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Down in the bumps: A brief look at mpreg (male pregnancy) fetishism

A few weeks ago I read an article in The Hornet entitled ‘10 unusual fetishes and their psychology, from sploshing to male pregnancy’ by Daniel Villarreal. The ten fetishes and sexual paraphilias included (in alphabetical order), (i) amputation fetishes (sexual arousal from the thought of being an amputee [apotemnophilia] and/or sexual arousal from individuals who are amputees – although the article featured just one specific type of amputee fetishism – ‘toe amputation’), (ii) emetophilia (sexual arousal from vomiting), (iii) entomophilia (sexual arousal from bugs and insects), (iv) eproctophilia (sexual arousal from flatulence), (v) looning (sexual arousal from balloons), (vi) macrophilia (sexual arousal from giants), (vii) mpreg fetishism (sexual arousal from male pregnancy), (viii) sploshing (sexual arousal from being ‘wet and messy’ [WAM] and also known as ‘wamming’), (ix) ursusagalmatophilia (sexual arousal from teddy bears), and (x) vorarephilia (sexual arousal from the thought of being eaten often shortened to ‘vore’).

I have covered all of these fetishes and paraphilias in previous articles on my blog with the exception of mpreg fetishism (although I have covered female pregnancy fetishes [maieusiophilia], childbirth fetishism, and impregnation fetishism, as well as an article on Couvade Syndrome [whereby the male partners of pregnant women experience empathetic pregnancy-like symptoms including loss of appetite, morning sickness, constipation, etc. but the male knows he is not pregnant]). According to a 2015 Mamiverse article on strange fetishes:

“While most sexual fetishes are driven by men, mpreg enthusiasts are said to include a lot kinky ladies. It stands for ‘male pregnancy’ and this sexy fetish was said to born from the evolution of gay themed fanfiction, and fangirls somehow taking it to the next level”.

Many aspects of male pregnancy have featured in the national news a lot over the past few years including stories on male pregnancy suits, how new medical procedures such as womb transplants could facilitate male pregnancy, and pregnancy among transgender men such as the UK’s first pregnant men Scott Parker and Hayden Cross (who stopped transitioning so that they could start families) and the film about Jason Barker’s pregnancy (A Deal With The Universe). On top of this, male pregnancy has occasionally featured in the world of entertainment, most notably Arnold Schwarzenegger’s pregnancy in the 1994 film Junior (where he gets pregnant as part of a scientific experiment), Billy Crystal’s pregnancy in the 1978 film Rabbit Test, Commander Trip Tucker’s pregnancy in an episode of Star Trek: Enterprise, the French film A Slightly Pregnant Man (where a taxi driver suddenly discovers he is four months pregnant), the 2017 comedy MamaBoy, and the and an episode in Futurama where the male alien Kif Kroker gets pregnant (‘Kif Gets Knocked Up A Notch’), as well as Israeli reality TV show Manbirth.

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Based on what I have read online, mpreg in fan fiction is a popular topic and some of the more considered writing about reasons for writing about male pregnancy comes down to a subversion of gender stereotypes. A couple of the better essays I found were by Slayer McCoy (‘Mysogyny and the fetishization of queer identities in fan fiction’) and Lady Geek Girl (‘Sexualized Saturdays: Male pregnancy in fanfiction’). I didn’t agree with everything that was said but they did at least try to look at some reasons for the growth and fascination in mpreg fan fiction. As Lady Geeky Girl opines:

“There is fetishism that happens in many mpreg stories. Now again, this isn’t all that much weirder than porn that shows pregnant women having sex, but that doesn’t make either of them okay. Both fetishize pregnancy, which can be rather demeaning, and mpreg has even fetishized conception… And of course there is one thing all mpreg fics have in common—the male characters are reduced to their biological functions. A biological function that in reality isn’t even theirs. They are magically or “scientifically” changed to be able to give birth and then the entire focus of the fic is on the fact that they are pregnant. Most mpreg fics make the entire focus of the fic on the pregnancy and rarely have any outside plot, putting the entire focus on this pregnancy and baby. Furthermore, these fics often take away the male character’s very identity as a man, not just because he gets pregnant, but usually everything about the character is feminized in the most stereotypical and sexist way possible”.

