Micah’s Birth Story: Part I

Cholestasis & The Induction Process

If you’ve followed my blog at all in the past couple months, you’ll be aware that I was diagnosed with cholestasis early in the third trimester. So just a quick recap: Cholestasis in pregnancy is a rare condition with your liver/gallbladder that occurs only because you are a pregnant, and resolves once your baby is born. The primary symptom is extreme itchiness, and for me, as long as I was being monitored and taking my prescription, it was safe for both Micah and I. However, the OB was concerned that with time, the placenta could begin to break down prematurely, causing real concern for Micah’s life. Again, as long as I was being monitored, things were okay, just not ideal.

The OB recommended that I be induced at 38 weeks, since at that point Micah would be considered “at term” and fully developed, and delivery would resolve the cholestasis. Stew and I had decided early on in my pregnancy that we really wanted to have a natural, drug-free birth, if at all possible. I knew that was possible to give birth without pain medication if I was induced, but that it could be much more difficult, due to more intense contractions, etc.

Knowing the potential risks for Micah, we agreed to being induced, at about 38.5 weeks. My name was put on the induction list at the hospital for November 17, so all we had to do was wait for a call to go in. We had lots of people praying that I would go into labour naturally before then, and I was doing everything I could to help things along. The midwives helped by giving me a recipe for Augmentation Tea, and a homeopathic remedy to help with birth.

Tuesday (Nov 17) rolled around, and I got a call saying the hospital was too busy, so I would be bumped to Wednesday. Phew. That gave me one more day to hopefully go into labour beforehand. It didn’t happen. Wednesday morning at about 10am I was at the hospital with my Mom, for the induction. We knew it was very unlikely that one round would put me into labour, so Stew had gone to work for the day. The OB on call checked me (my cervix was still closed), gave me Cervidil and sent me home. Almost immediately I had an intense back-ache and contractions. After about an hour of coping at home, with my Mom to help, I called Stew to come home. It was very intense- much more than I had expected. After four hours the Cervidil tampon fell out (it’s supposed to stay in for about 24 hours), and after another hour the pain eased, and I felt okay. I was ridiculously thankful that it fell out!

Thursday I was on the induction list again, and when they checked me at the hospital, I was 2cm dilated, and 50% effaced. I was so happy that all the pain of Wednesday had made notable progress. With that knowledge, the OB decided to use a prostaglandin gel this time. My body responded similarly as to the Cervidil, but less intense. Again, Stew had headed out in the morning to school as usual, and as soon as we left the hospital I called him to come home.

Friday I was again on the list, but this time they were busy, and I didn’t get called. Stew had stayed home from work, knowing that he needed to be around after the induction, but when we didn’t get a call by noon, he went off to work.

Saturday I was still waiting for a call, but again they were really busy. Finally at 8pm we were called to the hospital. When the OB checked me, I was still only 2 cm dilated and 50% effaced. Again I was given the gel, but somehow this time it didn’t take. There was no reaction at all. We went home, and went to bed, and didn’t have a single contraction. Of course it was nice to sleep, seeing as we had expected to be up all night coping with contractions, but also disappointing. We just wanted our baby to come, already!

Sunday morning we were again waiting for a call, but decided to go to church in the meantime. We were called and drove straight from church to the hospital for induction round four at noon. Lisa, our midwife, was there to meet us, and this time the OB applied the gel - 2mg, not just 1mg like the previous two times. Like the Cervidil, my body responded with intensity. It was a very rough afternoon, coping with major cramping, back pain, and contractions.

We planned on returning to the hospital 6 hours later, for another round, hoping that back-to-back doses would finally bump my body into labour, without having to be put on oxytocin IV (which is what I was most concerned about avoiding if at all possible). At 9pm we were at the hospital, and as we discussed what dose of gel to use, my water broke. Yay!

...to be continued...