Here at Beanie Designs, we have a soft spot for premature babies. You’ll be hearing later about some of our initiatives for preemies, but in the meantime I’m going to write about my own experience.
My first son came 4 weeks early. Though he didn’t need any interventions after his birth, this second pregnancy has brought the concern that the new baby may be born even earlier.
Doctors still don’t know what causes premature birth in most pregnancies, so early on my doctors recommended I take a progesterone supplement. (A study has shown progesterone may help in some cases.)
I’m at 32 weeks now. After learning more about what premature birth can mean for a baby, every week that passes feels like a victory.
But just a few days ago, it was discovered that I have cholestasis – a rare condition affecting only 1 in 1000 pregnant women here in the U.S. While the condition goes away soon after the baby is out, many babies born to mothers with this condition are born prematurely.
And if the baby hasn’t made an appearance of his own accord by 38 weeks, doctors will schedule an induction. The reasons for an early induction are chilling. Sometimes the baby is removed as early as 36 weeks if there are complications such as the early presence of meconium.
First, let me tell you a little more about how this rare condition works. Your liver produces bile acids, which are then used by your gall bladder to help with digestion. Cholestasis results when the flow of bile acids is interrupted. In pregnant women, this can be caused by the high levels of hormones estrogen and progesterone (I know! I was taking EXTRA of that!) The liver still produces the bile acids, but they can’t get to the gall bladder, so they build up in the liver and then eventually enter your bloodstream.
For most moms-to-be with cholestasis, this manifests in a super crazy itching sensation, particularly on the hands and feet. The intensity increases dramatically at night, making many moms with cholestasis severely sleep deprived and unable to function well during the day.
However, despite my discomfort, the scary part is this (from AmericanPregnancy.org):
“How will the baby be affected if the mother is diagnosed with Cholestasis?
Cholestasis may increase the risks for fetal distress, preterm birth, or stillbirth. A developing baby relies on the mother’s liver to remove bile acids from the blood; therefore, the elevated levels of maternal bile cause stress on the baby’s liver. Women with cholestasis should be monitored closely and serious consideration should be given to inducing labor once the baby’s lungs have reached maturity.”
I’ve been feeling the itching grow worse over the last 4 nights, to the point where I’ve asked my doctor for the medicine that helps reduce the bile and relieve the itching. It’s called ursodeoxycholic acid, and it’s basically another bile acid that helps regulate the buildup in your system.
The urso can also help prevent the dangers to the baby, since it will usually bring the level of bile in the bloodstream down.
I’m still waiting on the results of the blood tests to measure bile levels in my blood. But since it takes nearly a week to get the results back, my doctor feels that depending on the tests is not a reliable option. The bile acid in my system can spike with no warning in the meantime. And as the pregnancy progresses, the risk to the baby also increases.
Even though this condition is quite rare, I think it’s one more reason to pay close attention to all the things you notice about your body when pregnant. At my checkups, the nurses routinely asked about swelling and headaches, checked my weight, blood pressure and looked for protein, etc. Everything always checked out fine.
I causally mentioned the itching to my doctor when it was just reaching the point of annoyance, and I am so fortunate she knew of this condition. Since it’s quite rare, many doctors brush it off as the normal sort of itching that goes along with pregnancy.
There’s a lesson to be learned here. Ladies, don’t be afraid to bring up anything odd you notice during your pregnancy with your doctor, even if it’s not one of the routine questions at your checkup! Looking back, I had a milder itching on my hands towards the end of my first pregnancy, but It went away after, so I didn’t think twice. Now I wish I had paid better attention.