obstetric cholestasis - possibility of being induced. help!

[Woodenmouse]

I saw the midwife yesterday and mentioned I had crazy itching all over my body. She took some blood and a Dr called today to and said it looked like I had obstetric cholestasis and I might need to be induced. I have to go for a fasting blood test first thing tomorrow and the Dr is asking the hospital to rush the results back so I should know what's happening by tomorrow afternoon. Up to this point everything was going smoothly and I wasn't worried about the birth at all (this is my second dc). I really didn't want to be induced as I've heard it's more painful, more likely to have complications etc (obviously I'll agree to be induced if it's in the best interest of my baby). Im sat at home freaking out can someone reassure me that even if I'm induced it will be fine!!

I have this and they are not rushing to induce me yet as my bike levels are at 21 and they look at inducing at 40.
I am medicated though and I have to have weekly blood tests to monitor this.

I read that induction doesn't necessarily hurt more just speeds it up so there is no real preparation on the body for it. I'm pregnant with DC1 so I have no experience of normal birth or induction or anything.
I have heard with OC that your body is usually better prepared for an induction as the bile acids can make the womb more ready.

This is a good site
www.britishlivertrust.org.uk/liver-information/liver-conditions/obstetric-cholestasis/

Thank you. I'm 38+3 wks so I haven't got long left which if I understand the Dr right is why they will induce depending on the levels at my blood test tomorrow. Dr did tell me what the levels are today but I can't remember what he said!

If you google positive induction stories you'll find some great stuff out there - I was facing induction and it really helped. As it was, my baby eventually arrived (at 40+14...). I was given advice to only accept the drip with an epidural going in at the same time as it pushes your body into full labour with no prep. You need the painkillers, no need to be a hero

Congrats! Either way you'll have a new tiny DC soon. Good luck.

Hi i had OC (and PE) with DS and was induced at 37 weeks, it was quick, from starting the drip to DS being born is recorded as 35 minutes!
It was certainly easier than the 32 hours labour with my first. I think because normally induction is so much quicker it feels more intense. I wanted an epidural but there really wasn't time ( cue some horrific name calling at the midwife, followed by a grovelling apology and chocolates ) . I actually knocked the drip out by accident and ended up with a haemorrhage, and subsequent blood transfusion, but it was still better than i was expecting.

Realistically at 38+3 your body will be ready to give birth and that should make it a smoother induction x

Thank you you've made me feel better. I'm just waiting for my test results now and then they will make a decision. Today is dragging by!!

Let us know how you get on!

The hospital hasn't sent my bloody test results back yet!! They have form of doing this to me!! Every blood test I've had while pregnant the midwife has had to ring up and ask for the results. I'm getting so stressed now!

Could always have a go st accupuncture to see if will induce you more naturally. Looks like it worked for me and avoided induction (though could be coincidence of course). Was induced with first. If ever happens again will have epidural lined up straight the way as I found my labours a completely different ball game xx

woodenmouse that's really bad. My hospital has the bloods turned round within 3hrs!
Have you chased them?

I had OC with my second baby. I was booked in for a c-section at 38+5 (couldn't have an induction as had had a previous c-section...so out went my planned VBAC!).

In the end, my blood tests were showing a very poor liver function by 37 weeks and I had a section a week earlier than planned.

Chase the bloods. Don't let them slack on this. OC is quite poorly managed/understood by a lot of health professionals, unfortunately, but its really important to know how you're getting along. My OC was diagnosed at 33 weeks and I had weekly blood tests which showed no change/nothing much to worry about until 37 weeks, when they suddenly came back very bad. By the time I had my section, i had really reduced movement and my baby was in distress.

Not trying to scare you (sorry, dont want to stress you out), but chase those blood results up and dont let them fob you off.

My daughter had this twice and had to be induced . She had quick easy labours both times .

I've been induced twice due to this but didn't need pessary or drip as I was very favourable (ahem) both labours went well and two healthy girls watching tv in the next room. Am pg with third but have no itching thus far am confident if another induction is needed that it will go just as smoothly! X

I finally got hold of the Dr at 6.00 and He said he is happy with how things are at the moment and they want to retest on Monday. I'm feeling a bit better now!

That's good. Just make sure they test you weekly!

I had OC. In my area they wouldn't let you go overdue so would induce on EDD regardless of results. Maybe that has changed in the last 2.5 years or may be different in other areas? I was booked for induction at 39.6 but ended up having to be induced a day earlier due to waters breaking. I would advise requesting an epidural if you do end up on syntocin drip as it does make labour more painful and I wish I had known this in advance so I could have requested better pain relief.

Thank you. The Dr was really vague about it all, I'm seeing the midwife on Wednesday so I think I'll ask her, she's usually pretty upfront about everything!

You need to ideally get answers from the dr as midwifes are more general knowledge in everything rather than a master with them all (not a slight on MW - mine is fab and I prefer to speak things through everything with mine also)

If it's any help, I spoke to three different consultants and multiple midwives about my OC. The funny thing is, all of these guidelines about inducing are actually based on bugger all research or statistics. When pressed, the consultants all admitted that they actually don't know really know what effect (if any) having OC has on birth/baby because very little researh has been done but they are, of course, massively risk averse so the inducing/constant monitoring etc is all 'just in case'.

(Just something to bear in mind if they do try to press you into something you're not comfortable with)

I dont want to be a doom monger, but I dont know if that is necessarily true, PickledLily.

I got advice from the British Liver Trust when my midwife was a bit clueless, and they said OC was associated with increased risk of foetal distress and stillbirth at the end of pregnancy, which is why many hospitals will want induction or c-section at 37-39 weeks (my hospital was UCH, and they won't let a mother with OC go past 39 weeks, but prefer 37-38 weeks. I delivered at 37+5).

Based on what research and statistics though? Because yes, it is 'associated' with those things but from what I could tell, based on very little and certainly not any up to date or recent research. Most trusts have actually updated their guidelines in recent years as well and certainly in my area, they don't routinely induce early for OC anymore as it is seen as unnecessary.

PickledLilly I had moderate OC with both DC and recommended to deliver at 37 weeks - this was in 2011 and 2014 in two different London hospitals so some trusts do routinely deliver early depending on results.

OP, it's reassuring that your doc is happy with your bloods. Suggest that you read some of the research / boards on www.icpsupport.org and discuss with your midwife tomorrow.

I had my DD in 2013 and in my trust they no longer induced early then, they induced at 40 weeks. With this pregnancy my midwife has said if my OC re-occurs she's happy for them not to induce at all. Guess where I live they've just changed the guidelines!