Alexa's Birth Story

It was Wednesday, 7 July 2010, 8:40 am. I was just waking up. I'd been up every one or two hours during the night, as was my routine at that point, but I was feeling pretty good overall. I didn't have any plans for the day. The day before, I'd had lunch with some friends and brought home the infant car seat that their daughter had outgrown. The next day, I had my first appointment with the midwife who is part of my OB group--I'd met with one of the doctors once, and we'd agreed that I was more of a "midwife type of person" than an "OB type of person." But I had no real plans for the day. Maybe do some laundry, try to figure out what still needed to be purchased for the baby, read the last chapter of my Hypnobabies home study course ... nothing major.

I got up and went to the bathroom--again; all those middle of the night wakenings were for bathroom breaks too. While sitting on the toilet, I felt something unexpected: mild cramps that felt a lot like menstrual cramps. I immediately became concerned. I knew that many women's contractions start out like that, and I was not ready. Alexa wasn't expected to arrive for another month; Jeff was still in Egypt; we didn't have half the supplies we would need for a new baby. But I wasn't too worried. After all, I was expecting Braxton Hicks contractions to start any day. I did say a quick prayer, though: "God please don't let that be real contractions. Just let me be constipated or something, please."

And God laughed.

Around 8:50 am, I was reaching for the doorknob to leave the bathroom and go find some breakfast. Suddenly I felt warm liquid running down my legs. I stared in disbelief at the full-length mirror on the bathroom door. My pajama pants were soaked. A small, rational part of my brain informed me that my water had broken and that I needed to call the doctor's office.  A large, irrational part of my brain informed me that I had urinated on myself and that I needed to change clothes. I went to the closet to get my other pair of pajama pants. Right after I put them on, I felt another gush of warm liquid running down my legs. The small, rational part of my brain informed me that I definitely needed to call the doctor now. The large, irrational part of my brain informed me that I had just dirtied my last pair of pajama pants, so I needed to do laundry, especially if there was any chance that I was going to the hospital that day.

I didn't listen to either part of my brain. I called my husband at work in Egypt, where it was around 4 pm. No one answered the phone. I called his mobile. No answer. I called the house. No answer. I called work again--still no answer. I lost count of how many times I called various numbers at which I thought Jeff may be reached. Finally, I called my doula, Carey, here in the States. No answer. This was getting old, and I was getting stressed. The small, rational part of my brain kept insisting that I call the doctor. The large, irrational part of my brain still believed that if I didn't believe it was happening, it wasn't really happening. I'm convinced that the small, rational part of my brain was quietly processing information and making plans while simultaneously encouraging the large, irrational part of my brain to remain in a state of disbelief--if I actually started to believe what was happening before I had a fully developed course of action in place, it would not have been pretty.

Finally, I called the doctor. It was around 9:30 am. The nurse told me to have someone drive me to their office. I told her that I'd come, but it would be a while--I hadn't had a shower, and I had to have my mom go to the store to get some pads. She said that they didn't mind that I hadn't had a shower, and I needed to come as soon as possible. I said I'd come but made no promises about when--I didn't want to end up at the hospital with ruptured membranes, no contractions, and hours in which I could be offered interventions that I didn't want. After that call, I called my mom at work. My opening statement went something like this: "Mom, just listen and don't freak out. I know you've got a lot of work to do today [she'd mentioned that the night before when she told me that she'd be going in early and maybe staying late], but I need you to leave work, go to Wal-Mart, buy me some pads, and come home." She sounded much calmer than I had anticipated when she said she was on her way. But before she got the phone hung up, I heard her calling her boss's name to tell him she was leaving, and there was a definite note of urgency that bordered on panic. Oh well.

I started going around the room, methodically grabbing things and throwing them on the bed to pack. I hadn't packed my hospital bags yet--there was no need to pack them for another week or so at least, right? Mom arrived about 2 minutes later. (It should be about a 5-minute drive home from her office.) When she asked what she could do, I had her pull up my hospital bag list on my laptop (I'd planned what to bring, although I had not yet purchased about half the items on the list) and start packing. I got in the shower. I felt relatively calm and determined not to rush. After all, I wasn't even feeling real contractions yet, so I still had several hours to go at least, maybe even a day. I took my time in the shower. Then I helped Mom finish packing my bags--one labor bag and one postpartum bag, which included the things I wanted for Alexa.

At some point in that process, Mom handed me her phone so I could talk to my sister. Lisa urged me to go straight to the hospital, reminding me about her experience with her firstborn. Her water had broken, she had called the doctor, and she left for the hospital. Halfway there, her contractions had started with a vengeance. By the time they got to the hospital and found that my niece had rotated from head-down to breech, they had to hurry to get the C-section prepped (no breech vaginal births for those docs). My stubborn streak showed itself, and I continued to move quickly but unhurriedly. I did start moving a little faster around 10:30, when I noticed that the contractions were getting stronger and coming more frequently, but I tried not to let Mom see what was happening. Every few minutes, I tried to reach Jeff--still no answer.

Finally, around 11 am, we left for the doctor's office. On the way, the contractions got stronger, closer, and more regular--at the start of the drive, they were coming every 10 minutes or so; by the end, it was every 5 minutes, but they still weren't too incredibly strong. The doctor's office is 45 minutes from Mom's house, with the hospital about halfway in between. Unbeknownst to me, Mom seriously considered going there instead of to the doctor, despite my clear wishes.

Meanwhile, I continued trying to call Jeff. Finally, his boss answered the work phone and put Jeff on the line. My first words to my husband: "I've been trying to call you but no one would answer the [expletive]* phone. My water broke two hours ago." I don't remember his words, but I could hear his voice shift from concerned husband mode to I-have-a-task-to-accomplish mode as he immediately accepted that our baby was coming, he wouldn't be there for the birth, and he needed to get there as soon as possible.

I also was able to get in touch with my doula, Carey. I apprised her of the situation and told her I'd call from the doctor's office. I still had some hope that my labor was progressing slowly enough that I'd be sent home instead of to the hospital.

We arrived at my doctor's office shortly before noon. I gave the receptionist my name, and she said "Oh, you're the one they've been waiting for. Go on back." From there, things get a bit blurry, as the contractions were powerful enough and frequent enough that I wasn't much aware of anything else. I know I was taken back to see the midwife, Suzan. I don't recall if I was weighed or if my blood pressure was checked. At some point, one of the nurses started to say something to me while I was having a contraction, and another nurse shushed her. I wanted nothing more than to lie down on my left side--the very position I had loathed for the last several months, since I preferred to sleep on my back but no longer could. The midwife walked in the room and confirmed immediately that I was indeed in labor. By that point I think I was already lying on the exam table, on my side, curled up and just trying, with limited success, to relax. Suzan had me roll onto my back so she could check me. I was 6.5 cm dilated and 90% effaced. I asked if the baby was breech; last I'd known, she was transverse. But she had rotated to a head-down position, so one worry was relieved. I called Jeff and then my doula with the news.

I have vague memories of Suzan saying something about calling transport for me. Apparently she wanted me to go to the hospital by ambulance. Then I heard her telling my mom that it would take them too long to get there; I needed to leave immediately. If I started feeling the need to push on the way, Mom was to pull over and call the paramedics. I don't think I was supposed to hear that last part. I was told that I had plenty of time and that I wouldn't even be 9 cm by the time I got to the hospital.

I'm very glad not to remember much of the drive to the hospital. I know Mom drove like a madwoman, with her hazard lights on, horn blaring, weaving in and out of traffic. Her phone kept ringing. She went to answer it once. I snapped at her, telling her not to touch the phone while driving that fast and under that much stress. I think she told me to answer it. I'm not sure, but I think I talked to my sister at some point before telling her that I was having a contraction and hanging up on her. Mom started to say something during a contraction at one point. I have no idea what she wanted to say--I interrupted her with a sharp "Stop talking!" Apparently childbirth makes me rude. Sorry, Mom. Sorry, Lisa.

As we got closer to the hospital, the contractions intensified. I wanted to lie down so badly I could hardly stand it. I pressed my feet against the floor, braced my hand against the roof, and stretched out. I considered reclining the seat, but that small, rational part of my brain took control and reminded me that lowering it as far as I wanted to made the seat belt ineffective, and with the way Mom was driving, the seat belt needed to be effective.

At the hospital, neither Mom nor I knew which entrance to use--I was scheduled for my hospital tour the following week. I ended up going in the wrong entrance, although it was in the right part of the hospital. As I stepped through the door, I didn't know where to go next. But it didn't matter; I couldn't walk anymore. I hit my knees, then went to all fours. Suddenly I saw feet--lots of feet. At least four pairs. People kept asking me questions. I answered the first one, which was "Did you fall?" I said "No, I'm having a baby!" The next person who asked a question while within reach of my hand received some papers shoved toward her instead of an answer--the midwife had given me papers to give to the admissions person at the hospital. Once the woman (no idea who she was; I don't think I ever saw anything but her feet) had the papers, the questions stopped and a wheelchair arrived. With the assistance of about three extra sets of hands, I got in the wheelchair. Then there was a blur of faces, walls, and elevator doors. According to the time on my admission bracelet, it was 12:48 pm.