A couple of years ago, another article by Villarreal in The Hornet briefly looked at mpreg fetishes and featured five videos of “sexy men pretending to be pregnant” with some pretending to be in labour, while briefly overviewing the niche gay pornography Film911 website who specialize in other fetish areas that I have written about including muscle worship, vore, belly button fetishes (alvinophilia), and various aspects of medical fetishism, as well as mpreg fetishism. None of these videos depict gay sex and all of them feature gay models who would never entertain the idea of having gay sex on film. In his 2019 article, Villarreal claims that:

“For some, MPREG is entirely about emotional closeness and intimacy between men; MPREG videos and art show male couples being very sweet, vulnerable and nurturing, something rarely seen in porn. For others, MPREG remains inherently erotic and sexual as it involves literal daddies and breeding. MPREG fantasies can also bleed over into ‘feeder’ fantasies of men growing large with food. The MPREG fetish also contains a noteworthy gender component that idealizes sexual equality”.

Villarreal claims that “MPREG fetishists have dreamed up the idea of a secret ‘male vagina’ hiding directly in the anus with its own female-like reproductive system, though some MPREG babies actually get delivered through the male urethra. There’s even a fantasy taxonomy known as the ‘omegaverse’ where omega ‘carriers’ are impregnated by alpha or beta ‘seeders’. The fantasy sex can involve ‘knotting’ where the top’s penis gets so engorged that it gets trapped in the bottom until climax, much like with dogs. There’s even a lesbian omegaverse where female alphas have female penises”.

The largest online mpreg community is ‘MPREG Central’ and whose administrator goes under the pseudonym ‘Lyric’. Lyric was interviewed by Villarreal and was quoted as saying:

“There is a culture of people out there who are drawn to that idea – men and women who, on some level, wish men could really become pregnant just like women. Some women like the idea of having their man carry and birth their kids, while some gay men wish they could have kids together with their own bodies. [My own reason for getting into MPreg fetishism was a] fascination for stomachs and bellybuttons [and] feeling drawn to the mystery of pregnancy”.

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Academically, there appears to be very little on mpreg fetishism, and what has been published appears to only concentrate on the fan fiction element of mpreg within slash fiction (i.e., a genre of fan fiction that focuses on romantic and/or sexual relationships between fictional characters of the same sex). In a 2018 book chapter by Kristina Busse and Alexis Lothian entitled ‘A history of slash sexualities: Debating queer sex, gay politics and media fan cultures’ (in The Routledge Companion to Media, Sex and Sexuality), there is a section on ‘queerer, kinkier worlds exploring desire’ where MPreg is briefly mentioned but not expanded upon:

“The Fanlore entry for ‘kink’ notes that the term ‘usually refers to various non-normative sexual practices or desires, such as voyeurism, fetishism, and the many activities included under the BDSM umbrella’…Fans may also ‘refer to other, non-sexual preferences as ‘kinks’ meaning particular imagery, story-tropes, or elements that they enjoy so much they are worth considerable effort to find and collect’…Within this frame mpreg and domestic romance become ‘kinks’ whose preference ranks on the same order as love for fiction featuring rope bondage, sexual slavery or water sports”.

