Denial of pregnancy refers to being pregnant without being aware of it (1). And for good reason, the body does not show any of the usual signs of pregnancy: there is no stomach, practically no weight gain, or pregnancy mask. Fetal movements are not felt or confused with digestive disturbances. Amenorrhea is often transient or even absent. In the absence of these signs, those around them also ignore the pregnancy so that specialists often speak of “contagion” of denial of pregnancy. Thus, the spouse present in 50% of cases does not know anything (2).

In practice, there are two types of denial:

– Partial denial of pregnancy: pregnancy is discovered after the first trimester of pregnancy but before term, under varying circumstances: via the perception of fetal movements by the mother or the doctor, during an ultrasound for abdominal pain. Upon awareness of this pregnancy, the female body can transform in record time. Numerous testimonies3 thus relate a belly which “grows” as soon as pregnancy is recognized.

• -the total denial of pregnancy: the pregnancy is not discovered until the time of childbirth, during an emergency room consultation for severe abdominal pain or during the mother’s unexpected delivery at home.

Denial of pregnancy is a psychiatric disorder and has appeared as such since 1985 in the classification of psychiatric disorders (4).

It is more precisely a disorder of psychic gestation. Indeed pregnancy is not only a physiological process allowing the growth of the baby; it is also a psychic process during which the woman becomes “mother”. In case of denial of pregnancy, this psychic process does not take place due to unconscious conflict. The psyche denying pregnancy, all the physical manifestations of pregnancy are as if “blocked”.

Behind every denial of pregnancy there is a personal, intimate story, sometimes spanning several generations. Specialists evoke different elements in the genesis of the psychopathology of denial of pregnancy (5):

• the ambivalence of the desire for a child
• unresolved intrapsychic conflicts
• the relationship to the body
• the relationship to sexuality
• poor communication of emotions
• transgenerational issues
• any past or current trauma
• adjustment disorder

“The denial of pregnancy probably protects the psyche of the woman from a traumatic perception which questions various possible axes of the psychic gestation, among which the“ being-pregnant ”, the“ being-mother ”, the“ giving-her ”. -vie ”,“ having-a-child ”. », Analyzes psychiatrist Benoit Bayle (6).

The revelation of the pregnancy is a real psychic cataclysm for the mother who in a flash, must build her pregnancy. When the discovery of her pregnancy after a partial denial, the woman can persevere in the denial, refuse this pregnancy and ask for its interruption or the abandonment of the child, or on the contrary to develop a process of motherhood.

In the case of total denial of pregnancy, this time of pregnancy is even shorter and the discovery of pregnancy even more brutal. If the denial is massive, there may be a persistence of such a powerful divide that the baby is no longer a fragile being, but a cumbersome thing that must be got rid of as quickly as possible. Infanticide is then the most dramatic outcome of total denial of pregnancy. However, it remains rare.

Psychological support for the mother is essential for a psychopathological understanding of denial of pregnancy. Mother / child care may be necessary to help the mother form an emotional bond with her baby, because in the absence of the psychological maturation time of the pregnancy, this bond can be difficult to establish. In reaction to the feeling of guilt for not having seen anything about their pregnancy or for having engaged in risky behavior during it, some mothers may on the contrary be in excess with their child to compensate. Here too, mother / child support will help restore a healthy bond.

A French study (8) carried out in the maternity hospitals of Denain and Valencienne on 2 pregnant women hospitalized in the maternity hospitals reported 550 cases of denial of pregnancy, including 56 cases of total denial. According to the French Association for the Recognition of Denial of Pregnancy (29), 9 to € 600 women are affected each year in France by denial of pregnancy. A German study (1) reports a frequency of 800/10 deliveries, or 1 cases / year, 475% of which are total denial. An American study (1600) reports a frequency of 38/11 births. Based on these figures, in France each year 1 women give birth without being aware of their pregnancy, of which 515 would give birth alone at home, estimates the CNGOF (340).

Contrary to popular belief, denial of pregnancy can affect all women: of any age, of any socio-economic background, of any intellectual level, having already had children or not. This same French study showed that nearly half of the women victims of a denial (26 women out of the 56 studied) were already mothers of one or two children.