Eleventh in a series chronicling the Larches of New Orleans as they rebuild their lives in the Washington area.

At 6:15 yesterday morning, Michele Larche calls for the epidural.

She's four centimeters dilated, her stomach is hard, and pain radiates through her stomach and lower back.

At 7:30, Todd Larche, who has been alternately dozing or thumbing through a magazine, decides to capture a moment: He picks up the camera and goes under the covers to video.

"We're not going to be able to show this to anyone," Michele fusses at her husband.

"This will be our first New Orleans evacuee baby," says cheery nurse Barbara Berman. That's the "Louisiana Special" Michele got, she says, good, strong medicine for pain.

Oscar Mims Jr., director of maternal fetal medicine, arrives here at Washington Hospital Center shortly after 8. More than 30 years ago, his mother and Michele's older sister taught school together in Washington. So shortly after Todd and Michele evacuated and landed at her sister's Silver Spring home, Mims called Michele, also a doctor, to say he'd deliver her baby. It didn't matter whether they could pay. With Todd out of his teacher's job in New Orleans and Michele's solo practice washed away, the family ended up on Medicaid.

Now Mims leans in close to ask if she's comfortable.

When her cervix is five centimeters dilated, he breaks her water. It splashes the front of Berman's scrubs.

"This is Lake Ponchartrain right here!" the doctor jokes. The Larches laugh easily.

"Will you stay or will you go back to New Orleans?" he asks, passing time as he situates her for the next stage of her labor.

Michele rolls her eyes and shifts her weight in her bed. "That's the big question," she says.

In the short term, Todd and Michele have moved a donated crib into the crowded guest room they share with their 5-year-old, Kristen, and, until recently, Todd's father. To make room for the baby, they moved him into the computer room. Michele's mother is in another guest bedroom.

Shortly before 8:30, Kristen calls her daddy. Todd tells her she'll have her new baby by day's end. She can't wait. For two years after Kristen was born, Michele tried not to get pregnant. Then she tried and couldn't. They took fertility treatments that didn't work, then gave up and resigned themselves. One day, after visiting a newborn cousin, Kristen announced: I want to go to the babysitter right now and get a little brother or sister.

A month later, the Larches were pregnant. Eight months after that, Hurricane Katrina hit.

By 9:15, Michele is moaning. She's feeling pressure in her stomach and tingling in her foot. She's in pain, and it's worse with every contraction. Her niece Monica Beidleman has arrived and rubs her leg reassuringly.

By 9:20, an anesthesiologist is in the room. "I understand you're a doctor," he says.

"Yes, but I'm not good with pain," whimpers Michele, 39.

By 9:25, they've given her more drugs. Todd, 38, holds his wife's hand. He is silent. Monica is silent. The nurse is silent. A television newscaster drones. Michele's face contorts with the strain of her labor.

By 9:40, she is crying. "I was feeling so good. Now I can't feel my feet! I know a patient who saw a doctor for back surgery and came back paralyzed. I don't want to be paralyzed!"

"It's the medicine making you feel like that," soothes Todd.

"It's normal, sweetheart, I swear to you it is," says the nurse.

The minutes stretch and lengthen, and by 9:55 Michele withdraws into herself, wordless with the near-constant pressure contractions.

By 10 her cervix is fully dilated and effaced. Then she's pushing.

"I don't know if I can do this, I can't feel anything, I can't feel anything!" says Michele urgently.

"Push," says the doctor. "Puuush," says the nurse.

Michele bears down and her face turns red with effort.

"On your next contraction, get mad, get really mad, get mad at Katrina, girl! Push that thing right out of your house!" Berman says.

Shooting video over his wife's shoulder, Todd grunts loudly at the next contraction.

"Shut up!" says Michele.

"Push," says Mims.

"Puuush," says Berman.

Michele bears down with all her might.

By 10:18, Todd Michael Larche Jr., a son of New Orleans, the hospital's first evacuee baby, all 6 pounds 4 ounces of him, all 20 inches of him, is out and perfect and his lusty cry fills the room.

Michele Larche holds new arrival Todd Michael Larche Jr. for husband Todd, right, and physician Oscar Mims Jr.Delivered at last: Michele Larche shows off just-arrived Todd Jr. with niece Monica Beidleman at Washington Hospital Center.