Christina Yatrakis wrote a 2013 thesis on fan fiction and again mentioned mpreg in relation to it being a new development among fan fiction writers:

“Within slash communities, new norms or ways of writing have emerged that are widely accepted without much question. Two such creations are male pregnancies (mpreg) and women with male reproductive parts (G!P), either permanently or in lieu of periods. While not all slash readers enjoy, or even accept, these mystical deviations, a subsection of slash producers and consumers have coalesced around these biological anomalies. While there is no record of when such narrative devices first emerged or became common knowledge in different fandoms and online communities, they are no longer only posted on fetish or kink sites. One explanation is that they came from fandoms with supernatural source texts, i.e. Harry Potter or Star Trek. Within a supernatural context, both of these tools can make sense and through their continued reproduction in supernatural fanfics they could have become accepted and spread throughout different fandoms. Additionally, their popularity could be explained by the prevalence of heterosexual girls writing slash fan fiction. By allowing one partner of a same-sex relationship to have natural reproductive abilities, heterosexual female authors can still act out relationship fantasies with childbearing remaining a natural option”.

Kristina Busse also had a chapter on fan fiction in Anne Jamison’s 2013 book Fic: Why Fanfiction Is Taking Over the World. She noted that:

“Mpregs come in all shapes and sizes and, as a result, can fulfil a vast variety of fan desires: a romantic need to create a love child between male lovers, an interest in pregnancy’s emotional and physical fallout on a partnership, or even a fascination with the horrors of forced breeding…mpreg allows a female writer to play out themes of female bodies, concerns of gender in relationships, and issues of reproduction. And she can interrogate all these ideas in a setting that allows for a certain emotional distance by divorcing the pregnancy from the female body. At the same time, one of the criticisms of mpreg is that it often replicates rather than critiques the portrayal of women by embracing stereotypical gender roles”.

Based on my own brief research into the topic, there doesn’t appear to be any empirical evidence as to the popularity or prevalence of individuals’ involvement in mpreg fetishism. Reading about mpreg doesn’t itself mean that readers have a fetish concerning it although membership of online forums suggest small but dedicated communities that love all things mpreg.

Dr. Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Busse, K. (2013). Pon Farr, mpreg, bonds, and the rise of the omegaverse. In A. Jamison (Ed.), Fic: Why Fanfiction Is Taking Over the World (pp. 316-322). BenBella Books.

Busse, K. & Lothian, A. (2018). A history of slash sexualities: Debating queer sex, gay politics and media fan cultures. In: Smith, C., Attwood, F. & McNair, B. (Eds.). The Routledge Companion to Media, Sex and Sexuality. Oxford: Routledge

Gates, K. (2000). Deviant Desires: Incredibly Strange Sex. New York: RE/Search Publications.

Lady Geek Girl (2012). Sexualized Saturdays: Male pregnancy in fanfiction. October 13. Located at:

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Mamiverse (2015). 10 kinds of sexual fetishism that make you say WTF? April 12. Located at:

McCoy, S. (2016). Mysogyny and the fetishization of queer identities in fan fiction. Located at:

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

Villarreal, D. (2016). 5 videos of sexy men pretending to be pregnant. The Hornet, April 28. Located at:

Villarreal, D. (2019). 10 unusual fetishes and their psychology, from sploshing to male pregnancy. The Hornet, March 19. Located at:

Yatrakis, C. (2013). Fan fiction, fandoms, and literature: or, why it’s time to pay attention to fan fiction. College of Liberal Arts & Social Sciences Theses and Dissertations. 145.

Doggy day care: An overview of Puppy Pregnancy Syndrome

In my previous blogs, I have looked separately at pregnancy delusions (i.e., women and men who think and claim they are pregnant but are not – including Couvade Syndrome) and culture bound syndromes (i.e., a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies). Since writing those blogs I unearthed a fascinating academic paper examining one of the strangest culture bound syndromes I have ever come across. While idly looking for some inspiration for a new blog, I happened (by chance) to come across a blog written in November 2011 by Jesse Bering on the Scientific American website which began with this opening paragraph.

Are you suffering abdominal pain or discomfort, fatigue, nausea, flatulence, heartburn, and acid reflux? Have you been having difficulty urinating, or experiencing pain while doing so? Oh, and one other question – have you been spontaneously expelling microscopic bits of disintegrated dog fetuses through your urethra? If you answered “yes” to all of the above, then you may be suffering from “Puppy Pregnancy Syndrome”.

