DENIAL OF PREGNANCY - DESCRIPTION OF A PH ENOMENON BASED ON RESULTS OF 28 CASES AND PRESENTATION OF A PROSPECTIVE REGIONAL INTEGRATED STUDYIN BERLIN

Denial of pregnancy is defined as a gestation which is not recognised by the pregnant women until at a (very) advanced stage. Often it is de tected only through sudden birth. Results of a period of nearly nine y ears are presented, including 28 cases at a single obstetrical hospita l (the greatest case number reported so far). The evaluation is based on clinical records as well as post-partum interviews conducted with 2 3 women. The age of the population included in the study ranged from 1 6 to 44 years. Only seventeen women had never been pregnant before: ni neteen had a steady partner. Seven births took place completely unexpe ctedly at home without professional care. Two newborns died, one case could be regarded as potentially avoidable because of the lack of diab etic therapy for the mother throughout the pregnancy. Also, the five p reterm deliveries could potentially have been prevented if regular pre natal care had been practised. Five children were put up to adoption. Those interviewed provided surprising information: ten of them had vis ited a physician at least: once during the pregnancy, for the most par t for symptoms related to the gastrointestinal tract or circulatory co mplaints. Not a single pregnancy was diagnosed. Twenty-one women repor ted menstruation-like bleedings (three of them with ongoing use of ora l contraceptives). This phenomenon has not yet been clarified, but it has also been reported by other authors. Denial of pregnancy is not of ten encountered, a ratio of 1:586 is calculated compared with the tota l number of births occurring in the time reported here. This ratio is similar to that reported by other authors. No psychotic denial of preg nancy was observed. With regard to the striking and strange presentati on of denial of pregnancy, several mechanisms, i. e., rationalisations , and some fundamental theoretical considerations of the psychodynamic s from current literature are discussed. Additionally, a currently ong oing, one-year, prospective, integrated study taking place in Berlin i n which all obstetrical hospitals are participating is presented.