Family fear main cause for hiding pregnancies

Women from a rural background are more likely to hide pregnancy than their urban counterparts, with fear of parental reaction cited as a major reason why some pregnancies are still concealed.

One in every 148 pregnancies is hidden, according to a study published in the Irish Medical Journal.

A concealed pregnancy was defined as a woman who presents for antenatal care past 20 weeks gestation, having not disclosed her pregnancy to her social network.

The study compared the experience of 43 women who concealed their pregnancy with 30 women who did not, despite having a crisis pregnancy.

Of those who hid their pregnancy, almost six in 10 did so up to delivery. The main reason given — 79% — was fear of a negative reaction from family. Nearly a third of women who hid their pregnancy were also “unbooked”, meaning they had no antenatal sessions before presenting for labour. All the women in the study attended University Hospital Galway.

One of the study’s authors, Clare Thynne, said the data showed one in every 148 births was a concealed pregnancy, and this rate was higher than reported in any other Irish maternity hospital study. A previous study at the Rotunda Hospital, Dublin, had a much lower rate of one concealed pregnancy for every 768 births.

The study’s authors said that while it is not uncommon for a pregnancy to remain unrecognised up to the end of the first trimester, a pregnancy that remains unbooked in the second and third trimester is considered highly unusual and can pose a severe threat to the life and health of the mother and child.

Risks to a newborn who does not receive antenatal care include prematurity, lower birth weight, increased likelihood of being admitted to a neonatal unit, and a higher perinatal mortality rate.

Of nine women who had previously given birth, seven were found to have concealed a second pregnancy. The study’s authors said this weakened the argument that immaturity and inexperience may explain concealment and that it was more likely down to individual coping style. It may also be the case that societal and familial factors had not changed by the second pregnancy.

The women who concealed their pregnancy were aged 17-35, contradicting the theory that hidden pregnancy is largely a teen phenomenon.

Ms Thynne said fear of family reaction “seems to be a reality for women of various ages and not just a fear that exists during the teenage years”. Women who concealed their pregnancy were predominately single and tended to be educated and in employment or in an educational setting.

The study said that, as well as clinical implications for medical practitioners, the research findings raised concerns for infant health and development, along with the health of the mother. The authors recommended further research on rural origin and societal factors to clarify the prevalence of hidden pregnancy.