March 5, 2023

Birth By (LED) Candlelight & Flashlight

There is so much to say about the birth of our son Hugo. For some context, I wrote here about my desire for an unmedicated birth and here about how I trained for it.

The day before my labor starts, we do some mellow climbing at White Rock. I feel more tired than usual after and think that my third trimester energy is transitioning to the fatigue of pre-labor. In the evening I experience increased pelvic pressure, though I feel like GJ (our nickname for baby before he arrived, short for Gabriel Junior) has been lying low for awhile. But nothing feels drastically different, just part of the process of moving forward towards our due date in less than a week. Still, I do the laundry in slight anticipation. That evening G humors me by watching the Baby Sitters Club TV series with me, and he’s very touched by the episode about Stacey’s diabetes. I go to bed after my usual pre-labor routine, feeling grateful for a day on rocks and a cozy night with G.  

Around 1 AM, I’m woken by cramping low in my pelvis. I’ve been having a ton of Braxton-Hicks, but this is different in where it is and in that it is actually painful. I then need to have a bowel movement, which never happens to me in the middle of the night. Then I have a couple more in the next half hour, and recall that this can be a sign of labor from increased pressure. But like with everything in labor, there’s a spectrum and it can mean it could be hours or it could be days. I go back to bed, feeling like if I’m in early labor I should try to sleep through the initial contractions, as I’d read that most often they start out mild. But these quickly require me to breathe through them, and I can’t sleep--partly due to the pain and partly because I’m having anxiety about not having finished prepping my work for while I’ll be away.    

So I get out of bed and start clearing my work inboxes--the labs, patient messages, and chart notes. I finish preparing notes for patients who need follow-up so my colleagues can provide coverage. At the same time, I’m not sure if this is even real labor. My contractions feel like severe period cramps, but I don’t have any back pain or a sensation of a “wave” like pain moving from my uterus, like I’d read about. I do notice they are already fairly frequent and regular, 5-6 minutes apart, which is also different from what I’d read about them starting out as much more spaced out.

I still can’t sleep through the contractions, so I fold laundry, clean the kitchen, finish reading a book, and look over our list of right-before-labor to-do’s. Finally around 5 AM I’m tired enough that I’m able to sleep for the minutes between the contractions, which at that point are further apart, like 10-15 minutes. 

I wait until 6:30 AM to wake up G. He asks if I’m having contractions, having sensed my movements half-awake in the middle of the night. I tell him that I think so. We stay close in bed for a while, contemplating this possibility. G makes the preparations we’ve planned. He gathers our hospital bag, makes bagel sandwiches in addition to the snacks we’ve packed for the hospital, puts a frozen meal we’ve prepared into the fridge so we can eat real food post-delivery, gets all the supplies in the car (my pregnancy pillow, yoga mat, our own blankets). I put our towels and kitchen linens in the laundry, and we water the plants. G makes plans for cat care and calls his mom. 

We go to our favorite breakfast place, Opuntia, when it opens at 9 AM. As we walk there, a couple with a 20 month old boy walks alongside us and he calls out “Baby!” while pointing to us. We all laugh, impressed that he can recognize my pregnancy, the dad remarking that “usually you’re not supposed to assume…” The mom asks when I’m due, and I say, “I think maybe I’m in labor so maybe your baby is right and it’s today?” We all muse at this, as I’m still wondering if this is for real. 

I have huevos rancheros and a chocolate croissant, and enjoy this private time with G in a familiar place. Now my contractions are regularly four minutes apart, though still lasting less than a minute. I’m needing to breathe through each one but they are manageable (when G asks about the pain, I tell him they’re not as bad as Charley horses). G calls his dad and step-mom, who are worried that we’re eating at a restaurant and not at the hospital. We’ve talked about walking around after breakfast, but given the frequency of the contractions, I tell G I’d prefer to go home.

