Cryptic Pregnancy

What is a cryptic pregnancy?

A cryptic pregnancy (or stealth pregnancy) is when you're pregnant but don't know it. It's even possible not to realize you're pregnant until labor begins.

It's most common to realize you're pregnant somewhere between four and 12 weeks of pregnancy. This could be because you have symptoms of pregnancy or because you missed your period. A positive result on a pregnancy test can confirm pregnancy. With a cryptic pregnancy, nothing triggers you to believe you're pregnant. This could be because you don’t have symptoms of pregnancy or mistake symptoms of pregnancy as a virus, or your pregnancy test result was wrong.

Who is at risk for a cryptic pregnancy?

Anyone can have a cryptic pregnancy. You may be at higher risk if you:

• Recently gave birth: After you give birth, it may take several months for your period to return, and you may not ovulate if you’re breastfeeding. This can give you the false impression that you're completely safe from pregnancy. It’s difficult to predict when you’ll first ovulate during breastfeeding and become fertile again.
• Have a condition like PCOS (polycystic ovary syndrome): If you have PCOS, your periods are unpredictable. Because skipping periods is normal for you, you may not realize you're pregnant if you miss a period.
• Use birth control: If you use birth control, you may mistakenly think you're protected from pregnancy. Even when you use it correctly, there’s a small chance of failure.
• Are in perimenopause: When you're in your 40s, you may think you're too old to get pregnant or mistake pregnancy symptoms for menopause symptoms.
• Have never been pregnant: If you’ve never been pregnant before, you’re less likely to know what being pregnant feels like. This means a pregnancy could go unnoticed for longer.

How common is a cryptic pregnancy?

Cryptic pregnancies are uncommon. Studies suggest about 1 in 475 pregnancies go unnoticed until about 20 weeks gestation. About 1 in 2,500 pregnancies go unnoticed until delivery.

Will a cryptic pregnancy show on a pregnancy test?

You should still get a positive pregnancy test with a cryptic pregnancy. However, using an at-home pregnancy test correctly is the only way to get an accurate result. If you don’t use it correctly, you may get a false negative (meaning you’re pregnant but the test says you aren’t). Be sure to follow the instructions on the package and wait several days after your missed period to take an at-home test.

If your symptoms don’t agree with your home pregnancy test result, it’s always best to have a healthcare provider confirm pregnancy with a blood test.

Do you get your period in a cryptic pregnancy?

No. A cryptic pregnancy is similar to a regular pregnancy in that you don’t get a true menstrual period. However, you may experience implantation bleeding or abnormal pregnancy bleeding and think it’s your period.

What causes a cryptic pregnancy?

There are several reasons why you may not realize you're pregnant. Some of the causes are:

• An at-home pregnancy test may have shown a false negative result.
• You don't have pregnancy symptoms.
• You don't notice the pregnancy symptoms or dismiss them.
• You don't know the symptoms, and therefore, don't know you're pregnant.

What are the signs of cryptic pregnancy?

If you have a cryptic pregnancy, the symptoms are the same as those for a known pregnancy. The key difference is that you don't realize pregnancy is causing your symptoms. For example, you may think you're nauseous from eating a certain food or that you're tired because you need to sleep more.

Other symptoms of a stealth pregnancy include:

• Missed period: While a missed period is the clue for most people, this isn’t always the case. If your periods are always irregular, you may not realize you’ve missed your period due to pregnancy.
• Spotting or light bleeding: You might experience light spotting in early pregnancy and mistake it for a period.
• False negative pregnancy test result: This means you're actually pregnant, but the test says you're not. If you don’t use an at-home pregnancy test correctly, you may get an inaccurate result. To be sure, it’s always best to contact a healthcare provider to confirm a pregnancy.
• Weight gain or swollen belly: You may not notice you've gained weight due to being pregnant, or you might attribute an unusually bloated belly to eating a certain food.
• Fetal movement: Fetal movements usually aren't noticeable until about halfway through pregnancy. If you have an anterior placenta, the placenta’s in the front of your belly. This can make it harder to feel kicks. In the case of a cryptic pregnancy, this could be why you don’t realize you’re pregnant.
• Not knowing symptoms of pregnancy: If you’re very young or have developmental disabilities, you may be unaware of common signs of pregnancy like a missed period, tender breasts or nausea.

How long does a cryptic pregnancy last?

Most people realize they’re pregnant about 20 weeks into the pregnancy. However, it's possible to be unaware you're pregnant during the entire 40 weeks of pregnancy. There have been cases where a woman goes to the emergency room with pelvic pain only to discover she's in labor.

Some studies suggest cryptic pregnancies are more likely to result in preterm birth due to lack of prenatal care, poor nutrition or lifestyle choices.

How is it diagnosed?

Pregnancy care providers diagnose cryptic pregnancy like they would a typical pregnancy. Some of the ways providers confirm pregnancy include:

• Ultrasound.
• Blood test.
• Urine (pee) test.

How is a cryptic pregnancy treated?

Treatment for cryptic pregnancy depends on when you realize you’re pregnant. If you’re still months away from delivery, a pregnancy care provider will try to catch you up on the prenatal care you’ve missed. This could include:

• Blood and urine tests.
• Ultrasound.
• Measuring fundal height.
• A physical exam.
• Nutritional and lifestyle counseling.

Can you prevent cryptic pregnancy?

The best way to prevent a stealth pregnancy is to be aware of your body and sexual health. If you believe there’s any chance you could be pregnant, it’s always best to take a home pregnancy test or visit a healthcare provider for a blood or urine test.

What are complications of a cryptic pregnancy?

Complications of a cryptic pregnancy are a direct result of not knowing you’re pregnant. Some of those complications are:

• No pregnancy care: Since you don’t know you’re pregnant, you haven’t been seeing a provider for your prenatal care. This means you didn’t have the necessary bloodwork, nutritional counseling, ultrasounds or other support you need for a healthy pregnancy. Not knowing you’re pregnant could also mean going into labor on your own without help from a skilled healthcare provider.
• Lifestyle adjustments: Smoking cigarettes and drinking alcohol are harmful during pregnancy. Since you don’t know you’re pregnant, you may use these substances or take other medications and supplements that are generally unsafe during pregnancy.
• Higher risk of medical conditions: You won’t receive the care or tests necessary to diagnose certain conditions like gestational diabetes or preeclampsia.
• Higher risk of congenital conditions: The fetus is at risk for congenital conditions because you didn’t receive genetic tests or other evaluations that help diagnose birth disorders.

Studies also show infants born from cryptic pregnancy are more likely to be born premature, which puts them at risk for poor growth or respiratory issues.

A note from Cleveland Clinic

Not knowing you’re pregnant is a real condition. In a cryptic pregnancy, you may go several months or the entire pregnancy without knowing you're pregnant. The best thing you can do if you’re sexually active is to know the signs of pregnancy and get a pregnancy test from a healthcare provider if you at all think you might be pregnant. Getting regular prenatal care is important for the health and safety of you and the fetus.