I ended up in a room with a bed. I was out of the wheelchair and in the bed--again, lying on my left side--in what felt like milliseconds. After that I just let them do what they wanted. I ended up in a hospital gown. I saw my doula and my midwife come in; I'm not sure who came in first. Then my life became a blur of "Oh God!", "God, help me!", and "it hurts!" There were brief moments of what felt like sanity in between, but I'm not sure how sane I really was. I remember saying that I should have had a C-section--forget mere drugs, I wanted to skip straight to not pushing**--and telling my doula that I hadn't gone by the ATM to get the rest of the money I owed her. She laughed and said that was alright. But most of my "conversation," if you can call it that, consisted of curt demands: "Cold!" (translation: I want a blanket) and "Wash cloth!" (translation: I'm hot and I want that cool wash cloth on my forehead) were the main ones. Oh, and there was that great big "NO!!" when the midwife didn't hear me decline the first time and told me to give her my hand so I could feel the baby's head before she came out. I'm not sure why I was so adamant, but that simply was not happening.

Through it all, my doula was there. She placed a cool cloth on my forehead when I was hot, removed it when I tried to shake it off, put a blanket around my arms when I was cold. She reassured me that God would help me when that sincere prayer was all I could say. At one point, she asked if I could use my Hypnobabies light switch, to which I said "No, I never even read the last lesson!" She asked if I wanted to listen to one of the relaxation scripts. I informed her that they were on my iPod, which was in my labor bag, which was in the trunk of my mom's car.

It felt like I began pushing immediately. Then it felt like it took forever. Suzan kept saying that one more contraction would do it, but one more contraction came and went and the baby wasn't coming out. I found out later that Alexa's head slid partway out and then just stayed there for half an hour.

Eventually, finally, at 2:06 pm, I felt a huge, painful pressure, then a sudden release. With the release came a gush of liquid and the sensation of something solid sliding out of my body. I knew that the head had caused the pressure, and once it was out, everything else quickly followed. I did not immediately hear Alexa cry, although she cried within a few seconds. I saw her as they clamped and cut the cord--I started to protest that I wanted delayed clamping, but I subsided under the gentle pressure of my doula's hand on my arm. I knew that she was as pro-delayed clamping as you can get, so if she was silently urging me not to protest, there was something important and time-sensitive happening. Alexa was taken to the heat lamp across the room for a few minutes. Then she was in my arms for a few brief seconds before they took her away. I don't recall exactly what was said, but I knew she was being taken to the Neonatal Intensive Care Unit (NICU) for observation. Everyone was very reassuring, to the point that I didn't really get worried about her. I'd seen her, I knew she was breathing, and they said they just wanted to observe her and they may not even need to admit her. I found out later that she was having difficulty breathing, and because she'd come out face first, she had some bruising that made her look blue--it was easy to mistake the bruises for evidence of insufficient oxygen.

Then the real torture began. I shook uncontrollably from the adrenaline. I felt like I was freezing, and my whole body shook like you'd see in a cartoon, not like anything I'd ever experienced. My belly was massaged to make the placenta detach. The cord was yanked on to pull the placenta out. I was given a shot of pitocin to prevent hemorrhage--quickly enough that I didn't have time to decline it if I'd wanted to (I still was disoriented enough that I probably would have consented, especially since I wasn't able to breastfeed immediately to cause the uterus to contract). My second-degree tear was stitched up--and the anesthetic cream hadn't been applied to a large enough area; one stitch went in without anesthesia. I was so exhausted and out of it that my protests consisted solely of the occasional "Ow!" I was distracted by a nurse having me sign the consent forms giving them permission to do everything they'd already done--there hadn't been time before. I also learned then that I'd done the impossible--given birth in the hospital without so much as a hep-lock. Suzan had told the nurses not to bother with it; there wasn't time.

My doula informed me that I had family in the waiting room; should she make an announcement or let them come in? I asked her to wait until I'd talked to Jeff. I called him and gave him the news, then allowed my visitors in. My mother and my father-in-law were the first; then my father-in-law left and my brother came in. I don't remember the conversation or anything. At some point I became lucid enough to ask my doula about what exactly had happened with Alexa. At the time I understood what she said. Now I don't remember most of it.

I was in the delivery room for about an hour. Then the nurses brought a wheelchair for me. I was taken to the NICU, where I was able to see Alexa, although I couldn't hold her. One of the doctors came over and explained what was going on with her. She had been brought in for observation because of difficulty breathing. She was on oxygen and a few monitors. He wanted to start her on antibiotics because it was possible that she had an infection, but the blood work wouldn't show it for 48 hours. I gave permission for the antibiotics but declined the routine Vitamin K shot he wanted to give her. I was impressed that he respected my wishes without pressuring me.

After a too-brief visit with Alexa, I was taken to my recovery room. It was a strange, disconnected feeling: I no longer had the baby belly, I was in the hospital, I had just given birth. But I had no baby, at least not one for whom I had any routine care responsibilities or who was even within my sight. I was in the maternity ward with no baby. I actually got jealous when I heard the baby next door crying.

The rest of that day and most of the next brought a flurry of activity. I was seeing visitors, submitting to exams and checks, pumping breast milk, going down to the NICU to see Alexa whenever I could. I was also trying to figure out the State Department paperwork that needed to be done to get the ball rolling on Alexa's passport and medical clearance. Jeff called from various airports to report his progress. He arrived the following day around 7:30 pm, during the shift change at the NICU when even parents aren't allowed to visit. When the NICU re-opened at 8, we went down so he could meet his daughter. I'm glad I thought to have a camera available; I have a picture of when he first saw her. After some time with her, we went back to my room to get some sleep. That's when my body fell apart--it realized that with him there, I could relax some, and the pain began. It wasn't my stitches or perineum that hurt, though; it was my back, shoulders, and neck. The nurses gave me medicine that relieved the pain and let me sleep.

I was discharged from the hospital the next day. Jeff and I checked into a nearby hotel to stay near Alexa. We spent every moment we could with her. Finally, the following Tuesday, she was released. That's when I felt like I really became a mother, when we took full responsibility for her. That's when the birth was complete.


*I usually don't curse, but in this situation, it just seemed appropriate.

**My next birth also will be all-natural, despite my mid-birth desire for a C-section. The NICU nurses told me that had I had drugs, which would have been necessary for a C-section, Alexa's breathing problems could have been much more severe. Many babies whose mothers have epidurals are born sleepy; if they're already at risk, this exhaustion can interfere with their ability to transition to breathing air.

Introducing Alexa Ruth

I know it's been even longer than usual since my last post ... most of it is due to the usual: not much to say, too much going on, etc. But now I definitely have something to say, and even though there's still too much going on, I wanted to take a few moments to share.


Meet Alexa Ruth!*

In this post, I'll just give a few key details. I'll try to post her complete birth story in a few days, but no promises ... lots going on, you know.

Birthday: Wednesday, 7 July 2010, 2:06pm (almost exactly a month early)
Amount of time from first "I hope that wasn't a contraction!" to birth: 5 hours 16 minutes
Amount of time from Mom's arrival at hospital to birth: approximately 2 hours
Amount of time from birth to getting to meet Daddy: approximately 30 hours (first available flight and all that)
Weight at birth: 6 lb 6 oz
Length at birth: 18-3/4 inches**
Number of days in the Neonatal Intensive Care Unit (NICU): 6
Reason for being in the NICU: difficulty breathing
Date she came home: Tuesday, 13 July 2010



*Some of you may know that Jeff and I deliberately do not put pictures of ourselves, our family, our friends, or our colleagues on the blog for privacy reasons. However, we do acknowledge two important facts: (1) many of you will want to see Alexa and won't be able to unless we post a picture here, and (2) newborns change in appearance so quickly that pictures of them won't be a privacy concern after just a short time. So we decided to post this one picture of Alexa on the blog. This isn't a change in our policy regarding pictures on the blog; this is an exception to the rule.

**Oops, I originally posted her length as 15-3/4 inches. Thanks, Mom, for pointing out the mistake!

The Best and The Worst

I'm here! As I said in my last post, I'm now at my mom's house, where I'll be staying until a couple of months after the baby's birth. Things didn't go quite according to plan--when the last post posted, I was not somewhere over the Atlantic; I was still at the gate in Frankfurt--but eventually I made it. I don't think anyone is particularly interested in a play-by-play of the entire trip, so I'm just going to give you the best and the worst. I'll start with the worst so we can end on a good note.

The Worst

• I had to leave my husband and my cats behind.
• My 24-hour door-to-door trip turned into 31-1/2 hours.
• We were stuck at the gate in Frankfurt for 3 hours while they fixed the cabin air conditioner and tried to find the part to fix some other problem (I forget what it was) before eventually deciding that it would be okay for us to fly with the part broken; we'd just have to go a longer route. It added about 10 minutes to our flight time.
• I missed my connecting flight at Dulles, which was scheduled to take off at about the same time we ended up landing there. It was delayed 30 minutes, but that still wasn't enough time to clear customs and immigration and get to the gate.
• All the later flights to my destination airport were full. So were the later flights to the airport that's the same distance from my hometown in the opposite direction. (Our town is less than an hour from one tiny and one small airport, so we usually go with whichever one is cheaper at the time. It also allows for great flexibility in situations like this, unless the flights are all full.)
• I ended up taking a later flight to an airport that's 90 minutes from my mom's house.
• That flight was scheduled to leave approximately 5 hours after I arrived at Dulles. Due to a mechanical issue, it was delayed an hour.
• Throughout the entire day, a muscle in my gluteus maximus spasmed every time I put weight on it. Therefore, standing and walking was a slow and painful experience.
• The business class lounge at the Cairo airport was closed; there wasn't time in Frankfurt; and I was no longer business class in Washington. So quite possibly my only chance to experience a business class lounge has escaped me.
• I was still dealing with congestion, drainage, and general nastiness from my cold.
• My ankles currently are about the size of tennis balls, maybe slightly larger. They were twice as big early Tuesday morning when I arrived here.