At home, I encourage G to nap a bit, and while he tries I listen to music and dance around to get my body moving. He gets up after 20 minutes and takes out our sheet of pain coping strategies. I use the birthing ball to do exercises I’d learned to help labor go faster and easier. Assisted squats and side lunges really seem to trigger the contractions. It’s windy and hailing outside. G times my contractions, and asks if I want counterpressure or massage. I tell him my back doesn’t really hurt, so we don’t use any of those techniques, but light touch over my scalp and shoulders help. Along with breathing this is enough to get me through.

Since I’m hoping to go epidural-free, I’ve imagined that I will want to labor at home as long as I can, as I’d read that the transition from home to hospital can stall labor. G lets me take my time, and we joke that it’s like our approaches to the airport -- he always likes to be there earlier than me. Despite their intensity, my contractions never last a full minute and sometimes are less frequent, so I’m just not sure that I’m in active labor yet. But I also know that timing isn’t always reliable as an indication, and we both agree that it’d be nice to just settle into the hospital rather than wondering when we should go.

On the way to the hospital, which is just a few minutes from home, I joke that maybe I’m not even 1 cm dilated (I generally cope with anxiety by having low expectations). We arrive at the hospital around 1 PM, twelve hours after my contractions started. The emergency department is empty, and a labor and delivery nurse triages me right away. I didn’t realize then that she would be our nurse for my delivery, and how grateful I’d later be for our connection, but immediately feel welcomed by her warmth. She determines that I’m 5 cm dilated, says the midwife will be arriving shortly, and prepares my room. G and I look at each other, and I say, “I guess it’s real!” 

Going into childbirth, there are a couple uncertainties that linger for me. They’re outside my control, so I work to let them fade to the background. One is not having a doula. G asks me early on if I wanted one, and in my minimalist way, I’m not sure that I do. Then when I consider it more and think it would be a good idea, it’s a little late to find one. So we focus energy on maximizing the support I do have, in G. It’s important to me that he be an integral part of the process, so not having a doula makes this inevitable. He spends a lot of time learning about the kind of birth I wanted, and how to support me with affirmations, meditative practices, positions and exercises, and massage techniques. I know that he’ll be great, but I think we are both a little anxious given our lack of expertise.  

It turns out that having G as my pseudo doula is one of the best parts of the experience. It feels so intimate to labor with just the two of us. After laboring on my own in the middle of the night, G is with me for the next 12+ hours that it takes to deliver Hugo. Except for the last couple hours of labor after I’m completely dilated when our midwife and nurse are with us, it is just me, Gabriel and our child. It feels so special.

For all the labor up until pushing, I never feel like I need anything or anyone else to get through the sensations. We work together to figure out the best ways for him to help me through contractions, which change over the course of labor. He is great at adapting to my needs as the pain becomes more severe (for much of the contractions he uses a hypnobirth technique of counting down from ten to one, and when he continues that for the pushing phase I tell him, “No more counting, just tell me to push!” and he switches modes without blinking). As he has throughout pregnancy, he tells me several times that I am beautiful, in ways that make me know that this isn’t a strategic affirmation but how he naturally feels in the moment. During a process that can make you feel really messy, this is so helpful to me in feeling the power and beauty of what we are doing. I know that this experience gives him a sense of being a truly big part of bringing Hugo into this world. 

The other uncertainty I have is what my medical team would be like. So much of what I’ve read has emphasized having the right support team. In Santa Fe there aren’t many options to choose from so I didn’t feel like I did this in any deliberate way. For my OB care I see the midwife team, which means that I see a half dozen different ones over the course of pregnancy. I don’t know which one will be there for my birth, and while they are all kind, I don’t know any one of them that well. We are extremely fortunate to have an incredible midwife and nurse supporting us, and I don’t think I realize until it happens how important they are to our experience. 

We give them our birth plan, and we’ve prepared for advocating for ourselves if needed, as I’ve read about how medical staff don’t necessarily read your plan. But our nurse reads and respects everything carefully, well beyond what I’d expected. We’re never offered an epidural or medications, which is an incredible boost to my confidence that I can do it. I feel like when people ask if I’m sure about my preferences, or let me know that there are alternatives, it amplifies my own self-doubt that always lingers for me in doing something difficult. At the same time I know that I can ask for changes to my plan and they will accommodate quickly and without judgment. 

