Myth or fact: can women self-diagnose pregnancy?

283 women, aged 16 through 28 years, who requested a pregnancy test because of a late menses, were studied at 3 health centers in New Brunswick, New Jersey, to determine the accuracy of a woman's self-prediction of pregnancy before pregnancy test results and physical examination were known. 6 women wanted to be pregnant. 64 women had previous pregnancy experience. 98% of the sample had their last menses 60 days or less before requesting a pregnancy test. Each woman was asked to complete a comprehensive, structured contraception and sexual history questionnaire which included questions on whether she believed she was pregnant, and if subjective symptoms of pregnancy were present. All questionnaires were completed before the results of the pregnancy test (NeoCept) were available and before a physical examination was performed. Of the 283 pregnancy tests, 118 (42%) were positive and 165 (58%) were negative. Of 118 women with positive pregnancy tests, 92% were correct in stating they were pregnant. Women with previous pregnancy experience with 94% accurate. Of 105 women with negative pregnancy tests, 57% incorrectly state they were pregnant; 64% with previous pregnancy experience incorrectly thought they were pregnant. Of the 283 women requesting pregnancy test, 204 thought they were pregnant, but only 109 (53%) had a positive pregnancy test. Of the 79 subjects who did not think they were pregnant, 70 (89%) were correct and had negative pregnancy tests, while 9 (11%) were inaccurate and were pregnant. Of the study population, 64 women who had previoius pregnancy were not more accurate in their prediction of pregnancy than the rest of the group. Of the 118 subjects with positive pregnancy tests, 59 (50%) felt pregnant as compared to 34 (21%) of the 165 women with negative pregnancy tests. 89 (44%) of the 204 women who thought they were pregnant had subjective symptoms of pregnancy. Of these 89 women, 57 (29%) subsequently had a positive pregnancy test. Women who felt they were pregnant reported the higher percentage of unprotected intercourse (59% as compared to 36%). As expected, women who thought they were pregnant and subsequently had a positive pregnancy test had the higher rate of unprotected intercourse (71%) and the higher percentage of failure to use contraceptive agents (16%) compared to 10%. In sum, it apperars that self diagnosis is inaccurate in predicting pregnancy and physicians should not rely on history alone.