The Best

• I managed not to cry, although it was difficult.
• My Tempur-pedic travel pillow went a long way toward making all the seats, in the airports and the planes, much more comfortable. Depending on the seat, I used it rolled up or flattened out behind my back every time I sat for more than just a few minutes.
• Business class in the Lufthansa flight between Cairo and Franfurt was nice. I was able to put my feet up, although there weren't independent controls for the footrest and the back, so I couldn't get my feet as high as I wanted without reclining too far for Alexa's safety. I was able to compensate by getting onto my side--the seat wasn't quite wide enough for it to be truly comfortable, thanks to the belly, but it was a lot better than economy or than sitting there without my feet up. I slept for most of the flight, so it was comfortable enough. Service was only marginally better than it would have been in economy, although Lufthansa's economy service is much better than any other airline's that I've experienced.
• Business class in the United flight between Frankfurt and Dulles was wonderful, even considering the extra 3 hours I spent there. The seats could recline all the way back like a bed, they could recline like a recliner, or I could adjust the back and the footrest independently. I only slept for a couple of hours, although the seat was comfortable enough to sleep longer--the sleep on the previous flight was enough that my stubborn body wasn't ready to sleep more yet. I could watch any of a few dozen movies or TV shows whenever I wanted, and I could pause, fast forward, and rewind them too. I had my choice of meals--I chose the filet mignon for the first and the turkey sandwich for the second. The first meal (the second was considered a snack) was three courses--appetizers (yes, that's plural), main course (choice of beef, chicken, or pasta), and dessert (an incredible chocolate mousse parfait-type concoction with strawberry sauce, or fruit ... guess which one I chose). The service was incredible. One of the flight attendants took one look at my belly and made me her personal project--I was never without water, I was told to use the first class lavatory rather than waiting in line for the business class one, I was given the option--repeatedly--to go to cooler areas of the plane before the air conditioner was fixed (it really wasn't even that hot), and I was generally hovered and fussed over. The other flight attendants also were incredibly attentive, but I think they provided that level of service to all the business class passengers. If anyone is traveling overseas on a United flight, the upgrade is totally worth it, if finances allow.
• I didn't have to overnight in Frankfurt, although that option was offered to me by the gate attendant, who came down to ask how I was doing. The only time that my personal flight attendant seemed confident that I was doing just fine, thank you very much, was when the gate attendant tried to take me off the plane and away from her. Suddenly I went from practically invalid status to perfectly okay. I got the feeling she didn't trust him to take good enough care of me.
• When the maintenance issue was discovered at Dulles, it was less than 10 minutes before they announced exactly what the problem was (I forget now, but they told us), that the plane could fly but required a longer runway on which to land, that our destination airport didn't have a functional runway long enough (the long one was being worked on), and that we therefore were swapping planes with another flight heading to an airport with a runway that the broken plane could use. No 3-hour decision-making process there!
• I didn't have to overnight in Dulles. I was able to make it here, although it was a very long day. I think it woud have been worse if I'd had to overnight somewhere, even though it would have allowed me to sleep sooner.
• I'm here safely.

So there you have it--the best and the worst. Since I've been here, I've pretty well been taking it easy. I'm trying to drink lots of water and keep my feet up to bring the swelling down. On the bright side, the swelling actually is about the same as it usually is for me after this trip--I expected it to be worse because of the pregnancy, but apparently it helped that I was able to have my feet up most of the time until I got to Dulles. At some point soon, I'll finish unpacking (I've unpacked my stuff but not Alexa's stuff), go through the boxes that have arrived (things we shipped and things that were shipped from our online registry), do some ironing (that I should have done in Cairo but just threw in the suitcase unironed instead), and make a list of things I need to buy. But for now, I think I'm going to sit here with my water and my mom's laptop (mine is having internet issues right now), keep my feet up, and catch up on reading the blogs I've missed in the last few days.

Going Home

If I've done the math right, I will be somewhere over the Atlantic Ocean as this blog posts. I'm going home to the United States for the summer. This will be the first time that I've left Jeff for any significant amount of time since we married--three weeks for job training used to count as significant, but not anymore, not with this separation looming over us. I have mixed feelings about going.

On the one hand, it will be good to be home. It will be good to spend time with my family, to see my niece and nephews who have all changed so much over the last year, to get to know my little nephew who was born just before we left and who was too little during our visit last year to remember me. It will be good to shop at familiar American stores, to eat at my favorite restaurants, to live again in a community that is heavily influenced by Christianity. To understand the language spoken around me. It especially will be good to know that I'm in the place where, if it's needed, my daughter can receive the best medical care in the world--I realized not too long ago that if she were to be born prematurely, on that very day, in America, my daughter would have a hard fight ahead of her, but she probably would win it; if she were born even now in Egypt, she probably would die. From that day forward, I've been ready to step on a plane.

But on the other hand ... I'm going to be away from my husband for over a month before he's able to come for the birth, unless something unexpected happens. I won't see my cats--don't laugh! they're my fur babies, sweet little souls who are part of my family!--for four months. There are other aspects of life in Egypt that I'll miss, but not so much that I can't bear it. But I hate the thought that my husband won't see my belly grow or feel the increasing strength of Alexa's kicks, that my cats won't understand why I'm suddenly gone, that I won't be here to take care of my family. Even after Alexa's birth, Jeff will be with us for such a short time before he has to come back without us, while we wait for her medical clearance and all the paperwork to get her added to our orders and get her passport and visa. We're all going to miss out during this separation: Jeff, me, Alexa, Isis, and Cleo.

It doesn't help that Jeff and I both have been sick this week. Jeff has something going on with his inner ear, so he's experiencing vertigo--he has medicine that's supposed to take the edge off the symptoms, but it isn't doing much good, and the doctor says that his body basically has to deal with the problem itself. I've been fighting off a cold and finally admitted defeat last night. On the positive side, we've had more time together, since Jeff hasn't been able to work much. On the negative side, we've both wanted to do nothing but sleep. I'm not even finished preparing the freezer meals I want to leave for him--I still have a casserole, a double batch of macaroni and cheese, and a total of four batches (two singles and a double) of meatloaf to make, although I've already made the lasagna and more batches of chili than I care to think about. I still have so much to do (cooking, ironing, getting stuff together from all over the apartment, then packing on Sunday) ... and all I want to do is go back to bed.

This is turning into a downer. I've always been that way--more likely to be down when I'm tired, which is definitely the case this week. Time to look on the bright side. Everything that has to get done will get done, and the rest of it is probably not as important as I'm making it. I will be away from Jeff and the cats for way too long, but I'll have all that time with my extended family--parents, brother, sister, niece and nephews, the in-laws; I'll even get to see a grandmother, cousin, and maybe an aunt or two. I'll be able to do the needed shopping in air conditioned stores, with air conditioned transportation to and from them. My baby will be born in an environment where, even if things don't go according to the plan we have for her, things are incredibly likely to turn out well. I'll be staying with my mother for the first six to eight weeks of Alexa's life, a time when I'm sure to need and want her help more than ever. While I'm home, I'll get to attend, even be a bridesmaid in, my brother's wedding (assuming we can figure out the correct dress size and get it in time--the wedding's just two months after my guess date and I have no idea what size I'll be then). And even if I am dealing with sinus issues while I fly on Monday, at least I'll be dealing with them from the comfort of a business class seat--my first time ever in business class; thank you to my hubby for upgrading me!--rather than from a small, uncomfortable economy class seat.

As they say, every cloud has a silver lining, and when I think about it, I realize that this one really is more lining than cloud. The cloud is a doozy for someone who's philosophically and emotionally opposed to leaving her husband (and not fond of the idea of leaving her cats either!), but there is a lot of lining. Now to just focus on that ...

Pregnancy Update

It's been a couple of weeks since I last posted anything here--sorry about that. I'd like to say it's because things have been busy, but ... it isn't. It's because I've been so tired that I really haven't been doing much to write about. But there has been a little going on with the pregnancy, so I decided to update you about that anyway.