More than this immediate acceptance, our nurse actively values our process. I can tell she genuinely appreciates what we are doing. She tells us how beautiful it is that we are breathing together and what a good team we make. At one point, G and I are swaying together (a technique we had kind of joked about during our pre-labor preparations but one that actually works really well). Our nurse walks in, and instead of feeling like an intrusion, she finds the moment so moving that I’m glad to have shared it with her.  

At shift change, she tells the staff coming on what a beautiful labor it has been so far, and keeps referencing it as “birth by candlelight and flashlight.” We use cheap LED candles from Wal-Mart to keep off the overhead lights, and in such a moving commitment to our birth plan that asks for dim lights, our midwife uses a flashlight to monitor my pushing rather than turning on the lights. It’s not even a preference I feel strongly about, but I feel the immense generosity of how carefully they follow what we wanted. LED candles and flashlights are not what I’d imagine as romantic or atmospheric, but it is the people who make the mood.

The midwife also contributes to this atmosphere of calm and trust by not checking my cervix regularly. This wasn’t part of our birth plan, but I appreciate it for the faith it shows they have in me to listen to my body. They check when I arrive, and then tell me they will check if I want, or when I feel a change in labor, but won’t do it as a matter of course. And so it is that the only other time they check is the last, when I’m completely dilated.

A couple hours after we are at the hospital, I switch from a relaxation breath to a more shallow breath used for the transition phase of labor. I’d read this is the most painful part, the time when people start considering an epidural, but to push past it because it means you are very close. It wasn’t that much more severe for me though, so I wasn’t sure if it meant anything. After it has been going on for awhile, G encourages me to use the hot tub to see if that will help the pain. While there, I notice much more pressure and I’m naturally starting to use the breath meant for pushing (something called the J-breath which helps you breathe into the lower part of your pelvis, similar to how people say to push like you’re having a bowel movement). This is when I ask to be checked, and the midwife tells me, “I don’t feel your cervix, because you’re complete.” 

I am so happy to have gotten to this point, in what feels like a manageable amount of time and effort. I’d read that transition is the hardest, and that pushing is generally easier for people, so I think that I’m almost there. Still, when they tell me that I’m almost there, I maintain my approach of low expectations by responding that I only hope so. 

Compared to the maternal nurturing of our nurse, our midwife has a more direct, no-nonsense way of caring for us, and that also works really well for us because I really trust that she is honest about what is happening and what will work best. It turns out that I’m not as prepared for the pushing part of labor, and her steady guidance is extremely helpful in getting me through the incredibly painful process. At one point, I have trouble finding a pain-free rest position and she not unkindly tells me that every position will be painful and to commit to one that will help me push. At the same time, she quickly implements anything I ask for (birthing stool, squat bar) and always reassures me they will work with whatever works for me (which at one point requires her to squat on the ground with the flashlight). 

Apparently I am in the minority of people who find pushing much harder than contractions. I’ve trained well to relax through contractions, but working with them to push is a whole other kind of mindset. Instead of distracting myself from the contractions, I’m supposed to coordinate with their peaks to push along with them, and I find this mind-blowingly painful. I try using the J breath but it doesn’t seem to push things along, and it doesn’t help with the pain. Our midwife places her hand where I should be pushing into, which helps me focus. The contractions are coming faster and stronger, and there’s very little time for me to rest in between. I start crying and wondering how I will be able to do this. 

The midwife is right and everything I do hurts. I’d thought I’d push while squatting or on all fours, using gravity, and definitely not on my back as is conventional. But I struggle to find a good position with squatting and with the stool, so the nurse suggests that I lie down and push my legs back. I tell her I think this isn’t a good position for me. She gently advises me to try it for just one contraction and then decide, and it ends up being the position in which I push Hugo out. 

