Psychotic denial of third-trimester pregnancy

This paper presents a case report of denial of third trimester pregnancy and discusses practical clinical management of the risks to mother and unborn child, including unanticipated and unprotected labor and delivery, the possibility of neonaticide and/or subsequent child abuse and neglect. Ethically challenging decisions must be made concerning involuntary commitment, use of medication, controlled labor and delivery, curtailment and possible termination of parental rights through court action.