians. Yeah, it's just Schmidt.
There's their share Beyonce, Madonna and Schmidt Schmidt um. But anyway,
he wrote that it is as if impregnation proceeded from
the brain, a matter which can only be comprehended from
the intimate polar conception i e. Sympathy known to exist
(09:54):
between the cerebral and sexual systems. Now, Sigmund Freud also
had his own theory about pseudo scieesis as well, because
his most famous patient, in fact, Anna Oh, believe that
she was pregnant with a child of her previous psychoanalysts
and Freud being Freud attributed this to what he called transference,
(10:15):
or the strong attachments patients form to their psychoanalysts. Yeah,
I mean, I I think that's very close to actually
what like one of the reasons that pseudosciusis can emerge,
which has a lot to do with psychology, a lot
to do with stress that we put ourselves under or
anxiety that certain women can experience during various times of
(10:36):
their life. Well, it's a perfect segue then to talk
about this mind body loop involved in pseudosciesis how does
this phantom pregnancy happen? And essentially it's a bit of Freud, is,
a bit of Schmidt, it's a bit of Hippocrates, whoever
Schmidt is exactly, it's this interplay between those mental and
emotional issues and hormones. Yeah. Um, the endocrine system is
(11:03):
a thing of mystery and beauty UH case studies have
shown that many patients who experience pseudosy esis false pregnancy
have elevated levels of estrogen and prolactin, which can cause
the symptoms like abdominal swelling and milk excretion, in addition
to psychological ones like wanting to bond with a baby.
(11:26):
And something that seems weird but makes a lot of
sense is that if you talk to a vet, a veterinarian,
not a veteran um, you will hear a lot of
cases about dogs exhibiting this behavior, to the point where
if a dog is experiencing pseudo say esis, the vet
might inject her with testosterone to just sort of like
(11:49):
put an end to it. And I think it was
the New York Times story, but one one veterinarian or
researcher they were talking to was saying, you know, in dogs,
you will see them trying kind of nesting quote unquote,
and they'll get very protective of their squeaky toys because
they they they have this not only emotional but hormone
(12:10):
caused drive to be like this is my baby and
I'm protecting it, and you need to you need to
stay away. Human person and then with a little bit
of testosterone, they're like, Oh, I'm just gonna I'm gonna
tear the stuffing out of the squeaky toy. See you guys.
But we'll get more into how that kind of mind
body loop affects women more specifically when we come right
(12:32):
back from a quick break and now back to the show. Okay, So, um,
right before we took a break, we were talking about
the hormones causing dogs to experience pudicisis and how vets
will inject a little bit of testosterone to stop that
mind body loop that's going on making dogs think they're pregnant.
(12:55):
So let's get back to focusing on humans, which is
the general focus of this podcast. Um, and let's look
to Mary Erskine, who's a biologist at Boston University UH
and she she researches this topic, and she says that
there's an initial emotional state that induces abnormal hormone secretion,
which in turn has its own physical and psychological effects,
(13:17):
hence the mind body loop descriptor. She says that anxiety
maybe one emotional state that helps set this feedback loop
in motion, because she points out stress, for instance, can
interrupt the minstrual cycle. Yeah, so it makes sense that
a lot of times pseudo say esis might be preceded
by a situation such as repeat miscarriages, impending menopause, a
(13:41):
strong desire to get married, um, if a woman finds
out she's infertile. Sometimes the way that the psychological processing
can actually result in pseudocyesis and because of this, a
woman's body might produce some of those pregnancy signs that
we talked about, the swollen belly and large breasts, the amenorrhea,
even the sensation sometimes a fetal movement, and then the
(14:05):
brain misinterprets those signals as pregnancy, and thus we have
this feedback loop that starts of the body signaling to
the brain, Oh, hey, things are happening. I guess I'm
murder pregnant, maybe in the brain being like, yeah, I
guess you're pregnant. Let's keep doing this. It's like the
brain runs in through the door like the like the
kool Aid man, and it's like, oh, yeah, we're pregnant.
(14:26):
Let's get this estrogen and prolactin pumping. You need to lactate, lady.
