Life Force

"This pregnancy is no different from my others," said the Oklahoma housewife mildly. Physicians had indeed found that their 27-year-old patient had just about all the obvious signs of a four-month pregnancy. What flabbergasted them was the knowledge that two years before, she had undergone a hysterectomy, and thus could not possibly have conceived.

Last week the University of Oklahoma Hospitals reported that rarely in medical annals has the poignant phenomenon of false pregnancy--pseudocyesis--survived such odds of matter over mind. Pseudocyesis is older than Hippocrates, has affected subjects from seven to 79. Modern medicine knows it as a mental condition, arising from emotional needs so intense that they lead to suppression of menstruation, distention of the abdomen, enlargement of the breasts, and morning nausea. Most cases involve psychotic women with a feeble grasp of reality. But this patient was not psychotic. Her perceptions were normal; she knew all along that the operation had barred her from reproduction.

Maternity Clothes. Her trouble, as the physicians analyzed it, sprang from her intense desire to be "a whole woman." At 13, she developed chronic diabetes. After her first marriage at 18, diabetes complicated the birth of her only child, who was delivered by Caesarean section. Married again at 19, the girl insisted on a second pregnancy against the wishes of both her physician and new husband. The result was a stillborn delivery in the fourth month, followed by the hysterectomy.

Depressed after the operation, she tried vainly to adopt a second child. She lost interest in housework, devoted hours to playing with her daughter, sometimes reversing their roles. When her husband became interested in a more mature woman, she quickly seized upon pregnancy as the only means of keeping her home and selfesteem. Last year she developed all the symptoms of pseudocyesis, including the same sharp decrease in the insulin required to control her diabetes that she had experienced in her real pregnancies.

Labor Pains. She readily consented to psychiatric treatment at a University of Oklahoma hospital. Physicians found her responsive, warm in temperament, of high average intelligence--and inexplicably able to subsist on only six insulin units per day against her normal daily dosage of 30 to 40. After only five weeks of treatment, she appeared fully prepared mentally to end her strange charade. The only question seemed to be how to do it without social embarrassment. Her solution: she returned to the hospital in ordinary clothes after a weekend pass, told fellow patients that she had aborted spontaneously while at home.

Yet the symptoms of false pregnancy stayed on. Three weeks later, still in the hospital, she awoke with severe "labor pains." Not until the "labor pains" had continued for 24 hours did her "pregnancy" finally end, five months after it began. Next day her insulin need promptly rose. At last she gave away her maternity clothes and went home, where she is now living with her husband and child.

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