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DamaNegra
06-02-2010, 05:04 AM
Medically, how would a psychological pregnancy be treated?

Say, the person refused to see a doctor until she was "delivering". How far along in the delivery would people realize there was actually no baby?

How does this really work?

Thanks in advance! :)

Tsu Dho Nimh
06-02-2010, 06:49 AM
"Say, the person refused to see a doctor until she was "delivering". How far along in the delivery would people realize there was actually no baby?"

About 10 seconds in the ER, when there was no palpable "baby shape" in her abdomen, no fetal heartbeat detected.

An ultrasound would reveal "no baby" a few minutes after that.

And the lab's pregnancy test follows in about 15 minutes with a NEG.

veinglory
06-02-2010, 06:55 AM
I suspect that they would have a pretty good idea with the first physical exam/palpation unless the "mother" was very obese.

DamaNegra
06-02-2010, 07:24 AM
See, I've never delivered a baby (thankfully!)

So the doctors just pat down the woman to feel the baby? Is that the first thing a doctor will do?

This is going to be an at-home birth, so I don't know if that changes things.

ArcticFox
06-02-2010, 07:36 AM
You're talking about pseudocyesis http://www.minddisorders.com/Ob-Ps/Pseudocyesis.html

The answer is pretty damn quick. Yes, they would palpate the stomach

jennontheisland
06-02-2010, 07:39 AM
Doctors don't usually make housecalls.

Midwives are likely out of the question; I don't think they take on delivery only, usually includes pre-natal care as well.

You were planning on having a paramedic there? They're likely all that's going to show up for labour.

And yes, palpations on the belly are going to make it pretty obvious that she's not actually pregnant. Especially if she claims to be having a contraction.

divy
06-02-2010, 06:30 PM
what jenn said. the only professional that would attend an emergency home birth would be a paramedic.

does this woman have a partner, or is she on her own? if there was a partner involved, he'd have to be pretty oblivious to not realize that there is no baby.

do you have a good reason for her to avoid all prenatal care before she delivers? from what i know, usually pseudocyesis occurs in women who are trying to get pregnant, or have an intense desire to be pregnant, and i'd have a hard time believing that a woman would find herself pregnant, be very excited, but not want any prenatal care.

just my 0.02c

DamaNegra
06-02-2010, 07:02 PM
Thanks, guys! I'll look into the paramedic thing, but I'm sure I can get around the no-doctor-would-do-it with a bribe ;)


does this woman have a partner, or is she on her own? if there was a partner involved, he'd have to be pretty oblivious to not realize that there is no baby.


Yes, there is a good reason. This woman is a 40-something single woman. She's not single by choice, she is because she had to stay home and watch over her ill father. When he died, she was left completely alone in the world, which made her go a little insane. She started creating a pregnancy for herself to alleviate that loneliness. We're also talking about a culture that puts a really big emphasis on women getting married and having children as the only way in life (independently of career and studies, even a successful woman is nothing without kids and a husband to validate her).

Her family, of course, doesn't know that the pregnancy is fake. They look down on her and the "disgrace" she has brought upon the family by getting pregnant out of wedlock (and all that it supposedly entails). They start talking of harsh solutions and the woman becomes so scared she throws fits and lashes out whenever someone wants to take her over to the clinic, because she thinks she'll be forced to have an abortion and lose her precious baby.

Also, the family doesn't really care about the well-being of the baby (which is seen as a disgrace and often referred to as 'it'), so they don't push the matter further and just let her be.

dirtsider
06-02-2010, 07:46 PM
Yes, there is a good reason. This woman is a 40-something single woman. She's not single by choice, she is because she had to stay home and watch over her ill father. When he died, she was left completely alone in the world, which made her go a little insane. She started creating a pregnancy for herself to alleviate that loneliness. We're also talking about a culture that puts a really big emphasis on women getting married and having children as the only way in life (independently of career and studies, even a successful woman is nothing without kids and a husband to validate her).

Her family, of course, doesn't know that the pregnancy is fake. They look down on her and the "disgrace" she has brought upon the family by getting pregnant out of wedlock (and all that it supposedly entails). They start talking of harsh solutions and the woman becomes so scared she throws fits and lashes out whenever someone wants to take her over to the clinic, because she thinks she'll be forced to have an abortion and lose her precious baby.

Also, the family doesn't really care about the well-being of the baby (which is seen as a disgrace and often referred to as 'it'), so they don't push the matter further and just let her be.

I have a couple problems with this.

First, if they're so concerned about the 'disgrace', wouldn't the family try and pressure her to reveal who the father of the child is? That way, he could then be forced to 'do the right thing' and marry her. If she's slips up and states there is no father, they would then question the pregnacy. I don't really see them not pushing the matter if the situation is as bad as you make it out to be. They might also bring a doctor in on the sly, particularly if there's a midwife or female doctor in the family.

