A transgender man who had been taking testosterone thought he was out of shape and needed to work out more, but it turned out he was pregnant.
Kayden Coleman, 29, of Florida, had lived as a man for nearly a decade and was waiting for a double mastectomy when he notice he was putting on weight.
Now married to husband Elijah, he had been taking hormones for five years and never expected he would get pregnant.
But ahead of the mastectomy operation he had had to stop taking the injections.
A trip to the doctors confirmed Mr Coleman was 21 weeks pregnant, and the couple began to prepare for the surprise new addition.
He gave birth to baby daughter Azaelia, now 22 months old.
Mr Coleman's pregnancy appears to have gone largely unnoticed outside their family.
"This woman in a shop said to me, 'Honey, you look like you're pregnant'. I just laughed and said, 'I am pregnant!' She didn’t believe me," he was reported by The Mirror as saying.
In the hospital he said he was well treated by the medical staff but eventually became fed up with medical students coming in to see him.
"It got to the point where I had to put my foot down and demand a C-section," he said.
Speaking about his daughter, Mr Coleman said: "I couldn’t imagine, and don’t want to imagine, life without her. She is amazing."