Concealed or Denied Pregnancy – A Critical Realist Conceptual Analysis

Concealed or denied pregnancy remains an under researched area in relation to safeguarding children, especially from a Social Work perspective. This article used a critical realist methodology in order to understand what causal mechanisms may influence a concealed or denied pregnancy to occur. A total of 97 peer-reviewed articles, case studies, books and media reports were analysed using Mukumbang’s retroductive theorising model (2023) in order to create three conceptual maps. These maps indicate the potential causal mechanisms underlying concealed or denied pregnancy on an individual, interpersonal and a community and societal level. This research establishes that concealed or denied pregnancy occurs as a result of complex psychological, biological, physiological, interpersonal, cultural and societal causal mechanisms. Recommendations include further qualitative research to explore mothers’ experiences as well as fathers and the wider family network. For multi-agency safeguarding practice, recommendations include using the conceptual maps to support the training of professionals to become more aware of how to identify, assess and respond to concealed or denied pregnancy. Finally, this research suggests the development of national procedures in order to support a greater consistency of response to concealed or denied pregnancies by organisations and professionals working to protect children.