So yeah, it does. It sets up more seriously, it
sets up an interesting biological and hormonal loop going on,
but if you look at those hormones specifically. This is
coming from a study in reproductive biology and endochronology. Researchers
(14:47):
reviewed past studies. This was a meta study and found
that pseudosiesis shares a lot of endocrine system traits with
both polycystic ovarian SYNDA syndrome and major us of disorder,
which which is interesting um. But they found that the
indo con traits in pseudocyesis are way more like those
(15:09):
that happen when you have polycystic ovarian syndrome than when
you have major depressive disorder. Although we should pause to
specify that having PCOS does not cause pseudocyesis, so don't
don't get scared there. But along those same lines, talking
about the indocan system, women with pseudocyesis may experience things
(15:30):
like increased sympathetic nervous system activity, so this is responsible
for fight or flight, your fight or flight response, so
that ties into anxiety and stress. You might also have
a dysfunction in your nervous system pathways that deliver adrenaline
or dopamines, so you end up with a deficit in
brain dopamine activity. This causes a decreased inhibition of ganada
(15:54):
trope and releasing hormone otherwise known as g n r H.
Ganada trope and releasing hormone dials up your maternal behavior,
just like the dog running to the corner to protect
its squeaky toy that it thinks is it's baby. So
it's there's a lot going on in your body, and
it's fascinating that your brain and your hormones are just
(16:14):
like they're just not communicating right well, and that's why
it's so distinct. Siasis is so distinct from delusion of pregnancy.
It's actually not just something that's all in a woman's head.
Her brain and body are working together to confirm this
idea that pregnancy is happening. But you also mentioned too
(16:35):
that this phantom pregnancy shares many endocrine traits with major depression,
and it's not so surprising when you look at how
most women suffering from it also suffered from mild to
major depression, anxiety, and or emotional stress, which ties into
all those psychological effects that might be initiating all of
(16:57):
these brain body processes. So, for instance, there are examples
in case studies on this of a woman experiencing phantom
pregnancy symptoms around the anniversary of her son's death. There's
another woman who thought she was pregnant around the time
her very young son got his equally young girlfriend pregnant. Yeah,
(17:17):
this was a weird story. So basically, the woman had
had her son at a very young age and then he,
at a very young age, got his young girlfriend pregnant,
and the mom was like, this is terrible. You know,
I didn't want this to happen to you, like blah
blah blah. I don't accept this, I don't approve of
this young girl, blah blah blah. So then they sort
of like separated, you know, mom and son didn't speak.
(17:40):
But when she found out her quote unquote daughter in law,
her son's girlfriend was pregnant and expecting a baby, she
herself started experiencing these symptoms to the point where she
went quote unquote again went into labor, gave a quote
unquote final push, and then felt these feelings of joy
and elation and you're reunited with her son and was
(18:01):
like a okay with everything all of a sudden, So
it filled a very deep psychological need to be close
to her son and her grandchild. Yeah, there definitely seems
to be this theme in medical histories of pseudosi esis
of is filling a gap if that makes sense of
(18:22):
you know, the wanting of a child, or in more
rural areas, the societal pressures for women to have a child,
kind of in the case of Bloody Mary, the the
idea that she suffered from pseudosiasis because there was so
much pressure on her to have a son. And so
with that in mind, there have been some studies looking
at why phantom pregnancy actually tends to happen more often
(18:45):
in rural or more underdeveloped areas, because not only do
you have women not being examined by a doctor as often,
but you also might have more entrenched ideas of women
needing to be the child bearers, that is their role
in society. And if you can't have a child, or
if you don't have a son, for instance, then you
(19:07):
are really of no use. Yeah. A lot of researchers
have suggested that things like poverty and lack of education,
um relationship problems, all of these things might trigger play
a role in triggering false pregnancy. For instance, one of
the case studies we found was a woman from India
who experienced pseudo SISIs after having three daughters but no suns,
(19:29):
so she faced more of this cultural pressure to have
boys because boys would help, uh, you know, support them
when they're old, would carry on the family line all
of this stuff. Um. And when you look at the
medical differences specifically between rural and undeveloped regions versus more
urban and developed ones in you know, in western countries,
(19:51):
for instance, women are generally more likely to visit O, B, G, U,
I N S in the first trimester. They're more likely
to have an actual pregnancy test, ultrasounds of this stuff,
which leads to more accurate diagnosing, whereas in the more
rural and developed regions, women typically aren't examined by a
doctor or midwife until they're basically like in labor, needing help.
(20:13):
And so there was a study in reproductive biology and
into chronology that was comparing rates of pseudosiusis in the
US with African countries, um. And so you know, we
cited that number earlier for the U S, which was
there's about one to six out of every berths. And
you can compare that when you moved to South Africa
(20:36):
to there being one case of pseudo siusis out of
every two hundred births. And this is not exactly comparing
apples to apples, but um, when you moved to the Sudan,
one out of a hundred and sixty women who had
previously been investigated and managed for reproductive failure reported having
(20:56):
pseudo SISIs. So you see these different cultural pressures but
also sort of a lack of education for these mothers.