At my regular prenatal appointment a week and a half ago, my nurse asked all the standard questions, including "Have you been experiencing any pain?" The short answer to that question this time was yes, although there was nothing that I thought was unusual or problematic. However, it's always safer to report it all and let the doctor decide, so that's what I did. I was right about the hip and thigh pain that I've been experiencing for over a month now--that's normal, and it's normal for it to be worse at night than during the day. But that isn't the only pain I've experienced. I've also experienced a little bit of abdominal pain, mostly when I'm wiggling around in bed at night trying to get comfortable or when I reach for something on the top shelf in my kitchen cabinets. This pain also struck me as normal--after all, my abdominal muscles are under a lot of strain right now, so it makes sense to me that any use or stretching of them may be enough to push them over the edge into soreness or even a momentary acute pain. My nurse practitioner largely agreed with me, but she looked a little doubtful. She said that pain like that was unusual, and unusual is a little concerning, so she wanted me to go see a local OB just to make sure everything was okay.

We made that trip last week. Long story short, everything is fine. There is no indication that anything at all is wrong, other than that I may be a little dehydrated. Both my nurse practitioner and the OB emphasized that, especially now that I've started having a few Braxton Hicks pressure waves, which can be magnified by dehydration. The OB, Dr. Nevine, also recommended that I start taking Cal-Mag, a calcium supplement, in addition to the prenatal vitamins that I was already taking. That made sense to me, as I regularly realize that I've gone all day without eating or drinking much of anything that has a lot of calcium in it--I try so hard to make sure that I drink enough water (which means that I often drink nothing but water, drink it constantly even when I'm not thirsty, and still end up with signs of dehydration) that I don't drink much milk.

Dr. Nevine also palpated my abdomen and informed me that Alexa currently is transverse. That means that she's lying across my abdomen; instead of being head up (fully breech) or head down (in the proper birthing position), her head is on one side and she's lying against my cervix. It isn't a problem at this point; most babies turn sometime between weeks 32 and 38, and I'm just now at week 31. She'll probably turn into the proper birthing position on her own, but if she doesn't, my OB in the States may be able to turn her manually later on. I actually was happy to hear that she's transverse, just because that's how I felt like she was laying. It would have been disconcerting to be told that she was up-and-down when I could have sworn that I felt her more side-to-side. But it will be nice when she gets herself into the birthing position--if she were to stay transverse until time for her birth, that would be an automatic cesarian section, which I'd much rather avoid.

In other pregnancy news, I've started doing a home study course for natural childbirth. It's a 5-week course with weekly reading and daily practice. I have not been good about doing the practice, which is why I'm not keeping to the 5-week schedule so well--I keep realizing that it's time to read another lesson but I haven't done my practicing. The course I'm using is Hypnobabies. I was very skeptical of it at first, and I'm still skeptical of some of its claims, but overall I think it will be a good method for me. I don't think of it as self-hypnosis (although it turns out that there actually is some research out there indicating that people can be trained to use self-hypnosis for effective pain relief) so much as I think of it as teaching myself not to be afraid of childbirth and to relax deeply.

The idea is that fear causes the release of adrenaline and increased muscle tension. Increased muscle tension can stall labor, as the uterine muscle fibers that have kept the cervix closed during pregnancy tense up and refuse to be drawn out of the way by the uterine muscle fibers that are trying to open the cervix for birth. Increased muscle tension causes the experience of pain as these muscles work against each other. So it's important for a woman not only to not be afraid, but to be able to relax deliberately in order to minimize muscle tension and allow her body to birth with as little resistance as possible, which should minimize the pain she experiences as well.

Some claim that using self-hypnosis effectively leads to completely pain-free birth, but I don't expect that--although the course is trying hard to get me to expect it. I am, however, working to teach myself to expect a birth that is calm and manageable--one during which I will be able to use the relaxation cues I've learned in order to help my body relax. That's what the daily practice is all about--they call it learning self-hypnosis; I call it conditioning my body to relax in the presence of certain cues. I don't do the practice as often as I should, though, because apparently my body already relaxes in the presence of those cues--I keep falling asleep! I don't expect that to be an issue during my birthing time, so I do need to teach myself to relax in the presence of those cues while not falling asleep.

Oh, and if you've noticed some oddities in my vocabulary, it isn't just you. Part of the Hypnobabies method for reducing fear involves changing the way we think about certain things by changing the words we use to describe them. "Contractions" become "pressure waves," an equally accurate descriptor without the associations with pain that most people have. "Labor" becomes "my birthing time," again because so many associate labor with pain. I forget the other vocabulary changes that I'm supposed to be making, although there is one that may or may not be a Hypnobabies thing, but I've read it from several midwives and doulas: the word "delivery" is a little demeaning to mothers as it currently is used with regard to childbirth.

"Who will deliver your baby?" That makes it sound like the doctor is doing all the work--and making all the decisions--and the mom is just along for the ride. Midwives and doulas tend to talk instead about a medical professional attending the birth or catching the baby (although sometimes, depending on parental preferences, the doctor attends and the father catches), and the mother is the one who is birthing her baby. This change in terminology linguistically gives control to the mother, rather than to the birth attendant, at least to the extent that anyone can control birth. I like this terminology better than the traditional "delivery" terminology. After all, do I really want to use the same word for childbirth that I use when the pizza shows up at my door?

I think that's it for the pregnancy updates, other than one kind of amusing story. Alexa had been kicking me fairly regularly, although not all the time by any means. Then suddenly she stopped kicking me more than a couple of times a day. I started to get worried and mentioned it to Jeff. Within an hour, Alexa was kicking me constantly--four or more times in the first 15 or 20 minutes. Now it may be that frequently sometimes, less at other times, and none at all if I'm moving around a lot (probably rocking her to sleep), but it never gets to the point anymore where I even consider worrying before she goes into a frenzy of movement. It's almost as if she understood me tell Jeff that I was worried--I know she hears everything I say now, although understanding is unlikely--and she's determined not to worry me again.

Okay, that's really it. Hopefully it won't be two weeks again before I post something, but no guarantees. Right now my time is being spent sleeping, chasing Cleo away from the speakers (she's taken to licking them), and getting ready to head back to the States before too long. Speaking of those speakers ... gotta go!

Window Into the Womb

Modern technology is truly amazing. I don't often take the time to appreciate it, but sometimes I'm hit with the realization of just how awesome modern technology is--the ability to see and hear events that are occurring on the other side of the world, or right in front of us but so small that our eyes can't discern them; the ability to record and play back images of all kinds; even the ability to cool an entire residence to a comfortable temperature when it feels like a furnace outside (an ability for which I am becoming increasingly grateful as summer approaches!).

I am in even greater awe of the intricacy and majesty of God's creations for which He did not use human minds and hands as His tools--rugged mountains, beautiful meadows, delicately balanced ecosystems.

And then there are those times when modern technology and God's creation intersect. The ingenuity of man--enabled by God--allows us to see a side of God's creation that wasn't possible a century ago, a decade ago, or in some cases, a year ago. Those times truly fill me with wonder.

The most striking examples of those times recently have occurred as I'm lying in an exam room looking at a large screen mounted on the wall opposite me--staring in awe at my daughter as she rests, squirms, and hiccups inside me.

During this pregnancy, Jeff and I have had an opportunity that I doubt we'll have with any future pregnancies--the opportunity to watch as our daughter grows and matures before her birth. Most of these ultrasounds were obtained for less than desirable reasons, as you'll read, but the result is spectacular. So join me now as I offer you a glimpse through the window into the womb ...

The picture above was taken on 12 December 2009, when I was around six weeks along (around four weeks once you realize that the first two weeks of pregnancy are before ovulation even occurs!). We had an early ultrasound because of the cramping and bleeding that I was experiencing, which raised fears of an ectopic pregnancy. The purpose of this ultrasound wasn't actually to see the baby--that was impossible at this point--but to see the gestational sac and determine where it had implanted. The gestational sac is labeled on the above image as "GS," and as you can see, it was located within the uterus, much to our relief.

This next picture was taken on 20 December 2009, at almost 8 weeks. Because of my symptoms, my medical providers wanted to see evidence that the baby was still alive before they began any routine prenatal care. During this ultrasound, we saw the baby--I think they called her an embryo at that point--and the characteristic flutter that indicates the beating of a developing heart. The baby is the light spot inside the black area, with the two plus signs indicating her length. Although this ultrasound was just over one week later than the first, that one week plus the benefits of more sensitive equipment enabled us to go from "no baby" to "baby," albeit "tiny tiny baby." And there is no way I can describe the joy and relief of seeing the rhythmic flutter that showed that our baby was alive.

This picture was taken on 24 January 2010, at almost 13 weeks. We had this ultrasound because we wanted nucal translucency screening. This early screening gives a good indication of several possible problems with the baby--we knew that we would have this child even if she had problems, but we also knew that if that were the case, we would need time to prepare ourselves for the arrival of a special needs baby. So we opted for the screening. The opportunity for another ultrasound was a bonus! It was during this ultrasound that we first heard Alexa's heart beat and saw her move. You can see in the picture above that she definitely looks more baby-like here, with a recognizable head and body. We also saw her little arms and legs waving as she maneuvered--her high activity level during this ultrasound had me comparing her to a jumping bean.

