She was 44. Happily living with her fiancé and her adopted daughter. Financially secure, fulfilled in her work. And completely infertile, her doctor said.

Then, she got pregnant.

Alice Eve Cohen documents the tumultuous year following that surprise diagnosis in What I Thought I Knew , a memoir our reviewer called "darkly hilarious." We called her at her home in New York City to find out how this could have happened and how the ordeal made her relationships—with her husband, her daughter, and even herself—stronger than ever.

O: How did you not realize you were pregnant for six whole months?

Alice: When I was 30, I went to a fertility specialist who told me my estrogen level was so low it would take a miracle for me to become pregnant, and that, in addition, I had a small and deformed uterus. Doctors who looked at my records after that saw "Low estrogen. Infertile. On estrogen replacement therapy…" and never questioned any of it. When my gynecologist changed my dose of estrogen 14 years later, she told me I'd probably lose my period.

O: So when it went away, you didn't think, "Maybe I'm pregnant"?

Alice: The doctor told me that losing my period was menopause. I felt the lump in my belly, sore breasts—the classic symptoms of pregnancy—but even after my gynecologist performed an internal exam at 20 weeks gestation, she had an explanation for everything. She said to diet and exercise, and come back in a year.

A month later it was clear to me that this was not a dieting problem. I went to my general practitioner, and she, again without considering the possibility of pregnancy, said, "You have a huge tumor. I'm sending you for an emergency CAT scan right now. Go." So I went and the doctors told me they found something in me.

O: What would have been more shocking in that moment: cancer or pregnancy?

Alice: It would have been less of a surprise if he said, "We found a tumor." I wouldn't have been happy to hear it, but cancer is what I was expecting. It was much more of a surprise to find out I was six months pregnant. I didn't believe them.

O: After that, what was the scariest part?

Alice: No one would see me. A woman who hasn't had any prenatal care for six months is coming in with a greater risk. But I was shocked and in despair, because I felt like the most important thing was to salvage what had begun as a disastrous pregnancy, and get care for the baby and myself.

O: How did you get through that time?

Alice: My husband Michael, then my fiancé, was incredibly patient throughout my moments of indecision and pessimism and depression—and everything. Ten years later, having weathered this very difficult, challenging time, I think we are stronger for it.

Also, my daughter Julia was amazing. We'd adopted her when we thought we couldn't have children, and she was nine when all this happened. Towards the end of the pregnancy, I was confined to lying on my left side in bed, and she would come home from school, run upstairs, and lie there with me. She would do her homework under the covers; it was the coziest, nicest time.

O: How did both your daughters—Julia and Eliana, whose birth the book focuses on—react to the book?

Alice: Julia read it on the 10-hour bus ride to camp where she is a counselor and lifeguard this summer. She told me she liked it a lot.

With Eliana, we suggested she should wait until she was a teenager to read the book, but she is a strong-willed and very bright kid. She said, "No way. This is about my birth. I'm not going to let other people read about it before I do." We gave in, but told her we needed to be home while she read, so that if she had any questions, we were there to talk to her. So she read it before it was published, just a few weeks ago.

Afterward, she said, "Good book, Mom, I really liked it." When we asked if any of it was upsetting, she said, "No, I knew exactly the way it was going to turn out." For both me and Michael, that was a huge relief.


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