Bering’s report was based on a 2003 paper published in the International Journal of Social Psychiatry, entitled Puppy pregnancy in humans: A culture-bound disorder in rural West Bengal, India”. The paper described a phenomenon that has only ever been reported in this one Indian area (near Kolkata) where both and women are convinced that it is possible to become pregnant and carrying a canine foetus if they are bitten by dogs – particularly if the dog is sexually aroused and because the dog’s saliva contains dog gametes. The phenomenon is a fairly recent one as there are few reports of ‘puppy pregnancy’ prior to 2000.

The paper, by Dr. Arabinda N. Chowdhury (Professor of the Institute of Psychiatry, Kolkata, India) and colleagues featured seven cases of people suffering from puppy pregnancy (six males and one female). The men claim to give birth to the puppies via their penis (in a similar excruciating fashion to the way that men have to pass kidney stones). At night, the female case claimed she could hear the puppies barking in her abdomen.

They also interviewed a further 42 adult villagers to see how prevalent the belief in puppy pregnancy was. They reported that three-quarters of the villagers interviewed believed with “definite certainty” that puppy pregnancy existed (73%), while only 9% had no belief in the phenomenon. In fact, it was reported that almost all the villagers could name someone whose unexplained death they believed was the direct consequence of a toxic puppy pregnancy (including those who were among the most well educated). The authors noted that in relation to the cases they outlined that:

“Psychiatric status showed that there was a clear association of obsessive-compulsive disorder in two cases, anxiety-phobic locus in one and three showed no other mental symptom except this solitary false belief and preoccupation about the puppy pregnancy…One case (11-year-old child) exemplified how the social imposition of this cultural belief made him a case that allegedly vomited out an embryo of a dog foetus… the cases presented a mix of somatic and psychological complaints and their help-seeking behaviour was marked”.

Due to the widespread belief in the existence of puppy pregnancy fact, the village community has their own “medical” specialists who “treat” the condition called bara ojhas. These so-called specialists provide remedies and/or perform abortion-inducing rituals. During the early stages of “pregnancy”, the use of herbal medicines by bara ojhas are said to help dissolve the puppy foetuses so that they are naturally expelled through the person’s genitals in an unobtrusive way. In Jesse Bering’s account of puppy pregnancy, he describes the case of a male:

“After one 24-year-old college graduate had an encounter with a stray dog that scratched him on the leg six months earlier, he became extremely wary of dogs because he was deathly afraid that one might knock him up. He was so preoccupied with dogs that even in the interview room he was apprehensive that a dog may come out from under the table. To address his unending circular ruminations about puppy pregnancy, his dog anxiety, and his obsessive-compulsive need to search for microscopic fetal canine parts in his urine, he was prescribed Clomipramine (an antidepressant) and Thioridazine (an antipsychotic). Importantly, he also underwent a month of behavioral reconditioning with a dog while being treated as an inpatient”.

Obviously, the condition may have no medical basis, but on a psychological level, the people in the Indian community experiencing a puppy pregnancy believe it is real. Dr. Chowdhury and colleagues believe that the crux of the condition is “the absence of any realistic consideration about the absurdity of asexual animal pregnancy and pregnancy in males (to the degree of delusional conviction).”

Dr. Chowdhury and colleagues believe that Puppy Pregnancy Syndrome meets the criteria for a genuine Culture-Bound Disorder because the mass delusional belief occurs as a consequence of “emotionally fuelled social transmission” only found in a very particular community (in this case, rural West Bengal), and that the disorder needs “proper cultural understanding for its effective management”.

