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A medical update & thoughts on dealing with obstetricians

6 Comments

As some of you may know, I was recently sent to an obstetrician to see whether I might have obstetric cholestatis (OC), in which case they may have induced me early (around now actually!) due to possible harm to my baby. This led to a dramatic turnaround in my original birth plan and was a real eye-opener in terms of learning to expect the unexpected.

Well, the good news is that it is very unlikely I have OC as my bile salts are fine and my symptoms aren’t very suggestive of it. But the original tests still show a high ALT (liver function) test which is abnormal, and the weight of medical science suggests that this is a bit odd. That’s pretty much all I know, but I’m beginning to think its just a wierd symptom of pregnancy, of baby causing all sorts of problems. But in terms of hard, cold facts (which, as a risk-averse control freak I always like to be in possession of), I’m yet to know why I have this or what it means to me or my baby, so until we know more I am in a state of limbo, not knowing whether I will be able to have the natural birth I want, and worrying that things will get worse.

Note I have nothing against induction for medical reasons, I know how common they are, and I know that many inductions can lead to wonderful, natural births. Although I also know that something like 70% of inductions lead to epidurals (many are done at the same time) due to the sudden, quick contractions that don’t build up gradually as they do in natural labour, making you work super hard to cope. I also know you need to be monitored in hospital so my prefence for privacy at home for as long as possible, for active movement, would be reduced. Although as I say, I’ve heard some wonderful stories about brilliant induced births where mums managed to move around and have lovely, natural (and blessedly very quick!) births.

The obstetrician started by telling me: “Its my job to worry; and I get worried about heavily pregnant women with abnormal liver functions walking around in late pregnancy.”  Which hinted to me that he was thinking about induction. At this, I burst into tears, and when he asked me why I was so against induction (he seemed genuinely surprised), I explained I’d just rather things happened naturally, given all I’d read about the body’s natural production of oxytocin, and my hypno-birth/active birth preparation, although of course if there was any chance my baby could be harmed I’d induce at the drop of a hat.

I also asked him what was causing the dodgy liver function, and what harm it could do to me or my baby, and it transpires that he didn’t have a clue. It was an anomaly. It could be anything, possibly a virus that I’d picked up, but it was unlikely that we’d find out what it was. I suggested a liver scan (thanks to some great advice, as always, from twitter mums) to see if it was something as simple as the baby kicking my liver, and he proposed a raft of blood tests to check for things like hepatitis.

So, subject to the tests showing up something specific (unlikely), or the ALT levels increasing to a worrying level (fingers crossed), or me starting to feel ill (I feel great), or the baby stopping moving (baby appears to be doing a daily marathon inside me so no worries there), then I suppose I can carry on happily until labour starts naturally. Which is great news. The consultant isn’t seeing me again for another 2 weeks which shows he can’t be that worried. And I’m doing all the natural things to induce in the meantime – long walks, gardening on hands and knees, raspberry leaf tea.

However, I’m not sure we would be here in this relaxed “lets wait and see” situation if I hadn’t made it clear that I was against induction, and hadn’t asked a raft of questions about why my wierd liver results were a problem. So my tips if you find yourself in a similar predicament are:

  1. Find out as much as you can before you see the consultant. Ask your GP for information, speak to your midwife, ask twitter and find out what you can from the internet (although don’t panic if you read anything bad).
  2. Be clear about your personal choices for birth – you shouldn’t be pushed into something you don’t want to do if it isn’t necessary. If you’d rather only induce if absolutely necessary, make this clear as it won’t be assumed. I’m amazed at how many women I’ve seen on mummy forums saying they actively want to be induced even if its not clear that there’s anything specifically wrong.
  3. Ask lots of questions – if they want to induce then WHY – why are you or your baby at harm? What is wrong? If they don’t know, the next stage should surely be more tests – blood tests, ultrasound scans of your organs.. If you don’t know what you’re dealing with, how can you properly evaluate the risk?
  4. If you do find out you might need an induction, don’t panic or get upset, speak to other women in your NCT group, or email Natalie at Tell Me A Good Birth Story, to put you in touch with other women who have had happy, successful inductions, to hear some positive birth stories. It may not be what you planned, but with a little mind-change and some planning you can still have the birth you want.
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6 thoughts on “A medical update & thoughts on dealing with obstetricians

  1. It’s hard to search out educated folks on this topic, however you sound like you already know what you’re speaking about! Thanks

  2. Great advice, I too would like to do anything I can to avoid an induction. I had to have the hormones to speed things up last time and they did result in me needing an epi-dural which led to an assisted delivery etc etc
    I hope you go into labour naturally soon, or find out what the weird liver thing is..

    I kept getting blood in my wee last time, I also had random bursts of pain in my kidneys, I was scanned but they could never see anything. It’s not the same but they just put that down to one of those ‘weird pregnancy things’! xx

    • Thank you! Actually latest results show that liver “dodginess” has gone DOWN – still not normal but getting there so really pleased. Hope all well with you! xxx

  3. Great advice and such great timing. I am 40 weeks today and my doctor wants to talk induction Wednesday. I really am going to dig my heels and insist on waiting unless there’s an issue. And so far my pregnancy has been pretty easy so I don’t see a necessary induction.

    Thanks again for the post!

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