
Firstly, things continue wonderfully with our beautiful daughter, Evelyn. We have made a couple trips out to the pediatrician to monitor jaundice, which she has successfully fought off. As our pediatrician is near 23rd Ave, we took the opportunity to put her in the stroller and take a walk to get ourselves some delicious gelato.

Meanwhile, at home, we're working on developing a groove in time with her needs, which are indeed simple yet all-consuming. It's a deep, visceral pleasure to feed her and then see her sweetly content face reposed in sleep. Mike's become a pro at changing diapers already, while of course the fact that he works from home is an enormous boon to the whole family. My maternity leave will be almost four months (through late January) so overall I'm relatively relaxed, and having fun with this new "parenting" thing. We won't talk about how much sleep we're (not) getting, though!
Right now, Evelyn is having an exciting moment - she's riding in a sling for the first time, coping with a bout of hiccups, and has discovered her thumb for the second time and is avidly sucking away! Talk about milestones! Now if only she didn't poke herself in the eye while thumbsucking...that will come, I'm sure...and ah, the hiccups have eased....
** Warning: the remainder of this posting is fairly explicit, quite lengthy, and probably will interest only close family and women friends! **I wanted to record the story of my labor here, which several people have inquired about, and which is surely one of the most intense and unique experiences of my life. The short version of the story is that active labor took a very long time to get established and required medical intervention. It's a good thing that I knew going in that there is
no such thing as a typical labor, and that I was open-minded about the use of medical pain prevention. In sum, I spent about 16 hours in pre-labor, 9 hours in early labor, 6 hours in active labor, and 90 minutes pushing.
For those who haven't been geeking out on pregnancy lately, labor comprises several phases:
pre-labor (in which uterine contractions occur sporadically and are relatively mild -- this phase can actually last for days); the
early phase (in which contractions occur at a regular frequency from about 20 minutes, progressing to about 5 minutes apart, during which the cervix dilates to about 3 cm); the
active phase (in which contractions grow ever more intense up to a frequency of one to two minutes apart, during which the cervix dilates to about 7 cm); the
transition phase (in which powerful contractions pile on top of contractions and the cervix fully dilates to 10 cm); and the
pushing phase (where the baby passes down the birth canal and is delivered). There is also a final phase where the placenta is expelled.
The first sign of my labor was the show around noon on Thursday 10/5. I was excited and anticipatory, although trying to be patient. Around 4 pm, contractions started occurring about 20 minutes apart. By 7 pm, they were about 12 minutes apart, and I was using some breathing techniques to manage the feelings they induced. Mike was excited and we were filled with happy thoughts of imminent labor. Tori Amos's "Little Earthquakes" seemed like appropriate listening music. Then at 9:30 pm, my water broke. Only about 10-15% of labors actually begin with the bag of waters breaking; it's part of the protective package wrapping the baby in the womb, and generally the baby must get delivered within 24 hours due to the risks of infection that can result from its loss. I promptly got on the phone to my Ob/Gyn, Dr. Marni Sue Kwiecien. At my request, she agreed that I could spend the early phase of labor at home, either until 4 am or until my contractions were 5 minutes apart. Mike and I packed up some last items and tried to relax a bit. However, around midnight we were disappointed that the contractions slowed down, and by 4 am they were not any stronger or more regular in frequency.
We went in to Providence St. Vincent Hospital, which is just about a mile from our home, and during the assessment the contractions were actually about five minutes apart. I was admitted at 4:20 am and we were shown to Birth Room 21. We settled in, and while Mike caught a little shut-eye I walked the hallways to encourage labor to speed up. Each contraction would stop me in my tracks, but my breathing techniques were golden. However, by 9 am my cervix had not dilated past 1.5 cm, which had already been in effect as of my due date on Tuesday 10/3! It seemed that early labor hadn't even properly started -- I was still in pre-labor. This was extremely disappointing, and medical intervention for labor induction was indicated.
Dr. Kwiecien recommended beginning with cervical application of prostoglandin, which is a hormone that stimulates effacement and dilation. Unfortunately, this step meant that I now required constant fetal monitoring, and so I was bed-bound until the nurse located a fetal monitor equipped with long-range telemetry. The medicine was in place from about 11 am until 2:30 pm, during which time my contractions went down to between three & five minutes apart, requiring more intense concentration to apply my breathing techniques. We listened to Gnarls Barkley, Thievery Corporation, and acid jazz to keep the atmosphere light and familiar. The fetal monitoring meant that we were able to watch the contractions occur, as well as observe Evelyn's heartbeat, on that machine which goes Ping! We were both sure that I was now officially in early or even active labor.
However, after a promising start, the contractions slackened up somewhat, and by the end of this period my cervix remained only 1.5 cm dilated. Dr. Kwiecien now recommended administering an intravenous drip of oxytocin (name brand "Pitocin"), which is the hormone that stimulates uterine contractions. This was perhaps the lowest point of the whole labor, because I've read and heard nothing but scare stories about labor induction using oxytocin; it tends to stimulate extremely strong contractions very quickly and an epidural is generally recommended simultaneous with its application. However, my cervix had to reach at least 3 cm before an epidural would be authorized. Some tears were shed, as I feared what would come....
The pitocin drip started at 4 pm. Although chained to an IV pole and monitoring equipment, I was able to navigate around the room to a certain extent and use the birthing ball for variety. As before, Mike held my hand, massaged my back, and breathed with me. The contractions grew ever stronger, but after all, this was what laboring was about. When she left for the day around 5, Dr. Kwiecien told me that things were going well and that we could expect our daughter to have a 10/7 birthdate, since dilation usually proceeds at about 1 cm per hour. I kept my chin up, continued breathing, and looked forward to Evelyn's arrival.
Then, at 7 pm on Friday 10/6, a cervical exam revealed that over the past four hours I had only dilated to 2 cm. The Ob/Gyn who was now on call for the night, Dr. Shirley Fox, gave me two options: continue upping the dosage of oxytocin until labor was forcibly induced, or else stop the drug in favor of a re-application of prostoglandin overnight and the opportunity to rest until resuming infusions in the morning. Since the doctor recommended the slower route -- despite the fact that my waters had broken nearly 24 hours ago -- we followed this plan. Mike and I were exhausted and hungry; dinner was ordered and eaten. At 8 pm, the prostoglandin was applied, and I received a shot of pain medication to aid my attempt to sleep, after being assured by our new night nurse, Jeannette, that the progress of my labor would not be delayed by sleeping.
Bless pain medication! We put Air's "Moon Safari" on repeat, and I was able to relax somewhat into a more mellow place, while Mike laid down to try and get some shut-eye. Yet, rather than slackening off, my contractions picked up. So this was active labor! I focused my mind on the images we'd brought to use as focal points: a radiating Om symbol, and an image of a beach in Hawai'i where we'd spent blissful time. My breathing techniques were now a lifeline to move through each contraction. Mike roused himself, and kept in contact with me as a quiet source of comfort and strength. Jeannette, our nurse, was also a marvel of confidence and support. She kept a watchful eye on the monitor, which now showed the peaks of contractions higher than they'd ever been before, lasting a minute or so and occuring at a frequency of two to three minutes.
At 11 pm, a cervical exam revealed that I was 3 cm dilated. I promptly asked for the epidural to be administered, and Jeannette leapt into action to summon the anesthesiologist. I spent about fifteen minutes sitting up while it was administered. It's worth saying again -- bless pain medication!