Jesse Bering’s blog also made reference to another culture where giving birth to animals is a widely held belief. Bering cited the anthropologist E.E. Evans-Pritchard’s account of the Azande people in Africa who believe that some women can give birth to cats. I actually managed to get hold of Evans-Pritchard 1976 book Witchcraft, Oracles, and Magic among the Azande. The Azande believe that many animals are witches or dead witches inhabiting the animals. The most feared animal by the Azande are wildcats (called the adandara) that they believe have sex with female villagers. These women then allegedly give birth to kittens who are then said to breastfeed them like human children. The appendices in Evans-Pritchard’s book (based on his interviews with the Azande) reported:

The male cats have sexual relations with women who give birth to kittens and suckle them like human infants. Everyone agrees that these cats exist and that it is fatal to see them…There are not many women who give birth to cats, only a few. An ordinary woman cannot bear cats but only a woman whose mother has borne cats can bear them after the manner of her mother”.

When interviewing Azande people, Evans-Pritchard said that his personal contacts included only two cases of people who had actually seen adandara. He then went on to note:

“Azande often refer to lesbian practices between women as adandara…This comparison is based upon the like inauspiciousness of both phenomena and on the fact that both are female actions which may cause the death of any man who witnesses them…Homosexual women are the sort who may well give birth to cats and be witches also. In giving birth to cats and in lesbianism the evil is associated with the sexual functions of women”.

Given that so little information was given in Evans-Pritchard’s book, I have no idea if the belief in adandara could be classed as a culture-bound syndrome, but there do seem to be similarities with Puppy Pregnancy Syndrome.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Bering, J. (2011). Puppy pregnancy syndrome: Men who think they are pregnant with dogs. Scientific American, November 15. Located at:

Chowdhury, A., Mukherjee, H., Ghosh, H.K. & Chowdhury, S. (2009). Puppy pregnancy in humans: A culture-bound disorder in rural West Bengal, India. International Journal of Social Psychiatry, 49, 35-42.

E.E. Evans-Pritchard (1976). Witchcraft, Oracles, and Magic among the Azande. Oxford: Clarendon Press.

Voice of America (2012). Bizarre medical myth persists in rural India.Located at:

Things that go bump: A brief overview of Couvade Syndrome

In a previous blog, I briefly reviewed a number of different types of pregnancy delusion. One of the more interesting of these and somewhat controversial male psychological conditions that have been reported relatively frequently in the psychological research literature is Couvade syndrome (sometimes called sympathetic pregnancy) but is not generally recognized as a bone fide medical condition. There are two derivations of the name. The first derives from the French verb ‘couver’ meaning ‘to brood, to hatch’). The second derivation comes from a misunderstanding of the idiom ‘faire la couvade’ (“to sit doing nothing”). The term is over 150 years old and was used by Edward Burnett Taylor (an English anthropologist) to describe cross-cultural fatherhood rituals during their partners’ pregnancies. For instance, in 1865, Taylor described various cultures where it was the father who took to bed with labour pains while the pregnant mother continued to work in the fields. Taylor also described how the midwife stayed with the father rather than the mother.

Most health practitioners would agree that it appears to be a more psychosomatic condition and occurs when males appear to experience similar symptoms to that of their pregnant partner. Some of the more commonly reported symptoms have included morning sickness, increased or decreased appetite, strange food cravings, toothache, sleep disturbances (e.g., insomnia), indigestion, diarrhea, constipation, backache, hormone level fluctuations, nosebleeds, and weight gain. In more extreme cases, there have been reports of sympathetic stomach and labour pains, breast changes, breast secretions, hardening of the nipples, and postnatal depression. In these extreme cases, there are reports of expectant fathers gaining up to 30 pounds in weight and growing a belly similar to a 7-month pregnant woman (the so-called ‘false pregnancy syndrome’).

A paper by Dr. S. Masoni and colleagues in the Journal of Psychosomatic Obsteterics and Gynecology noted that thesevarious symptoms have been described in the partners of pregnant women with an incidence ranging from 11% to 65%, and that the most common of these symptoms were (a) appetite variations, (b) nausea, (c) insomnia and (d) weight gain. Physiological studies (such as those by Dr. A. Storey and his colleagues published in the journal Evolution and Human Behavior) have indicated that males living with their pregnant partners show sympathetic hormonal changes in cortisol, testosterone, estradiol, and prolactin, across the pregnancy and a few weeks after birth.

