It is clear I don't update this blog much anymore. But writing out the boys' birth stories is one thing I like to document in this space. As I've said in the past, I will give a relatively detailed account of the birth...mostly for my own records, but also because I know there are people out there who enjoy reading detailed birth stories!
I am going to start a few weeks before the birth to give some context.
One night around 34-35 weeks, I was laying in bed and out of nowhere my neck and shoulders began itching. And it wouldn't stop. It isn't uncommon for there to be itching in pregnancy, but mine had been localized to my stretching stomach. My neck and shoulders didn't make a lot of sense, since that skin wasn't really stretching too much. Within about half an hour, my arms, legs and back began itching. Insatiably. It is a really strange feeling to itch so intensely with no relief. I, of course, Googled what might cause intense itching in pregnancy. The list included the regular culprit of stretching skin, as well as double checking things like new soaps, laundry detergent, lotion etc... But then I came across a "less common, but more serious" condition: Cholestasis of Pregnancy.
In short, this is where the liver isn't processing bile, and bile acid builds up and spills into the blood stream, causing potential toxicity to me and the baby. Worst case scenarios were preeclampsia for me and stillbirth for the baby. But they said that the itching is usually concentrated to the palms of the hands and soles of the feet. I breathed a slight sigh of relief because mine didn't itch at that point.
Eventually they did, though, and I began to get concerned that maybe I had this condition. Long story short, I asked my midwife to do the blood test to confirm. Even though I could tell she didn't think I actually had cholestasis, she was very respectful and kind and very readily agreed to do the test to rule it out. I am grateful for a provider who took me seriously and was willing to check into it. Unfortunately, the test takes a long time to get back results. My midwife got back an initial liver enzyme result, which was in normal range, and said she would be surprised if my bile acid levels came back abnormal.
But then several days later they came back and were elevated. Ideally the number would be below 8. Mine was at 26. More severe cases are above 40, with numbers in 90s-100s being quite emergent. So I didn't have a severe case, but enough to trigger induction protocol. Baby needed to be out between 37-38 weeks. This completely changed my birth plan, as induction usually means pitocin, which can only be administered in the hospital...which meant I couldn't birth at the birth center.
I was disappointed. After 3 babies, I had finally felt like I was confident and was even looking forward to this baby’s birth. The Holy Family Birth Center aligns with so many of my preferences and philosophies surrounding birth and the providers are truly top-notch in my experience. But these feelings were also mingled with concern and fear of what this meant for the safety of baby and myself.
I should mention that the clinic and birth center are owned by a husband/wife team. He is an OBGYN who delivers babies at the hospital, and she is a midwife who delivers babies at the birth center. They work together to provide the kind of birth that each person wants and can transfer care seamlessly if need be. So I would still be under the care of the midwives, with the same mission and goal and care just with a hospital delivery.
The plan felt a little vague for a while because the timeline and severity of cholestasis is really difficult to pin down. It could get bad, but maybe not for a while. It is hard to know where the line is that it turns detrimental, and there are also risks with taking a baby earlier than absolutely necessary.
I was finally able to have a straight-forward conversation with the midwife who owns the birth center and we laid out a plan. She told me that she knew how much I wanted to birth at the birth center so they were going to offer me some choices. Basically, she told me I could still give birth at the BC if I was a minimum of 37 weeks and if I was able to kickstart my body into labor without Pitocin (they do not utilize medication induction at the BC). Then she said that if that if I was not able to do that before 38 weeks, they would schedule a hospital induction, since time was of the essence. I found out later that some rules were generously interpreted for me to be able to do this, and I was grateful they were willing to work with me to get the kind of birth I was hoping for. At that point, I also just wanted the baby here safely and was pretty willing to do whatever that took.
I should mention here that this whole experience was stretching and growing me in some important ways. Each step of the way, I had to keep holding my plans loosely. I was able to use a word picture that I learned years ago: If I’m honest, my plans were fairly tightly gripped in my fist. I knew how I wanted things to go and I didn't want to let that go. But as each change came, I could feel those plans getting pried from my tight grasp and it was painful (as pried things often are) and my anxiety and fear would spike. So in the spirit of trusting the Lord and leaning not on my own understanding, I decided to open my fist willingly…with the plans laying in my open palm. And then I would intentionally lift my open hands up to God where I then dumped those plans into his open hands. He takes them with the promise that he cares more for my desires and plans than I could ever imagine. He then reaches down and grabs my open hand, void of my carefully laid plans, and walks alongside me down the path that now lays before me. One I didn’t necessarily want. One that feels unknown, foreign, scary etc. The promise is that if I place my trust in him, he will make the path straight. The promise isn't that it will be easy, but that he will faithfully guide me on the way forward. This combined with the promise that he works things together for my good (and his glory) was comforting.
This is how I had to picture it, and when my anxiety would tend high, I kept coming back to this because giving plans over to God is rarely a one-time thing. We I like to try and snatch plans back, or offer God some suggestions on how to perfect the plan because I think I know better. But gripping his hand instead of the plans has served me much better through the journey.
That was longer than I intended initially, but felt like a relevant back story!
I am going to write out the actual birth in a Part 2…so check back in :)
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