babies having babies

I know.  It's been a while. Enough of a while for me to make and have a baby so, sorry.  Speaking of babies...mine is named everett.  He is very cute and very tiny and at the moment, very sleepy.  He is 13 days old. He has lots of dark hair and he is generally a very happy little guy. We are so happy to have him in our family. I know you all loooove birth stories, so I thought I would record ours for posterity's sake and for your entertainment. Here goes. (this is the long version)
I had a very normal/easy pregnancy. I never threw up once (continuing the nieman woman tradition). At about 35 weeks I started having a VERY itchy tummy. Obviously some itching is to be expected with all the skin stretching that goes on, and I tried to stick it out for as long as I could- but this was not normal. I stopped being able to sleep at night. I couldn't do my job. I was taking 2-3 oatmeal baths per day (which actually did nothing for me). It was NUTS. One night when I was up at 3 am scratching my stomach, I stumbled upon an article about a rare liver condition called intrahepatic cholestasis of pregnancy (or ICP). Turns out that sometimes the liver/gal bladder can kind of freak out and stop working during pregnancy. This causes an imbalance of "bile acids" (what ever those are) to circulate in the blood and for some reason this causes the crazy itch that can't be touched by benadryl or any known anti itch remedy.  Itching is often the only symptom of ICP.  The only "cure" for ICP is delivery, although there is a medication which helps regulate things enough to stop the itching.  I should also mention that the excess of bile acids make their way across the placenta to the baby and the baby's liver- which cannot filter them out- causing (in some cases)  still birth.  Not something that you want to read at 3 am. Anyway, I called my dr in the morning and she said I needed to come in for some blood work asap. This was a thursday. Luckily my kick trash dr had seen cholestasis before (it is super rare) and knew exactly what tests to do. Apparently it is so rare that there are only a few labs in the US that do the test, so you have to wait like a week to get your results back. My dr offered me the medication that could control the itching- but me, being myself and super crazy about  not taking medicine, thought we should wait until we knew I had it for sure before i started popping pills. However, on friday, after doing tons of research and praying about what to do- i went to the pharmacy to pick up that medicine. I took one that night and one the next morning and the itching was gonezo.  My positive response to the medicine was enough to convince my dr that I for sure had ICP (regardless of the blood test results we were waiting on). She consulted with some other drs and they agreed that I should be induced at 38 weeks to prevent still birth (apparently most still births with ICP happen in the last weeks of pregnancy- so they just induce you before things turn south).  The drs also said that I needed to have non stress tests twice a week to make sure the wee babe was ok (they probably did not use to the term "wee babe" but who knows- maybe they did). This was sunday.  On monday we went in for our first NST. After  monitoring the baby for 1/2 hour the nurse came in and said that things "looked ok." BUT apparently all the NSTs are reviewed by a maternal and fetal medicine specialist (or perinatologist?)  up in slc and when they caught wind that I had cholestasis they recommended delivery by the end of the week. Alan and I were like, "wigga whaaat?" We are suppose to have another MONTH are you CRAZY. So we went home.
The whole time I felt like everything was totally unreal. Like we were all just overreacting to a little itchy tummy. We decided that we needed to get more information and a 2nd opinion from the experts up in slc, so we made an appointment for the next day. This was tuesday.  My main questions for these peeps were 1. Do you really think I have ICP (w/o blood work, can we be super sure it's not something else?) and 2. Does the risk posed by ICP outweigh the risk of inducing me a month early?
answer 1. I told the dr about my response to the medication and he said that I had either had ICP or that that was one heck of a placebo effect. answer 2. and I quote, "the long term outcomes for babies born at 36 weeks are very good. the long term outcomes for still birth are.... not good."
He also explained that the "mechanism" by which ICP causes still birth is not understood. With other issues, typically you can tell from an NST if the baby is in distress but  with ICP there are no signs of trouble. One minute the baby is looking great, the next minute he's gone. So with that, I called my dr and scheduled the induction for the next day  (wednesday).
