Birth Story Part 1: Unexpected Challenges

My son was born in July, and I am just now getting around to sharing his birth story. It wasn't what I had planned or what I wanted. His birth went well, he was healthy and I was healthy, but it still took me a while to come to terms with what happened in those crazy few weeks surrounding his birth.

I know I love a good birth story. There's nothing more magical than the moment a new little person enters the world and you get to meet him or her for the first time. But this little man's birth story starts a few weeks before the actual birth.

The pregnancy had been textbook, smooth, and even easier than my first pregnancy (except of course for the toddler I was wrangling and carrying everywhere). Our little man was due mid August, right after we were set to move out of our vicarage house. We had a great plan in place to have the baby while staying with my parents and then move back to St. Louis Labor Day weekend for our last year of seminary.

Things didn't go as planned...

4th of July Weekend

Around the beginning of the month I started experiencing itchiness. The palms of my hands were especially itchy, but I was itchy everywhere. There was no rash though, which I thought was weird. Naturally, to set my concerns to rest I Googled itchiness and pregnancy, expecting to read something nice and calming, like, "Itchiness is completely normal in pregnancy. Relax and lotion up..." or something along those lines. But what I did read made me feel that a call to my midwife office was probably a good idea.

When I called in on the Friday night of a long, holiday weekend, the midwife on call listened to my symptoms and said that there was nothing we could do over the weekend, but she would schedule me to have some labs drawn on Monday morning. She confirmed what I had read online - that they worry with itchiness about Cholestasis of Pregnancy, and that the liver enzyme labs would give them a good idea if that was what was going on. So on Monday I drove down to the office to have labs drawn and drove straight back. (It was an hour drive both ways, so this was no small thing to work into my schedule.)

Monday Night, 12 Days Before Birth

I expected to get my lab results on Tuesday, so I was surprised when I got a call at 7pm on that same Monday from the midwife on call. We were at church for Jr. High youth night and I was playing with my daughter in the nursery. The midwife said that my lab results were abnormally high and they wanted me to come in to triage so they could run repeat labs and monitor the baby. Obviously that is not a fun phone call to get! A small level of worry set in at this point, but I was much more preoccupied with how difficult it would be to go into triage at a hospital an hour away at bedtime with a one-year-old when we weren't even at home for the evening yet. The nurse said I could go home, put my daughter to bed, and then come to the hospital, so that's what I did. I left my husband home with her, expecting that I would be back late that night or first thing in the morning with good news that this was all just some kind of false alarm. 

Well... repeat liver enzyme labs were even higher, although Baby looked perfectly healthy on the monitor and ultrasound. They told me that I should stay overnight so they could run the labs again in the morning. It was concerning to them that they were going up, and they wanted to get another data point and make sure things weren't getting worse too fast. They still didn't have a diagnosis at this point, but they didn't want to let me go. I asked if I could go sleep at my parent's house in the area and just come back in the morning, but after considering how the insurance coverage would work, I realized it would be cheaper to be admitted than to essentially pay for two ER visits. So even though I felt completely healthy, I spent a night in the hospital.

It just so happened to be my first night spend away from my daughter, which was the hardest part of the situation. 

Tuesday, 10 Days Before Birth

The labs in the morning were still higher and they were abnormally high for Cholestasis, so Tuesday was spent in the hospital running lots of tests to rule out scarier possibilities. I spent the day with a pen in hand, talking to so many doctors and taking notes the whole time trying to keep all the information I was getting straight. I saw a high-risk OB, continued to be monitored by my midwives, met an OB from the practice that works with my midwife practice, and saw a GI doctor to discuss my liver. I had lots of blood work done as well as non-stress tests and an ultrasound of both the baby and my liver. It was a busy day.

My husband came for the day with my daughter. She was still nursing, and she and I had been missing each other. Throughout the day we were all able to stay fairly calm because our little man looked great on the monitor and ultrasound. We knew that for the moment at least, things were okay.

I ended up staying the full day and another night, but by Wednesday morning they were ready to discharge me with a diagnosis and a treatment plan.

Wednesday, 9 Days Before Birth

In the end I was diagnosed with Cholestasis of Pregnancy, which although not immediately dangerous to the mother, poses increased risks such as stillbirth to babies in the last weeks of pregnancy. The standard treatment is close monitoring and early delivery. With delivery around 36-37 weeks, there is no increase to the risk of stillbirth, but if the pregnancy goes to term, each additional week brings increased risks. The doctors told me that although they can monitor closely, with cholestasis a baby can have a perfectly healthy non-stress test one day and be gone the next, which is obviously very scary! Since my liver enzymes were so high, the high-risk OB suggested I be induced at 36 weeks.

We had appointments on Thursday and then on Monday of the following week to do non-stress tests and repeat labs, to make sure the cholestasis wasn't advancing too quickly, but scheduled the induction for Thursday, July 16th.



I did not make the decision to be induced lightly. I am a strong believer in minimal interventions and natural childbirth. I asked for the research studies, read all the materials the doctors could give me, looked at the statistics, and weighed the risks associated with induction with the risks of the cholestasis. In the end it was easy to see that inducing at 36 weeks was the best idea. I was able to talk to my midwives and set up a minimal induction plan that was as close to the natural birth I had been planning as possible. They answered all my questions and were very positive about the whole situation, reassuring me that this was a good reason to induce and that even with inductions included, their practice had a very, very low C-section rate.

I felt comfortable with the plan, with the data, and was at peace with the situation, but that doesn't mean it wasn't stressful. In a matter of two days I went from being due in a month to having a scheduled induction for the following week, and this all in the middle of a move that I hadn't packed for yet!

I rushed home from the hospital that weekend determined to get as much done as possible before our little one showed up, knowing there wasn't much time!

The first thing I did to prepare was take the tags off of and wash all the little boy baby clothes. It's amazing how a drawer of clean, folded clothes can help you feel so much more prepared and at peace.

Birth Story Part 2: New Baby Boy