Dr. Arthur Brennan and colleagues carried out a critical review of the Couvade Syndrome in a 2007 issue of the Journal of Reproductive and Infant Psychology. They noted that the syndrome was a global phenomenon occurring in many industrialised countries worldwide but had wide international variance on terms of the symptoms that men displayed. Their review asserted that expectant fathers were most affected during the first and third trimesters of their partner’s pregnancy. They concluded that the syndrome’s relationship with socio‐demographic factors was “inconsistent, with the exception of ethnicity”. However, they also make the point that the differences in findings may simply “reflect methodological problems in the syndrome’s definition or criteria and type of measurement across studies”.

There are no definitive explanations for Couvade Syndrome but there have been no shortage of theories. In a 1991 issue of the International Journal of Psychiatry Medicine, Dr H. Klein overviewed several psychological theories. Reasons as to why men experienced sympathetic pregnancy symptoms included pregnancy envy, pseudo-sibling rivalry, paternal ambivalence, and paternal identification with the unborn baby. More specifically, psychodynamic theories argue that men are envious of their partner’s ability to procreate or that they are becoming rivals for the pregnant woman’s attention. However, Klein sits on the fence somewhat and concludes that: It is likely that the dynamics of couvade may vary between individuals and may be multi-determined”. Evolutionary psychologists speculate it is about the minimizing of gender differences and/or balancing of gender roles. The critical review by Brennan and his associates rightly pointed out that these theories have not been systematically investigated, and those that have been examined haven’t shown consistent findings. In one online summary of the disorder, it has also been noted that in some cultures, Couvade symptoms are often attributed to attempts at keeping spirits and demons from the mother or seeking favour of supernatural beings for the child.

The same authors also recommended that future research should utilize qualitative approaches to further uncover “the syndrome’s characteristics, definition and perceptions as seen by male partners”. They then followed their own recommendation and published a qualitative study (again in the Journal of Reproductive and Infant Psychology) interviewing 14 expectant fathers with pregnant partners aged 19–48 years (across different social and ethnic backgrounds). Their interviews revealed some key themes including (i) ‘Nature, Management and Duration of Symptoms’ (physical symptoms were more commonplace than psychological ones) and (ii) ‘Explanatory Attempts for Symptoms’ (symptoms influenced by cultural beliefs and conventions such as religion, alternative medical beliefs or through the enlightenment by healthcare professionals).

More recently (2010), Dr. Brennan also carried out a national online survey on Couvade Syndrome in Australia among 1439 men. He examined men’s health during and after their partner’s pregnancy. The diagnostic criterion that Brennan used for Couvade Syndrome was that men had to have experienced at least eight physical or psychological symptoms. The study found that 31% of Australian men were ‘diagnosed’ with Couvade Syndrome (compared to 25% found previously in a 2007 UK population carried out by Brennan, and 23% found in a 1982 study published by Dr. M. Lipkin and Dr. G. Lamb in the Annals of Internal Medicine). The most commonly reported symptoms were weight gain (26%), tiredness (45%), and “feeling stressed / anxious” (37%). The incidence of ‘abdominal distension’ – the so-called ‘phantom pregnancy’ was 7%.

Because Couvade Syndrome does not appear in any medical textbook, there does not appear to be any standardized and/or mainstream treatment. Anecdotally, expectant fathers suffering Couvade-type symptoms are simply told verbally that such symptoms are relatively commonplace and not to worry. Other simple interventions such as herbal remedies, relaxation techniques (e.g., meditation) and/or yoga can be employed.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Brennan, A. (2010). Couvade Syndrome in Australian Men: A National Survey, 2010. Located at:

Brennan, A., Ayers, S., Ahmed, H. & Marshall-Lucette, S. (2007). A critical review of the Couvade syndrome: the pregnant male. Journal of Reproductive and Infant Psychology, 25, 173- 189.