For this next one, I just had to show you two pictures. These were taken on 30 January 2010, at almost 14 weeks. We discovered after having the previous ultrasound taken that the hospital where we had been referred for that couldn't actually do the nucal translucency screening. They did the ultrasound but they didn't draw the blood or presumably have the connections to send the blood for testing. So we went to a different clinic, repeated the ultrasound, and had the blood drawn and shipped to the UK--or maybe it was Germany; I don't remember--for testing. The results eventually came back that there was little likelihood that the baby had any of the disorders that this test detects, and we were able to see our daughter in 3D for the first time. These are my two favorite pictures. The top one shows Alexa's big head, her face, and her little body, all facing left. I like how she appears to be praying. The bottom one--my all-time favorite--shows Alexa facing us. I'm not sure if the structure on the left is the placenta or what, but I love how it appears to cradle her as she rests comfortably against it.

I just had to show you two from this one as well. These sonograms were taken on 17 March 2010, around 20 weeks. This is the ultrasound that most people get, in which they find out the baby's gender. Our daughter was being modest that day. The doctor told us that he was "almost certain" that she was a girl, but his voice and body language was a little less confident than I would have found assuring. She wouldn't show us "the goods" that day, but she did let us get a couple of pictures of her face. In the top picture, you can make out her eyes, nose, and mouth as she lies on her back. You also can see her arms and legs, but she has a leg or foot strategically placed. The bottom picture had Jeff making cracks about Skeletor for a while. I admit it--I didn't get offended and even joined in the Skeletor comments some; it's an apt description of how her face appears in that picture!

Okay, I admit it--this picture also was taken on 17 March. We had our last ultrasound on 5 May 2010, just last week, at around 27 weeks. There was no medical reason for this ultrasound. We wanted confirmation on the gender, and when the doctor suggested another ultrasound, we saw no reason to decline. We also were hoping for a nice view of Alexa's face, since it should have a little more fat on it now and look more like a baby than a skeleton. However, she absolutely did not cooperate with that. The picture above shows a side view of the position that she stayed in pretty much the whole time. Her legs are up, in a pike position, so that her legs and feet cover her face. We can't even get a side view of her face because her arms were blocking it. During this most recent ultrasound, we didn't even get this view. We got the view that showed us her backside and the backs of her legs, hiding her face. I don't feel comfortable posting that picture online, because her backside is clearly discernible, and even though she is still in the womb, a lady is entitled to her modesty. She did shift position just enough for the doctor to say that she is definitely a girl--either that or he's "imagining things," in his words. He seemed confident enough this time to reassure me that all of our cute baby girl clothes will be put to good use. (Although I did wake up two mornings later from a dream in which our little girl turned out to be a boy who had to go nameless for several days because we hadn't picked out a boy's name.)

So there you have it--a sampling of the glimpses we've been given of Alexa's development so far. I don't think we'll have any more ultrasounds, unless something unexpected happens, so these will be the last pictures of her until her birth. It looks like the curtains have closed on the window, to take the analogy too far :) But I always will be grateful that during this, our first pregnancy, we were able to watch as our baby developed from a tiny bean-shaped embryo into a full-fledged baby.

Surprise!!

Last Thursday evening, Jeff and I attended an end-of-the-year potluck supper for our life group. We knew it would be fun--life group get-togethers always are--but we had no idea just how fun it would turn out to be.

It started out pretty much as expected. We arrived, we chatted, we laughed, and once everyone had arrived, we ate. While we ate, we chatted and laughed some more. After dinner, I was not surprised that those who finished first took their own dishes to the kitchen and then returned for the dishes of those who finished later. As one of the last to finish (I was talking too much), I was mildly surprised that two different people almost took my plate before I had finished. Strange, but I chalked it up to overeagerness to be helpful. It turns out that I should have chalked it up to a determination to keep me out of the kitchen!

Jeff finished even later than I did (he had seconds) and made it to the kitchen without being intercepted. I found out later that after he was already in the kitchen, across the room from the door, placing his dishes by the sink, he noticed that the two or three ladies who were in there at the time were looking at him in horror. At the same time, he noticed the cakes on the counter. He quickly whipped his head around in the other direction and said something along the lines of, "I didn't see anything!" He said later that he was surprised that he didn't turn from the sink to see the ladies lined up in front of the counter; they said later that they were frozen in shock and couldn't think quickly enough what to do.

Not too long after that, our hostess stood up to make a short speech. In it, she revealed that our life group had been talking about us behind our backs--planning a surprise baby shower! Then the games began. First up was a "descrambling" game. The group was divided into two teams, each of which was shown a scrambled word at the same time. The first team to descramble the word got a point. The words all were pregnancy- or baby-related, like "high chair" or "diapers." My team won by a huge margin.

Then there were races. For one, a couple from each team had to put a cloth diaper on a baby doll--using only one hand each. They were judged both on time and on how well the diaper was on. Other than banging the doll's head against the table--which both teams did at some point--both teams did well. There also was the "Who can drink a bottle of juice fastest?" race (we forgot to specify that it was against the rules to untwist the cap and guzzle it, so that's what the winner eventually did) and the hanging baby clothes race, in which a representative of each team had to multitask by simultaneously holding the baby, hanging baby clothes on a clothes line, and telling a story into a mobile phone. That one was funny because of the stories people came up with and the poor little baby doll who ended up with her face in a man's armpit while he held her in a basket.

After that, it was time for gifts. Wow, what a haul!

I don't know if you can see everything clearly in the picture, so let me tell you what's in there: We have three stuffed animals, massage oil (a gift for Jeff that I'm going to appreciate greatly!), a onesie/skirt set, a short set, a hooded winter suit with cool foldover arms and legs, and more assorted onesies and sleepers. We also have a wonderful variety of bibs, diaper covers, wash/burp cloths, a navel protector, and onesies that were embroidered just for us by one of our friends. And the circle pattern that you see peeping through in the middle is a tiny bit of the nursing cover that will be so incredibly useful as I learn to nurse modestly in public (think 14+ hours in airplanes and airports on the trip to Cairo). Oh, and I know you probably can't see this in the picture: there's also a bouncy seat. It's up at the top, at the corner of the "Drool is Cool" bib and the nursing cover. Okay, so it's just a picture in the picture, but the APO mail system has been slow lately, so the real thing didn't quite make it here in time for the shower. But from the picture, I think Alexa is going to enjoy it. And I like the looks of it--it has safari-type animals on it, sort of an unofficial, accidental theme in the bedding and such that we've picked out. (We didn't pick a whole matching set, just some separate sheets, blankets, and a mobile, but it definitely is turning out to be a safari theme.)

We have great friends, don't we?

After the gifts, we had a time of prayer. Our group prayed for us, for Alexa, and for the two couples in our group who will be leaving Cairo permanently this summer. That part was bittersweet--life as an expat has many more good-byes than life back in the States had. But at the same time, we would never have met all these wonderful people had we stayed at home, and the joy of the relationships definitely outweighs the sadness of the good-byes. It's even possible that we'll see one of the couples again.

After this more serious time, we got back to the lighthearted bits--it was time for cake. Two of them, to be precise. And they both tasted as wonderful as they look. You can't really tell from the pictures how large they were--we ended up taking home half of the chocolate one, at the insistence of the person who brought it. Only about 25% of the white one was eaten that night--it was huge--and the rest was divvied up among all the guests. We took home a paper-plateful of it, too. Both remained tasty over the next several days.

After cake, everyone started winding down. It was getting late; I wasn't the only one whose eyelids started drifting downward. After the other guests had left, our host and hostess kindly walked with Jeff and me back to our place--we live maybe 2 blocks from them--to help us carry our cake, presents, and dishes.

It was a good night. The potluck part was fun; the shower was hilarious. And most importantly, it was a time of great fellowship with great friends.

Cute Little Things

Not too long ago, Jeff spent two weeks back in the Washington, DC, area for work. His hotel was in the same area where we lived before we moved to Egypt--in fact, it was the same hotel in which we stayed for a few days after the movers took our stuff and before our scheduled departure. Jeff, therefore, was able to spend evenings and 3 weekend days (he arrived on a Saturday and left two Fridays later) with friends; he even attended our home church for the first time in almost two years. And even better (from my perspective, though not from his), he was able to spend a full weekend visiting Babies'R'Us, Target, and other brick-and-mortar stores to actually lay eyes--and hands!--on some of the things we've been looking at online and considering for Alexa. Thanks to his trip, we were able to decide on the glider we want for the nursery, and he was able to give me guidelines within which I can pick out any crib, changing table, and dresser I want once I go back this summer. He also made a decision about the baby carrier that we'll purchase for his use (I had already chosen mine--turns out he'll get the same kind, or we may even share) and the new digital camera we'll use to record those cute little moments of Alexa's life. It was a good, productive time, in addition to fun for him--watching March Madness live, eating at his favorite restaurants, seeing friends, and in particular, spending lots of time with his "bestest buddy" from college (who again earned his "bestest buddy" status by accompanying Jeff on the baby shopping expedition).

But Jeff did not content himself with doing the bare minimum that I had requested for Alexa. He dragged his buddy not only to the furniture department, but to the clothing department. Unbeknownst to me, he was on a mission to show me in a tangible way that he's excited about our coming daughter and that he wants to be involved in her life and in the decisions that we have yet to make before her arrival. This is what he came back with:

I'm not sure if you can read it or not, but the onesie says "Daddy loves me." I think that says it all, doesn't it?