So for an example of societal pressure, the researchers looked
at the Igbo culture in Nigeria, where marriage is very
sacred and pregnancy really confirms your womanhood but also your
(21:20):
place in your husband's family. This is also a polygamous culture,
so the importance of having a child is even more
crucial for you know, individual wives who definitely want a
bit more security. So if you look at that culture,
the rates of pseudosiesis are a lot higher, possibly because
(21:41):
again going back to that mind body loop that happens
compounded by a lack of education and prenatal care. Yeah,
and just I mean just wanting a child so badly,
and that is something that is not limited to these
African cultures that researchers have looked at I mean that
is behind a lot of the American and Canadian women
(22:04):
that have also been been um examined. Yeah, I mean
this is still happening today. So the question isn't what
how is this treated? I mean I have a feeling
that the woman who went into presumably have quint tuplets.
You know, she wasn't able to just go home and
resume her life per usual as though it never happened.
(22:26):
How how is this? How do how do you handle
a situation like this? Well, you know, I looked for
pseudo SISIs treatment and really it's the advice is Okay,
if you're a physician, you've got to break the news
so gently because this woman it's not that this woman
(22:47):
lost a baby, it's that she never ever had one.
And so I mean I can't even imagine the mental
break that would happen when you get the news that
oh no, you're just experiencing belly swelling. It So they
basically advised physicians break the news very gently, offer psychological support,
and refer the woman to a mental health professional. Yeah,
(23:12):
and that's about it. I mean that's there might also
not be so many robust resources out there at the
ready because it is so uncommon. But nonetheless, just considering
how I mean, thinking about how our minds, brains, bodies
all work together to sometimes cause this condition is incredible
(23:37):
that the wanting of a child can be so strong,
and even just the symptoms of a belly swelling can
signal our brain to release these hormones that then send
us even more messages that yes, the baby is on
the way. I mean, can you imagine no, because I
experienced belly swelling all the time, but it's usually related
(23:57):
to like beer and tacos. Yeah. So, but now I
do understand on a much smaller scale, I mean, I
do understand, like the psychosomatic illnesses or feeling nauseated or
things like that. When you've convinced your brain that like,
oh I smell a noxious odor, things that we talked
about in our mass hysteria episode. It's it's easier than
(24:19):
you could ever imagine, which is a funny turn of
phrase in this instance, but it's easier than you can
ever imagine to actually convince yourself that you are ill,
or that you are you know, I guess, pregnant. The
human mind is a powerful thing, so powerful like a
steel trap full of butterflies. Well, I'm curious now to
here whether or not there are any listeners who have
(24:41):
known anyone who have experienced a phantom pregnancy, or someone
in your town perhaps who has experienced this. Let us
know what you think about it. Mom Stuff at discovery
dot com is where you can send us your letters.
You can also tweet us at mom Stuff podcast or
send us a message on Facebook. And we have a
couple of messages to share with you right now about
one thing that probably causes a lot of our bellies
(25:04):
to swell sometimes, and that is chocolate. Okay, well, I
have a letter here from Saggy from Melbourne. Um. Sagi says,
really enjoyed your podcast on chocoholism. I was interested to
hear about the history behind women, chocolate and advertising. I
can also totally relate to Caroline Hey. Closer to that
(25:27):
time of the month, I crave chocolate, and of course,
after listening to your podcast, I treated myself to a
waffle drizzled with molten chocolate. That sounds amazing. She says,
no guilt here, but I'm definitely not missing spin class
tomorrow morning. Please continue your awesome work. Well, thanks a lot,
Saggy now I want to go also eat so many
(25:47):
things drizzled with chocolate. Well, I've got a letter here
from Shira talking about how she and her boyfriend have
a shared hobby of what she calls chocolate snobbery. She says,
we consider chocolate snobbery a shared hobby now and understanding
the flavor notes of chocolate based on tempering process, cocoa
(26:07):
content and origin has also parlayed into expanding our palate
for wine and coffee tasting too. We are both foodies
and make a point to visit local chocolate tears when
we travel together. We always make a point to try
confections or truffles that utilize unique or savory combinations. Some
favorites include chocolate basil, balsamic vinegar, or curry, and we've
(26:29):
been known to drop serious cash on quality chocolate. Most
of the chocolate sol in the US has only around
cocoa content, and checking labels one will find that many
are actually chocolate flavored candy. US chocolate is notoriously sweeter
than European varieties, but the key difference in quality is
the reincorporation of cocoa butter during the tempering process. Large
(26:50):
scale confectioners like Hershey's and Nestlie don't reincorporate the butter
after it's been separated for conking. Rather, it's sold to
cosmetic industries for cocoa butter products. For the smooth texture,
they'll add paraffin wax. Pretty gross, and since I have
more of a salty craving rather than sweet, she suggests
(27:10):
that I try milk chocolate with sea salt, or milk
chocolate covered potato chips, which he says, I must have
menstrual craving. Oh my god, I can't even handle it.