I didn’t envision this stage being so primal. I’m screaming so hard with each push to get through the movement and the pain. The midwife, nurse and G all adopt the mantra I have to quickly come up for myself to continue pushing. To get through the excruciating pain I really have to feel like I’m getting further with each push, so I keep asking them if it’s working and if I’m doing anything. They keep reassuring me that I am, so in the brief periods between contractions I yell “I’m doing it! It’s working!” and they all say back to me “You’re doing it! It’s working!” After I start the mantra that I’m doing it, there’s a shift and I feel my labor is working better, but the pain is just as bad. During the contractions themselves, they all tell me to push, push, push and G keeps reassuring me that our baby is coming. At first I ask him if he’s lying to me, but then over time I hear the excitement in his voice as he can see the progression with each push. 

Finally, the midwife tells me to reach down to feel Hugo’s head, and on the next contraction I’m determined it will be my last, and all of the sudden my hands are on his body as I carry him up to me. G and I obviously burst into tears. All in all the pushing lasted for little over an hour but is the most vividly physical part of labor for me, and absolutely the most painful thing I’ve ever experienced, and I can’t believe that I did it and it worked. G takes photos, and in the first capture of Hugo he looks like he’s smiling.

Our nurse stays until the end of our delivery even though her shift ends before I’m done. She tells us there is no way she would miss it, and when it’s all over she thanks us for the experience and we both get teary. I think about all the effort G and I put into preparing for this, and how much that preparation helped and also how much was unpredictable and entirely new to us, and how this layered mix of experience is the best gift as a human.    

I’ve always been curious about pregnancy and childbirth as these singular, intense embodiments of the body’s power. This process has challenged me physically and mentally in a way that you just can’t recreate in any other form, and this birth experience has stretched me so far beyond what I’d hoped. I am so grateful for all it gives: a kind of intimacy with G that doesn’t exist in any of our other shared experiences; a deep connection to the women with such empathy and wisdom helping deliver Hugo; a confidence in my own power. Hugo carries all of this in his being, all of what brought him here and just a glimpse of what the world has to offer. I can’t wait to see what he does with it.

February 24, 2023


 As we get closer and closer to our due date, I find myself focusing on all the positive support we have going into this adventure. Most of all, I am so grateful to be going into labor with G as my partner. While obviously pregnancy most physically affects the childbearing partner, G has had to do a lot to support our family through this process. 

When one of my hypnobirthing tracks encourages me to visualize a place where I am completely comfortable and relaxed, I immediately think of lying next to G in bed. The image instantly brings to mind how completely committed he is to me. He always encourages me to wake him up if I can’t sleep from anxiety or discomfort. I rarely actually wake him up but sometimes he senses my awakeness and wakes up to rub my back or talk to me about whatever is keeping me up. He never gets annoyed or grumpy if he can’t go back to sleep and is tired in the morning. 

During all the mood swings of the last nine months, G has remained calm and gentle with me. His understanding quickly smooths the severity of my feelings and as someone who tends to stay sulking in moodiness, our relationship has really changed my emotional flexibility. It is hard to stay upset in the midst of being so nurtured.

While we have different approaches to life, my need for structure and planning opposed to his mellow go with the flow approach, he is so adaptable to my type A personality. Thank you for watching a million videos on breastfeeding and labor with me, showing me how to use my breast pump and sterilizing every hand me down bottle and bottle parts we’ve inherited (he has a different kind of OCD from me), listening on your own to podcasts about positive birth stories and the fourth trimester and parenting, and never judging the somewhat woo woo practices I’m using in preparation for labor. 

While I plan, G is far better at implementing concrete actions. I’m so thankful for how quickly and efficiently he has prepared our home for the baby, both in terms of things directly related to the baby and things that we wanted to have for ourselves before newborn chaos. And especially during the first trimester, he pretty much took over every household chore and even now when I am less tired he tells me to save my energy and never complains about doing all the cleanup. At one point when I got anxious about the prospect of constantly cleaning breast pump supplies he gently reassured me that he will be the one to clean them.

