#MyUnintendedJoy Is My Greatest Gift


I am the last person anyone would expect to experience an unintended pregnancy. 

As a family physician and fertility awareness expert, I am very well informed about how to “plan” a pregnancy.  In fact, I spend a great deal of time explaining to people how women can learn to chart their cycle using a natural or fertility awareness based method (FABM) to either avoid or achieve a pregnancy.  I can quote both the perfect and typical use effectiveness rates for each method, as easily as my husband can share stats about the Dallas Cowboys.  Indeed, I knew with absolute certainty when I conceived each of my first three children, because we had planned to get pregnant those months.

And yet, my 2 year old baby girl -#MyUnintendedJoy – is the greatest gift our family has received.

The Perfect-Sized Family

In 2010, to the outside world, my husband and I had the perfect family, as the parents of both a boy and girl.  Yet, in my heart, I knew I wasn’t done … I wanted at least one more.  However, with two small children and two busy careers as family physicians, my husband wasn’t ready so we waited, continuing to use natural methods as effectively to prevent pregnancy as we had to achieve pregnancy.  Then, when I turned 40, I asked my husband if we could try for one more.  Nine months later we had another beautiful baby boy and life was good.

…Till We Rescheduled Date Night

At that time, I chose to stay home with my young children, as I was not sure if we would have any more.  It also gave me time to build the organization I had co-founded a couple years before, FACTS – the Fertility Appreciation Collaborative to Teach the Science, as I am so passionate about educating my colleagues about these true methods of family planning.  As such, I was traveling across the country giving presentations about the science of FABMs.  After flying to South Carolina one day to give such a talk, I had promised my husband we could have “a date” when I returned home that night but due to delays and an exhausting day, I just did not have the energy – I’m sure some of you can relate!  So, I promised my husband we could get together the next day.

Of course, I knew my cycle well enough that we would be cutting it close if we wanted to avoid a pregnancy.  And sure enough I experienced some mild signs the next day suggesting my fertile window may be opening, but I reassured myself and my husband that the chances of getting pregnant were so low, especially since I was now 42, so we were probably still ok.  So, I should not have been surprised two weeks later when my period was late.  

Yet, in my mind, I thought we weren’t planning to have a baby, so I couldn’t possibly be pregnant.  So I waited a few more days thinking for sure my period would come, but when it didn’t I knew I needed to take a pregnancy test.   I didn’t tell my husband at first, because I didn’t want to alarm him unnecessarily, as he typically had a harder time adjusting to the arrival of each new baby.   Besides with all the stress of building a new house and the back to school routines, I was sure my cycle was just off.

Imagine my surprise when the test came back positive.

A Baby Changes Everything…

“How could this be?” I thought initially.  Of course, I knew very well how this happened and yet even I was in a temporary state of denial.  While I expected my kids would be happy, I was not sure how my husband would react.  Also, I was planning to go back to clinical practice now that my baby boy was getting older, so those plans would have to be put on hold.  Naturally, as someone so knowledgeable about my body and natural methods of family planning, I was initially embarrassed about my “unplanned” pregnancy.  Would I lose all credibility?  Or maybe, could I relate to people better as an imperfect human being.  Ultimately though, my main concern, was how would this affect my family?

…For the Better!

Today, I can say with absolute certainty that while my husband and I may not have planned to have another baby, our daughter brings so much joy and happiness and in a way, seems to complete our family.  We named her Gianna Marie, after St. Gianna Beretta Molla, a physician like me, who died one week after giving birth to her fourth baby.  She is an inspiration and a reminder that while life may not always go as planned, to treasure this time with your family.

While I may not have planned to have a fourth child, as I awaited the birth of my baby, it gave me more time to reflect on my priorities and focus my efforts on what really matters.

As much as I enjoyed my previous career working full-time as a family physician, I really love having more time now to care my family.  I have also been able expand our FACTS programs, educating even more of my health care colleagues about the science supporting natural ways to manage fertility.

As for my plans to return to clinical practice, last year I did that too, albeit very non-traditionally. Together, with another family physician, we launched a direct primary care practice, Modern Mobile Medicine, seeing patients in their own homes, as we care for whole families.

As I write this blog with my beautiful baby girl sleeping next to me so peacefully, I can’t help but think, life may not have gone as planned—and for that I am so happy.  #MyUnintendedJoy, Gianna Marie means the absolute world to my husband and me and to our whole family!


Dr. Marguerite Duane, a board certified family physician and Adjunct Associate Professor at Georgetown University, is co-founder and Executive Team Leader of FACTS – the Fertility Appreciation Collaborative to Teach the Science

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