Hi Jessica:

Finally getting this to you after the craziness that ensued postpartum and during the holidays. Hope you are well. How I have missed your class. It was such a luxury during my pregnancy to have you and my fellow yoginis to fellowship with on a regular basis. And, as you will read below, your teachings really helped when the big moment came. Perhaps I will see you soon if I can get it together to bring the baby by for a visit.

Flora Luna Mack White was born at 37.5 weeks on November 14, 2005. She was 19 inches long and weighed 6 lb 7 oz. As my pregnancy entered the final two months, the Doctor grew more worried about my high blood pressure and the onset of preeclampsia. Finally in late October, he put me on modified bedrest - which meant no more prenatal yoga. He also began hinting that he wanted me to have an induced labor -- although he knew I was really against this option considering I started out with the goal of a home birth. In the first weekend in November, he was so worried about my health that he sent me to the hospital to rest and for observation, finding that my liver and kidney function were just inside the limits of normal. I was able to go home the following Monday, but had to go to the Dr.'s office every other day so they could make sure everything was okay. The next time I saw the Doctor, he pressed me about the induction. The midwives agreed that I was a walking time bomb because of the high likelihood for complications from preeclampsia, so we scheduled the delivery for the next Monday.

After a surreal ride to Cedars while the rest of the city slept, which was somehow fitting, Tom and I arrived at the hospital near the appointed time of 2 am on 11/14. We were put in a small room and the nurse immediately began getting me set up to insert the drug on my cervix. This meant taking my blood pressure, measuring my glucose level, liver and kidney function and other vital signs, inserting an IV and other tasks in preparation for the delivery.

I was under the impression the drug used for the induction was going to be a synthetic prostaglandin, but actually it was a drug called cytotec. After reading the waiver, I was little skittish about this option - the potential side effects seemed problematic - but, the very nice and competent nurse and the attending intern both assured me that the language was mostly precautionary and that they had very rarely seen anyone succumb to complications from the drug.

Not long after the application of the induction agent, contractions started at a pace consistent with what I expected in early labor. The standard time for this part of the process is four hours. At the end of this period, about 9 am, contractions were coming along nicely. We checked in with Margo Kennedy, my midwife, who was now scheduled to be the doula, and she said to call her when the contractions were closer together. Dr. Fischbein came in at this time also and recommended that they start intravenous magnesium sulfate to ward off possible eclampsia related seizures because the tests taken earlier in the morning showed that my liver function was starting to deteriorate. I had made up my mind to surrender to the process, so I didn't fight this intervention and the nurse started an IV drip of the mag sulfate. While I waited I continually meditated on the ripening of my cervix - envisioning it dilating from 1 cm to 10 cm. An inhouse midwife came into the picture at this point - Denise Ellison. She was very friendly with both Dr. Fischbein and Margo who was a college classmate. She was also a very good midwife.

The contractions gradually became stronger and more frequent -- thankfully, because this meant there was no need to administer Pitocin. To ensure that the labor continued progressing, Dr. Fischbein consulted with Denise and they decided to break my water. She also checked my cervix and she was able to stretch it to 2 cm. Margo happened to call at this time and Tom gave her the play by play of the procedure. Then we agreed it made sense for her to come to the hospital and join the team.

At about 11, shortly after they broke the water, they moved us to the delivery room across the hall. We had a choice to go into that room, which was windowless, or to wait for a room with a window. We decided that we wanted to move from the exceptionally tiny room as soon as possible to get ready for the birth. The very large room actually felt "womb-like" with no window. The nurse hooked me up to the monitors - I had baby monitors on the whole time! - while Tom setup the music. He was the DJ, in addition to being a member of the labor support team, readied by Julie Freitas' birth class.

After everything was in place, active labor seemed to come right on cue with India Arie singing "Strength, Courage and Wisdom." Denise provided excellent coaching as the contractions got stronger. Even with all the monitors on, she had me "belly dancing" in the bed in time to the music. Of course, this didn't make the nurses who were checking things from their station all that happy because it was hard to keep the monitors in place. Denise (and Dr. Fischbein, I think) came up with a solution to allow me a bit more freedom of movement - inserting a device vaginally to monitor my contractions. My cervix was still at 2 cm when it was inserted.

Margo arrived at 1 pm and went right to work, joining Denise and Tom on the labor support team. As the pain of the contractions increased, they did a great job coaching me through each one, encouraging me to change positions to achieve greater comfort and to give the baby more space (Jessica was there in spirit), and applying counter pressure and massage. It was very intense, but also very gratifying because I really felt in the flow.

Sometime between 1 and 1:30, over the loud speaker, a nurse announced the arrival of my parents who we weren't expecting. I was very relaxed and into the rhythm of the labor (thanks to all that prenatal yoga no doubt) and didn't want that feeling disturbed with the arrival of my parents in the room. We asked Margo how much longer it would be and, considering that my cervix hadn't dilated much past 2 cm, she said six hours. My first thought was, "I have to do this for six more hours!" Tom went out and told my mother and father to come back around 7 pm.

They left and things continued to move quickly forward. Sometime before 2 pm I hit transition. What an experience, feeling the full force of her traveling through my body with Bach's Suites for Unaccompanied Cello in the background. A little after 2 pm, Denise again measured the opening of my cervix - I was at 9 cm! At 2:15, I was told to push as the baby was nearing the opening. I remember pushing a couple of times and then Denise and Margo telling me to feel the baby's head. After touching her, I think I pushed one more time and she was out - born at 2:21 pm. They gave her to me to hold as she came out and then Tom cut the cord. Dr. Fischbein came in just in time to deliver the placenta. He missed the birth because she was born so quickly. I was able to breastfeed her before they took her to the nursery and we reconnected when Tom brought her back to the room.

So, I had a midwife delivery at Cedars. We got the best of both worlds, the warm and caring atmosphere of a home birth with the hospital technology immediately available to deal with any complications from preeclampsia. Margo said afterwards that it was because I was so relaxed that the labor went so quickly - according to the monitors my contractions were off the chart in terms of intensity. She added that she was amazed I could loosen up to such an extent in the environment of the hospital. I think I owe it all to my prenatal yoga classes (thanks Jessica!), our great birth class (thanks Julie and Anna) and the stellar labor support team. Also I have to say that finally surrendering to the birth I was given rather than holding on to what I thought I wanted also contributed to a very fulfilling experience.

Thanks again for everything.

Karen Mack