That stuff, the look on your face scare a lot.
I'm one of my favorite things. So there's this little
there's this little shop in Atlanta that sells I don't
know where they're from, but it sells these cookies and
(27:30):
a jar by the cash register that are chocolate chip,
like chunky chocolate chip with sea salt on top. It's
all I can do not to buy the entire jar.
I'm like, I'm salivating. I have to leave. We better
wrap up then, mom. Stuff at discovery dot com is
where you can send us your letters about chocolate, phantom pregnancies,
(27:51):
or really anything that's on your mind. We want to
hear from you, and for all of our social media links,
podcast videos, and blog host head on over to stuff
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Welcome to stuff Mom Never told you. From house Supports
dot com. Hello, and welcome to the podcast. I'm Kristen
and today's topic comes from a listener And I'm so
glad that she suggested this because I had never heard
(00:24):
of it before. Yeah, it's phantom pregnancy, yes, also known
as pseudosiasis. But I had heard about it and just
didn't realize that I had heard about it like I had.
I had heard about people imagining they were with child
when in fact they were not. I just didn't realize
(00:46):
that there was like a whole slew of medical research
behind it. Yeah, I was a lot more familiar with
sort of the exact opposite of pseudosiaesis of women not
knowing they're pregnant, and then oopsie, baby, where did you come?
Just thought I really had to pay exactly. But pseudoscisis, meanwhile,
is like you said, thinking that you're pregnant, sometimes having
(01:09):
the physical symptoms associated with pregnancy, such as a swollen belly,
and even in the case of a Canadian woman in March,
so only a few months before we were recording this episode,
going to deliver at the hospital what she thought was quintuplets,
(01:29):
which turned out to be zero tuplets, zero tuplets, no
tuplets at all. She had this. So this couple had
um you know, told everybody, friends, family, the community that
they were expecting five babies. Websites were set up for
them to help them afford the cribs and the toys
and the diapers, because how does just your average couple
(01:51):
afford all that? That's crazy. Well, uh, it turns out
that the boyfriend had to return as much as he
could to the people who had donated and to the
store because the woman had never been pregnant. She wasn't
It's not that like she had been pregnant and lost
the child. She had never been pregnant. So she shows
(02:12):
up to the hospital to deliver via c section. I mean,
this woman had experienced morning sickness, actual lactation UM. And
so after people realized what had happened, that this woman
was experiencing pseudoscisus, she ended up going in for psychiatric treatment. Yeah,
they had to. The doctor said to pull aside her boyfriend,
(02:35):
you know, as they were preparing her to go into labor,
you know, and they did an ultrasound and realized, oh,
there's nothing in there. So they would pull him aside
and say, hey, this, uh, there there's no baby. But
the way that her pregnancy or alleged pregnancy had progressed,
I think it started out where she said that she
was pregnant, and then it developed all of a sudden
(02:56):
into multiples, first twins and then all the way up
to quintuplets. So they had they had names picked out
the whole nine cribs. I can only imagine. But that's
still a better scenario than what happened in North Carolina
in two thousand eight, when another woman who was also
suffering from pseudoscisis went into a hospital to deliver. The
(03:21):
doctors actually make the incisions for a cesarean, only to
find lo and behold the womb is empty. Yeah, and
this wasn't something sudden. It's not like she ran screaming
into the hospital and they did the C section then
and there. They had been trying to induce labor for
two days before they went for the surgical option. I mean,
(03:46):
she comes into the hospital, she's got the full round stomach,
she's writhing in pain, and she drenches the doctor with
a clear liquid as if her water had broken. It
sounds like she's just through a water bottle on him.
