PURPOSE: Pregnancy can be denied or better "unperceived" by women in up to 1:300 pregnancies and poses the mother and her unborn at high risk when an unassisted birth follows. The importance of recognizing unperceived pregnancy and the risk of unassisted births for both mothers and their babies are described. METHODS: Description of a case of unperceived pregnancy and traumatic unassisted birth. RESULTS: A pregnant woman was not diagnosed in a clinic despite being at the verge of giving birth. She was turned away, was on her way to another hospital, and gave birth in a toilet in a dissociative state. The baby survived, but the mother was declared guilty of attempted manslaughter and received a 6-year prison sentence. The expertise of a perinatal psychiatrist reversed the verdict and the court apologized to the mother, now living with her son. CONCLUSIONS: This case shows the severe consequences when pregnancy and labor are not recognized by health professionals. The reversal of the original sentence is considered a pioneer case of restorative justice in the context of unperceived pregnancy and obstetric violence. Health providers and courts need to be informed by perinatal mental health professionals about the impact of unperceived pregnancy and obstetric violence.