Brennan, A., Marshall-Lucette, S. Ayers, S., & Ahmed, H. (2007). A qualitative exploration of the Couvade syndrome in expectant fathers. Journal of Reproductive and Infant Psychology, 25, 18-39.

The Free Dictionary (2012). Couvade Syndrome. Located at:

Klein, H. (1991). Couvade syndrome: male counterpart to pregnancy. International Journal of Psychiatry Medicine, 21, 57-69.

Lipkin, M. & Lamb, G.S. (1982) The couvade syndrome: an epidemiological study. Annals of Internal Medicine, 96, 509-511.

Masoni, S., Maio, A., Trimarchi, G., de Punzio, C. & Fioretti, P. (1994). The couvade syndrome. Journal of Psychosomatic Obsteterics & Gynecology, 15, 125-131.

Storey, A.E.,  Walsh, C.J,  Quinton, R.L. & Wynne-Edwards, K.E. (2000). Hormonal Correlates of Paternal Responsiveness in new and expectant fathers. Evolution and Human Behavior, 21, 79–95

Taylor, E.B. (1865). Researches Into the Early History of Mankind and the Development of Civilization. London: John Murray.

Wikipedia (2012). Couvade Syndrome. Located at:

Bump start: An overview of delusions of pregnancy

Delusions of pregnancy are relatively rare and have been reported in both males and females (although it is more common in men). The first documented case of delusional pregnancy was reported by Esquirol at the turn of the nineteenth century. Among women it can occur right across the age range including virginal young women and post-menopausal women. It has been associated with a variety of different disorders including general delusional disorders, organic brain syndromes (e.g., senile dementia), mental retardation, schizophrenia, schizoaffective disorder, epilepsy, metabolic syndrome, neuroendocrine abnormalities, sexual identity confusion, cerebral syphilis (following encephalitis), polydypsia, and drug-induced lactation.

A 1996 paper by Dr. Shabari and Dr. G.K. Vankar published in the Indian Journal of Psychiatry, made the important distinction between delusions of pregnancy and four other related – but psychologically different – disorders. Exactly the same observations were made in a 2009 issue of the European Journal of Psychiatry by a Hungarian team led by Dr. Maria Simon. The four pregnancy-related disorders were:

  • Pseudocyesis (whereby false ‘pregnancy’ occurs in either women or men with marked bodily signs of pregnancy but where the individuals are not actually pregnant).
  • Couvade Syndrome (whereby the male partners of pregnant women experience empathetic pregnancy-like symptoms including loss of appetite, morning sickness, constipation, etc. The male knows he is not pregnant)
  • Malingering (whereby individuals – male or female – claims to be pregnant knowing that they are not).
  • Pseudo-pregnancy (whereby a somatic state resembling pregnancy occurs in women that is triggered by organic factors, such as ovarian tumours causing endocrinal changes leading to pregnancy-like symptoms).

In a 1994 issue of the British Journal of Psychiatry, Dr. A. Michael and his colleagues reported five cases of pregnancy delusion (three females and two males) that included one case where the delusion had lasted 20 years. Other case reports by Dr. K.N. Chengappa and colleagues – also in the British Journal of Psychiatry – found that he same individuals can have multiple delusional pregnancies over long periods as well as believing they are having multiple births. There doesn’t seem to be any common characteristics among those with pregnancy delusions as demonstrated by these four reports from various cases reported in psychiatric journals.

