Can You Be Pregnant With No Symptoms?

Imagine finding out you're pregnant—and that you conceived five months ago. It sounds unfathomable, but being pregnant with no symptoms except a missed period is possible. In fact, it has a name: "cryptic" or "stealth" pregnancy.

A cryptic pregnancy is especially possible for people with irregular menstrual cycles, who may be less likely to notice when they've actually missed a period. Couple that with no morning sickness or other noticeable physical anomalies, and you can see how some people might miss a pregnancy until several weeks or months in.

Read on to learn who is most likely to miss pregnancy symptoms and whether there are any risks related to being pregnant with no pregnancy symptoms.

Can You Be Pregnant and Not Know It?

According to research, 1 in 475 people may not realize they're pregnant until 20 weeks, and another 1 in 2,500 only learn they're pregnant once they're in labor. This delayed realization might occur due to a cryptic pregnancy or pregnancy denial.

Cryptic pregancy

It's not uncommon to have no pregnancy symptoms in the four to six weeks after your last period. Doctors date pregnancy to the first day of the last menstrual period (LMP). This number is technically off by about two weeks because most people know the day of their last period (which is typically about two weeks before ovulation), but they don't know the day of conception, says Jane van Dis, M.D., OB-GYN and medical director at Maven Clinic, the largest telemedicine network in women's and family health.

With a cryptic pregnancy, this lack of pregnancy symptoms extends beyond the first six weeks. A cryptic pregnancy might occur because:

• The person doesn't have or doesn't notice pregnancy symptoms.
• The person mistakes pregnancy symptoms for other things.
• The person's pregnancy "bump" isn't very noticeable.

While rare, it's also possible to go on to experience a cryptic or stealth pregnancy after getting a false negative result on an at-home pregnancy test, which is possible if the test was taken too early in the pregnancy, the test was taken incorrectly, or the test was expired or defective.

Pregnancy denial

According to researchers, pregnancy denial is when a person does not notice they're pregnant and lacks "objective perceptions of the pregnancy." Denial of pregnancy is more likely to happen with those who don't want to be pregnant or who are not ready to have a child, especially teenagers and people with substance use disorders.

"I haven't done a lot of research into it, but it seems to me, for someone to not know they're pregnant until labor, there's a mixture of physiology—wherein there really were very few or no signs of pregnancy—and mental health issues," says Dr. van Dis. "There is such a distinct difference between a belly full of food or bloating in the intestines and the belly that develops over the course of pregnancy because there's a gestating baby inside," Dr. van Dis adds.

Who Is Most Likely to Miss Pregnancy Symptoms?

Every pregnancy is different. Some people will check off every early pregnancy symptom on the list while others may not feel much different at all. Some people are more at risk for not experiencing or missing pregnancy symptoms. According to researchers, people who are at higher risk of missing pregnancy symptoms include:

• People with irregular periods
• People with polycystic ovary syndrome (PCOS)
• People of young maternal age
• People with lower education and socioeconomic status
• People who didn't intend to get pregnant
• People with a history of a substance abuse or psychiatric disorder
  

The people most likely to miss pregnancy symptoms are those with irregular periods. "The patients I've cared for who've experienced this almost always report that their periods are irregular. They're not surprised or investigating if, for instance, they've missed their period for two, three, or even four months," says Dr. van Dis.

Irregular cycles

Many people's first pregnancy symptom is a missed period. But if your cycles are irregular, identifying a missed period can be tricky.

If, for example, you experience implantation bleeding, you may think that you had a lighter-than-usual period and not notice your missed period. If your breasts are tender around the same time, you may write it off as PMS rather than a sign of early pregnancy. And lots of things, including stress, can lead to fatigue.

In the same vein, people who recently gave birth, people who use hormonal birth control, and people who are in perimenopause may also be more likely to miss early pregnancy symptoms because of irregular cycles.

PCOS

According to Dr. van Dis, people with PCOS can go months on end without a period making it more difficult to spot a missed period. On the flip side, some have bleeding intermittently throughout the first trimester and even into the second trimester. Light vaginal bleeding or spotting can be a symptom of pregnancy, so if they have no other signs, they may attribute the bleeding to an irregular cycle.

A menstrual cycle is an important vital sign, says Dr. van Dis. Providing your doctor with a thorough menstrual cycle history offers insight into your reproductive organs and hormonal status.

Are There Risks Associated With Being Pregnant With No Pregnancy Symptoms?

Delayed prenatal care is the most significant risk associated with a lack of pregnancy symptoms. Researchers say not knowing you're pregnant may also mean you continue to engage in high-risk behaviors (like drinking or smoking, for example), leading to a greater chance of poor pregnancy outcomes.

A lack of pregnancy symptoms does not make you more likely to experience a miscarriage. Even though science has confirmed that morning sickness is a good sign, there is no evidence that the lack of symptoms makes a pregnancy more risky.

That said, if you previously had pregnancy symptoms and then lose them, you should report this to a health care provider right away. It doesn't necessarily mean something is wrong with your pregnancy, but there could be cause for concern, including potential miscarriage or a compressed umbilical cord. When in doubt, be sure to reach out to a health care provider with any new, unexpected, or changes in pregnancy symptoms.