Though it turns out she had a full bladder. Oh
she's just okay, but nobody but you know, she's in
(04:07):
such a state and they're in such a state trying
to take care of her. I mean, like, I mean,
you know, talk about we talked about with the first
woman preparing for the arrival of quintuplets, like talk about
people who weren't prepared, and I means what I mean,
it blows my mind, like he didn't. Nobody wanted to
do like an Ulders. Well, I think for that reason,
the doctors involved are actually under medical review because or
(04:29):
we're under medical review that was two thousand eight, because
something like that should not have happened. Their medical training
should have taught them a little bit better that if
a woman comes in and peace on your feet, it
doesn't necessarily mean you should give her a C section. Well, okay,
so talking about talking about symptoms, you know we mentioned
you know, your your belly can swell to look like
(04:51):
you're pregnant. You can experience pregnancy symptoms like nausea, backache, a, minorrhea,
so the cessation of your period um. Some women even
report feeling actual fetal movement, which may or may not
be gas. But the thing is in addition to all
of these crazy symptoms happening, they can last weeks, months,
(05:14):
or years. Yeah, and a small percentage of these women
will feel labor pains as well, and it's reminiscent of
the sort of sympathy pains that some you know, male
partners will report feeling if you know their girlfriends or
wives are pregnant. Some men actually will lactate, but this
(05:37):
is a different kind of thing, so it is not
very common at all. Pseudoscite uses happens in about one
to six out of every pregnancies, so not very common,
but yet it's still does happen. Well, it's not very
common in the US, but will explain the difference there
in a little bit. But Kristen, speaking of men ex
(06:00):
beriencing sympathy labor pains or sympathy lactation, it is a
thing that is a thing, and it's called Kuvad syndrome
and it's seen in men during or after the birth
of a child and their family. And basically the man's
behavior resembles that of his pregnant partner, although of course
he knows he isn't pregnant, but it's part of this
(06:20):
whole mind body loop, which is how a lot of
researchers describe pseudoscisis itself. Yeah, and pseudoscisis or phantom pregnancy
also shouldn't be confused with delusion of pregnancy, which is
a somatic type delusional disorder classified in the d s
M five within the schizophrenia spectrum. And essentially it's the
(06:41):
false belief of being pregnant, but you don't have those
attendant physical symptoms. And then on top of that, you
also have something called deceptive or simulated pregnancy. So that
would be, for instance, if that Canadian woman was simply
lying outright about believing that she was pregnant with quintuplets,
like knowingly deceiving her boyfriend, the community, etcetera. And then
(07:02):
there's erroneous pseudoscideusis, which involves those symptoms of what looks
like it could be pregnancy, but it's actually attributed to
something else. It might be resulting from an organic disease,
exposure to a substance, etcetera. Unless you think this is
a modern development of our modern overworked brains, we we
(07:25):
have to give you some history, pseudosieusis is definitely not
a new thing, and this is coming from a story
in the New York Times as well as a nineteen
forty one history written in the New England Journal of Medicine. Basically,
it's something that's been around forever, way back to three BC.
Hippocrates described twelve women who quote unquote felt they were
pregnant um. But the term itself, pseudosiusis, was coined in
(07:47):
eighteen twenty three by medical writer John Mason Good from
the Greek words suities false and casis pregnancy, so that
makes sense. But over the course of history and of
doctor's writing about it's been referred to as brain pregnancy
and also wind in the bowels, which is how I
refer to my own flatulence. And one historical point that
(08:09):
I thought was really interesting I had never heard this before, uh,
was the theory that Mary Tutor a k a. Bloody
Mary of England is widely believed to have suffered from
pseudo si esis because she was unable to produce a
male heir. There's lots of stress, and as we'll talk
about more that a lot of that can contribute to
(08:29):
the development of a false pregnancy and even before John
Mason Good describes it in eighty three. You also have
sixteenth century English physician William Harvey suggesting that the brain
and uterus of a woman were filled with quote imagination
phantasma brought on by sex or conception without results. And
(08:50):
then in the seventeenth century French obstetrician Francois Maris So
describes a false great belly created by wind mixed with waters.
And for this next historical point, maybe I don't know,
maybe some medical history buffs out there. Listening can fill
us in. But there is an individual with the name
(09:12):
Schmidt who was the first to consider a brain connection
with with false pregnancy. Um. Literally, guys, I searched high
and low for who Schmidt was, could not figure it out.
Assume he's some type of obstetrician um, but just can't
find his first name. And that's maddening to me. But anyway,
(09:33):
he's like the Madonna of obstetricians. Yeah, it's just Schmidt.
There's their share Beyonce, Madonna and Schmidt Schmidt um. But anyway,
he wrote that it is as if impregnation proceeded from
the brain, a matter which can only be comprehended from
the intimate polar conception i e. Sympathy known to exist
(09:54):
between the cerebral and sexual systems. Now, Sigmund Freud also
had his own theory about pseudo scieesis as well, because
his most famous patient, in fact, Anna Oh, believe that
she was pregnant with a child of her previous psychoanalysts
and Freud being Freud attributed this to what he called transference,
(10:15):
or the strong attachments patients form to their psychoanalysts. Yeah,
I mean, I I think that's very close to actually
what like one of the reasons that pseudosciusis can emerge,
which has a lot to do with psychology, a lot
to do with stress that we put ourselves under or
anxiety that certain women can experience during various times of
(10:36):
their life. Well, it's a perfect segue then to talk
about this mind body loop involved in pseudosciesis how does
this phantom pregnancy happen? And essentially it's a bit of Freud, is,
a bit of Schmidt, it's a bit of Hippocrates, whoever
Schmidt is exactly, it's this interplay between those mental and
emotional issues and hormones. Yeah. Um, the endocrine system is
(11:03):
a thing of mystery and beauty UH case studies have
shown that many patients who experience pseudosy esis false pregnancy
have elevated levels of estrogen and prolactin, which can cause
the symptoms like abdominal swelling and milk excretion, in addition
to psychological ones like wanting to bond with a baby.
