She wasn’t pregnant at 4 am (or so she thought) but became a mother several hours later. Klara Dollan spent nine months not knowing she was pregnant until she went into labor and gave birth in her apartment bathroom.
Circumstances like hers are known as cryptic pregnancies, a rare but not unheard-of phenomenon.
What are Cryptic Pregnancies?
A cryptic pregnancy, also known as a stealth pregnancy, cannot be detected by conventional medical testing methods. Although these methods are reliable for the majority of cases, there are always exceptions. Some women discover their pregnancy as late as seven, eight, or even nine months in. For Dollan and others like her, the first signs of their condition are labor pains.
To compare, most women discover their pregnancy within five to twelve weeks after conceiving after experiencing symptoms like:
- Missed period(s)
- Weight gain
- High blood pressure or hypertension
- Back pain
- Anemia, which can cause lightheadedness and dizziness
- Vomiting/Morning Sickness
- Tender or swollen breasts 
They take home pregnancy test leads, and if it’s positive, they continue to urine testing, a blood test, and an ultrasound to confirm the diagnosis.
How do Cryptic Pregnancies Go Unnoticed?
The above list of glaring physical discomforts makes it hard to understand why some woman couldn’t guess their condition. However, these symptoms can go unnoticed in cryptic pregnancies if:
- the home pregnancy test came out negative.
- the woman is accustomed to irregular periods.
- she is highly active with low body fat, which lowers hormone levels.
- she was previously told she was infertile.
- she uses birth control pills or an intrauterine device (IUD).
- she is going through perimenopause.
- she had recently given birth. 
When one or more of these circumstances are applicable, it’s natural for the expecting mother to assume she is not pregnant.
These women may experience the symptoms but attribute them to dietary or lifestyle choices. Pregnancy spotting could be mistaken for a light period. Morning sickness is blamed on food poisoning. Nausea and headaches are from the flu or digestive issues. The weight gain could be from missing the gym or eating out one time to many.
In cases where the placenta is in the front of the stomach—also known as a posterior placenta—it is unlikely the mother would feel much kicking. She may, like Dollan, assume the sensation is digestive movement or ‘butterflies.’ 
“Pregnancy symptoms can really vary,” says Dr. Michelle Evans, a reproductive endocrinologist from Pasadena, California. “Some women have very minimal or no symptoms. Other women will be throwing up every day.” 
Even an ultrasound could miss the fetus if:
- the embryo is implanted in a slightly different place in the uterus than normal,
- the shape of the uterus is unique, or
- in the case of a technical error.
Additionally, if previous tests came out negative, the technician is unlikely to search for a growing fetus for very long. 
The Complications of a Cryptic Pregnancy
The labor and delivery of a cryptic birth are similar to any other one, beginning with severe cramp-like contractions and ending with the birth, of what is hopefully a healthy child.
As one would imagine, the stress of childbirth without any warning or notion of what is happening can be distressing. Most women with cryptic pregnancies never attended prenatal care or had much time to consider the future with a baby. 
This circumstance can heighten the health risks to the mother and fetus from poor nutrition, inadequate care, and unattended and/or arduous birth. This could result in premature birth, a baby’s low weight, or a miscarriage. However, like Dollan, women with cryptic pregnancies who maintain good health are likely to have a successful, healthy delivery. 
Cryptic or Denied?
Some pregnancies go undetected because the expecting mother is unable to acknowledge it. This could be from the pressures of a disputing partner, mental illness, financial implications, or a strict upbringing that tabooed premarital relations. These cases of denied or concealed pregnancy are similar in symptoms and risks to cryptic pregnancies.
While these cases yield a similar result, there’s enough evidence to prove that some women are genuinely surprised by their delivery without any implications of denial or concealment during their terms. 
Klara Dollan: A Cryptic Pregnancy First-Hand
Dollan woke up with severe cramps in February 2016, not knowing they were contractions. She had been taking birth control pills for six months, had stopped two weeks prior, and assumed her period was returning. The pains were slow and lasted half a minute, which she had never experienced before.
“Why does it have to be the first day of my new job?” She remembers thinking. “This must be the worst luck I’ve ever had.”
It was cold during her commute but she was sweating profusely. When she arrived at the office, the pain intensified. During a meeting, the pen she was holding in her mouth snapped and her nails dug into her notebook. She informed her mentor and left.
All she wanted was to get into bed with a cup of tea or hot chocolate, but when she arrived at her front door, her keys were missing. She waited two agonizing hours for a locksmith to arrive, pacing all the while because walking helped ease the cramps.
The locksmith eventually breaks her door down, and by that point, Klara could barely care. She put on her pajamas and went into bed, but she couldn’t get comfortable until she was on the toilet.
The caretaker heard her screaming through the broken door and called on a neighbor for help. At this point, Dollan was bleeding heavily. The neighbor suspected a miscarriage and called an ambulance.
At that point, Dollan describes that her body took over, telling her to push the pain away. “And out came my daughter, Amelia. She full full-term, screaming and crying, and so was I.”
Dollan claims she had no signs of pregnancy. She was slim, had no back pain or cravings, and even had two periods, more like spotting, during the past nine months.
“I wouldn’t make something up like this because my health is at risk and the child’s health is at risk,” says Dollan when accused of lying about her story.
She has a warm relationship with her mother, who supported her as she recovered from the delivery. Although her family wouldn’t have been thrilled by her pregnancy at 22 before she was financially established, they would have been happy for her.
“There would have been baby showers; there would have been gifts. They would have completely gone crazy over it.”
Looking back, Dollan wishes she had the full experience of pregnancy.
“People have nine months to prepare to become parents. I had two seconds.” 
- What Do You Want to Know About Pregnancy https://www.healthline.com/health/pregnancy
- A prospective study of nausea and vomiting during pregnancy. https://bjgp.org/content/43/371/245.short
- What Is a Cryptic Pregnancy https://www.healthline.com/health/pregnancy/cryptic-pregnancy#causes
- Placental location and pregnancy outcome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935544/
- The perinatal outcome of pregnancy without prenatal care. https://www.ncbi.nlm.nih.gov/pubmed/11750959
- Not your average birth: considering the possibility of denied or concealed pregnancy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039772/
- ‘I didn’t know I was pregnant until I gave birth https://www.bbc.co.uk/sounds/play/p07849h7
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