sophable has obstetric cholestasis, please tell me about induction...

[Heathcliffscathy]

almost certainly have it liver results and itching indicate. liver scan tomorrow.

shite and fuck

i think this means no homebirth (absolutely gutted, not because i'm a lentil quiche wearer but because i do not feel safe in hospitals).

i'd really really appreciate any info you have on this and even more so any info about induction...is there ever a great outcome birth and breastfeeding wise???

if they do this at between 36 and 37 weeks it's going to be nightmarish isn't it and prob end up in c-section.

any help gratefully received, mars, mears, anyone else at all, i really need all the info i can get.

gutted gutted gutted

Hi Soph

I was diagnosed with OC at around 39 weeks (although I had been itching for weeks on my feet but thought it was only hands that were important so hadn't mentioned it)

My Independent Midwife also gave us loads of reading material on OC which suggested there was no evidence for early induction.

My waters had also broken a week before my due date so the hospital (St Peter's Chertsey) were trying everything to persuade me to agree to induction.

With the info my IM had given me I decided to wait a day, then another day, finally reaching my due date. I had decided if nothing happened in the next couple of days I would go in - the Dr's had scared me so much.

I went into Labour (suddenly with contractions very close together) in the early hours of the day after my due date and had the home birth that I had wanted. It was quite long - 8 hours of pushing (NHS would never allowed that) and contractions really died off towards so had to push without there help. But had a very healthy little boy.

I am not expecting number two in December and frightened already about getting OC again (90% likely). Now that I have had some time to learn more about OC, I wonder whether I was stupid not to go with the hospitals recommendations.

Hope you are getting lots of support and look forward to hearing about the arrival of you healthy little one.

xx

oh nelson you lucky thing to have been diagnosed so late!!! i know that's a crap thing to think but i'm envious.

having a very very bad day of it today, totally depressed. have let indep midwives go as they just felt so unsteady in the face of this, and now feel utterly alone with it.

dh is being fab but i can't bring myself to do anything am feeling so down.

so much to do in the house, need to plan summer hols for ds and just can't do it.

hospital panic every time bloods come back and it stresses me out so much.

am really so sorry sophable. can you retain the indie mw as a doula? although she can't deliver you in hospital, she can be there for you , pre , during and after the birth?

it's very hard to know what to do for the best , isn't it?

i don't trust them anymore...otherwise i would have.

it's all buggered.

oh is it too late to find a regular doula? marslady? hertsnessex?

why have you lost trust in them?

am terribly sorry yo ar in this predicament, i wish i could offer something other than a few vague words

sophable, I'm sorry you have had such confused and contradictory advice.

Have a look at the websites for the British Liver Trust and OC Support (online).

OC is associated with an small but definite increase in fetal distress and stillbirth. Hospitals don't like risk, which is why most of them manage the labour/birth of women with OC as 'high risk' (lots of monitoring, induction or section at 37-38 weeks, which is when the risk increases).

There are different ways of looking at risk. You could say the chances of having a perfectly healthy baby at full term through a spontaneous labour are much higher than the chances of anything happening to your baby - and you'd be right. I guess it just comes down to how you view these things.

The hospital should have one clear policy, though, and it is not on that they are sending you off in a panic.

the two stillbirths in the UK last year that were definitely due to OC were in unmanaged pregnancies.

I just can't mess with that.

So hospital birth it is. Have been in touch with Mars, there are some timing issues.

Had a very supportive chat with a good friend today who suggested that I needed to find ways of owning the hospital birth that I am going to have. Sounds silly, but taking a birthing blanket with me etc has helped me out of the hole I was in this morning...

The problem reasonable is that even for OC my bloods are massively out of whack, 10 times worse than most OC cases...which intuitively I feel argues a cautious approach...but not OVER cautious which brings with it it's own raft of risks.

Does anyone know what the protocols tend to be with OC labours? Is CFM a given?

sophable, I totally empathise and think your attitude is very sensible.

Also, totally get what you mean about 'owning your hospital birth'. I have had two hospital births (c-sections, actually), and the second was a much more relaxed and pelasant affair because I 'took ownership' as far as I could. I brought a few of my own things in (oils, pillow, blanket etc) and insisted on a few things happening (only small things, but important to me) that would make me feel more in control and more comfortable.

If you are induced, you will definitely have CFM. Not sure if you go into labour spontaneously?

I also had ridiculous bloods towards the end of my second pregnancy and had to be brought in for a few days before they delivered so they could do CFM, as my baby wasn't moving arund enough for the consultant's liking.

It can be quite scary, sophable. Hugs from me.

p.s. I had been planning a VBAC with my second baby, so there was also the same sense of disappointment and having to adjust and 'gte my head around it'.

My friend had OC this year, and didn't have CFM - I think as all was well when she went in, they just followed standard procedures of checking every so often.

Sorry you've got this to contend with. The latest research does suggest that it is not as risky as was thought a few years back, but I also understand that you don't want to take any risks at all. Hope the hospital improve their standard of care though, and that you can find some support at the birth.

Induction on its own doesn't necessarily mean CFM - I don't know when combined with OC though. My 1st was induced, and they monitored for a while after the prostin gel, but after 30mins or so were happy to take the monitors off. Had I needed the drip then they would have monitored, and with an epidural you have constant monitoring too.

I had OC with both babies, and was induced at 37 weeks with both.

1st birth ended in forceps (with a c-section being the next resort - thankfully not needed). Breastfed for a couple of weeks.

2nd one was much better. I opted for an epidural halfway through, and the pushing stage was actually wonderful. Didn't hurt much (obviously), so it ws calm and I watched DS come out (midwife held mirror).

Still breastfeeding him now, 9 months later!

It needn't be awful, try not to worry.

On the plus side, you won't be hanging about getting 2 weeks overdue with people texting you every 15 minutes to ask if you've had the baby yet!

Sophable - Sorry to hear about OC.

I hope things work out well for you.

One of my neighbours has just had her baby at 36 weeks, after developing OC and also gestational diabetes. The labour was induced, but was only 3 hours and the baby is well and breastfeeding fine.

you could compromise with CFM.. if you are induced, you will be given CFM after prostin to ensure no hyperstimulation.. if all looks good. you could then request intermittent listening in, say every 30 minutes..? you can accept or decline any or all of your care as long as it is informed

definitely take steps to 'own' the birth
take music in, take your blanket, you don't have to wear a hospital gown, draw the curtains and dim the lights ..

Hi Sophable,

Is it too late for you to ask for a one-to-one midwife?

I found mine brilliant at advocating for me during my twin pregnancy and delivery.

You CAN get them on the NHS- they are more for vunerable people, teenagers, refugees etc- but you may find one happy to take you on, particularly if they have an interest in your condition.

I am sure a big teaching hospital like St George's will have them- Queen Charlotte's does.

They are great at stopping you from feeling like you are alone with it all.

Wishing you all the very best luck.