Jeff wasn't the only one thinking of our little Alexa while he was home. Another good friend--friends, actually, a husband and wife couple--sent a gift back with Jeff. When we opened it after his return home, we found these adorable little items:

Again, I'm not sure how well the details will show up in the picture. The onesie in the middle (which does have sleeves; they're just folded back so you can see the other onesies too) has a teddy bear and a duck on it, and the one on the right has a giraffe. The left one has a pattern of teddy bears, giraffes, ducks, and sheep. And of course, the sleeper has frogs :)

I've also purchased just a couple of things for Alexa here in Egypt. At a charity bazaar, I bought a hooded towel and a board book that I remember fondly from my own childhood:

And then there are all the wonderful gifts that we received at a surprise baby shower a couple of nights ago--but I think I'll hold off on sharing those. I may write a post about the shower itself, so if I do, I'll share pictures then.

I think it may be a good thing that I'm not in the States right now. Baby items are just such cute little things--in the States, it's entirely too easy to go to the mall or to Target or to [insert your favorite store] and spend entirely too much money on them. Here, I'm sure that there are stores that have the same cute little things, but I've had no reason to find them before now, and I'm doing remarkably well at resisting the impulse. It's allowing us to save the money we'll need for the larger baby purchases I'll make this summer ... and maybe have enough left over to buy some more cute little things too :)

What's In a Name?

What's in a name? That which we call a rose

By any other name would smell as sweet.

                                       -- William Shakespeare

It is true that the name of a thing doesn't change the essence of the thing. A rose really would smell just the same whether it were called a rose, a cloud, a lamp, or a grave. The essence of the rose would not differ just because of its name. In fact, the reason why most of us probably consider the word rose to be pleasant is because of the thing that it names--rather than the name affecting our perception of the thing, the thing affects our perception of the name. We probably would not have such a positive attitude toward the word rose if it described, not a fragrant flower, but a putrid body odor.

The same thing holds true with human names. There are names that I never particularly liked, until I met some wonderful person who happened to have that name, and now I have a more favorable opinion of the name itself. There are names that I used to love, until I met some arrogant or cruel person who happened to have that name, and now I dislike the name itself. But to some degree, the opposite also holds true with human names. The names that we give sometimes seem to affect the character or personality of the child who is named. Of course, it may just be that certain types of parents give certain types of names and also engage in certain parenting behaviors that tend to result in certain types of children--a mother who names her child "Elizabeth" or "Matthew" will probably raise that child in a much more traditional way than a mother who names her child "Apple" or "Thor." Human names also can affect the way people view the person who carries the name--we tend to have a stereotype of "Martha" that is very different from our stereotype of "Delilah."

Given names are not the most important attribute of a person, but they are important, for the reasons stated above. Naming a child is one of the great privileges--and great responsibilities--of parenthood. It can be a difficult decision, but it's also one of the more fun tasks, provided that Mom and Dad both go into it with a positive and flexible attitude.

Yes, Jeff and I have been discussing names for our preborn daughter.

Yes, we have come to a decision. (No, we have not yet chosen a backup boy's name, just in case the doctor's "pretty certain" turns out not to be certain enough. We will choose one, but we haven't done it yet.)

Yes, we're announcing that name today.

No, not quite yet--you'll have to keep reading if you want to know :)

The first bit of the name that we decided on actually was the middle name. Jeff mentioned long ago--before we even married--that he would love to name his firstborn daughter after his paternal grandmother. He used to go visit his grandparents on their farm for the summer when he was a child, and he has wonderful memories of the time he spent there. Later, his grandmother moved into an assisted living facility near his father's home, and Jeff visited her as much as he was able. She died a year or so before we married, and it was a very difficult time for Jeff. So when he said that he would like to name his daughter after her, it didn't occur to me to refuse. However, I did negotiate with him--I asked if he would accept his grandmother's name as his daughter's middle name rather than as her first name. I freely admit that my preference was due to a superficial--but important to me--factor. His grandmother's name starts with the letter R. When I was a child, I had to attend speech therapy because my Rs sounded like Ws. I speak more clearly now, but there have been moments throughout my life when the R sound just wouldn't come out correctly, and I was teased unmercifully by a few schoolmates. I often feel slightly self-conscious when saying words beginning with R, so you can imagine my chagrin at the thought of going through the rest of my life with an R-named daughter! Luckily, Jeff was fine with the request, even before I explained why I made it.

Because we already had the middle name picked out, all that was left to us recently was to choose the first name. It was important to me that the name we chose be pretty and meaningful. I also would like for it not to be too common, but all of my favorites were more common than I prefer, so I focused instead on the meaning and on how it sounds with the middle name we chose and with our last name. I love the idea that names' meanings could influence the child's character, and I greatly appreciate the meaning of the middle name we chose: it means friend.

I considered several meaningful first names that sounded nice with the middle and last names our daughter will have. Jeff considered a few. I got stuck on one of the first ones that I considered--a name of Greek origin that means defender. I love the idea of my daughter being a defender. A defender of truth, of justice, of any younger siblings we may eventually give her. And I like how it combines with her middle name: defender-friend. A defender of her friends, a friend of those who defend. Someone strong and principled enough to be a defender, and caring and personable enough to be a friend. In my mind, it was perfect.

Eventually, Jeff agreed with me. So we have a name. Would you like to hear it?

Alexa Ruth.

Our daughter, the defender-friend. I can't wait to meet her.

Dreams

I hate dreams.

Oh, not the inspirational "I have a dream" goal-and-aspiration kind of dreams--I'm a big fan of those. No, the ones I despise are the ones that come when you sleep, when you're most vulnerable and defenseless. I've hated those as long as I can remember.

I have good reason, too: They've never been kind to me. As a child, I would wake with night terrors--those middle of the night awakenings that are filled with unexplainable fear, the remnant of nightmares that you don't remember even as you wake up. Sometimes I would remember the gist of the nightmare (it had "something" to do with vampires, or with demons, or with evil people trying to hurt my little brother--who actually was littler than me at the time--and only I was there to protect him; but I had no specifics, just the general awareness of who the bad guys had been). On very rare occasions I would remember more details, at least for a few minutes, until I was fully awake. Most often I didn't remember anything at all about the dream. Once my father told me that it would help if I talked about my nightmares, but I was ashamed to admit that I was still so terrified and didn't even remember what I was afraid of, so I made up a nightmare to tell him. I developed my own little mantra-like prayer that I would repeat over and over every night until I fell asleep--and every time I awoke in the night. "Jesus, help me. Let me fall asleep quickly and sleep all night. Don't let me have any bad dreams. Don't let me be afraid. Please help me, Jesus." I said it well into my 20s.

The blessing for me is that I don't remember my dreams. As I've gotten older, there have been times when one of my friends would tell me about the wonderful dream she had. I assume that there is no way all of my dreams could be bad, and from time to time I became determined to remember a good one. So I'd be sure not to set an alarm clock, and as I slowly woke up, I would focus on remembering. Without exception, every time, the dream I remembered would be scary or sad. Eventually I just thanked God for removing the memories of my nighttime fears and sorrows, and I stopped trying to remember. For me, there is no such thing as a good dream.

When I became pregnant and started researching what to expect, it didn't take long for me to find the little tidbit about dreams becoming more vivid. "Ha!" I thought. "Not a problem, I don't remember them anyway, and that's the way I like it." Famous last words.

So far I've remembered three: the gist of one of them and some details of the other two.

The first two weren't really that bad. They were both early on in the pregnancy, either the same night or within a few nights of each other. For the first, in the dream, I was very close to my due date, still here in Egypt (although that won't be the case in real life), when Jeff told me that he was going on a sailing trip with a friend. (No, Jeff doesn't sail, but in the dream he did, and the friend desperately needed him to go for some reason that was not explained to me.) I cried and begged him not to go, sure that something would happen and he wouldn't come back. He went anyway. In my dream, it was like one of those movies, where you see the person sitting still and time passing all around her--I sat on the sofa and did absolutely nothing the whole time he was gone, which I think was several days, possibly weeks; I didn't even eat. I just sat there, numb and abandoned. Then he came back and asked me what I had done while he was gone. I couldn't tell him; for me, it was like he had just walked out the door. I had shut down and I couldn't explain where the time had gone. He was very concerned. Then I woke up. This dream was miserable while I was in it, but as soon as I woke up, I was fine. I decided that apparently I had a fear of being abandoned, but even my subconscious knew that Jeff would never abandon me, so I shrugged it off.

The second dream is the one I only remember the gist of. In this dream, I left. I didn't want to but I had to. I was completely alone and afraid, hiding in some abandoned area from something bad that was following me. But in the dream I prayed and somehow knew it would all turn out okay. Then I woke up. I chose to interpret this dream in a reassuring way as well--I know that no matter how I feel or what my situation, God is there and will take care of me. Not so bad for me. Downright pleasant, considering my usual nighttime horrors.