I was very nervous about having an induction. I know lots of people are induced and it works out just fine. But I felt like the odds were stacked against us as far as avoiding a C-section (it's my first baby, it's a month early, everyone is worried about the baby so at the first sign of trouble i thought they'd wheel me into the operating room... the list goes on...)  I know there are lots of ways to have babies and all of them are ok as long as your baby comes out healthy. I just have a lot of unexplainable anxieties about medicine and blood and needles and cutting me open.  Anyway. I had a dr appointment in the afternoon and she said that I was already 3 cm dilated and 70% effaced. Please take a moment and appreciate what a miracle this was. Thank you. So the dr said that was a great start and the induction should go really well. The plan was to have me come in that night and they would put a cervadil in me to ripen my cervix further. I was suppose to sleep through the night with it in me for 12 hours, then they would start pitocin in the morning. I would labor all day and deliver sometime thursday night/friday morning. My body had other plans.  Instead of cervadil they gave me this other drug called cytotech? This made me a little mad because my dr had specifically told me that she wanted to use cervadil and I had had some time to research it. I didn't know anything about cytotech so I was a nervous about it. Anyway, picture a little sudafed pill. cut it in half. You have a dose of cytotech. it must be pretty powerful stuff because an hour after they placed it I was in active labor. The nurse said that if my body kept this up they wouldn't have to do the pitocin. After a few hours of contractions she checked me and I had only made one cm of progress (this is actually super normal progress for a first time labor, but she made it seem like it wasn't good enough). She said she was going to start the pitocin. Trying to avoid an IV, I asked if she could talk to my dr about giving my body a little more time. Permission granted, I just kept going. After getting the bad news about my progress and feeling threatened by the prospect of pitocin if my cervix failed to meet criteria... I was needless to say a little depressed. I was also super exhausted because the plan had been for me to get a full nights sleep in the hospital that night so I didn't take a nap or anything during the day.
Good thing for best friends in midwifery school. I rang my friend biz at 4 in the morning for a pep talk. Her advice was to get out of bed. Up until this point the nurse had been keeping me in bed so she could monitor things. I finally convinced her to let me stand still next to the bed. After a few contractions like this my water broke. It was just like in the movies. After the water broke my contractions got real intense. I started fainting and throwing up. it was awful. Alan had to keep telling me that everything was ok and that this was normal and that everything was ok and that this was normal. If he stopped saying these things to me i got really anxious and scared and panicky.
About this time (5 am?) the nurse came in and gave me the news that that if i wanted an epidural the anesthesiologist couldn't get to me until noon. I guess they had 3 c-sections and a bunch of inductions scheduled.  I had kind of prepared myself to do things naturally (due to my aforementioned anxiousness about medicine) so I was like, "whatev...let's do this." After another hour or so of cycling through passing our and throwing up, I got in the bath. My dr came in and was talking me through some contractions. Then I completely lost it. I told my dr that I wanted to die and that I needed an epidural before the next contraction hit (knowing full on well it wasn't an option- I think I just needed to hope). She told me to do 5 more contractions and then she would check me and get me an epidural (i don't know if she was aware of the anesthesiologist situation and just making false promises or if she didn't know, but I didn't care). I made it 2 more contractions. Got out of the bath. She checked me and then told me the best news of my entire life... that I was complete and could start pushing. Booyeah. 19 minutes later I wasn't pregnant anymore.  The whole affair was lasted 10 hours. Not too shabby for a first baby ya? Good thing too because I couldn't have done one more contraction.
Everett was super healthy- he breathed right away and got a 9 on his apgar. Everything we had been worried about had been avoided and we had a beautiful little boy.  total miracle count = like 37. And now we get to enjoy him for a whole extra month. Pretty good deal.  So far he is a wonderful wonderful baby. He's a great nurser, a pretty good sleeper, and he has the most adorable face this side of the mississippi. we just love him.