  • Report 1: A 51-year old American man turned up to a hospital insisting he was pregnant. The man was said to have no organic cerebral pathology but had a 20-year history of chronic delusional disorder. He even inserted a knife into his anus to facilitate delivery of the “baby”. The delusion of pregnancy subsided over a four-month period following a course of chlorpromazine (reported in the American Journal of Psychiatry, 1991).
  • Report 2: Delusions of pregnancy were reported in five women aged over 64 years. All five women were reported as having major depressive episodes with mood-congruent delusions. The symptoms were discussed in relation to other delusions such as Cotard’s Syndrome (reported in the International Journal of Geriatric Psychiatry, 1995).
  • Report 3: While on chlorpromazine medication, a psychotic 15-year old female developed a delusion of pregnancy. The delusions were initiated because the girl developed galactorrhea (breast milk production) – one of the side effects of taking high doses of chlorpromazine. It was concluded that the incidence of pregnancy delusions may be higher among female institutionalized patients treated with chlorpromazine (reported in the American Journal of Psychiatry, 1971).
  • Report 4: A 43-year old man presented with a persistent pregnancy delusion. The man suffered from chronic schizophrenia and was described as coming from a background of poor sexual adjustment (reported in the journal Psychopathology, 1995).

A 2002 study by Dr. D.S. Rosch and his associates published in the International Journal of Psychiatry in Medicine was the first to utilize a standardized mental disorder assessment tool (the Brief Psychiatric Rating Scale) to compare a group of 11 women with delusional pregnancy with a group of 11 female controls. Compared to the control group, women with pregnancy delusions had significantly higher levels of hostility, higher rates of prescribed poly-pharmacy, and a trend toward higher antipsychotic medication dosages. The authors reported that their findings may be suggestive of greater resistance to treatment in women with pregnancy delusions.

A more recent 2008 study published in the journal Psychosomatics by Dr. N. Ahuja and colleagues looked at the association between pregnancy delusions and antipsychotic-induced hyperprolactinemia. Among 12 patients taking such medication, six of them had erroneous ideas of being pregnant (four delusional and two non-delusional).

Most of the literature comprises case studies and therefore the literature base is limited by relatively few cases and by those who present for treatment. As Dr. Maria Simon and her colleagues concluded in their paper in the European Journal of Psychiatry:

“Case reports usually reveal demographic characteristics, describe response to treatment, and/ or suggest etiology. Patients with delusional pregnancy have been reported to be more hostile and treatment resistant compared with matched controls. Possible etiological factors in delusion of pregnancy are typically limited to neurophysiologic, endocrine and traditional psychodynamic factors. Given the growing evidence of cognitive and affective models of delusion formation, an integrated, individualized model of delusion of pregnancy can advantageously contextualize the phenomenology and course of the illness”.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Adityanjee, A.M. (1995). Delusion of pregnancy in males: A case report and literature review. Psychopathology, 28, 307-311.

Ahuja, N., Moorhead, S., Lloyd, A.J. & Cole, A.J. (2008). Antipsychotic-induced hyperprolactinemia and delusion of pregnancy. Psychosomatics, 49, 163-167.

Ali, J.A., Desai, K.D. & Ali, L.J. (2003). Delusions of pregnancy associated with increased prolactin concentrations produced by antipsychotic treatment.International Journal of Neuropsychopharmacology, 6, 111-115

Bitton, G., Thibaut, F. & Lefevre-Lesage, I. (1991). Delusions of pregnancy in a man. American Journal of Psychiatry, 148, 811-812.

Camus,, V., Schmitt, L., Foulon, C., De Mendonça Lima, C.A. Wertheimer, J. (1995).Pregnancy delusions in elderly depressed women: A clinical feature of Cotard’s syndrome? International Journal of Geriatric Psychiatry, 10, 1071-1073.

Chengappa, K.N., Steigard, S., Brar, J.S., & Keshavan, M.S. (1989) Delusion of pregnancy in men. British Journal of Psychiatry 155, 422-423

Cramer, B. (1971). Delusion of pregnancy in a girl with drug-induced lactation. American Journal of Psychiatry, 127, 960-963.

Dutta, S. & Vankar, G.K. (1996). Delusions of pregnancy – A report of four cases. Indian Journal of Psychiatry, 38, 254-225.

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