Then there was the dream I had last night. It was, without a doubt, the worst dream I have ever had. And I remember way too many details. Way too many. In the dream, I was with my husband and my mother when my mother told me that my sister had committed suicide. (In real life, there is no indication at all that she would ever do such a thing--she isn't even depressed.) I remember feeling the numbness that can be such a blessing in times of horrific news, the numbness that shields the mind from having to take it all in at once. And then I had to say something. My mind skittered across the questions that I knew I eventually would want--or need--to have answered. Why? How? As soon as I thought of a question, I recoiled from it, knowing that I couldn't handle the answer. Finally I settled on a question I could handle: When is the funeral? But as soon as I opened my mouth to ask, I lost control. I started sobbing and buried my face in my hands, trying to hold the emotion in until I could stuff it away somewhere. Then suddenly I was somewhere else, with someone else, who I don't know, other than that she was female. We were walking along a wide asphalt path with manicured lawns on either side. She was chattering on about some inane topic like people do when they don't know what to say about the thing that really matters, but I wasn't paying attention to what she was saying. I felt a burning need to know when my sister's funeral was, and I knew that this other person could tell me. But again, when I opened my mouth to ask, I lost control. That time, when I covered my face with my hands, I woke up.

I woke up gasping for air. I looked around my room, realized it was only a dream, and burst into tears. That's never happened to me before. I've woken up crying and even yelling before, but as soon as I realize it's only a dream, I'm able to let it go. Always--that's a skill I've spent a lot of time learning, and I've gotten really good at it. But this time I couldn't. I was struggling so hard to hold it all in, to stay quiet and not wake up Jeff, that it physically hurt. I got up and went into the bathroom, where I just cried for a good ten minutes. When I thought I was okay again, I went back to bed, but before I even lay down, I started crying again. Back into the bathroom I went. Eventually I calmed down enough to go back to sleep, but when I woke up again this morning, it was still there--which is very unusual; even if I do remember when I wake up at night, I don't remember the next morning, not more than the gist of it. But this one, I still remembered so clearly. I started to tell Jeff about it but started crying again and decided that maybe if I just didn't think about it, it would go away. It hasn't. It's lingered all day, making me tired and teary-eyed. I took a nap this morning, because I know that the more tired I am, the more emotional I get. It didn't help.

So now I'm writing about it, hoping that if I express it in this way, I'll be able to release it. I don't understand why this one is hanging on so tightly. There is no truth in this dream that I can discover. There is no reason to fear that my sister is suicidal. There is no reason for me to remember this dream. This dream has been haunting me all day--and on Easter, for crying out loud! It needs to go away already.

Which leads me back to the beginning, with some modification.

I do not merely hate dreams. I utterly despise, abhor, and loathe them.

Sugar and Spice

Sugar and spice
and everything nice
that's what little girls are made of

Sunshine and rainbows
and ribbons for hair bows
that's what little girls are made of

Tea parties, laces
and baby doll faces
that's what little girls are made of

                     ~ Anonymous Author


I have a feeling they're also made of spit up, poo, tears, and wails, but also coos, cuddles, smiles, and laughs.

I guess we'll be finding out come August.

That's right--we had our 20-week ultrasound last Wednesday. The doctor wasn't totally sure, because Baby was being modest, but he was "pretty certain" that we have a daughter. We'll try to confirm at our next ultrasound in early May.

So how do we feel about having a daughter? We're both very happy, of course! Jeff told me in the doctor's office that I was beaming. He's always said that as long as our child is healthy, he'll be happy--I think the exact words were "Ten and ten and I'm good"--even as he consistently used masculine pronouns with regard to Baby. (He accurately pointed out that as long as the sex is unknown, it's grammatically correct to use masculine pronouns.) Meanwhile, I've used feminine pronouns all along, spent more time and energy putting feminine names together, and daydreamed about our little girl. I've been well aware of the fact that I would be very happy with either a boy or a girl, but I somehow couldn't think of this child as a boy for more than a couple of hours at a time.

Now we officially get to start picking out our daughter's name! I've been looking at and playing with names for a long time, since well before we started trying to have a baby. I was ready to pick a boy name and a girl name beginning the day we got the positive pregnancy test, but Jeff would have none of it. "Why do the work twice?" he asked. He refused to consider names until we knew the baby's sex. Of course, even now, I'm planning to have one of each picked out, just in case Baby surprises us on her birthday by being a him--it's been known to happen, folks. But for now we'll focus on the girl name first, and then I'll work on getting Jeff to see the wisdom of picking out a boy name too--although if the next ultrasound confirms her status as a her, it'll be an uphill battle.

That's all for today--I just wanted to share the news. I'm hoping before too long to put up a post showing Baby's development through ultrasound pictures, since we've had so many ... but maybe I'll wait until after the May ultrasound to do that so I can post a complete set. For today I'll just share my favorite sonogram so far--one of the ones taken during the nucal translucency ultrasound on 30 January. I love how Baby looks so much like a teddy bear in this one, and how the placenta or whatever that is by her side appears to be cradling her.

Have a good week, everyone!

A Momentous Day

It was Sunday. It started off pretty normal, I think. I was exhausted--partly because I hadn't slept so well the night before, due (once again) to too many trips to the bathroom. I also was anxious. I knew that the day had the potential to be pretty momentous, and not necessarily in a good way. We had an ultrasound scheduled for that afternoon.

It was a routine ultrasound, for routine screening of genetic defects, of which we are not particularly at risk. But two things were stuck in my mind: When researching nucal translucency online, I had run across a sentence saying, in effect, "some people who go in for this ultrasound discover that the fetus has no heartbeat." And a few nights earlier, I had woken up with particularly painful cramps in my abdomen. The cramps were not accompanied by any blood at all. They actually were similar to cramps that I've had in the past when dealing with constipation (not a pleasant topic, but face it, it's common for many people and not just during pregnancy), and I had pretty well convinced myself that that's what they were. I didn't call the health unit, didn't consult with any medical professionals, didn't even tell my husband. But there was still that niggling worry in the back of my mind ... what if it was more? What if the ultrasound showed that the fragile little heartflutter that we saw before had disappeared altogether, rather than turning into the fragile little heartbeat that it should now be? You can see how quickly I go back and forth between trusting God with my worries and taking them right back upon myself. I have a feeling that the struggle to leave this little one in God's eminently capable hands is going to be a long one ...

Anyway, in addition to dealing with the anxiety, I was dealing with exhaustion. As I mentioned, part of it was due to too many nighttime excursions to the loo, as my British friends would say. But there's more to it than that. No matter how long I sleep at night, how well I sleep, or how few times I have to get up, I'm still exhausted during the day. I accepted that up until recently, but I'm coming out of the first trimester now. I'm supposed to be getting my energy back, and I'm not. I can easily sleep 12 hours at night, then take an hour-long nap within three hours of getting up in the morning, and still be ready for bed by 8pm. Friends have told me how tired and pale I look; one former labor and delivery nurse called me up just to ask if I'd been taking my iron tablets--she tried to be nonchalant, but it was clear she was concerned. I told her that I didn't have iron tablets, but I'd been taking my prenatal vitamins daily. She agreed that they should have an adequate amount of iron, so I should be okay. But this conversation made me curious, so I did what I always do when I have an unanswered question--I turned to the internet.

On Sunday afternoon, before the ultrasound, I started researching pregnancy and anemia. At first, everything seemed like old hat--there was nothing that What to Expect When You're Expecting hadn't already told me (great book, by the way; I highly recommend it, although I think I ended up with a British version--but I picked it up locally, so it's not too surprising). Then something clicked. It was something I'd read a million times but hadn't really applied to my prenatal vitamin. All the websites that talk about dealing with anemia and getting enough iron while pregnant caution readers that the body's absorption of iron is inhibited by calcium and is promoted by Vitamin C. I had skimmed over that important information so many times--and then it hit me. In order to disguise the nasty taste of my vitamin, I had been taking it with milk. As in high calcium, low Vitamin C, exactly the opposite of what I needed. I've probably prevented my body from actually using all that iron that the prenatal vitamin is providing. So I decided that I needed to start taking the vitamin with grape juice (low calcium, 100% RDA Vitamin C). That alone would have made the day momentous--I still don't have much energy, but it takes a while to replenish iron in the body, so I expect to feel better before too much longer. I also fully expect to be told by my doctor tomorrow that I'm anemic, based on last month's blood work, and I intend to explain what I'd been doing and see what other changes I need to make to replenish the iron as quickly as possible. So hopefully, one problem turned the corner and began being solved on Sunday, before it could do serious harm to me or the baby.

With one concern relieved (although I was beating myself up over my apparent inability to connect the dots earlier), I headed off to the hospital for the ultrasound. Jeff was able to meet me there, and we followed the instructions we'd been given as to where to go and whom to talk to. In no time, I was lying on the table with the cold goop on my abdomen, Jeff standing beside me. The doctor, whose English was perfect--he'd spent a few years in New York--was surprised that we wanted a nucal translucency ultrasound. He wanted to know why we were worried. He accepted that it's routine screening now in the United States, and seemed to have the typical Egyptian attitude of "well, if you want it, you can have it, although it does blow my mind that such an expensive procedure is routine, even for low-risk pregnancies, in America." (The ultrasound cost LE150, roughly $30, which is a big deal in a country where the average citizen survives on around LE10 or $2 a day.)

And then came the second momentous event on Sunday--by far the more momentous of the two. We saw our baby. And he* looked like a baby. A real baby, not the bean-shaped blob of former ultrasounds. The head was clearly a head, although disproportionately large, as expected at this stage of development. The body was clearly a body. I never did see the legs, although the doctor insisted that all the major body parts were present. But the baby was waving at us. You could clearly see his little hand sticking up above his head. And then he decided to greet us--or maybe to protest the ultrasound--in a more visible way. With the doctor holding the ultrasound wand perfectly still, we saw the baby's entire body shake, then lift. After that, baby did not take a break; he was jumping around for the rest of the ultrasound.

