"I had an incredibly easy pregnancy for the majority of it and really loved every second of it. I was one of the lucky ones who had no morning sickness or aches and pains despite a very sizeable bump and lots of cries of 'are you sure it isn't twins?' which of course I laughed politely at each time. I think I actually felt better during pregnancy than before as I was pacing myself during my long work weeks and no longer working until midnight or weekends.
When things started to become difficult at about 32 weeks I felt it was only fair considering I had an easy run so far. My feet and hands quickly began to swell in the sweltering summer heat and I became itchy which I put down to the swelling and heat rash. When my feet and hands resembled that of Frodo in the Shire, I asked to be checked a few times for pre eclampsia as I had a feeling that something wasn't quite right. All tests came back clear so I continued to dunk my feet in buckets of ice to relieve the swelling and the itching and tried to balance keeping my feet elevated with keeping active to prevent baby wiggling into a back to back position.
It was around this time that my husband and I spent a weekend with Holly Heather learning how to have a calm birth. I was already interested in hypnobirthing thanks to an article written by Giovanna Fletcher and I knew the power of positive attitude thanks to teaching so figured we had nothing to lose!
My husband Dan thought it all sounded a bit too 'hippy' for him and seeing as I have a father who barely wears shoes and a mother who loves tie dye and Ylang Ylang I couldn't blame him really. But he agreed to give it a go to relieve my anxieties surrounding a loss of control during birth.
Soon we were with two other lovely couples all relaxing in the South Downs whilst Holly took us through her wonderful course. We left that day with a book from 'The Calm Birth School' and bags of positivity with Dan a convert. Although initially we told anybody and everybody who would listen about our wonderful day spent with Holly, our family worried that we were preparing ourselves for an unrealistic experience and didn't want us to get our hopes up and the friends I told who were already mummys responded with the badge of honour replies; 'Oh well you can plan for these things to help but you won't be remembering music when it comes to it' or 'there is no point having birth preferences, I remember when I was like you.' So it went on until Dan and I learnt to keep our keep our approach to the birth between the two of us.
At 34 weeks I hadn't seen my midwife in a while and still had concerns about the size of my feet and I was developing a rash between the stretch marks on my abdomen which was unbearably itchy and it was spreading across my body. I'd done some self-diagnosis online and concluded I had a PEP rash, which is harmless but insanely itchy but wanted a second opinion on the feet. My midwife had gone on holiday so I rang triage, explained my symptoms and was told that they were not concerned as I didn't have a headache or itching on my palms or soles. They hadn't actually heard of the PEP rash before which we found time and time again when seeing GPs and Midwifes. It was only when we got to consultant level that there was a shared understanding despite a quick Google showing that lots of women suffer from it.
Two more days went by and soon I wasn't sleeping and had a rash all over my body. I was also itching where there was no rash. My feet were still enormous and I was crawling the walls so I decided I was going to manoeuvre a few hoops to get seen by somebody. Triage was called back and this time I told them I had itching on my palms and soles. I knew that they asked this to screen this for possible obstetric cholestasis which is diagnosed by blood test and I was desperate to have my blood tested to rule this and pre-eclampsia out. Sure enough this time they gave me an appointment and the relief washed over me.
Once in the Day Assessment Unit I dropped the facade about my palms and soles and expected to be dismissed quickly after that but the midwife still seemed concerned and despite having looked up PEP in her book (another who hadn't heard of it) and agreeing I had that and ruling out pre-eclampsia with a protein test she still wanted to check for cholestasis as thought I had unexplained symptoms still. Luckily for me entered a midwife who was currently researching cholestasis and so took a keen interest in me. She ran through what would happen if it was cholestasis and told us that induction is recommended and all about about a clinical trial for a medication. We listened but I knew I was only there to rule it out. It was a Friday afternoon so she told me to expect a call on Monday with my blood results. We left there feeling pleased that we had 'ruled out' everything and could now relax...
Everything shifted very quickly when we were called at 8pm that night by our lovely research midwife who told us that she had stayed beyond her shift to see if the bloods had been done and the bloodwork showed I had obstetric cholestasis. My bile acids were elevated and she was concerned enough to seek a second opinion about whether to get me into hospital over the weekend to monitor but it was agreed I could come in on Monday and have a second test and to meet with a consultant.
Cue a mad weekend of me researching the condition as though it was 2006 and I was an undergrad again . I found that there was an increased rate of stillbirth with cholestasis in the seventies but as of the nineties this additional risk disappeared. However they don't know if that's because in the nineties it became common to induce at 37 weeks after a diagnosis of cholestasis had been made. What followed was even more research until I had to conclude that there was no clear answer about whether induction is the best course of action. I knew I wanted to avoid induction but also knew if I was one of the heartbreaking 2% to suffer stillbirth after refusing an induction I wouldn't forgive myself. My logic told me to hold out as the research didn't support the fear but my emotions told me to get induced straight away.
In the end when we met with the consultant on the Monday, (who was incredible by the way like all the staff we encountered ante natally in St Richards) we told her we wanted to avoid induction but try sweeps to get baby moving. She was happy with that and said she would support us going to 42 weeks if necessary but to see how we go and keep reviewing as the itching can increase significantly with each day as the bile acids in the bloodstream rise. We booked two sweeps and a review in and also agreed to be part of a clinical trial where I would take tablets that may be a bile acid medication or may be a placebo to increase research in the field.
The first sweep happened that day and I was told I was already 2cm dilated at 37 weeks and had a score of 4. This seemed positive so we set about planning long walks, curries, bouncing on the ball and every other trick in the book to get baby moving. No luck. Second sweep showed no change so we went home feeling a tad disappointed.
By the time we were reviewed I hadn't slept in four days because of the itching and was showering six times a day. Warm water relieved the cholestasis itching where there was no rash but made the parts of my body with a PEP rash on worse so I would have to carefully time them and then cover myself head to toe with menthol aqueous cream afterwards. I was totally miserable and felt as though my body was telling me that it was ready to be done with pregnancy now. At our review I sobbed as I said that I couldn't bear it much longer and that's the day we decided to book an induction in for three days time.
In those three days we continued to try and encourage baby to come on his own but to no avail. So we amended our birth preferences for an induction and arrived nervously at St Richards on a Monday morning."
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