Itching to meet Aiden – Cholestasis of Pregnancy

The story of Jeannie

It was around 34 weeks when I started having my little itch. At first I didn’t think anything of it, and played it off as just one more symptom from all of the pregnancy hormones. After experiencing morning sickness, migraines, preterm contractions, bed rest for a month, and throw in a kidney stone over the course of the pregnancy, a little itch was no big deal after all, right? (side note: who decided to call it “morning” sickness anyway when it happens morning, noon and night?)

Over the course of the next two weeks, the itching got progressively worse. The itching was very specific to my hands and feet and was significantly worse in the evening hours and overnight. As if the insomnia and multiple trips to the bathroom in the middle of the night weren’t enough to keep me up at 35 weeks pregnant, the itching was just one more thing. I would wake up in the middle of the night multiple times and had to run my hands under cold water and put a cold washcloth on my feet to help relieve the itching. By the time I was 36 weeks along, the itching was to a point where I could no longer just brush it off as pregnancy hormones. Therefore, I did what all worried and concerned pregnant mamas to be would do: I called upon Dr. Google. I typically know better than to have Dr. Google give me a diagnosis, but my motherly instinct was telling me something wasn’t right and I was worried. Those that know me, will tell you that I’m a “worrier.” I always have been a worrier, and now being in my late 3rd trimester the pregnancy hormones seem to have escalated my worry and stress. Little did I know before I sat down at the computer and typed, “itchy hands and feet at night in pregnancy” did I know that me being a worrier would lead to the arrival of our little warrior. Dr. Google told me that it could be a rare condition called intrahepatic cholestasis of pregnancy (ICP). Rare. I felt a sense of relief when I saw it was very rare. What were the chances that I could actually have this condition? I have never even heard of it before, but my curiosity wanted to learn more. I was reading the other symptoms of cholestasis, besides the itching, and I didn’t have any. I thought maybe this was a good sign and I was in the clear. After all, this would not work out with my birth plan, you know, the one we carefully spend 9 months thinking about and planning? Come to find out later on, itching is usually the only symptom most woman have.

I continued to read about this condition and there it was – the word stillbirth. “Cholestasis increases your risk of stillbirth.” That was all I needed to see before I called my doctor’s office after hours and made an appointment to go in the very next day. (I actually wanted to go for blood work that night but was told if I waited one week to call, what was one more day? That obviously didn’t sit with me very well.) So I went in the next day and the nurse practitioner I saw informed me that the condition was very rare but they would complete some blood work anyway to rule it out (she said she has only seen 1 case in the 15 years she has been there) She said that even if it came back normal, they would most likely repeat it one week later as sometimes it can take a week or two for it to come back abnormal. The blood work that was done evaluated my liver function and bile acid levels. What was interesting, is that I learned that the itching is caused by the build-up of bile acids which is ultimately the blood work that diagnoses the condition. Unfortunately, this takes one full week for the results to come back. One very, very, long itchy week. I couldn’t believe that with the increase risk of stillbirth it would take an entire week to be officially diagnosed. A lot could happen in one week, but I was trying to stay optimistic. Part of the blood work came back on Friday, two days later, which thankfully were normal. I asked the nurse practitioner if that was a good sign that I didn’t have cholestasis and she explained that the liver function results could still be normal but the bile acid levels could be abnormal. So of course, I continued to worry and itch all weekend. Well, worry, itch, and also attempt to satisfy my cravings by having my wonderful husband go on a wild adventure to find me fried dough at a local festival.

Monday was Memorial Day, so I followed up with the doctor on Tuesday and the results still weren’t back. I continued to itch and worry. Wednesday, I was scheduled for my 37 week appointment. I was originally scheduled to see the nurse practitioner but when I arrived, they informed me that I would be seeing the doctor instead. At the time, I didn’t think anything of it but when my husband arrived he immediately asked why we were seeing the doctor rather than the nurse practitioner. He knew something was up, perhaps his fatherly instinct. The doctor came in and informed us that my blood work just came back. She said, “you’re seeing me today because we just got your blood work back and you were right. You have cholestasis and we need to deliver your baby.” Scared, nervous, emotional, anxious, worried, will our baby be OK? So many thoughts and emotions went through our minds. The doctor told us to go home, grab our stuff quickly, and head to the hospital. It was time to have our baby. We felt so worried, scared, and anxious because this was of course, not a part of our birth plan. My very good friend and new mama met us at the house to help calm my nerves and help me figure out what I needed for the hospital since we only had half of our hospital bag packed. So thankful that she did because I was in complete panic mode. Again, this wasn’t part of the plan.

I was induced that evening at 6pm, and our little warrior, Aiden Leo Fancher, arrived the next morning at 7:30am on June 2nd weighing 7lbs 4oz! It was relatively a smooth delivery thankfully! Although he was jaundice, he was a healthy baby. What a blessing! Two weeks later, we learned he had a heart defect (which is unknown if it is a result of the cholestasis), but thankfully his cardiologist has been very optimistic that he won’t run into any future issues. This diagnosis came after another gut instinct of mine in which I insisted that the pediatrician examine him yet again. (Yes, I was that new mama who called the pediatrician about 100 times in the first week and so thankful I did even if they thought I was crazy)
We are so very blessed and thankful for our happy and healthy warrior baby, Aiden Leo! He brings us so much love and happiness and we are so grateful to be his mom and dad. We are sharing our story to help raise awareness of ICP (intrahepatic cholestasis of pregnancy) as there needs to be more awareness and research to learn more about this rare disorder. Unfortunately, there are too many mamas and babies that have had different outcomes, and our hearts go out to them. Thank you fellow ICP mamas for sharing your stories, no matter what the outcome was. The night that I sat down with Dr. Google, it was your stories I came across that made me take action and ultimately led to the safe arrival of our Aiden.

For mamas to be and future mamas to be, please always follow your intuition. If you feel something is off, don’t hesitate to call your doctor. Advocate for yourself and your baby if you feel something is not right. Listen to your gut, as I am so very thankful that I did. Follow your motherly instincts, even if you feel people will think your over overreacting. Your baby will be happy you did and that’s all that matters. If your a mama that has been diagnosed with ICP and of course this wasn’t part of your birth plan, we want to tell you that its ok. At the end of the day, the only thing that matters is the safe arrival of your little warrior baby. Thanks for taking the time to read our story!