G has also been incredibly supportive of my climbing throughout pregnancy, trusting my judgment and encouraging whatever I feel I can sustain in terms of physical activity. Amidst not so positive feedback, I’m thankful to him for being proud of me for continuing to move. Similarly, he’s been the most encouraging of my desire for an unmedicated labor, and has learned a lot about what he can do to support me during that process.

So as this event looms ahead, with much possibility to induce fear and anxiety, I feel calm and assured that I have everything I need in a birth partner and I’m really excited to experience this together. 

February 23, 2023

Baby Showers Sans Gifts

 We’ve had several people say to us, “No gifts? What’s the point of a baby shower without gifts?” Because we wanted to get as many items second hand as possible we’ve asked our family and friends not to get us anything. Other than our cloth diapers and crib (which my brother insisted on gifting), we’ve been able to find most everything else used (some friends actually gathered a ton of free used items from Craigslist and FB in the Bay, and brought them to us in NM which was the kindest gesture in the world). It’s less a desire to conserve expense and more a desire to reduce consumption. But we know people like to give things, and it can be a bummer for them not to. Which is why we tried, unsuccessfully, not to have any showers--yet I ended up having five of various sizes and sorts. But I’m really happy to have had them, because I found how much more there is to be given at these gatherings than material items.

The first was a small get together with two of my friends living in Oakland, who met each other through me and have sons the same age. They gifted me hand-me-down clothes and consumables like tea and perineal balm, which was love enough for me, but the joy of the event was seeing their kids bumble around together. I love that my friends connected with one another, and it was so heartwarming to see the connection continuing through another generation.

Then my family surprised us with a family baby shower, kids abounding. I’ve loved seeing our nieces and nephews grow over the years, and seeing them anticipate the arrival of our own child made the process more real for me. The kids decorated a million onesies for their new cousin, and it made this sense of a new generation very visceral for me. I’m also happy to have reminders of our family connected in a material form to the baby, since they won’t be close by when he arrives.

Our Santa Fe friends organized an in person shower, and it was really touching to see our new community of friends come together. Leaving a community of friends we’d created over almost a decade in San Francisco, we weren’t sure how we’d form connections in Santa Fe. We’re so grateful to have organically found really wonderful people, uniquely bonded by how we deliberately moved to this unusual place. They stayed true to our desire not to have gifts, instead focused on what we always do together: eat, play games, converse and connect.

A small group of my college girlfriends did a zoom shower, where we spent time catching up with each other’s lives. Then they did an exercise where they posed a question to the group and had everyone answer. This was unexpectedly so meaningful for me. When asked what their hopes for the baby were, people mentioned hoping the baby would always feel loved and accepted through all the pressures and expectations placed on us through life. When asked what they hoped the baby would get from mama, they mentioned qualities that I perceive as my primary goals in life - thoughtfulness, openness, and sense of adventure. When asked what they hoped the baby would get from dad, they mentioned G’s love for me, his capacity to walk with me through anything, his ability to venture into uncertain spaces, and of course his handiness.  Then they talked about what they wished they’d known about pregnancy, labor, motherhood. They told me to always advocate for myself, prepare for peeing while laughing, and to ask for help - and told me each in turn that they were there for me any time. One of the things I love about friendship is having parallel experiences, and this felt like the epitome of why. I’m so grateful for how friendship enables you to be seen with love, and held with warmth, through difficult, joyful times.

The last was another virtual shower with my medical school friends, many of whom are already parents. In some ways, the phase of medical school felt like a kind of childhood and coming of age for me, so it’s still striking every time we catch up now to see how we’ve grown. It’s still surreal to me to see their babies and kids flitting in and out of the zoom screen. They gifted us a newborn photo shoot, which feels emblematic of how all these times and people are framed and treasured in my life. 

Sometimes it can seem like a dark world we’re bringing children into these days, but when it comes to our lives, I can’t be more grateful for how much community surrounds us. Connection is what I seek most in life, and I can’t wait for our child to develop those neurons and sensors and feelers that will grasp all the loving hands extended toward him.