(11:26):
And something that seems weird but makes a lot of
sense is that if you talk to a vet, a veterinarian,
not a veteran um, you will hear a lot of
cases about dogs exhibiting this behavior, to the point where
if a dog is experiencing pseudo say esis, the vet
might inject her with testosterone to just sort of like
(11:49):
put an end to it. And I think it was
the New York Times story, but one one veterinarian or
researcher they were talking to was saying, you know, in dogs,
you will see them trying kind of nesting quote unquote,
and they'll get very protective of their squeaky toys because
they they they have this not only emotional but hormone
(12:10):
caused drive to be like this is my baby and
I'm protecting it, and you need to you need to
stay away. Human person and then with a little bit
of testosterone, they're like, Oh, I'm just gonna I'm gonna
tear the stuffing out of the squeaky toy. See you guys.
But we'll get more into how that kind of mind
body loop affects women more specifically when we come right
(12:32):
back from a quick break and now back to the show. Okay, So, um,
right before we took a break, we were talking about
the hormones causing dogs to experience pudicisis and how vets
will inject a little bit of testosterone to stop that
mind body loop that's going on making dogs think they're pregnant.
(12:55):
So let's get back to focusing on humans, which is
the general focus of this podcast. Um, and let's look
to Mary Erskine, who's a biologist at Boston University UH
and she she researches this topic, and she says that
there's an initial emotional state that induces abnormal hormone secretion,
which in turn has its own physical and psychological effects,
(13:17):
hence the mind body loop descriptor. She says that anxiety
maybe one emotional state that helps set this feedback loop
in motion, because she points out stress, for instance, can
interrupt the minstrual cycle. Yeah, so it makes sense that
a lot of times pseudo say esis might be preceded
by a situation such as repeat miscarriages, impending menopause, a
(13:41):
strong desire to get married, um, if a woman finds
out she's infertile. Sometimes the way that the psychological processing
can actually result in pseudocyesis and because of this, a
woman's body might produce some of those pregnancy signs that
we talked about, the swollen belly and large breasts, the amenorrhea,
even the sensation sometimes a fetal movement, and then the
(14:05):
brain misinterprets those signals as pregnancy, and thus we have
this feedback loop that starts of the body signaling to
the brain, Oh, hey, things are happening. I guess I'm
murder pregnant, maybe in the brain being like, yeah, I
guess you're pregnant. Let's keep doing this. It's like the
brain runs in through the door like the like the
kool Aid man, and it's like, oh, yeah, we're pregnant.
(14:26):
Let's get this estrogen and prolactin pumping. You need to lactate, lady.
So yeah, it does. It sets up more seriously, it
sets up an interesting biological and hormonal loop going on,
but if you look at those hormones specifically. This is
coming from a study in reproductive biology and endochronology. Researchers
(14:47):
reviewed past studies. This was a meta study and found
that pseudosiesis shares a lot of endocrine system traits with
both polycystic ovarian SYNDA syndrome and major us of disorder,
which which is interesting um. But they found that the
indo con traits in pseudocyesis are way more like those
(15:09):
that happen when you have polycystic ovarian syndrome than when
you have major depressive disorder. Although we should pause to
specify that having PCOS does not cause pseudocyesis, so don't
don't get scared there. But along those same lines, talking
about the indocan system, women with pseudocyesis may experience things
(15:30):
like increased sympathetic nervous system activity, so this is responsible
for fight or flight, your fight or flight response, so
that ties into anxiety and stress. You might also have
a dysfunction in your nervous system pathways that deliver adrenaline
or dopamines, so you end up with a deficit in
brain dopamine activity. This causes a decreased inhibition of ganada
(15:54):
trope and releasing hormone otherwise known as g n r H.
Ganada trope and releasing hormone dials up your maternal behavior,
just like the dog running to the corner to protect
its squeaky toy that it thinks is it's baby. So
it's there's a lot going on in your body, and
it's fascinating that your brain and your hormones are just
(16:14):
like they're just not communicating right well, and that's why
it's so distinct. Siasis is so distinct from delusion of pregnancy.