Second, if there's such a emphasis on marriage and motherhood, having a single female relative would be seen as much a disgrace as a pregnancy out of wedlock. So I have a problem with her being "all alone in the world" to the point of having a false pregnancy then having the family all of a sudden stepping in at that point. If marriage and children are so important to the society, why wouldn't the family try and get her married off as soon as possible after the father died, if only to a widower or older man who just wants a companion?

Petroglyph
06-02-2010, 08:18 PM
For interesting reading: http://abclocal.go.com/wtvd/story?section=news/local&id=7361148

Of course, that is rare.

Usually a decent physical exam plants suspicion, followed by an ultrasound and labwork, as our friend from W. Enchilada described.

DamaNegra
06-02-2010, 10:37 PM
First, if they're so concerned about the 'disgrace', wouldn't the family try and pressure her to reveal who the father of the child is? That way, he could then be forced to 'do the right thing' and marry her. If she's slips up and states there is no father, they would then question the pregnacy. I don't really see them not pushing the matter if the situation is as bad as you make it out to be. They might also bring a doctor in on the sly, particularly if there's a midwife or female doctor in the family.

Of course they do. The emphasis is on finding the father and forcing them to marry. They do try to pressure her to reveal the father's name until they realize she's too far gone to be coherent anymore. Then they start an independent investigation but it obviously turns up nothing. The family gets frustrated with the whole affair and just tries to sweep it under the rug by confining the woman at her sister's house and they trying to figure out what to do with the baby. They finally decide to give the baby to one of the woman's nieces, who's reaching her 30s with no plans to have children of her own, and just forget about the whole situation.


Second, if there's such a emphasis on marriage and motherhood, having a single female relative would be seen as much a disgrace as a pregnancy out of wedlock. So I have a problem with her being "all alone in the world" to the point of having a false pregnancy then having the family all of a sudden stepping in at that point. If marriage and children are so important to the society, why wouldn't the family try and get her married off as soon as possible after the father died, if only to a widower or older man who just wants a companion?

Well, this is a different culture, I guess. After a certain age (say, 30-40), a woman becomes a "solterona", which means they're doomed to stay single for life because they're already too old to marry. These women usually just become a nuisance to their families.

Like I said, the problem with this woman in particular is that she was expected to sacrifice her life to take care of her father (her mother died giving birth to her). She doesn't have an education, which makes her unfit for getting a job, and she's too old to marry. After her father's funeral, there's an argument among her siblings because none of them really want to take care of her.

ArcticFox
06-02-2010, 10:57 PM
Just to add that sometimes an intense fear of pregnancy or stress around pregnancy can cause pseudocyesis, not just the desire to have children. Just FYI for everyone.

dirtsider
06-02-2010, 10:57 PM
The emphasis is on finding the father and forcing them to marry. They do try to pressure her to reveal the father's name until they realize she's too far gone to be coherent anymore. Then they start an independent investigation but it obviously turns up nothing. The family gets frustrated with the whole affair and just tries to sweep it under the rug by confining the woman at her sister's house and they trying to figure out what to do with the baby. They finally decide to give the baby to one of the woman's nieces, who's reaching her 30s with no plans to have children of her own, and just forget about the whole situation.

Ok, that's logical. Is the niece married but has no children, then? (Otherwise, they're just making things worse for the niece if she isn't married.)


Well, this is a different culture, I guess. After a certain age (say, 30-40), a woman becomes a "solterona", which means they're doomed to stay single for life because they're already too old to marry. These women usually just become a nuisance to their families.

Like I said, the problem with this woman in particular is that she was expected to sacrifice her life to take care of her father (her mother died giving birth to her). She doesn't have an education, which makes her unfit for getting a job, and she's too old to marry. After her father's funeral, there's an argument among her siblings because none of them really want to take care of her.

How far gone is the woman in her insanity? Because they could probably put her some place where she could be a caretakeer for another person (as a sort of hospice worker) if none of them wanted to take care of her. She has the basic skills for it.

It wouldn't change the basics of the story. She would still want to have a child of her own, rather than be shuffled off from one dying person to another. Not to mention, wanting/needing a child to care for her when she got old.

DamaNegra
06-03-2010, 03:03 AM
Ok, that's logical. Is the niece married but has no children, then? (Otherwise, they're just making things worse for the niece if she isn't married.)

Of course she's married :) that's why they're trying to give the baby to her.


How far gone is the woman in her insanity? Because they could probably put her some place where she could be a caretakeer for another person (as a sort of hospice worker) if none of them wanted to take care of her. She has the basic skills for it.

