Hello from ob gyn world...I could tell you stories about patients who couldn't imagine they were pregnant until at least the baby started moving, which for first time mothers is usually about 21-22 weeks (5 months),,,I try not to watch TV where the women didn't know they were pregnant the entire time, pretty hard to believe...and I know that in many of these cases denial is a strong tool...
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and for heavy women you don't necessarily show at 4 months, but thin women usually you can tell a little something but I have many patients that dress cleverly if they are not "out in their pregnancy"(many women wait till the anatomy scan to say that the kid is ok before they go public), but clearly the women all know themselves,,,and in this day of ultrasound very few women get by without knowing they are pregnant very early on,
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sometimes I get a lady who just missed her period for a day or two and wants me to assure her that the baby is ok and she is pregnant,,,and I laugh and ask them "What are you 2 hours pregnant"?