The teen years can be tough. Let’s be real, it was an awkward time for the best of us. During those tender years, we all did our best to navigate the tumultuous world between childhood and adulthood amidst raging hormones, love triangles and knife fights... the usual teenage stuff.


Ok, perhaps not every teenager gets in a knife fight, but this particular case has all the drama you would expect to find in a daytime soap opera.


The story involves a 15-year-old girl who was employed in a local bar (well that’s the first red flag right there). She was admitted to hospital after a knife fight outside the bar involving her former lover and a new boyfriend. Exactly who stabbed who was not quite clear, but all three participants in the small war were admitted with knife injuries.


The young girl received minor lacerations on her left hand and a single stab wound in her upper abdomen. Under general anaesthesia, a laparotomy (surgical incision into the abdominal cavity) was performed to reveal two holes in her stomach as a result of the stab wound. Ouch.


A successful surgery was completed, her stomach was noted empty and no gastric contents were seen in the abdominal cavity. All healed up after 10 days of routine post-operative care, she was discharged from the hospital and sent home. 


Precisely 278 days later… The girl was admitted to hospital once again. This time with acute intermittent abdominal pain. Upon examination, the doctors found something very surprising indeed... A fully grown baby. 


Given the increase in her abdominal size over the previous months, she and others around her had questioned whether she was pregnant, but she just couldn’t believe it. Sure, she’d fooled around with guys, but she couldn’t possibly be pregnant… she didn’t have a vagina!!


Despite her disbelief, an emergency caesarean section was performed under spinal anaesthesia and a live male infant was born. 


Now, the girl was fully aware that she had no vagina (hence her disbelief). She had only a shallow skin dimple below the external urethral meatus between the labia minora, a condition that affects about 1 in 5000 women, to varying degrees. 


So how the heck did she get pregnant if she didn’t have a vagina???


The doctors were also very curious about this and upon exploration through her nearly completely dilated cervix, it was found that her uterus ended in a two centimetre deep vagina but it just didn’t connect to the outside. 


The uterus adnexa and renal tract appeared normal so they closed her up. Mother and baby were alive and well and with the help of a sympathetic nursing sister, the whole saga of “how” eventually emerged. 


See, considering she had no vagina, the young girl was well-versed in other sexual explorations. That night, just before she was stabbed in the abdomen, she had practised fellatio with her new boyfriend and was caught in the act by her former lover. Let the knife fight begin.


The stabbing appeared to have opened enough of a hole between her stomach and her uterus for the semen to take an unconventional route to baby land. Yep, she got pregnant from oral sex. 


Thankfully this story has a happy ending though. The young mother and the presumed father adapted themselves rapidly to the new situation and some cattle changed hands to prove that there were no hard feelings with the knife-wielding ex.


A lesson here for all teenage girls, perhaps consider the option to spit, not swallow, particularly if you are likely to encounter angry, former boyfriends with impaling implements.

 
 

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SOURCES:

  • Oral conception. Impregnation via the proximal gastrointestinal tract in a patient with an aplastic distal vagina. Case report, by Douwe A A Verkuyl, in BJOG

 
  • [00:00:00] Will: This one came in from a listener. I get a case report. So thank you very much to PEZ on Instagram. The patient was a 15 year old girl employed in a local bar. She was admitted to hospital after a knife fight involving her former lover, and a new boyfriend. Who exactly stabbed whom was not quite clear, but all three participants in the small war were admitted with knife injuries.

    [00:00:24] The girl had some minor lacerations of the left hand and a single stab wound in the upper abdomen. Under general anesthesia, laparotomy was performed, so they had a look, through an upper midline abdominal incision to reveal two holes in the stomach. These two wounds had resulted from the single stab wound through the abdominal wall.

    [00:00:42] Rod: Oh so he got double bang for buck.

    [00:00:45] Will: The two wounds were repaired in two layers. The stomach was noted empty at the time of surgery and no gastric contents were seen in the abdominal. Nevertheless, the abdominal cavity was lavaged. They cleaned it out.

    [00:00:55] Rod: Lavaged?

    [00:00:56] Will: With normal saline before closure.

    [00:00:58] Rod: Can we say like, I didn't have a shower, I just lavaged?

    [00:01:01] Will: You could say that, you could. Happily, the condition of the patient improved rapidly following routine post operative care and she was discharged home after 10 days. Precisely 278 days later.

    [00:01:13] Rod: Ah, see, that's the danger day.

    [00:01:15] Will: The patient was admitted again to hospital with acute intermittent abdominal pain.

    [00:01:19] Rod: Okay. Okay. Can I guess?

    [00:01:21] Will: I'll tell you more about that.

    [00:01:35] Welcome to the wholesome show.

    [00:01:37] Rod: I'm supposed to do that.

    [00:01:38] Will: Oh, you're supposed to do it.

    [00:01:39] Rod: Welcome to the wholesome show.

    [00:01:41] Will: The podcast in which two academics take the afternoon off and grab a beer to go down the rabbit hole, down the rabbit hole of this case report. I'm Will Grant.

    [00:01:49] Rod: I'm Rod Lambert.

    [00:01:50] Will: All right. I'll keep going. I don't need anything else, just directly from this case report. So yeah, I left her precisely 278 days after her stab wound in the stomach was admitted again to hospital with acute intermittent abdominal pain.

    [00:02:03] Rod: Am I allowed to guess?

    [00:02:04] Will: Yeah, give it a guess.

    [00:02:05] Rod: Okay. My guess is things were left in.