It's actually not just something that's all in a woman's head.
Her brain and body are working together to confirm this
idea that pregnancy is happening. But you also mentioned too
(16:35):
that this phantom pregnancy shares many endocrine traits with major depression,
and it's not so surprising when you look at how
most women suffering from it also suffered from mild to
major depression, anxiety, and or emotional stress, which ties into
all those psychological effects that might be initiating all of
(16:57):
these brain body processes. So, for instance, there are examples
in case studies on this of a woman experiencing phantom
pregnancy symptoms around the anniversary of her son's death. There's
another woman who thought she was pregnant around the time
her very young son got his equally young girlfriend pregnant. Yeah,
(17:17):
this was a weird story. So basically, the woman had
had her son at a very young age and then he,
at a very young age, got his young girlfriend pregnant,
and the mom was like, this is terrible. You know,
I didn't want this to happen to you, like blah
blah blah. I don't accept this, I don't approve of
this young girl, blah blah blah. So then they sort
of like separated, you know, mom and son didn't speak.
(17:40):
But when she found out her quote unquote daughter in law,
her son's girlfriend was pregnant and expecting a baby, she
herself started experiencing these symptoms to the point where she
went quote unquote again went into labor, gave a quote
unquote final push, and then felt these feelings of joy
and elation and you're reunited with her son and was
(18:01):
like a okay with everything all of a sudden, So
it filled a very deep psychological need to be close
to her son and her grandchild. Yeah, there definitely seems
to be this theme in medical histories of pseudosi esis
of is filling a gap if that makes sense of
(18:22):
you know, the wanting of a child, or in more
rural areas, the societal pressures for women to have a child,
kind of in the case of Bloody Mary, the the
idea that she suffered from pseudosiasis because there was so
much pressure on her to have a son. And so
with that in mind, there have been some studies looking
at why phantom pregnancy actually tends to happen more often
(18:45):
in rural or more underdeveloped areas, because not only do
you have women not being examined by a doctor as often,
but you also might have more entrenched ideas of women
needing to be the child bearers, that is their role
in society. And if you can't have a child, or
if you don't have a son, for instance, then you
(19:07):
are really of no use. Yeah. A lot of researchers
have suggested that things like poverty and lack of education,
um relationship problems, all of these things might trigger play
a role in triggering false pregnancy. For instance, one of
the case studies we found was a woman from India
who experienced pseudo SISIs after having three daughters but no suns,
(19:29):
so she faced more of this cultural pressure to have
boys because boys would help, uh, you know, support them
when they're old, would carry on the family line all
of this stuff. Um. And when you look at the
medical differences specifically between rural and undeveloped regions versus more
urban and developed ones in you know, in western countries,
(19:51):
for instance, women are generally more likely to visit O, B, G, U,
I N S in the first trimester. They're more likely
to have an actual pregnancy test, ultrasounds of this stuff,
which leads to more accurate diagnosing, whereas in the more
rural and developed regions, women typically aren't examined by a
doctor or midwife until they're basically like in labor, needing help.
(20:13):
And so there was a study in reproductive biology and
into chronology that was comparing rates of pseudosiusis in the
US with African countries, um. And so you know, we
cited that number earlier for the U S, which was
there's about one to six out of every berths. And
you can compare that when you moved to South Africa
(20:36):
to there being one case of pseudo siusis out of
every two hundred births. And this is not exactly comparing
apples to apples, but um, when you moved to the Sudan,
one out of a hundred and sixty women who had
previously been investigated and managed for reproductive failure reported having
(20:56):
pseudo SISIs. So you see these different cultural pressures but
also sort of a lack of education for these mothers.
So for an example of societal pressure, the researchers looked
at the Igbo culture in Nigeria, where marriage is very
sacred and pregnancy really confirms your womanhood but also your
(21:20):
place in your husband's family. This is also a polygamous culture,
so the importance of having a child is even more
crucial for you know, individual wives who definitely want a
bit more security. So if you look at that culture,
the rates of pseudosiesis are a lot higher, possibly because
(21:41):
again going back to that mind body loop that happens
compounded by a lack of education and prenatal care. Yeah,
and just I mean just wanting a child so badly,
and that is something that is not limited to these
African cultures that researchers have looked at I mean that
is behind a lot of the American and Canadian women
(22:04):
that have also been been um examined. Yeah, I mean
this is still happening today. So the question isn't what
how is this treated? I mean I have a feeling
that the woman who went into presumably have quint tuplets.
You know, she wasn't able to just go home and
resume her life per usual as though it never happened.
