Understanding False and Denied Pregnancies from an Evolutionary Perspective

False and denied pregnancies are insufficiently understood mental health disorders affecting women. Denied pregnancies in particular can result in unexpected births, putting both mother and child at risk. Improved understanding is therefore required to address these public health concerns. This paper is rooted in Darwin’s theory of evolution of species. As humans, we are a highly social species. However, our earliest land ancestors were instinct-driven solitary animals. These oviparous animals reproduced by depositing their fertilized eggs in favourable locations. They were progenitors but not parents. The emergence of parenting traits facilitated the transition from solitary to social life, fostering the inherent interdependence of individuals. Humans are relational psychological beings housed in separate physical bodies. This physical-relational duality, or physiological-psychological duality, is inherent to our evolution. It can create conflict by opposing physical reality to paradoxical psychological demands. Such conflicts are likely to affect pregnancy that triggers major changes in both physiology and psychology. Furthermore, pregnancy is a parental trait where the pregnant woman, as a relational being, supports an immature dependent. We explain false and denied pregnancies as temporary and fictitious responses to such intractable conflicts. A single conflict formulation is assigned to each disorder: An imperative need for motherhood in a non-pregnant woman for false pregnancy; and a psychological inability to accept impending motherhood in a pregnant woman for denial of pregnancy. It is hoped that these clear starting points will help clinicians to explore the factual causes of these disorders in their patients on a case-by-case basis.