An active-duty British soldier who reportedly didn't realize she was pregnant until she went into labor delivered a baby boy in a field hospital in Afghanistan on Tuesday (Sept. 18). The woman's son is believed to have the honor of being the first-ever baby born to a British soldier in a combat zone, but how could his mother, and her fellows in the 12th Mechanized Brigade, have failed to notice her pregnancy for nine months?
As difficult as the soldier's experience may be to fathom, it's nothing new to obstetricians. A 2001 study found that a phenomenon called denial of pregnancy, in which a woman is unaware of her pregnancy until soon before her due date, happens about one time in every 475 births. And the same study found that cases in which a woman is unaware of being pregnant all the way up until labor begins occur about three times more often than triplets.
Though there is often a psychological component to denial of pregnancy, a variety of physical factors can encourage a woman's ignorance of a pregnancy or lend credence to alternate explanations for the changes it causes.
Some of these factors might be especially likely to occur in a woman who works in a warzone, according to Dr. Clara Paik, an associate professor in the University of California Davis' department of obstetrics and gynecology.
"The most common indication for a woman that she might be pregnant is missing her periods," Paik wrote in an email. "However, there are many other factors that might make a woman not have a period for a prolonged period of time, including stress, vigorous exercise, and lean body mass [or] low body fat (i.e. marathon runners). This woman obviously had a lot of stress and it is a very common scenario that a woman does not have periods" during times of stress.
The British soldier, who delivered her son at the Camp Bastion field hospital in Afghanistan's Helmand province, had responsibilities that included providing covering fire for troops fighting insurgents, according to Reuters.
What would seem to have been another telltale sign for both the woman and her fellow soldiers, a conspicuously protruding belly, is not the guaranteed result of a pregnancy.
"Some women have very small babies with very little fluid around the baby and this may contribute to her having a small abdomen during her entire pregnancy," Paik explained, adding that baggy army clothing may have helped to conceal the pregnancy.
Paik said she has also seen cases in which women have failed to notice pregnancies because they are obese, or because they believe they are nearing menopause and attribute physiological changes to menopause rather than pregnancy.