February 20, 2023

Third Trimester Joy

 I’ve found it consistently interesting how during my pregnancy others will counter what I’m feeling in the moment with what they expect I should be feeling at this stage in pregnancy. Through the first six months, when I told people I wasn’t loving pregnancy, most would continue to pepper me with their excitement. Then, when I suddenly started loving pregnancy in my third trimester, many can’t seem to let go of their perception that this must be an uncomfortable phase for me. I found this exchange with a man, of all people, particularly amusing:

Him: “Are you so ready for that baby to come out?”

Me: “I’m actually really enjoying this phase right now.”

Him: “I can give you some core exercises…it’s such a great time, having to pee all the time and having that weight…”

Me: “Actually, I’ve been able to exercise quite a bit and I haven’t had those problems--”
Him: “And ahh they’re kicking all the time, keeping you awake, so fun…”

At this point I realize he’s not really listening to me and just wants to hear himself talk about his expertise about an experience he’s never had, so I don’t tell him that I’ve loved the strong, erratic movement of our baby. One of the benefits of daily meditation for me has been an increased capacity to deflect negative or disconcerting interactions. 

And also, I’m happy. After the difficulties of my first and second trimesters, the ease of this third trimester feels all the more miraculous. In the first trimester I felt like I had every symptom possible, and in this one I’ve been so lucky not to have many of the classic third trimester symptoms - no fatigue, leg swelling, heartburn, constipation, constant urination, or back pain.  I love growing into my body’s ability to carry weight, and making adjustments while still feeling strong. I love knowing the baby will be here soon, and that everything I’m doing is helping them along. 

February 17, 2023

Climbing at 38 Weeks

 During the first half of 2022, I felt really strong and fulfilled while climbing. After sending my first outdoor 12a sport climb in 2021, I set a goal to climb at least two more. Within the first few months of 2022, I was able to project and send three more 12a’s, and also send my first 5.9+ on trad. I started projecting more challenging 12a’s, ones that G and I worked on together which felt like a big step for me after being accustomed to him easily doing my projects; I started thinking about 10’s on trad that I could project, which had never felt like a reachable goal for me before. My mind and body welcomed this liberating opening of possibilities. Our May trip to the Enchanted Tower was memorable for me in how many long 11’s I could onsight, meaning I could complete them without stopping on the first try. I felt very in sync with rock, and felt like there were so many open areas to improve. 

In June, I got pregnant. I used to say that once I was able to climb 12a I’d feel okay taking a break from climbing to get pregnant. But it turns out the wonderfully addictive quality of climbing that pushes me to try harder doesn’t stop feeling intoxicating at a particular number. I was happy to have gotten pregnant, and I was sad about the disruption to my flow of climbing. 

As with many things, it has been most helpful to share with others in the same situation - pregnant climbers. From others, I received mostly unhelpful advice and encouragement. I have much respect for other athletes, especially as I’m pretty much not good at any other sport. But being told that someone was able to hike or work out or ski strenuously up until delivery, was not super relevant to my ability to climb throughout pregnancy. All activities require different muscles and movements, and I wouldn’t conflate what I know about climbing to someone else’s sport. I was also told by many that this was temporary, and that I would regain my strength postpartum. It’s hard to explain how high maintenance a sport climbing can be, and how nine months of pregnancy and an uncertain number of months of postpartum recovery can add up to a daunting prospect of regression. 

That being said, I have learned a lot during pregnancy about how to be a stronger climber, despite climbing easier than in my first year of climbing. In my third trimester, I feel stronger climbing easy than I did while trying hard in my first trimester. The power I feel in my body is so different than anything I’ve experienced before, and I know that childbirth is similarly going to be a uniquely powerful challenge. There is also so much more going on in my mind, and the practice of processing is such a big part of climbing. 

When I mentioned to G that last year’s winter climbing was a really great season for me, he responded that this year’s winter climbing was a great season for me too. And it’s true. I haven’t broken into any new grades, but I’ve carried something entirely new.

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