The doctor pinpointed the heart and showed us the little heartbeat, although by that point, I didn't need to see it. The baby's movements were enough to convince me that our little guy is still alive and kicking. But the doctor had another surprise in store for us. He turned on the speakers. And I heard the most beautiful sound--the rapidly beating heart of our preborn child. We even heard the extra effort that it took to make a particularly high leap in the womb. It was a strong, steady heartbeat that would have reassured even the most anxious mother that her baby was doing just fine.

It was such a special time. I don't know if it was seeing the baby, or hearing the heartbeat for the first time, but something inside me that hadn't fully believed that we really are pregnant finally started to believe. It still doesn't feel completely real yet, but ... I'm not quite sure how to explain it. Even though it doesn't always feel completely real, I completely believe now that there really is a little life growing inside of me. Before, I knew it was true, but I didn't fully believe it somehow. I'm sorry; that's the best I can do. Maybe others who have experienced pregnancy can explain it better than I can.

So there you go. That was my momentous day. I'm sure there will be others during--and after--this pregnancy, and I'll be sure to share them with you as well.




*A note on pronouns: It's still too early to tell the baby's sex from the ultrasound, although we will find out just as soon as we can. I generally use whatever pronoun pops out, although it seems to be feminine most of the time for me, whereas Jeff tends to use masculine pronouns. Some days I say "she" all day; others I say "he" all day; and others, I alternate. But Jeff and the doctor both were saying "he," and that is technically the correct pronoun to use when the sex is unknown and you don't want to use the cumbersome, politically correct "he or she." So for the purposes of this post, I'll stick with masculine pronouns ... although I make no promises about future posts.

The Birth That's Right for Me

Last night I finished reading a book called The Birth That's Right For You: A Doctor and a Doula Help You Choose and Customize the Best Birth Option to Fit Your Needs by Amen Ness, Lisa Gould Rubin, and Jackie Frederick-Berner. I have to say--I loved this book!

Everyone has an opinion about childbirth. People who have given birth before are adamant that others should (or should not) have experiences like theirs. It seems that the web is full of natural-birth advocates, whereas real life is full of medicated-birth advocates. Doulas and midwives say that the best place to give birth is at home or in a stand-alone birthing center. Doctors and disbelieving lay people insist that the only safe place to give birth is at a hospital. Many people assume that birth will happen in a hospital, with a doctor in attendance, and anything else occurs only if you wait too long to head for the hospital. Others assume that if you go to the hospital, you'll end up with a Cesarian or a cookie-cutter vaginal birth that you weren't really present for anyway, because of the drugs. Even if you go natural, people will push Lamaze, or Bradley, or waterbirth, or hypnobirth ... No matter what the opinion is, it seems like everyone has one, or at least an assumption about what childbirth will look like.

That's what I loved about this book--they didn't.

This quote from the introduction pretty well sums up the philosophy of this book: "The best and most satisfying birth experiences happen when you're able to make choices in labor and delivery that are based on who you are, not someone some childbirth expert tells you that you should be." So if you feel most comfortable giving birth at home, go for it! If a homey birth center is more up your alley, feel free. And if you feel most protected and comfortable in a hospital setting, that's exactly where you should be. Narcotics, epidural, natural pain management strategies--you'll know what methods will work best for you based on how you handle stress and pain in your normal, not-giving-birth-at-the-moment life.

I started this book feeling pretty confident that I wanted a natural birth in a stand-alone birthing center, with a midwife to catch the baby and my husband and a doula to help coach me through it. I wanted a natural birth because I truly do believe that a medication-free birth is best for the baby--narcotics can cause a baby to born sleepy, so sleepy in some cases that the child can't even breathe without help; an epidural is difficult to dose right, and if you're given too high a dose, you may not feel your body's cues to push or be able to push effectively when you try, resulting in the need for an emergency Cesarian, which is major abdominal surgery. I figured that the best way to have a natural birth was to birth in a location where that was the only option--there would be no pressure, no repeated offers, and a major relocation to the hospital if I changed my mind. But I also have to admit--I was pretty scared of the whole notion of natural childbirth. By the time I get back to the States, I may or may not have time for a natural childbirth course. Even if I take one, they often seem to rely on one's ability to relax using visualization, which is not my strong point. And the more I read about birth, the more I am told that fear, anxiety, and an inability to manage the pain of contractions combine to stall labor, resulting in a Cesarian ... which I absolutely do not want unless it's necessary to save the life of my baby.

As I read this book, I started thinking about my natural coping strategies. What do I do when I'm afraid, stressed out, and in pain? My first response, at least to pain: Go to the medicine cabinet. Uh-oh, Houston, we have a problem. Because I really do want to avoid medication during childbirth, yet I also really do have a notoriously low tolerance for pain. And the natural coping strategies that I've read about so far really don't fit my personality all that well, either. I can't visualize to save my life. I do eventually relax in a hot tub or pool, but never until I can be confident that everyone else is engaged somewhere else, and no one is paying attention to me--unlikely if I'm using a birth pool to take the edge off of contractions during labor, with my attentive husband and doula hovering over me. When I'm in pain, I don't "walk it off." I tend to freeze, sink into the couch or bed, and maybe rock back and forth just a little. My main coping strategy is prayer, combined when possible with a generous dose of medication. I haven't seen either of those strategies listed in any natural childbirth books!

So where does that leave me? Someone who wants a natural birth but who seriously doubts her ability to have one? This book helped me realize that it really doesn't have to be an all-or-nothing proposition. I can give birth in a hospital, with a doctor or nurse midwife who is supportive of my preference for natural birth. But if my labor stalls and it starts looking like a Cesarian is in my future, or I just can't handle it, I'm exhausted, and I need to sleep--to remove myself from my body so that I stop fighting the work my contractions are trying to do--I can request an epidural. And the knowledge that I can request an epidural, that I don't have to handle the pain indefinitely if I feel like I can't do it, will allow me to focus on one contraction at a time, which I think I can handle. And if I can't, there's the epidural. After all, if I can't relax enough for my contractions to fulfill their function, I'm headed for a Cesarian. As much as I shudder to think of a needle going that close to my spine, a catheter staying there, an IV pumping me full of fluids to avoid a sudden drop in blood pressure--all of those things will happen by necessity if I have to have a Cesarian. Why not try everything possible to avoid one?

So here's what I'm currently thinking I want in childbirth. Keep in mind, though, that as I do more research on natural childbirth methods, gather information about classes that may be available once I'm back home, and come into more information in general, I may change my mind. And that's okay. But here's what I'm currently thinking:

1. I intend to deliver in a hospital, with my husband and a doula by my side, using natural coping strategies. However, it will give me peace of mind to know that medication is available if I need it. (I'm still going to have to get myself okay with the idea that I'll probably have to have an IV, or at least a hep-lock, soon after I arrive at the hospital, but that's a compromise I think I can make.)
2. There is a women's center 30-45 minutes from my hometown that is staffed by two female obstetricians and one female midwife. Seeing as how I've never had a pelvic exam from a male doctor, and the very thought makes me tense up like crazy, I think I need to give them a call on Tuesday (after the holiday), ask a few questions, and see if they could be a good match for me. I don't want a male doctor doing a routine exam to cause me to tense up and stall my labor on the big day--and I know myself well enough to know that I will never be comfortable with a man who is not my husband doing anything "down there." This women's center was recommended by a doula who is a firm advocate of natural childbirth, so I'm pretty sure that they will be supportive of my desires for a natural childbirth. But they also deliver in a hospital, and the doula who recommended them knows that I want the option of pain medication, so I'm thinking that will be an option too. I'll confirm all of this when I talk to them. And I already know that these practitioners are preferred providers for my insurance, which is a big financial plus!
   
3. I want to hire a doula who is very experienced in natural childbirth, but who also can function well within a medicated childbirth situation. I have referrals for two women--one a newly certified midwife who still does doula work while building her midwife practice, and one who is in training to be a midwife. I'm thinking they will be comfortable functioning as doulas in any birth situation, but their midwife training will be particularly useful when it comes to helping me keep the birth natural. I've already sent emails to these women, so I'm waiting to see if they're available and how much they charge before I start trying to figure out which of them is the better match for us.
   
4. I'm still hoping to find a natural childbirth class that will work for me, and maybe even a last-minute "crash course" for my husband.
5. My ultimate goal at the end of the day--or the beginning of the day, depending on when the baby decides to arrive--is a healthy baby and a healthy mama. My secondary goal is vaginal birth, as opposed to a Cesarian. (Cesarians are fine for those who need or want them--please don't think I'm saying anything other than that--but I'd really rather avoid surgery if at all possible.) My tertiary goal is a natural vaginal birth, as opposed to a medicated vaginal birth.

So there you have it. The birth that's right for me. At least, the birth that I think is right for me at the moment. Any comments or suggestions? I'm still exploring natural birth options in particular, so if there's something that worked really well (or really not-so-well) for you, I'd love to hear about it.