The questions started soon after Gennifer McCauley gave birth:
Did you feel the baby kick?
Did you have morning sickness?
How could you not know you were pregnant?
McCauley understands the skepticism. She, too, did not believe the news when she first heard it. But that fact is, she says, she did not know she was pregnant until her labor started.
McCauley gave birth to her first child, a boy, at Mary Washington Hospital on March 1. She said she first learned that she was pregnant about four hours earlier, when a hospital technician did an ultrasound test.
"You're 81/2 months pregnant," the technician told her.
McCauley figured that there must be a mistake. She had not missed a period. She was using the contraceptive patch.
"You're 81/2 months pregnant," the technician repeated.
"I lay there and cried and cried," McCauley said.
McCauley's mother, Michele Hepner, walked into the exam room to find her daughter in tears.
"What's wrong?" Hepner asked.
At first, neither daughter nor technician would answer her.
"Somebody tell me," Hepner insisted.
"I'm pregnant," McCauley finally said.
"How far along?" Hepner asked.
"I'm 81/2 months," McCauley said.
"No way in hell," Hepner said.
Actually, McCauley was about to deliver. She had started cramping and bleeding that morning while at her job as a grocery store cashier. Now she was dilated to 8 centimeters.
Benjamin Michael McCauley-Lang was born at about 2 p.m. that day. He weighed 7 pounds, 3 ounces, was 19 inches long and appears to be perfectly healthy.
Since then, McCauley, her boyfriend and their families have tried to figure out what happened. How could a healthy 22-year-old woman--a little overweight but not obese, who lives with her parents in North Stafford--carry a baby to term and not know it?
It turns out that the clues were there, though unrecognized.
McCauley said she now knows that the "flu" she had for six weeks last fall was morning sickness.
The cravings, the leg cramps, the swollen feet, the heartburn, depression, difficulty sleeping, and the "spare tire" and 20-pound weight gain--all of these, McCauley now realizes, were symptoms of pregnancy. When they were happening, she did not recognize them.
"I had no reason to think," she said.
The reason that she did not suspect pregnancy, she said, was that she was wearing a contraceptive patch on her hip the entire time. Also, her period continued normally for eight consecutive months, she said.
In addition, her baby made no movements inside her to arouse suspicions.
"I didn't feel anything in my stomach," she said.
Cases of "undiagnosed pregnancy" are rare, but not unheard of.
In 1994, researchers at Harvard Medical School tested 800 young women, ages 12 to 21, who were at the hospital for same-day surgery. They found four women who did not know they were pregnant. It was not clear from the study how far advanced the pregnancies were.
In 1995, the University of Illinois did a similar study of 2,056 women of childbearing age and found six women who did not know they were pregnant.
Dr. Declan Burke, a Fredericksburg obstetrician/gynecologist, said the phenomenon is more common than you'd think. Those who work in maternity units frequently hear mothers say that they did not know they were pregnant. But Burke believes it's almost always a case of "self-deception," where the woman refuses to admit the obvious.
A woman can become pregnant while using a contraceptive, Burke said. The birth control patch is 98 to 99 percent effective if applied and removed at appropriate times, according to federal Food and Drug Administration.
However, if the user delays or misses a weekly application or removes a patch too early, pregnancy can result.
A woman also may have irregular spotting during pregnancy, Burke said, or she may bleed from other causes, such as hemorrhoids or cancer.
But regular, cyclic bleeding should stop during pregnancy.
"You can't have menstrual bleeding," he said.
Also, a mother will usually feel the fetal movements of a normal baby, especially as pregnancy advances, Burke said.
McCauley said she never considered pregnancy and had no reason to. Neither family members nor co-workers mentioned pregnancy as a serious possibility, she said. She and her mother also said she did not look pregnant.
Benjamin's unexpected arrival forced McCauley and her family to make some quick decisions. She had to arrange for maternity leave from her job, and she had to select a name for the baby. She chose her great-grandfather's name.
The family also had to convert a spare bedroom to a nursery, which they quickly filled with donated equipment and supplies.
"We had nothing, no diapers, no crib, no bassinet," Hepner said.
As for the contraceptive patch, McCauley said, "I wouldn't recommend it to anybody."
Staff librarian Craig Schulin contributed to this story.
To reach JIM HALL: 540/374-5433 jhall@freelancestar.com