This is my story. I had possible cholestasis and ended up with a planned induction.
Our pregnancy was as planned as it gets. We had tried for 1.5 years to get pregnant. Along the way I had an HSG, an exploratory laparoscopy, 2 months of clomid cycles, and then 2 cycles at a fertility clinic. Our first full treatment with gonadotropin injections, a trigger shot, and an IUI was successful! Feel free to read about our full journey here. In March of 2014, we were finally pregnant! Skip forward to October 2014, and things started to get interesting.
Around 30 weeks, I started feeling intense vaginal pressure. I could hardly walk without the pain feeling unbearable. I was on my feet all day teaching, so things were getting progressively worse and fast. One Thursday afternoon, I made the call to go in and see my doctor. They ordered an ultrasound where I found out that my cervix was measuring short- in other words, it was thinning and was about 50% effaced if I remember correctly. They ordered me to bed rest immediately, since it was too early for baby to arrive just yet. I remember the day vividly. My heart broke, because I had a field trip with my IB chemistry students the next day that I was not going to be able to attend. I made arrangements at work and wrapped my mind around being home on bed rest so early on. I focused on keeping Caroline inside of me until at least 35 weeks- that was the goal.
To add yet another wrench to the plans, my skin started feeling very itchy. I casually mentioned this to my OB not thinking anything of it- just listing my long list of pregnancy symptoms to her when she asked. Little did I know, itchiness is a symptom of cholestasis. Cholestasis is a liver disease that can happen during pregnancy and can be fatal to your baby. So, all of the sudden things got a bit more serious. They ordered blood-work, which came back borderline. They were unable to officially say if I had cholestasis or not. I saw a specialized team for my ultrasounds and they kept an eye on me weekly from that point on.
It's a bit of a blur at this point, but I'd been to the hospital a couple of times having contractions in recent weeks. They had put me on procardia to stop the contractions. Week 35 arrived. We'd made it to our goal of 35 weeks and Caroline was staying put for now. I was released from bed rest but told to take it easy. I also stopped the procardia at that point. My weekly visits to get ultrasounds were measuring the length of my cervix and very focused on how "itchy" my skin was feeling. They were relying heavily on my itchiness symptom to make their decision on if I truly had cholestasis. If I did, I was going to have to have a scheduled induction right at 37 weeks for her safety. Talk about pressure. You know how when people talk about being itchy, you suddenly feel itchy? It was so hard for me to figure out how itchy I truly was. Was it bothersome enough that it was cholestasis, or was it just a slight itch and all was fine? I didn't want to make the wrong call, and end up inducing my baby too early. There are, of course, risks to inductions at 37 weeks and I was having such a hard time that the decision seemed to be on my shoulders.
I think the doctor sensed the fear in my eyes and my reluctance to make the decision. He calmed me down, asked me one more time if I was itchy. I was, so told him yes. He made the decision for me. I was going to be induced at 37 weeks- which was in two days. He left the room. My mom was with me, luckily. I made it to the parking lot and called my husband only to tear up immediately. It had suddenly hit me how fast everything was moving and I still wasn't sure if we'd made the right call.
My OB called a few minutes later and asked me to stop by. She checked my cervix and said that I was actually already dilated to 4 cm! I was shocked! She was going to send me home, but I think the look on my face told her I had other plans. I was nervous to be 4 cm dilated already, and 45 minutes away from the hospital. She said that it was alright to go ahead and go down there. I called my husband again and told him to come home and get me.
We headed down to the hospital. I was not having contractions, and I was not progressing, so they sent me home. After all of the checks on my cervix, when I was home, I was bleeding a lot and having contractions. We went in again that night because I had started feeling regular contractions. We were again sent home. The next day I had lost several blood clots and was getting nervous. The contractions seemed to be more intense. I called my doctor and he told us to go back in. We went back to the hospital. I was told I was still 3-4 cm and not making progress. Since I had a scheduled induction the following day, however, they decided to keep me overnight.
Wednesday finally rolled around. I don't remember the exact sequence of events, but at some point they broke my water and then started me on pitocin. I knew I wanted an epidural so I requested that the anesthesiologist stop by. When he did, I was so glad. The pitocin had kicked in and the contractions were much more intense- nothing too painful, but I knew I didn't want to find out how severe they were going to get! I told the anesthesiologist that I wanted as light of an epidural as he could give me. I wanted him to take the edge off, but I did not want to be completely numb. He did this perfectly. When it came time to push, I could feel the contractions just enough that I knew when it was time. I was telling my OB when I was ready. I started pushing at 2:50 pm and Caroline was born at 3:57 pm.
They placed Caroline on my chest and my mom got to cut the cord. They took Caroline over to clean her up and Daddy went with her. I watched Caroline as they stitched me up (I had a second degree tear). I didn't tear until the last push. I saw and felt it happen! I watched as my husband became a dad. He cried and smiled and fell in love. He talked to her while she was getting cleaned up, and Caroline turned her head to his voice. She reached out for him and grabbed his finger. She knew his voice. Such a beautiful moment that I will never forget.
The nurses then informed me that I wasn't done. They had already pulled the placenta out of me, but they had to make sure that they got all of the remaining blood and clots out as well. They pushed so hard on my stomach, even my husband cringed. I remember feeling like it was worse than the pressure I felt when Caroline was actually coming out. No one really warns you about this part of the process!
We did skin to skin as immediately as possible. I held Caroline on my chest and loved every minute of it. We also tried breastfeeding as soon we could. Caroline was happy and healthy. Her bilirubin levels were borderline, so we ended up having to stay one extra night in the pediatric wing, while they put Caroline under blue lights. This was the hardest night of our lives, but Caroline pushed through. Daddy was our superhero that night. He took care of me as best he could, and allowed me to try and get some rest in between my 2 hour attempts at pumping and breastfeeding, and he syringe fed Caroline to help supplement and get her weight up so that we could all go home.
I had such an amazing experience. I loved every minute of the actual process of giving birth. The anesthesiologist honored my requests perfectly, and I was not in any pain- even though I could feel what was happening. I ended up requesting a mirror (something I didn't think I wanted), and I watched as Caroline made her appearance into the world. I pushed extra times when they would allow me to, and was able to tell the doctor when I needed to start pushing before she could even tell on the monitor. I felt so strong in that hour and seven minutes. I hope my next experience goes as well as the first did!
Caroline Villegas 7 lbs 4 oz, 20 inches, born at 3:57 pm with Dr. Poshni and Nurse Asra
My advice to the first time mom out there- Make a decision on if you want an epidural. Other than that... you can't make too many plans. Find a doctor that you trust so you can follow their lead. Have your bag packed, your car seat installed, and be ready to go with the flow. Enjoy the process because it truly is amazing. Don't feel the need to prove anything- get the drugs if you want them! ;)