Spielvogel A M, Hohener H C
Birth. 1995 Dec;22(4):220-6. doi: 10.1111/j.1523-536x.1995.tb00262.x.
This paper describes the characteristics of women who deny awareness of their pregnancies, the underlying causes and conflicts, and specific interventions required to address these issues. Case reports illustrate this complication of pregnancy. The absence of many physical symptoms of pregnancy, inexperience, general inattentiveness to bodily cues, intense psychological conflicts about the pregnancy, and external stresses can contribute to the denial in otherwise well-adjusted women. Assessment should include the possible contribution of painful reactivation of memories concerning childhood or adult trauma and the effect of dissociative states on the development of denial of pregnancy. Psychotherapy is recommended to resolve these conflicts, and to prevent future pregnancy denials and child abuse or neglect. Denial of pregnancy is easier to understand in women with psychosis or serious cognitive impairment than in those without such disorders. The underlying illness requires treatment by a psychiatrist. Psychological conflicts also exist in psychotic women, such as the intense wish to have a baby while fearing loss of the infant to child-protection services. Acknowledging the conflict and supporting the mother despite her puzzling behavior is an important task for health caregivers.
本文描述了否认自己怀孕的女性的特征、潜在原因和冲突，以及解决这些问题所需的具体干预措施。病例报告说明了这种妊娠并发症。妊娠的许多身体症状不明显、缺乏经验、对身体信号普遍不留意、对妊娠存在强烈的心理冲突以及外部压力，都可能导致原本适应良好的女性出现否认妊娠的情况。评估应包括童年或成人创伤记忆痛苦重现的可能影响，以及分离状态对妊娠否认发展的影响。建议采用心理治疗来解决这些冲突，防止未来出现妊娠否认以及虐待或忽视儿童的情况。与没有此类障碍的女性相比，患有精神病或严重认知障碍的女性更容易出现妊娠否认。潜在疾病需要精神科医生进行治疗。精神病女性也存在心理冲突，比如强烈希望生育，但又担心婴儿会被儿童保护服务机构带走。认识到这种冲突并在母亲行为令人费解时给予支持，是医护人员的一项重要任务。
