A 41-year-old woman discovered she was carrying a baby only after seeking medical help for an unexplained abdominal lump, giving birth to a son just hours after learning she was pregnant. Sammy Evans, from Bournemouth, England, had attributed changes in her body to exercise and significant weight loss, while months without a period did not immediately raise concerns about pregnancy.

Evans and her partner, Triston, appeared on ITV's This Morning in October to share the unexpected arrival of their son, Noah. According to reports, Evans initially visited her doctor because she felt unusual discomfort and noticed a lump near her ribs. Initial tests identified a urinary tract infection, while a pregnancy test reportedly returned a negative result with a very faint positive line.

After developing abdominal pain overnight, she went to the hospital and discovered she was pregnant. She initially thought she might still have months before delivery, only to learn that she was already in labour.

Her experience is an example of cryptic pregnancy, a phenomenon in which someone does not realise they are pregnant until late in pregnancy or, in rare cases, until labour begins.

What Is a Cryptic Pregnancy?

Cryptic pregnancy, also described in medical literature as pregnancy denial, occurs when a pregnant person remains unaware of their pregnancy for an extended period. It is different from a concealed pregnancy, in which someone knows they are pregnant but deliberately keeps the information private.

A 2023 review published in Case Reports in Women's Health cited estimates from a population study suggesting that approximately one in 475 pregnancies remained unrecognised at 20 weeks, while around one in 2,500 went unrecognised until term.

These figures suggest that the phenomenon is uncommon but not unheard of. However, estimates can vary depending on how pregnancy recognition is defined and the population being studied.

There is no single explanation for why cryptic pregnancies occur. In some cases, pregnancy symptoms may be absent or subtle, while other physical changes may be mistaken for unrelated health concerns. The experience can differ significantly from one person to another.

Why Might Pregnancy Symptoms Go Unnoticed?

Pregnancy does not look or feel the same for everyone. Common symptoms can include nausea, fatigue, breast tenderness, frequent urination and a missed period, but not every pregnant person experiences all of them.

Some people may continue to have bleeding during pregnancy and mistake it for menstruation. Others may attribute changes in weight, abdominal discomfort or fatigue to stress, exercise, medication or an existing health condition.

In Evans' case, reports said she had lost a substantial amount of weight and had not had a period for some time. She attributed these changes to weight loss rather than pregnancy. She also reportedly mistook the shape of her abdomen for a change associated with her gym routine.

These details offer context for her experience but do not establish why her pregnancy went unrecognised. Researchers have found that pregnancy denial is a varied phenomenon, with no single physical characteristic or psychological factor that explains every case.

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Can Pregnancy Tests Miss a Pregnancy?

Pregnancy tests detect human chorionic gonadotrophin (hCG), a hormone produced during pregnancy. According to the UK National Health Service (NHS), most home pregnancy tests are reliable when used correctly from the first day of a missed period, although a negative result is less reliable than a positive one.

Testing too early or not following the instructions correctly can affect results. If someone receives a negative result but still suspects pregnancy, the NHS recommends waiting a few days and testing again. Anyone who continues to miss periods despite negative tests should speak to a healthcare professional.

Evans reportedly received an inconclusive pregnancy test result during her initial medical assessment before her pregnancy was confirmed at hospital. The available reports do not establish why the earlier test failed to provide a clear answer, so her experience should not be taken as evidence that pregnancy tests routinely fail to detect late-stage pregnancies.

A clinician may use further testing, including blood tests or ultrasound, when pregnancy is suspected despite an unclear result.

Why Early Pregnancy Recognition Matters

Discovering a pregnancy late can mean missing opportunities for routine antenatal care. Pregnancy monitoring helps healthcare professionals assess maternal health, track foetal development and identify complications that may require treatment.

A medical review of cryptic pregnancy highlights concerns associated with delayed antenatal care, including the possibility that conditions such as pre-eclampsia or problems with foetal growth may go undetected for longer.

Late recognition can also bring emotional challenges. An unexpected delivery may leave a parent with little time to prepare practically or emotionally for a newborn, even when the baby is healthy.

People experiencing unexplained abdominal changes, persistent pelvic pain or missed periods should seek medical advice rather than relying on symptoms alone to determine whether they could be pregnant. Severe abdominal pain, heavy bleeding, fainting or other urgent symptoms require prompt assessment.

What Evans' Story Reveals About Cryptic Pregnancy

Evans' unexpected labour illustrates how pregnancy can remain unrecognised even when someone continues with everyday activities and seeks medical advice for symptoms.

Instead, it highlights the importance of considering pregnancy when clinically appropriate, even when symptoms are atypical or an initial test is unclear. For healthcare professionals, careful assessment and follow-up can help resolve uncertainty. For patients, persistent symptoms or concerns deserve further evaluation rather than dismissal.

Frequently Asked Questions

  • What is a cryptic pregnancy?
    A cryptic pregnancy occurs when a pregnant person remains unaware of their pregnancy for an extended period.
  • Why might pregnancy symptoms go unnoticed?
    Pregnancy symptoms can be absent or subtle, and physical changes may be mistaken for unrelated health concerns.
  • Can pregnancy tests miss a pregnancy?
    Pregnancy tests can sometimes give false negatives if taken too early or not used correctly. Further testing may be needed if pregnancy is suspected.
  • Why is early pregnancy recognition important?
    Early recognition allows for routine antenatal care, which helps monitor maternal health and foetal development, and identify any complications.
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