Can You Be Pregnant and Not Know It?

Given the fact that people of childbearing age tend to be very tuned into their cycles, it might seem impossible to actually be pregnant and not know it until you're far along—or even in labor—but it happens. Believe it or not, there's a long list of reasons someone can be pregnant and have no idea.

Of course, there are many explanations other than pregnancy for a missed period. Rigorous exercise, having excess weight or low weight, stress, and even your birth control can mess with your cycle. Finding yourself crazy-busy at work, traveling, or taking care of family can also distract you from realizing that your period hasn't made an appearance in a while. It might be that it's just a little late or it could be that you're pregnant and don't even realize it.

We talked to healthcare providers about how it's possible not to recognize you're pregnant and why this situation is more common than you think.

Early Symptoms of Pregnancy

The most common early symptoms of pregnancy are fatigue, nausea, vomiting, and weight gain. As soon as you're hit with one of these, you'd think you'd suspect that pregnancy might be the cause. But it's not quite so simple. The signs manifest differently in everyone, Bat-Sheva Lerner Maslow, MD, a reproductive endocrinologist at Extend Fertility, told Health. For some people, symptoms are severe but can be attributed to other causes, like a stomach bug. In others, symptoms are so mild that they don't even register.

If symptoms accompany a missed period, it's likely something's up and it's worth buying an over-the-counter pregnancy test.

Yet even though home pregnancy kits boast a 99% accuracy rate, there's still a chance the test wasn't sensitive enough to detect the pregnancy. That may be because you took it too soon after you realized you skipped a period (the ideal window of time is one week after your missed period) or you checked the results too soon. Another possible explanation is that you did the test with diluted urine—which is why the instructions advise taking the test first thing in the morning when urine is most concentrated.

More Signs You Might Miss

If it's not unusual for you to experience irregular periods, you may not realize you've conceived because you're used to your unpredictable cycle. If you're carrying extra weight, you might not detect pregnancy weight gain. And if you've never been pregnant before, you may not recognize early fetal movement—or dismiss it as something else.

If you take a urine pregnancy test at this point, it can come back negative because of something called the "hook effect," said Dr. Lerner Maslow. This happens after the first trimester when levels of a pregnancy hormone can be so high that they essentially overwhelm the test.

As the pregnancy continues, it's possible to not notice your belly expanding or to have abdominal growth that's very hard to detect or barely presents itself (not every parent-to-be sports an obvious baby bump). The pregnancy fatigue that many people deal with can easily be confused with other conditions, such as an autoimmune disorder, anemia, or insomnia, Orlando-based OB-GYN Christine Greves, MD, told Health.

On top of physical signs that can go unnoticed, there could also be underlying psychological reasons for not recognizing pregnancy, like denial. A 2015 review in Psychosomatics reported that approximately one in 475 women didn't recognize being pregnant at 20 weeks gestation. Maybe you understand that you're pregnant on some level, but you don't know how to deal with it, or you feel embarrassed or ashamed. Some people fear finally going to a healthcare provider when they're very far along, afraid that they'll be judged for not knowing their own bodies.

Not Knowing Can Put Parent and Baby at Risk

Being unaware of your pregnancy means you not only miss out on taking the prenatal vitamins that are super beneficial to your child's growth and development but you might also continue to drink alcohol or take drugs—both of which can be harmful to the developing baby. And if you have a medical condition like diabetes or high blood pressure, your pregnancy could be in jeopardy without medical intervention, said Dr. Greves.

A Quick Review

If you've skipped a period or you're feeling unusually nauseous or exhausted, get in touch with your healthcare provider to find out why. If you are in fact pregnant, the sooner you know it, the better—for both you and the baby.