    [00:02:07] Will: Yes, but not surgical instruments

    [00:02:10] Rod: pint glass, money, a duck

    [00:02:14] Will: abdominal examination revealed a term pregnancy. The uterus was contracting regularly and the fetal heart was heard. Inspection of the vulva showed, and I'm going to add a however here, no vagina.

    [00:02:27] Only a shallow skin dimple was present below the external urethral meatus between the labia minora.

    [00:02:33] Rod: So a crater.

    [00:02:33] Will: Yeah, it's a condition that affects about 1 in 5000 women.

    [00:02:37] Rod: That many?

    [00:02:38] Will: Of varying extents. Of varying extents.

    [00:02:41] Rod: So like a non opening.

    [00:02:42] Will: There are certainly, yes, women with no opening in the vagina.

    [00:02:46] Rod: That can't be good. I feel like surgical intervention.

    [00:02:49] Will: Which, I will just, I'll just pause you for a second there. We have a pregnancy.

    [00:02:54] Rod: Oh, believe me, I was going to get to that.

    [00:02:55] Will: With no vagina.

    [00:02:56] Rod: So she's been drinking the semen cause that's the other way to do it.

    [00:03:00] Will: An emergency lower segment caesarean section was performed under spinal anesthesia and a live male infant was born.

    [00:03:08] On exploration through the nearly completely dilated cervix, it was found that the normal uterus ended in a two centimeter deep vagina and that the vagina did not exist more distally. So there is a bit of vagina connected to the uterus, but it doesn't connect to the outside.

    [00:03:23] Rod: That's useful.

    [00:03:24] Will: The uterus adnexa and renal tract appeared normal, routine closure of the uterus and abdominal followed, a large tube drain was left in the uterine cavity.

    [00:03:31] Rod: So they sewed her up and they drained out the gook.

    [00:03:34] Will: Now I love this bit. While closing the abdominal wall, curiosity could not be contained any longer.

    [00:03:40] Rod: This is why I could not be a surgeon and be like, Oh, hang on a minute. Let's have a look at that.

    [00:03:43] Will: And the patient was interviewed with the help of a sympathetic nursing sister. The whole story did not become completely clear during that day, but with some subsequent inquiries, the whole saga emerged. The patient was well aware of the fact that she had no vagina and she had started oral experiments after disappointing attempts at conventional intercourse. Just before she was stabbed in the abdomen, she had practiced fellatio with her new boyfriend.

    [00:04:08] Rod: Fuck off

    [00:04:09] Will: and was caught in the act by her former lover.

    [00:04:11] Rod: No, they created a bespoke vagina.

    [00:04:17] Will: The fight with knives ensued. She had never had a period and there was no chase of Lockyer after the Caesarean section. She had been worried about the increase in her abdominal size, but could not believe she was pregnant, although it had crossed her mind more often as her girth increased and as people around her suggested that she was pregnant. She did recall several episodes of lower abdominal pain during the previous year. The young mother, her family, and the likely father adapted themselves rapidly to the new situation and some cattle changed hands to prove that there were no hard feelings.

    [00:04:45] Rod: Here have a cow

    [00:04:45] Will: yeah.

    [00:04:46] Rod: So, she basically got banged in a stab hole by accident.

    [00:04:50] Will: I think what happened. I think what happened. She has a new boyfriend. They're having some oral sex outside the bar, he's completed the job and Keith comes along and says, that's my lady, stab all round. The stabbing appears to have opened enough of a hole for some between the stomach and the uterus for the seminal fluids to go in through internally to make a baby.

    [00:05:13] Rod: And this is one of what, how many thousand times this has happened before?

    [00:05:17] Will: A plausible explanation for this pregnancy is that spermatozoa gained access to the reproductive organs via the injured gastrointestinal tract.

    [00:05:24] Rod: Listen to the language, gained access, like it has intent and agency.

    [00:05:31] Will: Well, it does

    [00:05:33] Rod: scientific language is hilarious though.

    [00:05:35] Will: So look, this came a while ago where we're talking about you know, different definitions of sex and we did find a story of someone becoming pregnant from anal sex.

    [00:05:44] Rod: That's a thing.

    [00:05:44] Will: This is a story of someone becoming pregnant from oral sex.

    [00:05:47] Rod: From a knife fight.

    [00:05:49] Will: It required a pretty, pretty unique set of circumstances to occur, but there you go.

    [00:05:54] Rod: So, okay. So there are a bunch of takeaways. If you're going to do oral maybe at a bar where your recent boyfriend could be around, don't swallow.

    [00:06:03] Will: well, I think don't have the knife fight might be better.

    [00:06:06] Rod: Yes. And if you're worried about pregnancy as opposed to getting stabbed, and I've realized now that the two come closely together, if you're not careful, firstly, don't swallow it.

    [00:06:17] Ladies, especially 15 year old ladies, think about that, particularly if you are likely to encounter angry, former boyfriends with impaling implements.

    [00:06:26] Will: So there you go you lot. Send us in awesome case reports. I got to say, one of the most beautiful scientific papers I've read in a while, like the journey that you go through where she starts 15 year old girl employed at the local bar

    [00:06:40] Rod: and the exchange of cows. I assume it wasn't in England.

    [00:06:43] Will: It was in Lesotho.

    [00:06:44] Rod: Right.

    [00:06:45] Will: So exchanging cows is a more common thing after knife fight based oral pregnancy.

    [00:06:50] Rod: You have shamed me. Give me a cow.

    [00:06:53] Will: Good luck to everyone out there.

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