Valerie Hodgkins
I can’t believe it’s been a year since I was pregnant! My little boy Daniel is now one and he is such a wonderful baby (although toddler is probably more appropriate now).
I was under joint care (consultant and midwife) as soon as I found out I was pregnant and saw my GP at 4 weeks. This was because I have an underactive thyroid gland (which needs to be managed very carefully in pregnancy as it controls metabolism – too much or too little can be harmful to the growing baby). This condition (hypothyroidism) is one that newborns are tested for. Also I had had two previous missed miscarriages (13 weeks and 10½ weeks). We think the miscarriages may have been linked to being on the incorrect level of medication for my thyroid condition, as after the second one I underwent many tests and a blood test showed that I was on too high a dose. The miscarriages were quite close together and for a while we weren’t emotionally ready to try to get pregnant again. When we were ready, I made sure I was on the right amount of medication. During pregnancy my GP understood my thyroid gland concerns and sent me for regular blood tests and adjusted my medication accordingly. I had two increases in medication quite early on and one later on.
When I was 6 months pregnant, I started getting upper right quadrant discomfort, which was stopping me getting to sleep. I mentioned this on numerous occasions to my midwife and a GP and they dismissed it as either a stretched ligament or the baby kicking me. I didn’t think that it was either of these things, which is why I kept telling them about it. Looking back now I think this was the start of OC. I wasn’t diagnosed until much later.
I was 36 weeks pregnant when the itching started on the palms of my hands and the soles of my feet. It was worse at night, to the point where I couldn’t sleep and was scratching so much that I needed to stand in a bowl of cold water and place my hands in cold water to help relieve the itch. It was a few days before I decided that this wasn’t normal. My GP dismissed the itching as normal as I didn’t have a rash. I was still concerned, so I read my green pregnancy notes about symptoms to get checked and they said that itching in pregnancy can be normal, but sometimes if it is on the palms of your hands and soles of your feet and worse at night it can be an indication of a liver disorder which can lead to stillbirth if not detected and treated.
I phoned up the community midwives at our local hospital and they advised me to phone the day assessment unit. I explained the symptoms and they asked me to go for a blood test. Later that day they advised that the doctor would like me to go into triage. They confirmed that I had developed OC. They put a baby monitor on me to check that the baby was OK. They said that they would induce early, as the condition can lead to foetal demise if left to go into labour naturally. They gave us a leaflet about OC and it had Jenny Chambers’ contact details on it too. Also the doctor gave me some medicines (Urso, Vitamin K, antihistamine and calamine lotion) to take until the induction at 38 weeks. (they used to induce at 37 weeks at the local hospital, but have changed it to 38 weeks as they weigh up the risks of delivering at 37 weeks with OC baby staying in the womb for another week). Personally, my husband and I would have preferred them to induce at 37 weeks as at least we could see Daniel rather than worry if I hadn’t felt him move for a bit. It was reassuring when we had to go in for a growth scan and monitoring the week before induction and could see that the Daniel was doing well. The medicines helped the itch feel a little bit less intense after a few days, although I still required the bowl of cold water in the night! Also this was around Easter time so I resisted eating Easter eggs as we read that cutting back on fatty foods can help. (I ate one in the hospital though the day after I had Daniel!)
We arrived at the hospital for induction at 38 weeks and they put a baby heartbeat and a contractions monitor on me. Then it was time to start the induction. The induction process can vary from needing just one pessary right up to 3 pessaries, waters being broken and a drip to start labour.
I was surprised at the contraction feelings that I got from starting the induction. I had a few baths to help relieve the pain. As I wasn’t in established labour by 9 p.m., Michael went home. I was still having ‘contractions’, so the next pessary couldn’t be given just yet. Overnight, the ‘contractions’ disappeared. On day 2 it was time for the second pessary. Again, it had an effect but I wasn’t in established labour. Also I wasn’t favourable to have my waters broken. Michael went home again at night (partners can only stay past 9 p.m. if you’re in established labour) and my ‘contractions’ disappeared. On day 3 it was time for another pessary. It was funny because each day I kept thinking, ‘I’ll have the baby today’.
The staff were really good and explained what they were doing. I was sensitive to the pessaries, which led to me being sick on days 2 and 3. Also my blood pressure was high so they monitored it and took blood tests. At teatime on day 3 the midwife said they could break my waters and we got moved from the ward to our own room. This was pleasing as it felt we were really entering the labour process. The waters had meconium in them. The contractions became strong and we put the TENS machine on. After a while the contractions wore off, so I had the syntocin drip to bring on contractions. I was monitored constantly with a baby heartbeat monitor, contractions monitor and blood pressure monitor. Walking to the bathroom with the drip and TENS machine was interesting!
I used the TENS machine until I was 8 cm dilated. We had relaxing music playing and dimmed the lights slightly, and Michael and I did breathing exercises through each contraction. It was like a scene out of ‘Rocky’ as between each contraction Michael gave me a drink and dabbed my face with a cold wet flannel! From 8 cm dilated I used the gas and air and the TENS machine until I was pushing.
My blood pressure kept going really high so I had to have blood pressure tablets every half an hour until it was under control. The baby’s heart rate dropped with each push so he had to have a blood sample taken from his head, which came back fine. However, after over 1½ hours pushing, when they'd been able to see his head for a while, they scanned me and realised the baby’s head was at an unusual angle and was stuck, so we had to have an emergency caesarean. This is probably the point at which I started to worry, as the doctor said to stop pushing and it could be difficult to get Daniel out even by caesarean. However, I was trying my best to be positive and reassure Michael. (We’d attended the NCT antenatal training and had done a caesarean role play. The idea was to show us how many health professionals actually attend a caesarean so that we wouldn’t feel concerned if we ended up having one.) I kept saying to Michael ‘Look: that one’s Ann’ etc. He had no clue what I was on about and probably thought I’d had too much gas and air!
Daniel was born on Friday 17 April 2009 at 7:42 a.m. weighing 7 lb 4 oz. His Apgar score was only 3 at 1 minute but this went up to 9 at 5 minutes. We heard him cry a little while they wrapped him in a towel and then they carried him over to us. When we saw him for the first time it was so wonderful; he looked at both of us. Michael stuck his tongue out at him and Daniel copied. It was so nice. Michael had bonding time with Daniel in the recovery room. Then after the operation I was moved into the recovery room and I held Daniel and it was so wonderful to be holding our baby and that he was all right.
Michael did ‘kangaroo care’ that day as I was still ill. I seemed OK for a bit but then I was sick and couldn’t stay awake long enough to hold him. Also I was dehydrated and so I had to have a rehydration fluids drip. The next day, the midwife helped me get out of bed as I had been in bed for 24 hours since the op. I felt so much better and had eaten lots in the night and was able to hold Daniel and help with feeding him bottles and changing him. I stayed in hospital for three days after having Daniel. The staff at the hospital were great.
When I next saw the GP that had dismissed my itching, I mentioned that I had had OC. Hopefully that is one extra doctor who is now aware of the condition, which should help diagnose other women.
Also I felt that I wanted to raise awareness of the condition, as my OC almost went undiagnosed.
There’s an NCT magazine that is published quarterly for our area. I contacted the editor explaining that I would like to raise awareness of the condition and why, and she published my birth story last year. I received quite a few comments, so at least I know people read it!
© Valerie Hodgkins 2010