It wouldn't change the basics of the story. She would still want to have a child of her own, rather than be shuffled off from one dying person to another. Not to mention, wanting/needing a child to care for her when she got old.

It's not really clear. She's definitely a little looney, but of course, it plays into her family's interests to play her off as more insane than she really is to morally justify taking the baby away from her. I mean, they wouldn't want the baby to be raised by a madwoman, right?

Anyway, your post really helped me realize some things that are going to help my novel immensely... thanks!

dirtsider
06-03-2010, 04:42 PM
She's definitely a little looney, but of course, it plays into her family's interests to play her off as more insane than she really is to morally justify taking the baby away from her. I mean, they wouldn't want the baby to be raised by a madwoman, right?

Anyway, your post really helped me realize some things that are going to help my novel immensely... thanks!

You're welcome. ;) These were just some things that were nagging at me. Another thought: Since the woman was raised with the expectation that she'd be the one to care for her father when he got sick, why not have her be trained as a nurse or nurse's aid? That way, the family doesn't have to pay for one since she's got all the necessary skills. Plus, since there was a good possibility he wouldn't die until after she was no longer marriagable age, she would still be useful as a private nurse or the like, therefore not being a financial drain on the family. This way, she can fight the family by saying that she'd know whether or not she was pregnant due to training. (Doesn't mean it's true, though, given the circumstances.)

And as for the family, if they think she's mentally ill, wouldn't they try and put her into a private facility? Both to have her looked at as well as hiding her 'pregnancy'?

Tsu Dho Nimh
06-03-2010, 06:40 PM
So the doctors just pat down the woman to feel the baby? Is that the first thing a doctor will do?
An external abdominal exam for a normal delivery should reveal a distinct curled-up baby shape with it's head jammed into the pelvis and its buttocks up by the ribs. If they are sideways, it's obvious. During a contraction you can feel the uterus tightening up - it's independent of the abdominal muscles. Feels like a watermelon.

An internal exam (gloved fingers into vagina) can feel the baby's head pushing down onto the cervix, cervix would have a certain feel.

This is going to be an at-home birth, so I don't know if that changes things. Who will be there? A midwife or EMT would not see and feel the things as expected - like the baby shape. Or hear the baby heartbeat.

***********
What does the plot need?

tjwriter
06-03-2010, 06:53 PM
For interesting reading: http://abclocal.go.com/wtvd/story?section=news/local&id=7361148

Of course, that is rare.

Usually a decent physical exam plants suspicion, followed by an ultrasound and labwork, as our friend from W. Enchilada described.
I was going to link to that story of the doctors performing a c-section on a woman that was not actually pregnant. Beyond bizarre that the resident doctor that woman first saw did not do a real check, followed by an ultrasound of a woman that just showed up in the ED with no prior documented prenatal care.

A very weird story.

DamaNegra
06-04-2010, 04:23 AM
This is going to be an at-home birth, so I don't know if that changes things. Who will be there? A midwife or EMT would not see and feel the things as expected - like the baby shape. Or hear the baby heartbeat.

***********
What does the plot need?

Well, it doesn't really matter who "delivers" the baby. Either a midwife or a bribed doctor would do. Is there any significant difference?

The plot needs for the family to find out that the pregnancy is false almost during birth.

So I'm really interested in knowing, how would a doctor handle this? They come in, they realize that there's no baby, what happens afterwards? Obviously, they tell the family, but what happens to the pregnant woman? They just let her "give birth" and then call it a day?

tjwriter
06-04-2010, 02:40 PM
This is going to be an at-home birth, so I don't know if that changes things. Who will be there? A midwife or EMT would not see and feel the things as expected - like the baby shape. Or hear the baby heartbeat.

Midwives in particular are trained in external palpitation as they don't have the use of an ultrasound machine unless in a hospital setting. Most would have an portable doppler or fetoscope for checking the heartrate.

****
Also there are some good videos of homebirth on YouTube. I was watching them with my daughter a few weekends ago.

shaldna
06-04-2010, 04:09 PM
Ok. Having had a baby fairly recently I can tell you that you see so many people before birth that there's no chance of it going unnoticed.

Doctors and midwives with feel your stomach every visit, you'll have two, sometimes three ultrasounds, not counting any emergency ones. You may have an internal examination close to birth (not nice).

These days you get visits from midvies or health workers before your due date, previously they just came after you had the baby.

Whe you are delivering, unless by prior arrangement or sheer luck, your midwives probably won't be there. Doctors don't usually deliver babies unless there is a problem or a section is needed. Usually it will be two midwives.

Psychological or phantom pregnancies don't usually continue through that long though.

You will also have blood tests done