To transmit genes without becoming mother: An evolutionary conflict behind denial of pregnancy

Aim : The etiology of pregnancy denial remains poorly understood. Neither necessary nor sufficient conditions can be synthesized from the risk factors identified from psychological analyses. In accordance with clinical observations, we aim to explain denial of pregnancy from an evolutionary conflict perspective. Methods : Authors investigate evolutionary biology aspects and emphasize on the transition from solitary animal species to social species. The possibility of conflicts between primitive species-perpetuation forces and subjective social-identity forces are explored. Results : As members of a social species, human beings have a dual, contradictory character of independent organisms but interdependent people. This results in evolutionary inherited conflicts that, with respect to women's reproduction, distinguish between primitive and social-identity issues: i) to transmit genes by giving birth and ii) to become mother. Authors explain denial of pregnancy as a standby-in-tension response to a conflicting attempt to transmit genes without becoming mother. It may thus be considered as temporarily adaptive response by postponing conflict resolution. This model, based on subjective internal appraisals, is compatible with a huge diversity of causative events as expected from the specificity of each woman's life course. Conclusions : The proposed etiology is consistent with clinical observations and brings prior models into agreement. From a clinical practice perspective, the ability to explain denial of pregnancy rationally may favor understanding and acceptation by concerned women. Health professionals' information may also be facilitated and psychotherapeutic follow up may gain in efficiency with reduced recidivism. More generally, this evolutionary conflict approach provides a supplementary perspective to explore psychosomatic dysfunctions.