Cholestasis. Do I have to be induced? Is it mandatory?

[Stardelight]

I'm pregnant with my second child and everything is going well (I'm 3 months)

With my first child I developed a severe case of cholestasis and I was put on medication for it. I spoke to my midwife recently and she said it may not get it again but there is a 60%- 90% chance of it recurring. My question is I had to get induced last time at 36 weeks as there's a risk of still birth ( this result in a traumatic birth and I needed an emergency c section) my question is could I refuse to be induced? Could I ask for extra scans to check my baby, or extra blood test etc to monitor my bile levels within my blood? I know I sound crazy as the risk of stillbirth is high but I have very valid reasons for not wanting to be induced.

I don't know anything about the risks so can't comment on what you should do, but you absolutely have the right to refuse to be induced if you wish. It is your body and your choice. You are not owned by the NHS.

Agree to be induced. I promise its not worth the risk.

I.had three pregnancies all with OC. I was induced twice. I've got two surviving children.

I've never got over it.

I am not saying this will happen to you but my beautiful baby was proof that it's not a risk worth taking

Well, no one is going to pin you down and force you to be induced.

But I think you should talk through your reasons for not wanting to be induced with your midwife. Would a planned c section be an option instead?

Oh my god, I am so sorry for your loss. This is awful. Can I ask, did you refuse to be induced? I'm sorry to pry. Thank you for your reply.

I ended up having an emergency c section due to the induction not going as planned. I was hoping to avoid this.

Nobody realised I had OC before it was too late. I was quite young and just throught the itching was a normal side affect of pregnancy..No one ever asked and I never thought to mention it. Thankfully people are far more aware of it now

You always have a choice, no one can force you to do anything, but there is currently no monitoring that can ensure your baby is safe. I found the charity ICP support to be an excellent source on the most up to date information and research on the condition and i believe they also have a support line you can call to talk through concerns. https://www.icpsupport.org/

I had OC in my last 2 pregnancies - undiagnosed with DS who luckily was born fine. With DD it was very severe and I was to be induced at 37 weeks, but was favourable for a sweep which began natural labour for me. You could try a sweep before induction if possible?

Of course it's not mandatory - induction is always your choice.

Do you know what your levels were last time? There is recent research that suggests that the risk of stillbirth is only increased when bile acids go over 100 - guidelines might have been updated since last time.
If your bile acids are lower than 100 but you have ICP induction will probably be offered closer to 39/40 weeks now too.

Look up the charity ICP Support for information (they have a helpful Facebook group) and read the fairly new RCOG guidelines on managing ICP to inform your choices.

I didn't get ICP second time but if I had would have considered waiting for spontaneous birth if my bile acids stayed under 100 and were regularly tested.

You could also possibly request an elective c-section instead of induction? I think induction can be riskier if you already had a c-section.

I had oc for both my pregnancies. Induced at 36 weeks for my first, it was horrendous. Took 2 days and eventually as I was so exhausted, had a forceps delivery. My second was almost as bad , but managed to give birth naturally. Can you ask for a caesarean this time?

@nettytree I had an induction at 36 weeks, they attempted forceps once and it ended up in an emergency c section. I don't want to go down that route again. It was awful. I'd rather if possible not be induced at all and just wait for my waters to break. I' was hoping extra blood test or scans may help. Obviously if I really needed to be induced or have a c section then I would. I just want to find out my other options.

Planned C section. It's absolutely wonderful. No stress!

I had OC in both my pregnancies and was told that it normally gets slightly worse with each pregnancy. I went into spontaneous labour with first, induction at 38 weeks for 2nd. I started off with my cervix closed, high and completely unfavourable. I was given 2 pessaries. Although I was having contractions (which were not painful) it wasn't triggering the labour. The midwife told me that the Dr would come and speak to me in the morning to go over my options. I was fully preparing myself for a Csection. All of a sudden my waters broke and my daughter was born less than 2 hours later.

I would want to get to term if I was you and then I would listen to the Dr's and make a decision. If your bile acids end up ridiculously high, then I personally don't think it's worth the risk.

Could you request a planned c section rather than induction? Friends who have had planned sections after previously having emergency ones have said they are a completely different environment.

The icp support group is amazing' highly recommend it
the new guidelines from august state scans only show u wats happening there and then? And stillbirth isnt always seen?

Blood tests are the way foreard but it only suggests once a week (uk) and mine shot up at the end and i wish i had bloods twice a week they take two days to come back. I was induced at 38 weeks

wasnt great but managed to avoid forceps and csection... third baby. Only baby iv had chloestasis

i coulsnt cope at the end not knowing if she was safe of not with the levels changing so quickly i wanted her out and safe. Had scans but only show u that minute? And had reduced movements day before my induction

i got consultant apps near the end and she was amazing
think if uv had a rough birth prev maybe push for csection if levels do reach that point?
good luck in your pregnancy