(22:26):
How how is this? How do how do you handle
a situation like this? Well, you know, I looked for
pseudo SISIs treatment and really it's the advice is Okay,
if you're a physician, you've got to break the news
so gently because this woman it's not that this woman
(22:47):
lost a baby, it's that she never ever had one.
And so I mean I can't even imagine the mental
break that would happen when you get the news that
oh no, you're just experiencing belly swelling. It So they
basically advised physicians break the news very gently, offer psychological support,
and refer the woman to a mental health professional. Yeah,
(23:12):
and that's about it. I mean that's there might also
not be so many robust resources out there at the
ready because it is so uncommon. But nonetheless, just considering
how I mean, thinking about how our minds, brains, bodies
all work together to sometimes cause this condition is incredible
(23:37):
that the wanting of a child can be so strong,
and even just the symptoms of a belly swelling can
signal our brain to release these hormones that then send
us even more messages that yes, the baby is on
the way. I mean, can you imagine no, because I
experienced belly swelling all the time, but it's usually related
(23:57):
to like beer and tacos. Yeah. So, but now I
do understand on a much smaller scale, I mean, I
do understand, like the psychosomatic illnesses or feeling nauseated or
things like that. When you've convinced your brain that like,
oh I smell a noxious odor, things that we talked
about in our mass hysteria episode. It's it's easier than
(24:19):
you could ever imagine, which is a funny turn of
phrase in this instance, but it's easier than you can
ever imagine to actually convince yourself that you are ill,
or that you are you know, I guess, pregnant. The
human mind is a powerful thing, so powerful like a
steel trap full of butterflies. Well, I'm curious now to
here whether or not there are any listeners who have
(24:41):
known anyone who have experienced a phantom pregnancy, or someone
in your town perhaps who has experienced this. Let us
know what you think about it. Mom Stuff at discovery
dot com is where you can send us your letters.
You can also tweet us at mom Stuff podcast or
send us a message on Facebook. And we have a
couple of messages to share with you right now about
one thing that probably causes a lot of our bellies
(25:04):
to swell sometimes, and that is chocolate. Okay, well, I
have a letter here from Saggy from Melbourne. Um. Sagi says,
really enjoyed your podcast on chocoholism. I was interested to
hear about the history behind women, chocolate and advertising. I
can also totally relate to Caroline Hey. Closer to that
(25:27):
time of the month, I crave chocolate, and of course,
after listening to your podcast, I treated myself to a
waffle drizzled with molten chocolate. That sounds amazing. She says,
no guilt here, but I'm definitely not missing spin class
tomorrow morning. Please continue your awesome work. Well, thanks a lot,
Saggy now I want to go also eat so many
(25:47):
things drizzled with chocolate. Well, I've got a letter here
from Shira talking about how she and her boyfriend have
a shared hobby of what she calls chocolate snobbery. She says,
we consider chocolate snobbery a shared hobby now and understanding
the flavor notes of chocolate based on tempering process, cocoa
(26:07):
content and origin has also parlayed into expanding our palate
for wine and coffee tasting too. We are both foodies
and make a point to visit local chocolate tears when
we travel together. We always make a point to try
confections or truffles that utilize unique or savory combinations. Some
favorites include chocolate basil, balsamic vinegar, or curry, and we've
(26:29):
been known to drop serious cash on quality chocolate. Most
of the chocolate sol in the US has only around
cocoa content, and checking labels one will find that many
are actually chocolate flavored candy. US chocolate is notoriously sweeter
than European varieties, but the key difference in quality is
the reincorporation of cocoa butter during the tempering process. Large
(26:50):
scale confectioners like Hershey's and Nestlie don't reincorporate the butter
after it's been separated for conking. Rather, it's sold to
cosmetic industries for cocoa butter products. For the smooth texture,
they'll add paraffin wax. Pretty gross, and since I have
more of a salty craving rather than sweet, she suggests
(27:10):
that I try milk chocolate with sea salt, or milk
chocolate covered potato chips, which he says, I must have
menstrual craving. Oh my god, I can't even handle it.
That stuff, the look on your face scare a lot.
I'm one of my favorite things. So there's this little
there's this little shop in Atlanta that sells I don't
know where they're from, but it sells these cookies and
(27:30):
a jar by the cash register that are chocolate chip,
like chunky chocolate chip with sea salt on top. It's
all I can do not to buy the entire jar.
I'm like, I'm salivating. I have to leave. We better
wrap up then, mom. Stuff at discovery dot com is
where you can send us your letters about chocolate, phantom pregnancies,
(27:51):
or really anything that's on your mind. We want to
hear from you, and for all of our social media links,
podcast videos, and blog host head on over to stuff
Mom Never Told You dot com for more on this
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