Some time after the 18-year old single female delivered the baby she didn't know she carried in her womb, I saw a 39-year-old married woman who presented to the emergency department with - yep - acute onset crampy lower abdominal pain of several hours duration.
Other than her age, marital status, and somewhat less obesity, this lady's case evolved very similarly to the one I described in my last post. History was unremarkable except for irregular menses. Physical exam at first revealed nothing, then the unmistakable contractile mass in the abdomen, with palpable fetal head in the pelvis. No clinical badness here. This lady was in active labor with a full term baby, yet vigorously denied that she could be pregnant.
"My husband had a vasectomy," she told me with absolute sincerity. "We can't afford another child. I'm not pregnant."
My mind quickly sorted through the various reasons why the mere fact of her mate's vasectomy did not rule out what the physical exam unequivocally indicated. I reassured her that she was indeed 1) pregnant, and 2) in active labor. Then we did the math. She recalled the date of her husband's vasectomy with fair certainty. Assuming that she was now truly at term and in her 40th week of gestation, she had conceived roughly two weeks BEFORE her husband underwent the baby prevention procedure. At the very least, that should mitigate any paternity doubts that might afflict her mate.
I found her husband in the waiting room and invited him to join his wife briefly before we whisked her up to labor and delivery. "Yes," I confirmed, "she's in labor." The gentleman appeared briefly stunned but took the news in relative stride. He opened his mouth as if to ask a question, then paused, and then remained silent.
As he entered the room, his wife looked at him plaintively. "Sorry," she said. He held her hand. "What are we going to do?" she moaned.
"We're going to have this baby," he replied warmly, "together." Then he tightly but gently squeezed her hand.
I smiled as they were whisked out of the emergency department to L & D.
They say that good pitching beats good hitting on any given day in baseball. In life, truth holds that same edge over denial.
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