Within several minutes of completing the epidural, Jeannette asked, "Did you feel that?" and when I responded "What?", Mike whistled in awe because the monitor had showed another Himalayan contraction. As the pain receded, I began to shake all over, which Jeannette said was a normal bodily reaction to the cessation of stress. My labor now progressed very rapidly. Over the next couple hours, the shaking ceased and I worked on relaxing and visualizing the physical reality of how my powerful and obedient uterus was contracting in order to open my cervix and deliver a baby. By 12:45 am Sunday morning, I was dilated at 5 cm; by 1:45 am, I was dilated to 9.5 cm and Jeannette told us to prepare for the pushing phase.
The challenge of the pushing phase when you've had an epidural is that you're not necessarily able to feel the exact place where the pushing should be directed. Here's where I must extol the virtues of Kegel exercises...if you're already in touch with this part of your body, you will succeed! I won't say it wasn't exhausting, pushing during each contraction for 90 minutes in a semi-sitting position. I'd asked for a mirror to be set up so that I could benefit from witnessing her progress down the birth canal. With Mike supporting me on one side and Jeannette on the other, it wasn't that long before we could see Evelyn's head appear with its shock of dark hair. Words can't describe the feelings of joy this sight brought to us both.
After this fast progress, we plateaued for awhile, but when Dr. Fox came in to handle the actual delivery I responded with renewed energy. Or perhaps it was switching the music from Scissor Sisters back to Air? At one point, Dr. Fox warned me that she might have to perform an episiotomy, but happily this was not necessary, although I did need one stitch. Once Evelyn's head fully crowned, a couple final pushes had her entering the world. She had the umbilical cord wrapped twice around her neck -- which I was sure would happen because she'd been so very active in the womb! -- but Dr. Fox didn't even blink and in a moment our baby girl was laid upon my chest.
I felt utterly awestruck to see and touch her little form, while Mike tells me that his prevailing emotion was one of relief. Various things kept happening down at the end of the bed that didn't interest us -- my only thought was for this new person we were finally privileged to meet. The vision of her bright almond eyes, pouty-pursed mouth and dimpled chin will forever warm my soul. Soon, she was suckling at my breast and the reality of our new family was starting to take form.

And now I will return to the fold, knowing how truly lucky Mike and I are to have and to hold this sweetheart we've named Evelyn Arcadia.
--Liz